To quantify the change in availability of hyper-palatable foods (HPF) in the US foods system over 30 years (1988 to 2018).

Three datasets considered representative of the US food system were used in analyses to represent years 1988, 2001, and 2018. A standardized definition from Fazzino et al (2019) that specifies combinations of nutrients was used to identify HPF. Differences in the prevalence of HPF were characterized by Cochran’s Q and McNemar’s tests. Generalized linear mixed models with a fixed effect for time and random intercept for food item estimated change in the likelihood that a food was classified as hyper-palatable over time.

The prevalence of HPF increased 20% from 1988 to 2018 (from 49% to 69%; p <.0001). The most prominent difference was in the availably of HPF high in fat and sodium, which evidenced a 17% higher prevalence in 2018 compared to 1988 (p <.0001). Compared to 1988, the same food items were >2 times more likely to be hyper-palatable in 2001, and the same food items were >4 times more likely to be classified as hyper-palatable in 2018 compared to 1988 (p values <.0001).

The availability of HPF in the US food system increased substantially over 30 years. Existing food products in the food system may have been reformulated over time to enhance their palatability.

The study examined the association between depressive symptoms and iron status, anaemia, body weight, and pubertal status among Mexican adolescent girls.

In this cross-sectional study, depressive symptoms were assessed by the 6-item Kutcher Adolescent Depressive Scale (6-KADS), and latent class analysis (LCA) was used to identify and characterize groups of girls based on depressive symptoms. Iron status and inflammation were assessed using ferritin and soluble transferrin receptor, C-reactive protein and alpha-1-acid glycoprotein, respectively. Multiple logistic and linear regression were applied to model class membership as a function of iron status, anaemia, body weight, and pubertal status.

We collected data from 408 girls aged 12-20 years.

public schools in northern Mexico.

LCA yielded three classes of depressive symptoms; 44.4% of the adolescents were “unlikely to be depressed”, 41.5% were “likely to be depressed”, and 14.1% were “highly likely to be depressed”. Our analyses demonstrated that iron deficient girls had greater odds of being “likely depressed” (odds ratio, OR=2.01, 95% CI 1.01-3.00) or “highly likely depressed (OR=2.80, 95% CI 1.76-3.84). Linear regression analyses revealed that lower haemoglobin concentrations and higher body weight increased the probability of being “likely depressed”. There was no evidence that depressive symptoms were associated to age at menarche and years since menstruation.

This study shows that iron deficient adolescent girls are more likely to suffer from depressive symptoms, and that lower concentrations of haemoglobin and higher body weight increased the probability of experiencing depressive symptoms.

To explore the factors influencing Taiwanese adolescents’ consumption of sugar-sweetened beverages (SSBs) and sugary snacks from a socioecological perspective.

This study adopted a qualitative design by using face-to-face, in-depth interviews guided by a semistructured questionnaire.

Eight junior high schools in New Taipei City and Changhua County, Taiwan, September to November 2018.

Fifty-nine participants aged 12–14 years participated in this study.

Reflexive thematic analysis was used to analyse the data. This study identified four themes to address the multifaceted factors that influence adolescents’ consumption of SSB and sugary snacks.

At the intrapersonal level, physiological factors, psychological factors, individual economic factors, and taste preferences were mentioned in connection with people’s consumption of SSBs and sugary snacks. Positive or negative influences of parents, siblings, peers, and teachers on SSB and sugary snack intake were identified at the interpersonal level. The availability of SSBs and sugary snacks at home, their availability in vending machines or in school stores in the school environment and participants’ access to convenience stores and hand-shaken drink shops in the broader community influenced SSB and sugary snack consumption. Additionally, food culture and food advertising were identified as influencing societal factors.

Overall, this qualitative study determined not only that the consumption of SSBs and sugary snacks is influenced by intrapersonal factors but also that interpersonal, environmental, and societal factors affect adolescents’ increased sugar intake. The findings are helpful to broaden the options for designing and developing interventions to decrease SSB and sugary snack consumption by adolescents.

