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To examine awareness and recall of healthy eating public education campaigns in five countries.
Data were cross-sectional and collected as part of the 2018 International Food Policy Study. Respondents were asked whether they had seen government healthy eating campaigns in the past year; if yes (awareness), they were asked to describe the campaign. Open-ended descriptions were coded to indicate recall of specific campaigns. Logistic models regressed awareness of healthy eating campaigns on participant country, age, sex, ethnicity, education, income adequacy and BMI. Analyses were also stratified by country.
Participants were Nielsen panelists aged ≥18 years in Australia, Canada, Mexico, UK and US (n=22,463).
Odds of campaign awareness were higher in Mexico (50.9%) than UK (18.2%), Australia (17.9%), US (13.0%) and Canada (10.2%) (P<0.001). Awareness was also higher in UK and Australia versus Canada and US, and US versus Canada (P<0.001). Overall, awareness was higher among males versus females and respondents with medium or high versus low education (P<0.001 for all). Similar results were found in stratified models, although no sex difference was observed in Australia or UK (P>0.05), and age was associated with campaign awareness in UK (P<0.001). Common key words in all countries included sugar/sugary drinks, fruits and vegetables, and physical activity. The top five campaigns recalled were Chécate, mídete, muévete (Mexico), PrevenIMSS (Mexico), Change4Life (UK), LiveLighter® (Australia), and Actívate, Vive Mejor (Mexico).
In Mexico, UK and Australia, comprehensive campaigns to promote healthy lifestyles appear to have achieved broad, population-level reach.
Dietary interventions did not prevent depression onset nor reduced depressive symptoms in a large multi-center randomized controlled depression prevention study (MooDFOOD) involving overweight adults with subsyndromal depressive symptoms. We conducted follow-up analyses to investigate whether dietary interventions differ in their effects on depressive symptom profiles (mood/cognition; somatic; atypical, energy-related).
Baseline, 3-, 6-, and 12-month follow-up data from MooDFOOD were used (n = 933). Participants received (1) placebo supplements, (2) food-related behavioral activation (F-BA) therapy with placebo supplements, (3) multi-nutrient supplements (omega-3 fatty acids and a multi-vitamin), or (4) F-BA therapy with multi-nutrient supplements. Depressive symptom profiles were based on the Inventory of Depressive Symptomatology.
F-BA therapy was significantly associated with decreased severity of the somatic (B = −0.03, p = 0.014, d = −0.10) and energy-related (B = −0.08, p = 0.001, d = −0.13), but not with the mood/cognition symptom profile, whereas multi-nutrient supplementation was significantly associated with increased severity of the mood/cognition (B = 0.05, p = 0.022, d = 0.09) and the energy-related (B = 0.07, p = 0.002, d = 0.12) but not with the somatic symptom profile.
Differentiating depressive symptom profiles indicated that food-related behavioral interventions are most beneficial to alleviate somatic symptoms and symptoms of the atypical, energy-related profile linked to an immuno-metabolic form of depression, although effect sizes were small. Multi-nutrient supplements are not indicated to reduce depressive symptom profiles. These findings show that attention to clinical heterogeneity in depression is of importance when studying dietary interventions.
To explore the effect of maternal BMI class pre-pregnancy (overweight/obese versus healthy weight/underweight) on childhood diet quality and on childhood overweight/obesity risk.
Dietary data were collected using 3-day parental-completed food records for their children at ages 18 and 43 months. An index of diet quality was derived by classification of food items into core and non-core foods. Adjusted multiple linear regression analyses were used to explore the effect of maternal BMI class on diet quality in their children.
A 10% subsample of the Avon Longitudinal Study of Parents and Children. 908 children provided complete dietary data at 18 months and 769 at 43 months.
Children with overweight/obese mothers consumed greater amounts of energy from non-core foods than children with healthy weight/underweight mothers (0.20 MJ [48 kcal]/day more at 18 months (p<0.001); 0.19 MJ [45 kcal]/day more at 43 months (p=0.008)) in adjusted models. Diet quality deteriorated between 18 and 43 months (children reduced their dietary energy intake from core foods (p<0.001) and increased intake from non-core foods (p<0.001)). However, this change was not associated with maternal BMI class in adjusted models. Having an overweight/obese mother was associated with an increased odds of the child being overweight/obese at 43 months (OR 1.74 (1.17, 2.58)).
