This study aimed to evaluate the association between vegetable intake and major depressive disorder (MDD) through cross-sectional analysis and bidirectional two-sample Mendelian randomisation (MR).

Cross-sectional analysis was conducted on National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2018 and the corresponding Food Patterns Equivalents Database (FPED). Genome-wide association study (GWAS) data were obtained from UK Biobank and Psychiatric Genomics Consortium (PGC) dataset. Logistic regression analysis was performed after calculating the weights of the samples. Inverse variance weighted, MR-Egger and weighted median methods were used to evaluate the causal effects.

A Patient Health Questionnaire-9 score ≥ 10 was considered to indicate MDD. Low vegetable intake was defined as < 2 cups of vegetables per day.

30 861 U.S. adults from NHANES. The GWAS data sample size related to vegetable intake were comprised 448 651 and 435 435 cases respectively, while the GWAS data sample size associated with MDD encompassed 500 199 cases.

There were 23 249 (75·33 %) participants with low vegetable intake. The relationship between vegetable intake and MDD was nonlinear. In the multivariate model adjusted for sex, age, education, marital status, poverty income ratio, ethnicity and BMI, participants with low vegetable intake were associated with an increased risk of MDD (OR = 1·53, 95 % CI (1·32, 1·77), P < 0·001). Bidirectional MR showed no causal effects between vegetable intake and MDD.

Cross-sectional analysis identified a significant relationship between vegetable intake and MDD, whereas the results from bidirectional two-sample MR did not support a causal role.

The high availability of energy-dense nutrient-poor discretionary foods in large serving and package sizes may have shifted portion size norms (described as a typical perception of how much people choose to eat from a given food at a single eating occasion) towards larger sizes. Few public health recommendations exist around appropriate discretionary food portion sizes. This qualitative study aimed to explore the underlying rationale of portion size norms of discretionary foods among Australian adults 18–65 years.

Four focus group sessions were conducted. Collected data were analysed using inductive thematic analysis.

Focus groups were held online via Zoom between September and October 2023.

Thirty-four participants were recruited in the study (mean age 38 years, 19 females).

The key themes raised from inductive analysis were personal factors, eating context factors and food environment factors relevant to the portion size norms. A framework was established to illustrate the interaction across these themes during the conceptualisation of the norms. For serving size availability, consumers found that there were limited serving size choices when making portion size selections and lacked the knowledge and skills in portion control.

These findings highlight the need to make positive changes to the current food environment and develop relevant public health guidelines around appropriate portion sizes to promote healthier portion size norms and enable better portion control.

In this paper, we examined whether there are inequalities in access to food retail (by type and healthiness) across local government areas (LGA) in Greater Melbourne and by LGA grouped based on their distance from the central business district and Growth Area designation. We also examined whether these inequalities persisted over time.

This is a secondary analysis of a repeated cross-sectional census of food outlets collected at four time points (2008, 2012, 2014 and 2016) across 31 LGA. Using Geographical Information Systems, we present a spatial analysis of food retail environments in Melbourne, Australia, at these four times over eight years.

Greater Melbourne, Australia.

31 LGA in Greater Melbourne.

Findings show significant inequalities in access to healthy food retail persisting over time at the LGA level. Residents in lower density urban growth areas had the least access to healthy food retail. Unhealthy food retail was comparatively more accessible, with a temporal trend indicating increased accessibility over time in urban growth areas only.

Accessibility to food outlets, particularly healthy food outlets and supermarkets, in Greater Melbourne is not equal. To identify and address health inequalities associated with rapid urban growth, further understanding of how people interact with the food environment needs to be explored.

To assess the availability and marketing of ultra-processed foods (UPF) in modern retail food outlets (supermarkets and minimarts) in Kenya and associated factors.

This cross-sectional study was conducted in Kenya from August 2021 to October 2021. Variables included the geographic location and the socio-economic status (SES) levels, the food items displayed for sale and advertised in the stores, and locations in the stores such as the entrance.

Three counties in Kenya (Nairobi – urban, Mombasa – coastal tourist and Baringo – rural). Each county was stratified into high and low SES using national poverty indices.

Food outlets that offered a self-service, had at least one checkout and had a minimum of two stocked aisles were assessed.