Higher neighbourhood walkability would be expected to contribute to better health, but the relevant evidence is inconsistent. This may be because residents’ dietary attributes, which vary with socio-economic status (SES) and influence their health, can be related to walkability. We examined associations of walkability with dietary attributes, and potential effect modification by area-level SES.

The exposure variable of this cross-sectional study was neighbourhood walkability, calculated using residential density, intersection density, and destination density within 1-km street-network buffer around each participant’s residence. The outcome variables were dietary patterns (Western; prudent; and mixed) and total dietary energy intake, derived from a food frequency questionnaire. Main and interaction effects with area-level SES were estimated using two-level linear regression models.

Participants were from all states and territories in Australia.

The analytical sample included 3,590 participants (54% women, age range 34 to 86).

Walkability was not associated with dietary attributes in the whole sample. However, we found interaction effects of walkability and area-level SES on Western diet scores (P<0.001) and total energy intake (P=0.012). In low SES areas, higher walkability was associated with higher Western dietary patterns (P=0.062) and higher total energy intake (P=0.066). In high SES areas, higher walkability was associated with lower Western diet scores (P=0.021) and lower total energy intake (P=0.058).

Higher walkability may not be necessarily conducive to better health in socio-economically disadvantaged areas. Public health initiatives to enhance neighbourhood walkability need to consider food environments and socio-economic contexts.

To determine if limb lengths, as markers of early life environment, are associated with the risk of diabetes in China.

We performed a cohort analysis using data from the China Health and Retirement Longitudinal Study (CHARLS), and multivariable-adjusted Cox proportional hazard regression models were used to examine the associations between baseline limb lengths and subsequent risk of diabetes.

The CHARLS, 2011-2018.

The study confined the eligible subject to 10,711 adults aged over 45 years from the CHARLS.

During a mean follow-up period of 6.13 years, 1,358 cases of incident diabetes were detected. When controlling for potential covariates, upper arm length was inversely related to diabetes (HR 0.95 [0.91 to 0.99], P = 0.028), and for every 1-cm difference in knee height, the risk of diabetes decreased by about 4% (HR 0.96 [0.93 to 0.99], P = 0.023). The association between upper arm length and diabetes were only significant among females while the association between knee height and diabetes were only significant among males. In analyses stratified by BMI, significant associations between upper arm length/knee height and diabetes only existed among those who were underweight (HR 0.91 [0.83 to 1.00], P = 0.049/0.92 [0.86 to 0.99], P = 0.031).

Inverse associations were observed between upper arm length, knee height and the risk for diabetes development in a large Asian population, suggesting early life environment, especially infant nutritional status, may play an important role in the determination of future diabetes risk.

This study investigated associations between types and food sources of protein with overweight/obesity and underweight in Ethiopia.

We conducted a cross-sectional dietary survey using a non-quantitative food frequency questionnaire. Linear regression models were used to assess associations between percent energy intake from total, animal, and plant protein and body mass index (BMI). Logistic regression models were used to examine associations of percent energy intake from total, animal, and plant protein and specific protein food sources with underweight and overweight/obesity.

Addis Ababa, Ethiopia.

1,624 Ethiopian adults (992 women and 632 men) aged 18-49 years in selected households sampled using multi-stage random sampling from five sub-cities of Addis Ababa, Ethiopia.

Of the surveyed adults, 31% were overweight or obese. The majority of energy intake was from carbohydrate with only 3% from animal protein. In multivariable-adjusted linear models, BMI was not associated with percent energy from total, plant or animal protein. Total and animal protein intake were both associated with lower odds of overweight/obesity (Odds Ratio [OR] per 1% energy increment of total protein 0.92; 95% CI: 0.86, 0.99; P=0.02; OR per 1% energy increment of animal protein 0.89; 95% CI: 0.82, 0.96; P=0.004) when substituted for carbohydrate and adjusted for sociodemographic covariates.

