To use Internet search data to compare duration of compliance for various diets.

Using a passive surveillance digital epidemiological approach, we estimated the average duration of diet compliance by examining monthly Internet searches for recipes related to popular diets. We fit a mathematical model to these data to estimate the time spent on a diet by new January dieters (NJD) and to estimate the percentage of dieters dropping out during the American winter holiday season between Thanksgiving and the end of December.

Internet searches in the USA for recipes related to popular diets over a 15-year period from 2004 to 2019.

Individuals in the USA performing Internet searches for recipes related to popular diets.

All diets exhibited significant seasonality in recipe-related Internet searches, with sharp spikes every January followed by a decline in the number of searches and a further decline in the winter holiday season. The Paleo diet had the longest average compliance times among NJD (5.32 ± 0.68 weeks) and the lowest dropout during the winter holiday season (only 14 ± 3 % dropping out in December). The South Beach diet had the shortest compliance time among NJD (3.12 ± 0.64 weeks) and the highest dropout during the holiday season (33 ± 7 % dropping out in December).

The current study is the first of its kind to use passive surveillance data to compare the duration of adherence with different diets and underscores the potential usefulness of digital epidemiological approaches to understanding health behaviours.

The aim of the current study is to analyse the trends, determinants of prelacteal feeding (PLF) and its relations with the mode of delivery among infants <24 months over the years 2003–2018.

We pooled data from Turkey Demographic and Health Surveys (TDHS). The key outcome variable was PLF. Factors associated with PLF were analysed by using complex sample multiple logistic regression analysis, separately and merged database.

TDHS in 2003, 2008, 2013 and 2018.

Mother–infant dyads (n 4942).

PLF rates fluctuated between 29·3 and 41·4 %. The most common types of PLF were infant formula (61·1 %) followed by sugar/glucose water (24·9 %) and plain water (9·3 %). PLF rate was 1·51 times higher (95 % CI 1·28, 1·78) in cases delivered by caesarean section as compared with those delivered by vaginal route. According to the initiation time of breast-feeding after delivery, the most significant absolute change in PLF rate was observed within 1 h (10·9 % increase). Delayed initiation of breast-feeding was associated with significantly higher odds of PLF compared with the first hour (1 to < 2 h: adjusted OR (AOR) 1·29, 95 % CI 1·04, 1·61; 2–23 h: AOR 1·73, 95 % CI 1·42, 2·11; ≥24 h: AOR 11·37, 95 % CI 8·81, 14·69).

To eliminate suboptimal breast-feeding practices, counselling on breast-feeding and delivery type during antenatal visits, postnatal breast-feeding support and social support should be provided to all mothers and families.

To develop a questionnaire to measure food nutrition, food expenditures and time spent in food-related activities; and to assess the association between diet quality, time spent in food-related activities and food expenditures using data from a pilot study.

Cross-sectional study. Multiple linear regression models were used to analyse participants’ survey response behaviours and the relationship between food nutritional quality and time and money expenditures.

Online survey using Qualtrics software in a public university located in West Texas, USA.

Faculty and staff aged 18 years and older from a public university located in West Texas, USA

Combining questions from three survey instruments that collect data on food nutrition, food expenditures and time spent in food-related activities resulted in a thirty-page survey instrument. The median completion time of the survey instrument was about 30 min. Preliminary results suggest that time and money expenditures are associated with food quality but that their role is small relative to sociodemographic characteristics such as race and gender.

Time and money expenditures are associated with food quality but their role is small relative to sociodemographic characteristics such as race and gender.

To evaluate the validity and reproducibility of a 152-item semi-quantitative FFQ (SFFQ) for estimating flavonoid intakes.

Over a 1-year period, participants completed two SFFQ and two weighed 7-d dietary records (7DDR). Flavonoid intakes from the SFFQ were estimated separately using Harvard (SFFQHarvard) and Phenol-Explorer (SFFQPE) food composition databases. 7DDR flavonoid intakes were derived using the Phenol-Explorer database (7DDRPE). Validity was assessed using Spearman’s rank correlation coefficients deattenuated for random measurement error (r s ), and reproducibility was assessed using rank intraclass correlation coefficients.

This validation study included primarily participants from two large observational cohort studies.

Six hundred forty-one men and 724 women.