Children aged 18 and 43 months with overweight/obese mothers are likely to have a poorer quality diet than those with healthy-/underweight mothers. Parents should be supported in discouraging the consumption of non-core foods in children at these ages.
To study the association between organic food consumption and lifestyle, socio-demographics, and dietary habits.
Cohort participants completed detailed questionnaires about organic food consumption, diet, and lifestyle between 1999 and 2002. Polytomous logistic regression models were used to estimate the association between organic food consumption, and lifestyle, socio-demographics, and dietary habits.
This cross-sectional study uses data from the Danish Diet, Cancer and Health cohort.
A total of 43,209 men and women aged between 54 and 73 years were included in the study.
Overall, 15% reported never consuming organic food, 39% had low organic food consumption, 37% had medium organic food consumption and 10% had high organic food consumption. The relative risk of consuming organic food versus never consuming organic food was highest among women, persons with body mass index <25 kg/m2, persons with low alcohol intake, persons participating in sports, persons who did not smoke or were former smokers, and among persons who adhered to the Danish national dietary guidelines. Associations were more distinct with higher levels of organic food consumption.
Based on a historical cohort of Danish adults, organic food consumption was associated with a generally healthy lifestyle, more favorable socio-demographics, and dietary habits. These findings have to be considered in the adjustment strategy for future studies linking organic food consumption with health outcomes.
We investigated the association of dietary Mg intake with insulin resistance and markers of endothelial function among Iranian women.
A cross-sectional study.
Usual dietary intakes were assessed using a validated FFQ. Dietary Mg intake was calculated by summing up the amount of Mg in all foods. A fasting blood sample was taken to measure serum concentrations of glycemic indices (fasting plasma glucose and insulin) and endothelial function markers (E-selectin, soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1). Insulin resistance and sensitivity were estimated using the Homeostasis Model Assessment-Insulin Resistance (HOMA-IR), Homeostasis Model Assessment β-cell function (HOMA-β) and quantitative insulin sensitivity check index (QUICKI).
Iranian female nurses (n 345) selected by a multistage cluster random sampling method.
The Mg intake across energy-adjusted quartiles was 205 (se 7), 221·4 (se 8), 254·3 (se 7) and 355·2 (se 9) mg/d, respectively. After adjustments for potential confounders, QUICKI level was significantly different across quartiles of Mg intake (Q1: 0·34 (se 0·02), Q2: 0·36 (se 0·01), Q3: 0·40 (se 0·01), and Q4: 0·39 (se 0·02), P = 0·02); however, this association disappeared after considering markers of endothelial function, indicating that this relation might be mediated through endothelial dysfunction. After controlling for all potential confounders, Mg intake was inversely, but not significantly, associated with serum concentrations of sICAM (Q1: 239 (se 17), Q2: 214 (se 12), Q3: 196 (se 12), and Q4: 195 (se 17), P = 0·29). There was no other significant association between dietary Mg intake and other indicators of glucose homoeostasis or endothelial markers.
Higher dietary Mg intake was associated with better insulin sensitivity in Iranian females. This linkage was mediated through reduced endothelial dysfunction.
Neuropsychiatric disorders are major causes of the global burden of diseases, frequently co-occurring with multiple co-morbidities, especially obesity, type 2 diabetes mellitus, non-alcoholic fatty liver disease and its various risk factors in the metabolic syndrome. While the determining factors of neuropsychiatric disorders are complex, recent studies have shown that there is a strong link between diet, metabolic state and neuropsychiatric disorders, including anxiety and depression. There is no doubt that rodent models are of great value for preclinical research. Therefore, this article focuses on a rodent model of chronic consumption of high-fat diet (HFD), and/or the addition of a certain amount of cholesterol or sugar, meanwhile, summarising the pattern of diet that induces anxiety/depressive-like behaviour and the underlying mechanism. We highlight how dietary and metabolic risk influence neuropsychiatric behaviour in animals. Changes in dietary patterns, especially HFD, can induce anxiety- or depression-like behaviours, which may vary by diet exposure period, sex, age, species and genetic background of the animals used. Furthermore, dietary patterns significantly aggravate anxiety/depression-like behaviour in animal models of neuropsychiatric disorders. The mechanisms by which diet induces anxiety/depressive-like behaviour may involve neuroinflammation, neurotransmitters/neuromodulators, neurotrophins and the gut–brain axis. Future research should be focused on elucidating the mechanism and identifying the contribution of diet and diet-induced metabolic risk to neuropsychiatric disorders, which can form the basis for future clinical dietary intervention strategies for neuropsychiatric disorders.