Increasing proportion of energy intake from total protein or animal protein in place of carbohydrate could be a strategy to address overweight and obesity in Addis Ababa; longitudinal studies are needed to further examine this potential association.

To identify determinants of egg consumption in infants and young children ages 6-23.9 months in Ethiopia

Data used were from the cross-sectional baseline survey of an egg campaign in Ethiopia implemented by the Global Alliance for Improved Nutrition.

Children aged 6-23.9 months (n=453) were sampled. Data on sociodemographic characteristics, economic resources, caregiver’s behavior, child health and feeding practices, and egg consumption in the last seven days were collected using interviewer-administered questionnaires. Multivariable ordinal logistic regression was used to examine the association between explanatory variables and egg consumption in the last seven days.

About half of children (53.4%) did not consume eggs in the last seven days. The odds of children consuming eggs were 4.33 (p < 0.002) times higher when their caregivers had some college education compared to no education. Wealth was positively (OR, 1.13, p = 0.029) and household food insecurity was negatively (OR, 0.96, p = 0.117) associated with child egg consumption. Purchasing eggs (OR, 9.73, p < 0.001) and caregiver’s positive behavioral determinants (OR, 1.37, p=0.005) were associated with child egg consumption. The associations of sociodemographic characteristics and economic resources with egg consumption provide evidence of partial mediation through caregiver behavior and child health.

About half of children aged 6-23.9 months consumed eggs. Availability of eggs in households, mainly through purchase, was strongly associated with egg consumption. Education of caregivers and household heads and economic resources were associated with egg consumption and may operate through caregiver behavior.

To identify the efficacy of group-based nutrition interventions to increase healthy eating, reduce nutrition risk, improve nutritional status, and improve physical mobility among community-dwelling older adults.

Systematic review. Electronic databases MEDLINE, CINAHL, EMBASE, PsycINFO, and Sociological Abstracts were searched on July 15, 2020, for studies published in English since January 2010. Study selection, critical appraisal (using the Joanna Briggs Institute’s tools), and data extraction were performed in duplicate by two independent reviewers.

Nutrition interventions delivered to groups in community-based settings were eligible. Studies delivered in acute or long-term care settings were excluded.

Community-dwelling older adults aged 55+ years. Studies targeting specific disease populations or promoting weight loss were excluded.

Thirty-one experimental and quasi-experimental studies with generally unclear-high risk of bias were included. Interventions included nutrition education with behaviour change techniques (BCT) (e.g., goal setting, interactive cooking demonstrations) (n=21), didactic nutrition education (n=4), interactive nutrition education (n=2), food access (n=2), and nutrition education with BCT and food access (n=2). Group-based nutrition education with BCT demonstrated the most promise in improving food and fluid intake, nutritional status, and healthy eating knowledge compared to baseline or control. The impact on mobility outcomes was unclear.

Group-based nutrition education with BCT demonstrated the most promise for improving healthy eating among community-dwelling older adults. Our findings should be interpreted with caution related to generally low certainty, unclear-high risk of bias, and high heterogeneity across interventions and outcomes. Higher quality research in group-based nutrition education for older adults is needed.

Overweight and obesity have been related to a variety of adverse health outcomes. Understanding the overweight and obesity epidemic in Bangladesh, particularly among reproductive-aged women, is critical for monitoring and designing effective control measures. The purpose of this study was to determine the prevalence of overweight and obesity in reproductive-aged women and to identify the risk factors of overweight and obesity.

A total of 70,651 women were obtained from the five most recent and successive Bangladesh Demographic and Health Surveys (BDHS). The multilevel logistic regression model was used to explore the individual-and community-level factors of overweight and obesity.

Five most recent nationally representative household surveys across all regions.

Reproductive aged (15–49 years) non-pregnant women.