When compared with two 7DDRPE, the validity of total flavonoid intake assessed by SFFQPE was high for both men and women (r s = 0·77 and r s = 0·74, respectively). The r s for flavonoid subclasses ranged from 0·47 for flavones to 0·78 for anthocyanins in men and from 0·46 for flavonols to 0·77 for anthocyanins in women. We observed similarly moderate (0·4–0·7) to high (≥0·7) validity when using SFFQHarvard estimates, except for flavonesHarvard (r s = 0·25 for men and r s = 0·19 for women). The SFFQ demonstrated high reproducibility for total flavonoid and flavonoid subclass intake estimates when using either food composition database. The intraclass correlation coefficients ranged from 0·69 (flavonolsPE) to 0·80 (proanthocyanidinsPE) in men and from 0·67 (flavonolsPE) to 0·77 (flavan-3-ol monomersHarvard) in women.

SFFQ-derived intakes of total flavonoids and flavonoid subclasses (except for flavones) are valid and reproducible for both men and women.

To examine the gestational weight gain (GWG) trajectory and its possible association with pregnancy outcomes.

GWG trajectories were identified using the latent class growth model. Binary logistic regression was performed to examine the associations between adverse pregnancy outcomes and these trajectories.

Negeri Sembilan, Malaysia.

Two thousand one hundred ninety-three pregnant women.

Three GWG trajectories were identified: ‘Group 1 – slow initial GWG but followed by drastic GWG’, ‘Group 2 – maintaining rate of GWG at 0·58 kg/week’ and ‘Group 3 – maintaining rate of GWG at 0·38 kg/week’. Group 1 had higher risk of postpartum weight retention (PWR) (adjusted OR (AOR) 1·02, 95 % CI 1·01, 1·04), caesarean delivery (AOR 1·03, 95 % CI 1·01, 1·04) and having low birth weight (AOR 1·04, 95 % CI 1·02, 1·05) compared with group 3. Group 2 was at higher risk of PWR (AOR 1·18, 95 % CI 1·16, 1·21), preterm delivery (AOR 1·03, 95 % CI 1·01, 1·05) and caesarean delivery (AOR 1·02, 95 % CI 1·01, 1·03), but at lower risk of having small-for-gestational-age infants (AOR 0·97, 95 % CI 0·96, 0·99) compared with group 3. The significant associations between group 1 and PWR were observed among non-overweight/obese women; between group 1 and caesarean delivery among overweight/obese women; group 2 with preterm delivery and caesarean delivery were only found among overweight/obese women.

Higher GWG as well as increasing GWG trajectories was associated with higher risk of adverse pregnancy outcomes. Promoting GWG within the recommended range should be emphasised in antenatal care to prevent the risk of adverse pregnancy outcomes.

A social network is a valuable resource in later life. Therefore, the current study aims to investigate whether social networks within homes and neighbourhoods are associated with older adults’ daily fruit and vegetable consumption.

Cross-sectional secondary data analysis.

USA.

A nationally representative sample of 6865 community-dwelling older adults over age 53 in the Health and Retirement Study – Health Care and Nutrition Survey.

Older adults who lived alone with no children or friends nearby had the lowest fruit and vegetable consumption. However, the daily fruit and vegetable consumption of respondents who lived alone and had children or friends nearby or those who lived with someone and had no children or friends nearby was not statistically different from those who lived with someone and had children or friends nearby. This suggests that having a social network either at home or in the neighbourhood complements the absence of living with someone or having children or friends nearby and attenuates the negative association between limited social networks and daily fruit and vegetable consumption. A greater decrease in the number of fruits and vegetables consumed was observed among men when they lived alone with no children or friends nearby.

Special attention should be given to older adults with limited social networks, especially older adults living alone with no children or friends nearby. Provision of help with grocery shopping and meal preparation as well as social support networks and more opportunities that can improve social engagement appear to be necessary.

Using a legal standard for scrutinising the regulation of food label claims, this study assessed whether consumers are misled about wholegrain (WG) content and product healthfulness based on common product labels.

First, a discrete choice experiment used pairs of hypothetical products with different amounts of WG, sugar and salt to measure effects on assessment of healthfulness; and second, a WG content comprehension assessment used actual product labels to assess respondent understanding.

Online national panel survey.

For a representative sample of US adults (n 1030), survey responses were collected in 2018 and analysed in 2019.