This study examined Na intake and identified the major food sources of Na in healthy Chinese adults aged ≥50 years in Hong Kong.
Participants who completed a baseline assessment of a randomised controlled trial assessing the effectiveness of exercise and nutrition supplementation on improving physical and cognitive functions were included. A single 24-h urine sample and a 3-d diet record were used to measure urinary Na excretion and dietary intake, respectively. The compliances to the WHO (<5 g/d) and China Nutrition Society (<6 g/d) recommendations for salt intake were assessed based on the urinary Na excretion. The relative contribution of sixteen food groups to the dietary Na intake was expressed as percentages. Associations between food groups and urinary Na excretion were analysed using multiple linear regression.
Totally, 114 healthy Chinese adults (mean age 60·6 years, 55 % women).
The mean urinary Na excretion over 24-h was 2876·6 ± 1249·4 mg/d (7·3 ± 3·2 g salt/d). Overall, 22·8 % of participants met the WHO recommendation and 34·2 % met the Chinese Nutrition Society recommendation for salt intake. The major food sources of dietary Na intake were condiments (42·4 %), cereals and their products (16·8 %) and soups (13·5 %). Higher intakes of seafood and nuts were associated with lower urinary Na excretion.
Public health strategies should target healthy Chinese adults in Hong Kong to modify the current patterns of Na intake. Targeting condiments, cereals and their products and soups will be an important strategy to reduce their Na intake.
The present study was aimed at (1) the differences between current weight v. ideal weight, (2) total energy intake and comparing it with required energy (Rkeer), (3) absolute protein intake in g/kg per d and g/1000 calories, (4) how energy and protein intake relate to the nutritional status of the subjects in terms of overall overweight (OEW) [overweight + obesity] and conservative overweight (CEW) [obesity] and (5) the contribution (%) of protein to total energy intake based on the acceptable macronutrient distribution range (AMDR). A dietary study was carried out in Colombia with 29 259 subjects between 1 and 64 years of age, based on cross-sectional data collected in 2015 by a 24-h dietary recall (24HR) administered as part of the National Nutrition Survey. Energy and protein intake did not differ by nutritional status. In the general population, energy intake was 2117 kcal/d (95 % CI 1969, 2264). The total protein intake was 64⋅3 g/d (95 % CI 61⋅4, 67⋅3). Adequate energy intake ranged from 90 to 100 %, except for the 1–4-year-old group, which ranged from 144 to 155 %. Protein intake was 1⋅64 g/kg per d (95 % CI 1⋅53, 1⋅75). The mean AMDR for protein to total energy intake was 13⋅3 % (95 % CI 12⋅9, 13⋅7). Excess weight began during the first 4 years of age. In conclusion, it is worth reviewing and updating energy and protein intake recommendations and dietary guidelines for the Colombian population and designing and modifying public policy.
To present an overview of how artificial intelligence (AI) could be used to regulate eating and dietary behaviours, exercise behaviours and weight loss.
A scoping review of global literature published from inception to 15 December 2020 was conducted according to Arksey and O’Malley’s five-step framework. Eight databases (CINAHL, Cochrane–Central, Embase, IEEE Xplore, PsycINFO, PubMed, Scopus and Web of Science) were searched. Included studies were independently screened for eligibility by two reviewers with good interrater reliability (k = 0·96).
Sixty-six out of 5573 potential studies were included, representing more than 2031 participants. Three tenets of self-regulation were identified – self-monitoring (n 66, 100 %), optimisation of goal setting (n 10, 15·2 %) and self-control (n 10, 15·2 %). Articles were also categorised into three AI applications, namely machine perception (n 50), predictive analytics only (n 6) and real-time analytics with personalised micro-interventions (n 10). Machine perception focused on recognising food items, eating behaviours, physical activities and estimating energy balance. Predictive analytics focused on predicting weight loss, intervention adherence, dietary lapses and emotional eating. Studies on the last theme focused on evaluating AI-assisted weight management interventions that instantaneously collected behavioural data, optimised prediction models for behavioural lapse events and enhance behavioural self-control through adaptive and personalised nudges/prompts. Only six studies reported average weight losses (2·4–4·7 %) of which two were statistically significant.