Of 115 outlets assessed, UPF occupied 33 % of the cumulative shelf space. UPF were the most advertised foods (60 %) and constituted 40 % of foods available for sale. The most commonly used promotional characters were cartoon characters (18 %). UPF were significantly more available for sale in Mombasa (urban) compared to Baringo (rural) (adjusted prevalence rate ratios (APRR): 1·13, 95 % CI 1·00, 1·26, P = 0·005). UPF advertisements were significantly higher in Mombasa ((APRR): 2·18: 1·26, 3·79, P = 0·005) compared to Baringo and Nairobi counties. There was a significantly higher rate of advertisement of UPF in larger outlets ((APRR): 1·68: 1·06, 2·67 P = 0·001) compared to smaller outlets.

The high marketing and availability of UPF in modern retail outlets in Kenya calls for policies regulating unhealthy food advertisements in different settings in the country.

Provide an in-depth examination of consumers’ food safety beliefs and practices to draw implications for interventions to improve nutrition and food safety in Ethiopia.

Adapted Focused Ethnographic Study approach using in-person semi-structured interviews and free-listing exercises, in two iterative phases.

A traditional food market in Hawassa, a mid-sized city.

Forty-six market shoppers, selected randomly in line with quotas for age and gender.

Consumers did not clearly differentiate between quality and safety, seeing them through connected concepts such as ‘freshness’. While most respondents had some understanding of the causes of unsafe food, they did not generally worry about becoming ill themselves and felt food safety risks were easily mitigated through in-home behaviours. Thus, food safety practices were not a main motivator of market or vendor choice. There was no evidence that food safety concerns led consumers to prefer packaged, processed food or to avoid consuming fresh foods.

The study offers novel depth and detail on a topic of strong policy relevance. While building on an encouraging base of understanding of food safety, there remains considerable scope for increasing knowledge, particularly with regard to the need to procure safe food as opposed to expecting household-level practices to mitigate all safety risks. Motivating customers to give food safety factors more consideration when making food purchasing decisions, such as by leveraging emotion-based communication from trusted messengers to elevate the issue’s salience in their minds, may contribute to improvements in food safety in low-income countries such as Ethiopia.

This study aimed to assess the association between emotional attitudes towards diabetes, eating behaviour styles and glycaemic control in outpatients with type 2 diabetes.

Observational study.

Endocrinology Division of Hospital de Clínicas de Porto Alegre, Brazil.

Ninety-one outpatients diagnosed with type 2 diabetes. Baseline assessments included data on clinical parameters, lifestyle factors, laboratory results, eating behaviour styles and emotional attitudes. All patients received nutritional counseling following diabetes recommendations. A follow-up visit was scheduled approximately 90 days later to evaluate changes in weight, medication dosages and glycated Hb (HbA1c) values. Patients were categorised based on their emotional attitude scores towards diabetes (positive or negative), and their characteristics were compared using appropriate statistical tests.

At baseline, no differences were observed in the proportion of patients with good glycaemic control, eating behaviour styles and emotional attitudes. However, patients with a positive attitude towards the disease exhibited a significantly better response in glycaemic control compared with the reference group (OR = 3·47; 95 % CI = 1·12, 10·75), after adjusting for diabetes duration, sex and medication effect score. However, when BMI was included in the model, the association did not reach statistical significance. Therefore, these results should be interpreted with caution.

Patients with a positive attitude towards diabetes showed a greater reduction in HbA1c levels following nutritional counseling. However, baseline BMI could be a potential confounding factor.

This study aimed to determine differences in food consumption by the NOVA food categories in South Africa and Ghana and how they relate to poverty and food supply systems.

This study used a cross-sectional design to assess household food acquisition and lived poverty index.

The study was conducted in Khayelitsha and Mount Frere, urban and rural communities in South Africa, respectively, and Ahodwo and Ejuratia, urban and rural communities in Ghana, respectively.

An adult in charge of or knowledgeable about household food acquisition and consumption was selected to participate in the study.

A total of 1299 households participated in the study. Supermarkets were a prominent source of ultra-processed foods for households in South Africa, while informal outlets were an important source of ultra-processed foods in Ghana. Consumption of unprocessed foods was higher among South African households (58·2 %) than Ghanaian households (41·8 %). In South Africa, deprivation was associated with increased odds of infrequent consumption of both unprocessed foods (OR 3·431 P < 0·001) and ultra-processed foods (OR 2·656 P < 0·001) compared with non-deprivation. In Ghana, no significant differences were observed between deprived households and non-deprived households in relation to the consumption of the NOVA food classes.

