Australia’s dominant food system encourages the overconsumption of foods detrimental for human and planetary health. Despite this, Australia has limited policies to reduce the burden of disease and protect the environment. Political donations from the food industry may contribute to policy inertia on this issue. We aimed to explore the extent of political donations made by the food industry in Queensland and investigate the timing of public health nutrition policies in relation to these donations.

We collected publicly declared political donations data in Queensland, Australia, as it has the most transparent donation records. Policy data were sourced from the Australian National and Queensland State Parliaments, and consultations from the Australian and New Zealand Ministerial Forum on Food Regulation.

Queensland, Australia.

Not applicable.

The Liberal National Party (LNP) received 68 % of all donations, with most immediately preceding the 2017 and 2020 state elections. The Australian Labor Party, despite forming government for the time period under study, received only 17 % of total donations. Most donations were given by the meat industry, followed by the sugar industry. Few policies exist to protect and improve human and planetary health, with limited associations with political donations for most industries except sugar.

Industry preference for the LNP, particularly as most donations coincided with election periods, may be due to the party’s emphasis on minimal state involvement in economic and social affairs. The relationship between industry donations and policies is not clear, partly due to the limited number of policies implemented overall.

Restaurants may be important settings for interventions to reduce children’s energy intake. The objective of this study was to test the impact of a parent-focused social marketing campaign to promote healthy children’s meals on calories ordered and consumed by children at quick-service restaurants (QSR).

Using a repeated cross-sectional study design, two urban communities were randomised to intervention (IN) v. control (C) condition. A community-wide social marketing campaign was implemented in the IN community to empower Black and Latinx mothers who frequent QSR (priority population) to select healthier options for their child.

Data were collected in 2016 at QSR located within the communities pre- and post-IN and analysed in 2017.

Parents (n 1686; n 819 and n 867 for I and C conditions, respectively) were recruited after placing their QSR order; a survey, receipt and their child’s leftovers were collected.

Calories ordered did not differ significantly between the IN and C conditions (changeadj = –146·4 kJ (–35·0 kcal); 95 % CI –428·0 kJ (–102·3 kcal), 134·6 kJ (32·2 kcal)). In a sub-analysis of only the priority audience, children in the IN community ordered significantly fewer calories compared to C children in unadjusted models (changeunadj = –510·4 kJ (–122·0 kcal); 95 % CI –1013·4 kJ (–242·2 kcal), –7·5 kJ (–1·8 kcal)), but the trend did not persist after adjusting for covariates (changeadj = –437·2 kJ (–104·5 kcal); 95 % CI –925·5 kJ (–221·2 kcal), 50·6 kJ (12·1 kcal)). Calories consumed followed similar trends.

The campaign did not significantly reduce children’s QSR calories ordered or consumed. However, a quantitatively important mean reduction in calories was suggested among the priority audience, indicating potential for community-wide promotion of healthful children’s meals.

To analyse the implementation of front-of-pack nutrition labelling (FOPNL) in Mexico.

Review of publicly accessible documents, including legislative websites, news sources, and government, intergovernmental, and advocacy reports. Usage of the policy cycle model to analyse the implementation and evaluation stages of Mexico’s General Health Law, amended with FOPNL (2019–2022).

In October 2019, the government published a draft modification of the Norma Oficial Mexicana (Official Mexican Standard) to regulate and enforce a new FOPNL warning label system. A 60-d public consultation period followed (October–December 2019), and the regulation was published in March 2020 and implementation began in October 2020. An analysis of nine key provisions of the Standard revealed that the food and beverage industry and its allies weakened some original provisions including health claims, warnings for added sweeteners and display areas. On the other hand, local and international public health groups maintained key regulations including the ban on cartoon character advertisements, standardised portions and nutrient criteria following international best practices. Early implementation appears to have high compliance and helped contribute to reformulating unhealthy products. Continued barriers to implementation include industry efforts to create double fronts and market their cartoon characters on social media and through digitalised marketing.

Early success in implementing the new FOPNL system in Mexico was the result of an inclusive and participatory regulatory process dedicated to maintaining public health advances, local and international health advocacy support, and continued monitoring. Other countries proposing and enacting FOPNL should learn from the Mexican experience to maintain scientifically proven best practices, counter industry barriers and minimise delays in implementation.