The use of AI for weight loss is still undeveloped. Based on the current study findings, we proposed a framework on the applicability of AI for weight loss but cautioned its contingency upon engagement and contextualisation.
The intestinal tract is the entry gate for nutrients and symbiotic organisms, being in constant contact with external environment. DNA methylation is one of the keys to how environmental conditions, diet and nutritional status included, shape functionality in the gut and systemically. This review aims to summarise findings on the importance of methylation to gut development, differentiation and function. Evidence to date on how external factors such as diet, dietary supplements, nutritional status and microbiota modifications modulate intestinal function through DNA methylation is also presented.
Invasive species can disrupt food webs by altering the abundance of prey species or integrating into the food web themselves. In the Gulf of Maine, there have been a suite of invasions that have altered the composition of the benthic ecosystem. These novel prey species can potentially benefit native predators depending on their nutritional value and relative abundance. We measured feeding instances of the native blood star, Henricia sanguinolenta, and changes in the seasonal abundances of invasive ascidian prey species. Results indicate that H. sanguinolenta forages optimally, as the blood star will prey on invasive ascidians when in high abundance, but feed on other species during periods of scarcity. Further, our study shows that blood stars prey on a wider variety of species than was previously known, such as small bivalves and barnacles. Additionally, we compared growth and reproduction of sea stars fed different combinations of invasive ascidians (Diplosoma listerianum or Botrylloides violaceus) or a native sponge (Haliclona oculata). Sea stars grew more on the native diet when compared with the invasive ascidian species, and D. listerianum appeared to be a superior quality food source when compared with B. violaceus. By comparing our data with historical data, we determined that there was a dramatic increase in sea star populations between 1980 and 2011, but then populations decreased by almost half from 2011 to 2016–2017. These data suggest that while invasive ascidians may have helped sea star populations at one point, sea stars are declining without their native food source.
Intake of vegetables is recommended for the prevention of myocardial infarction (MI). However, vegetables make up a heterogeneous group, and subgroups of vegetables may be differentially associated with MI. The aim of this study was to examine replacement of potatoes with other vegetables or subgroups of other vegetables and the risk of MI. Substitutions between subgroups of other vegetables and risk of MI were also investigated. We followed 29 142 women and 26 029 men aged 50–64 years in the Danish Diet, Cancer and Health cohort. Diet was assessed at baseline by using a detailed validated FFQ. Hazard ratios (HR) with 95 % CI for the incidence of MI were calculated using Cox proportional hazards regression. During 13·6 years of follow-up, 656 female and 1694 male cases were identified. Among women, the adjusted HR for MI was 1·02 (95 % CI 0·93, 1·13) per 500 g/week replacement of potatoes with other vegetables. For vegetable subgroups, the HR was 0·93 (95 % CI 0·77, 1·13) for replacement of potatoes with fruiting vegetables and 0·91 (95 % CI 0·77, 1·07) for replacement of potatoes with other root vegetables. A higher intake of cabbage replacing other vegetable subgroups was associated with a statistically non-significant higher risk of MI. A similar pattern of associations was found when intake was expressed in kcal/week. Among men, the pattern of associations was overall found to be similar to that for women. This study supports food-based dietary guidelines recommending to consume a variety of vegetables from all subgroups.
The author of this chapter is a member of the Upper House of Japan who proposed and established the Hate Speech Elimination Act: a philosophical law that includes no penalty provisions because if punishments were imposed on the grounds of the content of expression, then the government would have the authority to decide which expressions were to be subject to punishment – an obvious violation of the ‘freedom of expression’ provided for under the Constitution of Japan. In this chapter, the author discusses the importance of empowering a society in which everyone spontaneously raises their own voice and acts to eliminate hate speech, rather than prescribing a society in which people think, ‘Hate speech will not disappear unless it is punished.’ Through the effects of the Act, local governments and judiciaries were finally able to define hate speech as ‘unacceptable’ and use their own discretion to implement measures accordingly. Even though it is a philosophical law, the Act has therefore raised public awareness and inspired a mass movement seeking to eliminate discrimination voluntarily.