Different food supply systems and poverty are associated with household acquisition of the different NOVA food classes. Policies should be geared towards formal shops in South Africa and informal shops in Ghana to reduce the consumption of key obesogenic foods.

Behaviour Change Communication (BCC) intervention programmes often lack documentation of successful processes. This manuscript aims to describe the development of Program Impact Pathway (PIP) using Theory of Change (ToC) approach for a mHealth BCC intervention titled ‘Mobile Solutions Aiding Knowledge for Health Improvement (M-SAKHI)’ aimed at reducing stunting in infants at 18 months of age.

The PIP was developed using ToC to design the intervention and plan its implementation. Literature review and data from previous pilots helped to identify health service gaps that needed to be addressed by the PIP of this intervention.

M-SAKHI was implemented in 244 villages under governance of forty primary health centres of Nagpur and Bhandara districts of eastern Maharashtra in central India.

The study investigators and the public health stakeholders participated in developing the PIP. M-SAKHI evaluation study recruited 2501 pregnant women who were followed up through delivery until their infants were 18 months old.

The PIP was developed, and it identified the following pathways for the final impact: (1) improving maternal and infant nutrition, (2) early recognition of maternal and infant danger signs, (3) improving access and utilisation to healthcare services, (4) improving hygiene, sanitation and immunisation practices, and (5) improving implementation and service delivery of community health workers through their training, monitoring and supervision in real time.

This paper will illustrate the significance of development of PIP for M-SAKHI. It can aid other community-based programmes to design their PIP for nutrition-based BCC interventions.

(1) To develop a new regression equation for estimating fat mass percentage (%FM) from anthropometric measurements in a heterogeneous Caucasian population and (2) to compare it with the Durnin and Womersley equation, which is one of the most used anthropometric equations for FM assessment.

Body mass, stature and four skinfolds (biceps, triceps, subscapular and supracrestal) were assessed by an accredited anthropometrist, according to the International Society for Advancement in Kinanthropometry. Participants completed a dual-energy X-ray absorptiometry (DXA) whole-body scan to determine their %FM. A new anthropometric equation to estimate %FM was developed using multiple forward regression analyses with DXA as the reference method. Tests for the accuracy of the different equations included mean differences, coefficient of determination, SE of the estimate (SEE), concordance correlation coefficient (CCC) and Bland–Altman plots.

Spain.

Two hundred and eighteen healthy Caucasian participants aged 18–65 years participated in this cross-sectional study.

Our proposed equation explained 89·9 % of the variance in the DXA-derived %FM, with a low random error (SEE = 3·00 %), a very strong agreement (CCC = 0·93), no fixed or proportional bias and a relatively low individual variability (5·84 %). However, the Durnin and Womersley equations obtained a fixed bias of –3·65 % when compared with DXA and a greater individual variability (6·74 %).

The proposed equation can accurately estimate %FM in a heterogeneous Caucasian population with a wide age range (18–65 years). Additionally, the Durnin and Womersley equation was inadequate when applied to our participants.

The aim of this study is to conduct a comparative analysis across nations to: (1) identify the determinants influencing knowledge and attitudes related to sodium (Na) intake and (2) to analyse the association between knowledge and attitudes related to Na intake.

We utilised a secondary data from a cross-sectional study that was conducted across seven nations. Structural equation modelling (SEM) was utilised to assess the impact of socio-economic and health-related predictors on knowledge and attitudes pertaining to Na intake and further to investigate the relationship between knowledge and attitude.

Indonesia, Brazil, Thailand, Japan, France, the UK and the USA.

7090 participants aged 15 years and above were included in the study.

SEM analysis showed a strong association between knowledge about Na intake and related attitude across all countries, particularly in the UK (2·65, 95 % CI 1·48–3·82), France (2·62, 1·45–3·79) and the USA (1·97, 1·21–2·73). In Brazil, Japan and France, individuals or family members having certain health conditions such as raised blood pressure, heart diseases, strokes or other diseases exhibited a positive attitude towards reducing Na intake. Conversely, socio-economic factors like education and income demonstrated the complexity of influences on knowledge and attitudes about Na intake.

The study underscores the need for tailored public health interventions to reduce excessive Na consumption, considering the diverse cultural, social and economic factors. It highlights the complex determinants of knowledge and attitudes towards Na intake, calling for further research in varied populations.