Approximately 35.2% (95% CI: 34.9-35.6%) of women were either overweight or obese in Bangladesh. At the individual- and community-level, higher age (aOR=5.79, 95% CI: 5.28–6.34), secondary or higher education (aOR=1.69 [1.60–1.78]), relatively wealthiest households (aOR=4.41 [4.10-4.74]), electronic media access (aOR=1.32 [1.26–1.37]), and community high literacy (aOR=1.10 [1.04–1.15]) of women were significantly positively associated with being overweight or obese. Whereas, rural residents (aOR=0.79 [0.76–0.82]), from larger-sized households (aOR=0.80 [0.73–0.87]) and have high community employment (aOR=0.92 [0.88–0.97]) were negatively associated with the probability of being overweight or obese.

Individual- and community-level factors influenced the overweight and obesity of Bangladeshi reproductive-aged women. Interventions and a comprehensive public health plan aimed at identifying and addressing the growing burden of overweight and obesity should be a top focus.

To quantify perceptions of tap water among low-income mothers with young children residing in Michigan and examine associations between perceptions of tap water, mothers’ and young children’s beverage intake, and mothers’ infant feeding practices.

Cross-sectional study.

Online survey.

Medicaid-insured individuals who had given birth at a large Midwestern US hospital between fall 2016 and fall 2020 were invited by email to complete a survey in winter 2020 (N=3,881); 15.6% (N=606) completed eligibility screening, 550 (90.8%) were eligible to participate, and 500 (90.9%) provided valid survey data regarding perceptions of tap water, self and child beverage intake, and infant feeding practices.

Two-thirds (66.2%) of mothers reported that their home tap water was safe to drink without a filter while 21.6% were unsure about the safety of their home tap water. Mothers’ perceptions of their home tap water were associated with their own tap and bottled water intake and their young children’s tap water and bottled water intake. Mothers with more negative perceptions of tap water in general, independent of their perceptions about their home tap water, consumed more bottled water and sugar-sweetened beverages, and their young children drank bottled water and fruit drinks more frequently. Few associations were observed between mothers’ perceptions of tap water and infant feeding practices.

Uncertainty about tap water safety and negative perceptions of tap water are common among low-income Michigan mothers. These beliefs may contribute to less healthful and more costly beverage intake among mothers and their young children.

To identify temporal patterns of sleep and eating among school-aged children during school closure due to the COVID-19 pandemic and to examine their associations with lifestyle behaviours and dietary intake.

In this cross-sectional study, questionnaires were used to assess sleep and eating times, lifestyle behaviours, and dietary intake during school closure. Latent class analysis was performed to identify temporal patterns of sleep and eating based on self-reported clock times for wake-up, going to bed, and eating meals. Lifestyle behaviours and dietary intake were compared between latent classes.

48 primary and secondary schools in Japan.

6220 children (aged 8–15 years)

Four patterns, labelled “Very early (20% of children)”, “Early (24%)”, “Late (30%),” and “Very late (26%),” were identified and ordered according to the circadian timing. Latter patterns were characterised by later timings of sleep and eating, especially in clock times for wake-up, breakfast, and lunch compared to earlier patterns. Children with latter patterns had a less physically active lifestyle, longer screen time (>4 h/d), shorter study time (<2 h/d), and more frequent skipping of breakfast and lunch than those with earlier patterns. In addition, children with latter patterns had lower intakes of several vitamins, vegetables, fruits, fish and shellfish, and dairy products, and higher intakes of sugar and confectionaries and sweetened beverages.

More than half of the participants had later wake-up, breakfast, and lunch during school closure, which was associated with more unfavourable lifestyles and dietary intakes.

Evaluating the association of water intake and hydration status with nephrolithiasis risk at the population level.

A cross-sectional study in which daily total plain water intake (TPWI) and total fluid intake (TFI) were estimated together with blood osmolality, urine creatinine, urine osmolality, urine flow rate (UFR), free water clearance (FWC) and urine/blood osmolality ratio (Uosm:Bosm). The associations of fluid intake and hydration markers with nephrolithiasis were evaluated using multivariable logistic regression.