To examine associations between diet and risk of developing gastro-oesophageal reflux disease (GERD).
Prospective cohort with a median follow-up of 15·8 years. Baseline diet was measured using a FFQ. GERD was defined as self-reported current or history of daily heartburn or acid regurgitation beginning at least 2 years after baseline. Sex-specific logistic regressions were performed to estimate OR for GERD associated with diet quality scores and intakes of nutrients, food groups and individual foods and beverages. The effect of substituting saturated fat for monounsaturated or polyunsaturated fat on GERD risk was examined.
A cohort of 20 926 participants (62 % women) aged 40–59 years at recruitment between 1990 and 1994.
For men, total fat intake was associated with increased risk of GERD (OR 1·05 per 5 g/d; 95 % CI 1·01, 1·09; P = 0·016), whereas total carbohydrate (OR 0·89 per 30 g/d; 95 % CI 0·82, 0·98; P = 0·010) and starch intakes (OR 0·84 per 30 g/d; 95 % CI 0·75, 0·94; P = 0·005) were associated with reduced risk. Nutrients were not associated with risk for women. For both sexes, substituting saturated fat for polyunsaturated or monounsaturated fat did not change risk. For both sexes, fish, chicken, cruciferous vegetables and carbonated beverages were associated with increased risk, whereas total fruit and citrus were associated with reduced risk. No association was observed with diet quality scores.
Diet is a possible risk factor for GERD, but food considered as triggers of GERD symptoms might not necessarily contribute to disease development. Potential differential associations for men and women warrant further investigation.
Populations' diets typically fall short of recommendations. The implication of this on ill health and quality of life is well established, as are the subsequent health care costs. An area of growing interest within public health nutrition is food choice architecture; how a food choice is framed and its influence on subsequent food selection. In particular, there is an appeal to manipulating the choice architecture in order to nudge individuals' food choice. This review outlines the current understanding of food choice architecture, theoretical background to nudging and the evidence on the effectiveness of nudge strategies, as well as their design and implementation. Interventions emphasising the role of nudge strategies have investigated changes to the accessibility, availability and presentation of food and the use of prompts. Empirical studies have been conducted in laboratories, online and in real-world food settings, and with different populations. Evidence on the effectiveness of nudge strategies in shifting food choice is encouraging. Underpinning mechanisms, not yet fully explicated, are proposed to relate to salience, social norms and the principle of least effort. Emerging evidence points to areas for development including the effectiveness of choice architecture interventions with different and diverse populations, and the combined effect of multiple nudges. This, alongside further examination of theoretical mechanisms and guidance to engage and inspire across the breadth of food provision, is critical. In this way, the potential of choice architecture to effect meaningful change in populations' diets will be realised.
White-bellied Heron Ardea insignis (WBH) is critically endangered, but we lack data on many aspects of its basic ecology and threats to the species are not clearly understood. The goal of this study was to analyse WBH foraging microhabitat selection, foraging behaviour, and prey preferences in two river basins (Punatsangchhu and Mangdechhu) in Bhutan which are likely home to one of the largest remaining populations of WBH. We also explored the relationship between the relative abundance of the WBH and prey biomass catch per unit effort within four foraging river microhabitats (pool, pond, riffle and run). Prey species were sampled in 13 different 100-m thalweg lengths of the rivers using cast nets and electrofishing gear. Riffles and pools were the most commonly used microhabitats; relative abundance was the highest in riffles. The relative abundance of WBH and prey biomass catch per unit effort (CPUE) also showed a weak but significant positive correlation (rs = 0.22). The highest biomass CPUE was observed in riffles while the lowest was found in the ponds. From the 97 prey items caught by the WBH, 95% of the prey were fish. The WBH mainly exploited three genera of fish (Garra, Salmo, and Schizothorax) of which Schizothorax (64%) was the most frequently consumed. This study provides evidence in support of further protection of critical riverine habitat and fish resources for this heron. Regular monitoring of sand and gravel mining, curbing illegal fishing, habitat restoration/mitigation, and developing sustainable alternatives for local people should be urgently implemented by the government and other relevant agencies. Further study is also required for understanding the seasonal variation and abundance of its prey species in their prime habitats along the Punatsangchhu and Mangdechhu basins.