Encouraging healthy eating is a public health priority in the United Kingdom (UK), given the high prevalence of poor diet and overweight/obesity among school-aged children. Holiday clubs are organisations providing childcare and activities during the school holidays and frequently provide food to children at risk of food insecurity, primarily through government-funded programmes like the Holiday Activities and Food programme. However, the research suggests that holiday clubs could do more to maximise opportunities to promote children’s healthy eating by using evidence-based feeding practices.

During August–September 2020, video-based interviews were conducted exploring staff perceptions of the feasibility of using four evidence-based feeding practices to promote children’s healthy eating: modelling; involvement in food choice; involvement in food preparation and cooking and involvement in meal planning. Feasibility was assessed using four dimensions of a feasibility framework (acceptability, demand, practicality and implementation).

UK holiday clubs.

Twenty-five staff actively involved in delivering UK holiday clubs (project leaders, coordinators, cooks and coaches/youth workers).

Staff generally reported good acceptability (dimension 1) and demand (dimension 2) for the feeding practices. However, the practicality (dimension 3) of using the practices was dependent on various factors (logistics, resources, staff readiness, children, peers and parents). Promisingly, in the fourth feasibility dimension (implementation), staff provided numerous practical solutions to overcome these barriers.

Evidence-based feeding practices can be implemented in numerous ways and are therefore generally feasible in holiday clubs. Holiday clubs should be empowered to use evidence-based feeding practices through training resources, sharing networks and provision of sustainable funding.

To assess the attitudes and perceived knowledge of health professionals regarding the food product judgemental-labelling reform that began in January 2020 in Israel.

Cross-sectional survey.

An online survey among health professionals working in the Israeli health system.

456 participants (118 physicians, 207 nurses, 131 nutritionists).

Most respondents (89·9 %) were women, 36 % had over 20 years of professional experience. All nutritionists, 96·6 % of physicians and 94·7 % of nurses reported hearing about the reform, and most (88·9 % of nurses, 76·3 % of physicians and 75·6 % of nutritionists) claimed supporting the reform to a great or very great extent. Most respondents believe they should discuss issues related to healthy eating with their patients (91·8 % of nurses, 94·9 % of physicians and all nutritionists), but only about half (47·5 % of physicians and 57·0 % of nurses) reported that they have sufficient knowledge in this field, particularly about food labelling. Almost two-thirds of nutritionists (60·3 %) reported instructing patients to change their food intake according to labelling v. 40·1 % and 34·7 % of nurses and physicians, respectively. Only some respondents felt that they could influence their patients’ nutrition habits. Most participants believe that additional regulatory measures should also be used to promote healthy nutrition.

There is a gap between the desire of physicians and nurses to provide nutritional guidance to the public and their actual knowledge about the labels’ meaning as well as their competencies in providing nutrition counselling. When formulating a reform, policymakers should provide clear guidelines about the expectations of implementing it in therapeutic practice.

This work aims to demonstrate an original approach to identify links between locally situated shared values and contextual factors of stunting. Stunting results from multi-factorial and multi-sectoral determinants, but interventions typically neglect locally situated lived experiences, which contributes to problematic designs that are not meaningful for those concerned and/or relatively ineffective.

This case study investigates relevant contextual factors in two steps: by first facilitating local stakeholder groups (n 11) to crystallise their shared-values-in-action using a specialised method from sustainability studies (WeValue_InSitu (WVIS)). Secondly, participants (n 44) have focus group discussions (FGD) about everyday practices around child feeding/food systems, education and/or family life. Because the first step strongly grounds participants in local shared values, the FGD can reveal deep links between contextual factors and potential influences on stunting.

Kaffrine, Senegal, an ‘Action Against Stunting Hub’ site. December 2020.

Eleven stakeholder groups of mothers, fathers, grandmothers, pre-school teachers, community health workers, farmers, market traders and public administrators.

Local contextual factors of stunting were identified, including traditional beliefs concerning eating and growing practices; fathers as decision-makers; health worker trust; financial non-autonomy for women; insufficient water for preferred crops; merchants’ non-access to quality produce; religious teachings and social structures affecting children’s food environment.