First, 29–47 % of respondents incorrectly identified the healthier product from paired options, and respondents who self-identified as having difficulty in understanding labels were more likely to err. Second, for actual products composed primarily of refined grains, 43–51 % of respondents overstated the WG content, whereas for one product composed primarily of WG, 17 % of respondents understated the WG content.

The frequency of consumer misunderstanding of grain product labels was high in both study components. Potential policies to address consumer confusion include requiring disclosure of WG content as a percentage of total grain content or requiring disclosure of the grams of WG v. refined grains per serving.

This study investigated whether the duration and type of screen time (ST) (TV viewing, recreational computer use, video gaming) is longitudinally associated with z-BMI and if these relationships are mediated by disordered eating (emotional, restrained).

At baseline, participants were n 1197 (T1; 60 % female) adolescents (mean age = 13·51 years) who completed surveys over 2 years. ST was assessed by a self-reported measure created by the investigative team, while emotional and restrained eating was measured by the Dutch Eating Behaviour Questionnaire (DEB-Q). Height and weight were objectively measured to quantify z-BMI.

Thirty-one public and two private schools from the region of Ottawa, Canada.

Students in grades 7–12.

Parallel multiple mediation analyses revealed that more time spent watching TV at baseline is associated with higher z-BMI at T3 (total effect; B = 0·19, se = 0·07, P = 0·01, 95 % CI 0·05, 0·34), but no relationships were observed for total ST exposure or other types of ST and z-BMI. Disordered eating did not mediate the positive association between baseline TV viewing and z-BMI at T3.

TV viewing was longitudinally associated with higher z-BMI in a community-based sample of adolescents, but disordered eating behaviours did not mediate this relationship. However, other non-pathological eating behaviours may mediate the association between ST and obesity and warrant further investigation. Finding suggests that targeting reduction in youth’s TV viewing may be an effective component in the prevention of childhood obesity.

To examine whether skipping breakfast or lunch increased the next meal’s energy content and changed total daily energy content and the quality of food intake measured by the 2010 Healthy Eating Index (HEI-2010).

Means were compared across intake days and meal patterns. Multivariate individual fixed-effects model was used to account for individual food intake and diet quality preferences.

National Health and Nutrition Examination Survey, 2007–2016.

Adults aged 18 years or older who reported 2 d (24-h periods) of dietary intake and were not pregnant or lactating (n 23 488).

Adults consumed 193 more kJ at lunch after skipping breakfast and 783 more kJ at dinner after skipping breakfast and lunch. Skipping at least one meal reduced total daily intake between 1053 (breakfast) and 1464 (dinner) kJ and reduced the daily HEI score. Skipping breakfast or skipping lunch reduced the HEI component scores for fruit, whole grains, dairy and empty energy; skipping lunch reduced the component scores for fruit, vegetables, whole grain, dairy, seafood and plant protein, and empty energy. Skipping dinner reduced component scores for vegetables, greens and beans, dairy, protein food, seafood and plant proteins, and empty energy. Skipping one or more meals increased component scores for total vegetables (breakfast), whole grains (dinner), Na (lunch or dinner) and refined grains (breakfast, lunch or dinner).

Skipping meals (particularly dinner) reduces daily energy intake, but the reduction in daily diet quality (particularly when skipping breakfast) may impact health negatively over time.

Adequate energy and nutrient intakes are important for workers who spend at least one-third of their day working. We investigated differences in these intakes among Korean workers because few studies have reported on energy or nutrient intakes, related to working conditions (long working hours, shift work and non-standard work).

Dietary intake was assessed using 1-d 24-h recall. Energy and nutrient intakes were evaluated using age- and sex-specific dietary reference intakes for Korean citizens. Occupational characteristics were obtained from self-reported Korean National Health and Nutritional Examination Survey (KNHANES) data (occupational classification, working hours, shift work and non-standard workers). An age, education and household income-adjusted logistic regression model was applied to investigate differences in inappropriate energy and nutrient intakes, by sex and occupation.

Cross-sectional study.

From KNHANES (2007–2016), 11 145 participants (5401 males; 5744 females) were included, finally.