Adequate dietary intake is critical to prevent adverse pregnancy outcomes. India has a high burden of maternal and child morbidity and mortality, but there is a lack of adequate tools to assess dietary intake. We validate an FFQ, New Interactive Nutrition Assistant - Diet in India Study of Health (NINA-DISH), among pregnant women living with and without HIV in Pune, India. Women were selected from a cohort study investigating immune responses to HIV and latent tuberculosis during pregnancy. The FFQ was administered during the third trimester and validated against multiple 24-h dietary recalls (24-HDR) collected in second and third trimesters. Data for analysis were available from fifty-eight women out of seventy enrolled into this sub-study, after excluding those with incomplete data or implausible energy intake. The median (Q1, Q3) age of study participants was 23 (20, 25) years. Median (Q1, Q3) daily energy intakes were 10 552 (8000, 11 958) and 10 673 (8510, 13 962) kJ by 24-HDR and FFQ, respectively, with FFQ overestimating nutrient intake. Pearson correlations between log-transformed estimates from FFQ and 24-HDR for energy, protein, carbohydrate, fat, Fe and Zn were 0·47, 0·48, 0·45, 0·33, 0·4 and 0·54, respectively. Energy-adjusted and de-attenuated correlations ranged from 0·41 (saturated fat) to 0·73 (Na). The highest misclassification into extreme tertiles was observed for fat (22 %), saturated fat (21 %) and Na (21 %). Bias existed at higher intake levels as observed by Bland–Altman plots. In conclusion, NINA-DISH is a valid and feasible tool for estimating dietary intakes among urban pregnant women in Western India.
The identification of early-life determinants of overweight is crucial to start early prevention. As weight gain accelerates between 2 and 6 years, we studied the association between diet quality in children aged 3 years and the change in BMI and overweight incidence in the following 7 years. From the Dutch GECKO Drenthe birth cohort, 1001 children born in 2006 or 2007 with complete data on diet (food frequency questionnaire at the age of 3 years) and growth at the age of 3 and 10 years were included. Diet quality was estimated with the evidence-based Lifelines Diet Score (LLDS). Measured height and weight at the age of 3 and 10 years were used to calculate BMI z-scores standardized for age and sex. The associations of the LLDS (in quintiles) with BMI-z change and overweight incidence were studied with linear and logistic regression analyses. Overweight prevalence in the total study population increased from 8.3% at the age of 3 years to 16.7% at the age of 10 years. The increase in overweight prevalence ranged from 14.7% in Q1 to 3.5% in Q5. Children with a better diet quality (higher quintiles of LLDS) increased significantly less in BMI-z (confounder adjusted βLLDS = −0.064 (−0.101; −0.026)). Children with a poor diet quality at the age of 3 years had a considerably higher risk for overweight at the age of 10 years (confounder adjusted OR for Q1 vs. Q5 was 2.86 (95% CI 1.34–6.13). These results show the importance of diet in healthy development in the early life following the first 1000 days when new habits for a mature diet composed of food groups with lifelong importance are developed, providing a relevant window for overweight prevention early in life.
RCTs provide evidence that stroke risk is reduced by several risk factor control strategies reviewed in this chapter: adhering to a Mediterranean Diet , avoiding long-term estrogen hormone replacement, and treating severe obesity with gastric balloons or bariatric surgery. In addition, observational evidence suggests stroke risk is reduced by quitting smoking, controlling blood glucose, losing weight in moderately obese individuals, exercising regularly, abandoning heavy alcohol consumption, and improving diet (less salt and more unsaturated fats) via other approaches. Optimal goals for risk factor control are delineated in the American Heart Association Life’s Simple 7 ideal targets. The beneficial effects of these measures are likely largely mediated by amelioration of well-established risk factors such as blood pressure, cholesterol, diabetes, and coagulation status. To achieve these lifestyle changes, both the individual and the community must contribute. Governments have a responsibility to: improve public education; increase access to healthy foods and built environments with pedestrian, bicycle, and exercise infrastructure; and use regulation, legislation, and taxation to discourage hazardous lifestyle behaviours (e.g. smoking, alcohol, and perhaps salt or sugar in foods). Continued cultural change is also required among individuals and communities to promote regular physical activity, a healthy diet, and minimal exposure to smoking in everyday life.