Local contextual factors were identified. Pre-knowledge of these could significantly improve effectiveness of intervention designs locally, with possible applicability at other sites. The WVIS approach proved efficient and useful for making tangible contextual factors and their potential links to stunting, via a lens of local shared values, showing general promise for intervention research.

Dual modality feeding (DMF) – feeding human milk interchangeably from the breast and from a bottle – comes with unique practical, emotional and relational challenges, as well as support needs. Yet, there is little research that explores the experiences of individuals who use DMF in the Canadian context. The aim of this study is to explore the practices, challenges, reasons and enablers of DMF.

Repeat, semi-structured one-on-one interviews were conducted at 8 weeks and 22 weeks postpartum. Interview transcripts were thematically analysed using a critical feminist lens.

Nova Scotia, Canada.

Ten DMF mothers.

DMF practices were influenced by a mix of social and material circumstances, including breast-feeding challenges, the involvement of support persons, finances and access to lactation support. Individuals who predominantly fed at the breast expressed milk strategically to mitigate transitory breast-feeding challenges, for convenience under specific circumstances, and to share feeding responsibilities with other caregivers for personal and practical reasons. Individuals who mainly bottle-fed did so due to long-term breast-feeding challenges or a need to return to employment. Enablers of successful DMF were consistent between the two groups and included practical, personal and relational aspects.

DMF is a unique practice compared to feeding human milk solely from the breast or bottle. Despite the potential growing prevalence of DMF, it is currently understudied and inadequately addressed in existing support programmes in Nova Scotia. Tailored programming and public messaging are needed to support DMF families.

Online food delivery (OFD) platforms offer consumers a convenient and fast delivery service of foods and drinks sourced from foodservice partners (e.g. restaurants, quick service restaurants). There is a need to assess the impact of this emergent segment of the foodservice sector on diet and diet-related health. The aim of this narrative review was to describe the OFD sector in Australia, its use and identify potential ways to include OFD platforms in existing public health nutrition policy.

A search was conducted in peer-reviewed and grey literature. Sources were analysed and synthesised to report the characteristics of OFD platforms, delivery process, users and potential drivers of usage. The aim and scope of public health nutrition policies were analysed to identify ways of including OFD platforms.

Australia.

General population.

There are three main operators with 9000–16 000 foodservice partners based predominantly in the main cities of Australia. OFD revenue has grown by 72 % in the last 5 years and is predicted to increase driven by usage by working adults with high disposable income who demand convenience. Current policies and initiatives aimed at manufacturers, retailers and foodservice outlets do not specifically regulate OFD platforms, although there is scope for these to be extended to such platforms.

OFD platforms are disruptors of the foodservice sector. Innovative and consistent health policy options that target the unique challenges and opportunities posed by OFD platforms are required to limit the potentially negative impact of OFD platforms on diet and diet-related health.

To understand the impact of Na reduction on the nutrient content of Child and Adult Care Food Program (CACFP) meals served through At-Risk Afterschool Meals (ARASM) without compromising the nutritional quality of the meals served.

Sodium Reduction in Communities Program (SRCP) partnered with a CACFP ARASM programme from October 2016 to September 2021. We assessed changes in Healthy Eating Index 2015 (HEI-2015) food component scores and macro- and micronutrients using cross-sectional nutrient analyses of October 2016 and 2020 menus.

ARASM programme sites in Indianapolis, IN, USA.

October 2016 and 2020 menus from one CACFP ARASM programme.

Na reduction strategies included implementing food service guidelines, modifying meal components, changing procurement practices and facilitating environmental changes to promote lower Na items.

From baseline in 2016 to 2020, fifteen meal components were impacted by the intervention, which impacted 17 (85 %) meals included in the analysis. Average Na per meal reduced significantly between 2016 (837·9 mg) and 2020 (627·9 mg) (P = 0·002). Between 2016 and 2020, there were significant increases in whole grains (P = 0·003) and total vegetables (P < 0·001) and significant reductions in refined grains (P = 0·001) and Na (P = 0·02), all per 1000 kcal served.