Males with long working hours had higher inappropriate carbohydrate, protein, water, vitamin B2 and phosphate intakes than those who worked ≤60 h/week. Long working hours among females were significantly associated with total energy and nutrient ‘under-intake’. Male shift and non-standard workers had higher inappropriate protein, water, mineral and vitamin intakes. Multivariate logistic regression revealed that white- and male pink-collar workers had significantly increased risks of water and vitamins A, C, B1 and niacin ‘under-intake’.

We found different rates of inappropriate energy and micronutrient intakes according to working conditions. Younger workers with long hours and shift work schedules were vulnerable to inappropriate energy and nutrient intakes.

Nut consumption is associated with a range of health benefits. The current study aimed to examine nut consumption in the 2011–2012 National Nutrition and Physical Activity Survey (NNPAS) and to investigate associations between nut intake, nutrient intake and anthropometric and blood pressure measurements.

Secondary analysis of the 2011–2012 NNPAS. Usual consumption of nuts in the 2011–2012 NNPAS was determined, and nut consumption was compared with population recommendations of 30 g nuts per day. The relationship between nut consumption and intakes of key nutrients, anthropometric outcomes (weight, BMI and waist circumference) and blood pressure was examined using linear regression for participants aged over 18 years.

Australia.

Australians (2 years and older, n 12 153) participating in the representative 2011–2012 NNPAS.

Mean nut intake was 4·61 (95 % CI: 4·36, 4·86) g/d, with only 5·6 % of nut consumers consuming 30 g of nuts per day. Nut consumption was associated with significantly greater intakes of fibre, vitamin E, Fe, Mg and P. There was no association between nut consumption and body weight, BMI, waist circumference, or blood pressure.

Exploration of nut consumption in a representative sample of Australians identified that nut intake does not meet recommendations. Higher nut consumption was not adversely associated with higher body weight, aligning with the current evidence base. Given the current levels of nut consumption in Australia, strategies to increase nut intake to recommended levels are required.

To gain more comprehensive understanding of metabolic syndrome (Mets) among in general Chinese population.

Cross-sectional study. Mets was defined by three widely accepted definitions including modified Adults Treatment Panel (ATP) III criteria, International Diabetes Federation (IDF) criteria and harmonized definition. Risk factors were evaluated by using multivariate logistic regression.

Nineteen rural villages in northeast China.

The survey was conducted in September 2017 and May 2018 on 10 926 individuals.

According to modified ATP III criteria, IDF criteria and harmonised definition, the overall prevalence of Mets was 41·3 % (95 % CI 40·3, 42·2), 34·2 % (95 % CI 33·2, 35·1) and 44·1 % (95 % CI 43·1, 45·1), respectively. Females had a higher prevalence, and elevated blood pressure was the most frequent. Age, female sex, non-peasant worker, higher BMI and lower-annual income were independent risk factors of Mets in all three definitions (all ps < 0·05). Based on modified ATP III criteria and harmonised definition, heavy drinking was positively correlated with Mets. In contrast, former drinking was inversely associated with Mets.

Mets is highly prevalent in rural areas of northeast China. Its independent risk factors include higher age, female sex, non-peasantry worker, higher BMI and lower-annual income. Modified ATP III criteria and harmonised definition may be superior definitions of Mets.

To assess availability, variety, price and quality of different food products in a convenience sample of supermarkets in Germany and the USA.

Cross-sectional study using an adapted version of the Bridging the Gap Food Store Observation Form.

Information on availability, quality, price and variety of selected food products in eight German and seven US supermarkets (discount and full service) was obtained and compared by country.

A general tendency for lower prices of fruits and vegetables in Germany was observed, while produce quality and variety did not seem to differ between countries, with the exception of the variety of some vegetables such as tomatoes. Chips and cereals did not differ significantly in variety nor price. In both countries, high energy-dense foods were lower in energy costs than lower energy-dense foods.

The influence of food prices and availability on consumption should be further explored, including the impact of country differences.

This article explores the relationship between childhood obesity and educational outcomes in Mexico, a country where excess weight is predominant.

Using complementary multivariate estimators, we empirically investigate the association between childhood excess weight, measured in 2002, and schooling attainment measured 10 years later. Non-linear specifications are tested, and heterogeneous effects according to gender, living area and economic backgrounds are investigated.

To fill the literature gap, this study focuses on the understudied context of emerging countries such as Mexico.