General US population

A total of 8195 adults aged 20 years or older from the National Health and Nutritional Examination Survey 2009–2012 cycles.

The population medians (interquartile ranges, IQRs) for daily TPWI and TFI were 807 (336–1481) and 2761 (2107–3577) mL/day, respectively. The adjusted odds ratios (95% confidence intervals) of nephrolithiasis for each IQR increase in TPWI and TFI were 0.92 (0.79, 1.06) and 0.84 (0.72, 0.97), respectively. The corresponding odds ratios of nephrolithiasis for UFR, blood osmolality, Uosm:Bosm, and urine creatinine were 0.87 (0.76, 0.99), 1.18 (1.06, 1.32), 1.38 (1.17, 1.63), and 1.27 (1.11, 1.45), respectively. A linear protective relationship of fluid intake, UFR, and FWC with nephrolithiasis risk was observed. Similarly, positive dose–response associations of nephrolithiasis risk with markers of insufficient hydration were identified. Encouraging a daily water intake of >2500 mL/day and maintaining a urine output of 2 L/day was associated with a lower prevalence of nephrolithiasis.

This study verified the beneficial role of general water intake recommendations in nephrolithiasis prevention in the general US population.

To examine associations of school food availability with student intake frequency and BMI, and whether the number of neighborhood food outlets modifies these associations.

Baseline assessment of a nationally representative cohort study of U.S. 10th graders. Students reported intake frequency of fruits and vegetables (FV), snacks, and soda. BMI was calculated from measured height and weight. Administrators of 72 high schools reported the frequency of school availability of FV, snacks, and soda. The number of food outlets within 1 km and 5 km were linked with geocoded school addresses. Data were analyzed using adjusted linear and logistic mixed models with multiple imputation for missing data.

U.S. 2009-2010.

2,263 U.S. 10th graders from the Next Generation Health Study (NEXT).

Greater school FV availability was positively associated with student FV intake. Food outlets within 5 km of schools (but not 1 km) attenuated the association of school FV availability with student intake; this was no longer significant at schools with >58 food outlets within 5 km. School food availability was not associated with student BMI or student snack or soda intake.

School food availability was associated with student intake of FV, but not with snacks, soda, or BMI. Attenuation of the observed associations by the school neighborhood food environment indicates a need to find ways to support healthy student eating behaviors in neighborhoods with higher food outlet density.

Ready to eat fried liver meat balls (LMB) were developed to fight anaemia and vitamin A deficiency and promote cognitive function.

Randomized controlled trial (RCT) consisting of 2 arms; control group with no supplement and LMB group receiving LMB supplement 3 times a week for 90 days. Criteria of evaluations included dietary assessment, anthropometric measurements, laboratory investigations and cognitive function by Wechsler test. Setting: Kinder garten and primary school in Urban Giza

Sixty boys and girls aging 3-9 years.

The LMB supplement contributed to significant increases in the intakes of high bioavailable iron and vitamin A in the diets of all children. Initial overall prevalence of mild and moderate anemia was 43 %, which disappeared completely from all children aging < 72 months and from 88 % of children ≥ 72 mo after the 90 day dietary intervention with the LMB. Fecal systemic immune globulin A; urinary hydroxyproline index and urinary iodine excretion increased significantly (P<0.05) only after the dietary intervention with the LMB supplement for 90 days. The standard scores of verbal and nonverbal cognitive function tests (∆ day 90 – day 0) increased significantly (P<0.05) among the LMB group compared with the respective changes observed among the control group. The increase in HAZ and blood hemoglobin were good predictors for improvement in cognitive function.

LMB supplement is effective sustainable nutritious bio-therapeutic food in fighting hidden hunger and promoting the cognitive function.