This study demonstrates that Na content can be reduced in CACFP meals without compromising the nutritional quality of meals served. Future studies are needed to identify feasible best practices and policies to reduce Na content in the CACFP meal pattern.

This review aimed to identify and synthesise the enablers and barriers that influence the long-term (≥ 2 years) sustainment of school-based nutrition programmes.

Four databases (PubMed, Cochrane Library, Embase and Scopus) were searched to identify studies reporting on the international literature relating to food and nutrition programmes aimed at school-age (5–14 years) children that had been running for ≥ 2 years (combined intervention and follow-up period). Eligible studies were analysed using the Integrated Sustainability Framework (ISF), which involved deductive coding of programme enablers and barriers. A quality assessment was completed, using the Mixed-Methods Appraisal Tool and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

International school-based nutrition programmes.

Individuals involved with the implementation of school-based nutrition programmes.

From the 7366 articles identified, thirteen studies (seven qualitative, five mixed methods and one quantitative descriptive) were included, from which the enablers and barriers of eleven different nutrition-related programmes were analysed. Thirty-four factors across the five domains of the ISF were identified that influenced the sustained implementation of programmes. The most common barrier was a lack of organisational readiness and resources, whereas the most common enabler was having adequate external partnerships and a supportive environment.

These findings have application during the initiation and implementation phases of school-based nutrition programmes. Paying attention to the ‘outer contextual factors’ of the ISF including the establishment and maintenance of robust relationships across whole of government systems, local institutions and funding bodies are crucial for programme sustainment.

As global warming intensifies, residents of temperate regions will also face heat waves in the near future. Food habits are one component in addressing the global challenge of climate change. However, water, the most important food for humans, has not been adequately addressed.

For this commentary, on the one hand, publications on the increasing heat stress of children were consulted. On the other hand, publications on the special demands of children’s temperature regulation in hot environments on fluid balance were analysed.

The situation of young children in care facilities on days with heat stress is presented as a scenario. In this way, the effects of climatic changes on fluid balance can be estimated and measures to reduce heat stress and stabilise the fluid balance of children can be developed.

For this analysis, first, infants will be considered in order to identify their specific fluid needs. Second, the possibilities for caregivers to improve fluid intake and train appropriate drinking habits already in infancy will be highlighted.

Climate change should be included in recommendations on hydration for children. The need to adapt drinking habits requires educational approaches to weather and water – starting in early childhood care.

In the face of rapid climate change, countries must act now by protecting, preparing and prioritising the high-risk group of children. Particular focus should be placed on supporting adequate hydration.

Religious/spiritual beliefs and behaviours (RSBB) have been associated with health outcomes, with diet a potential mediator of this relationship. We therefore explored whether RSBB were associated with differences in diet.

Dietary patterns and nutrient intakes were derived from food frequency questionnaire completed by pregnant women in 1991–1992 (mean age = 28·3 years, range = 15–46) and by the mothers and partners 4 years post-partum (mothers mean age = 32·3, range = 19–49; partners mean age = 34·5, range = 18–74). RSBB exposures measured in pregnancy included religious belief, affiliation and attendance. We first explored whether RSBBs were associated with dietary patterns in confounder-adjusted linear regression models. If associations were found, we examined whether RSBB were associated with nutrient intake (linear regression) and following nutrient intake guidelines (logistic regression).

Prospective birth cohort study in Southwest England (Avon Longitudinal Study of Parents and Children; ALSPAC).

13 689 enrolled mothers and their associated partners.

In pregnant women, RSBB were associated with higher ‘traditional’ (i.e. ‘meat and two veg’) and lower ‘vegetarian’ dietary pattern scores. Religious attendance and non-Christian religious affiliation were associated with higher ‘health-conscious’ dietary pattern scores. Religious attendance was associated with increased micronutrient intake and following recommended micronutrient intake guidelines, with weaker effects for religious belief and affiliation. Comparable patterns were observed for mothers and partners 4 years post-partum, although associations between RSBB and nutrient intakes were weaker for partners.

RSBBs are associated with broad dietary patterns and nutrient intake in this cohort. If these reflect causal relationships, diet may potentially mediate the pathway between RSBB and health.