Panel data from the Mexican Family Life Survey (2002–2012) are used. We restricted the sample to adolescent individuals who had between 9 and 15 years old in 2002 (attended primary or secondary school in 2002). The survey provides an accurate follow-up information on weight, height and waist circumference for each individual.

Controlling for a comprehensive set of covariates, we find that the relationship is non-linear in Mexico. While weight-based childhood obesity and abdominal adiposity are significantly associated with lower school attainment, at least in urban settings, no schooling gap is found between overweight students and their normal-weight counterparts. Along with rural–urban heterogeneity, obesity-based educational penalties appear to be stronger for girls and students from privileged economic backgrounds.

These results emphasise the co-occurrence of anti-fat and pro-fat social norms in Mexican schools: while anti-fat norms may particularly concern female, richer and urban students, pro-fat norms might persist among male, poorer and rural students. These findings have important implications for public policy, namely about awareness anti-obesity programmes.

The main objective was to assess the cost, acceptability and affordability of the Cypriot Diabetic Healthy Food Basket (DHFB).

The development of DHFB was based on the Cypriot HFB with adjustments based on the nutritional guidelines for diabetes as developed by the American Diabetes Association (ADA) and information retrieved through the questionnaires. Two DHFB were constructed for adult women and adult men (±40 years) diagnosed with diabetes. Affordability was defined as the cost of DHFB as a percentage of the Guaranteed Minimum Income (GMI).

Cyprus.

422 diabetic patients aged 18–87 years from different socioeconomic backgrounds.

DHFB consists of eight food categories, similar to Cypriot HFB, but different specific food items. The total monthly budget for a diabetic woman is about 15 % (25·68 Euros less) lower compared with HFB, and the relative percentage for a diabetic man is about 16 % (37·58 Euros less). The total monthly budget for a diabetic woman is about 30 % lower (60·32 Euros less) compared with that of a diabetic man. For low-income adults receiving GMI, the proportion of income that would need to be spent on DHFB ranges from around 30 to 42 % for women and men, respectively.

The cost of DHFB is lower compared with HFB, meaning that nutritional treatment based on the practice guidelines for diabetes could be a cost-efficient therapy for these patients. DHFB is still not affordable among low-income persons.

To understand who engages in home gardening and whether gardening is associated with fruit and vegetable intake and weight status.

A national cross-sectional survey.

Online survey panel in the USA.

Adults aged 18–75 years representing the US population with respect to gender, age, race/ethnicity, income and geographic region (n 3889).

Approximately 30 % of survey respondents reported growing edible plants in a home garden. Gardeners were more likely to be White or Asian, employed, have higher income, be married, have children in the household and live in rural areas. Gardeners were less likely to be obese and more likely to meet US dietary recommendations for fruit and vegetable consumption. In multivariable analyses, home gardens remained associated with fruit and vegetable intake and BMI when controlling for a range of socio-demographic characteristics and level of rurality.

The current study identifies who is gardening in the USA and provides useful information for public health efforts to increase gardening as a nutrition intervention. Future research should examine the benefits of home gardening and interventions to increase home gardening using more rigorous designs.

Governments worldwide have been implementing interventions aimed at improving citizens’ dietary habits. Examining how individuals perceive these interventions is relevant for promoting future policies in this area, as well as informing the way they are designed and implemented. In the current study, we focused on interventions aimed at reducing sugar intake in Portugal, given the current high sugar consumption patterns in the population.

Online survey to assess which interventions are the most salient and receive greater public support.

Portugal.

1010 (76·7 % female, M Age 36·33, sd 13·22).

Data from a free-recall task showed that only about one-third of participants reported knowing about these interventions, namely those related to taxation, weight restrictions in individual sugar packets and limited availability of products with high sugar content. We also found evidence of high support for the eight interventions presented (except for replacing sugar by artificial sweeteners), positive attitudes towards the need of reducing sugar intake in the Portuguese population and high agreement with the importance of reducing sugar intake across all age groups, particularly among children. Participants also indicated paying attention to the amount of sugar in their diets and a low self-reported frequency of consumption of high sugary foods and beverages. A hierarchical regression analysis suggested that these variables were significantly associated with the overall acceptance of interventions, independently of social-demographic variables (i.e., age, education and sex).

By examining how people perceive and accept different interventions targeting the reduction of sugar intake, the current work aims to support policymaking in this domain.