This study aimed to investigate the mediating role of FPPs, including home availability of different types of foods and drinks, parental modelling of fruit intake, permissiveness, and the use of food as a reward, in the relationship between parental education and dietary intake in European children.

Single mediation analyses were conducted to explore whether FPPs explain associations between parents' educational level and children’s dietary intake measured by a parent-reported food frequency questionnaire.

6 European countries.

Parent–child dyads (n = 6705, 50.7% girls, 88.8% mothers) from the Feel4Diabetes-study.

Children aged 8.15 ± 0.96 years were included. Parental education was associated with children’s higher intake of water, fruits, and vegetables and lower intake of sugar-rich foods and savoury snacks. All FPPs explained the associations between parental education and dietary intake to a greater or lesser extent. Specifically, home availability of soft drinks explained 59.3% of the association between parental education and sugar-rich food intake. Home availability of fruits and vegetables were the strongest mediators in the association between parental education and fruit and vegetable consumption (77.3% and 51.5%, respectively). Regarding savoury snacks, home availability of salty snacks and soft drinks were the strongest mediators (27.6% and 20.8%, respectively).

FPPs mediate the associations between parental education and children’s dietary intake. This study highlights the importance of addressing FPPs in future interventions targeting low-educated populations.

To validate a Food Diversity Questionnaire that identifies the prevalence of the risk of deficiency in the intake of 11 micronutrients.

The Food Diversity Questionnaire paper form, an online application for data entry and handling, was designed and compared with the 24-hour recall as a reference method. All data were processed in PC-SIDE v1 software. A descriptive analysis and comparisons between prevalence, concordance and reproducibility analyses were performed.

Medellín, Colombia.

Women of childbearing age between 19 and 50 years of age (n = 186) who worked for the Buen Comienzo programme in 2019.

When comparing the adjusted 24-hour recall technique and the Food Diversity Questionnaire, there was no significant difference in population-level data at risk of deficiency in any micronutrient intake. However, based on individual-level data of the best linear unbiased predictor, the concordance analyses were weak, and although agreements were high according to the diagnostic performance tests, a good ability to detect deficiency was only observed in a few nutrients: vitamin A 100.0%, calcium 98.7%, iron 92.8%, folates 91.6%, and pyridoxine 81.8%.

The Food Diversity Questionnaire validated in this study is useful and faster at evaluating population-level data at risk of deficiency in the intake of calcium, iron, zinc, thiamine, riboflavin, niacin, pyridoxine, folates, vitamin B12, vitamin C, and vitamin A. Based on individual-level data, a good ability to detect deficiencies was observed in the intake of vitamin A, calcium, iron, folates, and pyridoxine.

The purpose of this study was to cross-culturally adapt and validate an online questionnaire to assess eating habits and physical activity of university students under confinement due to COVID-19.

Generation of a cross-sectional online survey to university students conducted during confinement due to COVID-19. The study was divided into 2 phases.

Students, Chile.

Phase 1 considered the process of translation and back translation, expert panel, cultural adaptation, and the generation of a pilot to validate a preliminary format of the questionnaire. In Phase 2, information from the instrument was collected from two hundred and sixty-eight university students, ages 16 to 30 years old, with a mean age of 21.6 (3.3) The major proportion of participants were female (82 %).

The adapted questionnaire was statistically validated in three dimensions: (A) Eating habits and behaviors during quarantine, (B) Perception of risk, and (C) Physical activity changes during the quarantine. The reliability of Cronbach’s alpha for dimensions A, B and C was 0.59, 0.85, and 0.97, respectively. The complete questionnaire obtained 0.61 in internal consistency and 0.61 (0.58-0.67) ICC reliability. A statistically significant positive correlation matrix was observed.

This questionnaire is a practical tool to obtain accurate information about the relation of COVID-19 confinement on people’s eating habits and physical activity. Therefore, it could contribute to establishing appropriate strategies to prevent negative effects on people’s health.