To describe food consumption during the school day of rural Jamaican children and participation in two government school feeding programmes. To determine factors which were related to these.

Cross sectional.

16 primary schools in rural Jamaica.

415 children in grades 2 and 5 (ages 7 and 10 years).

Consumption of sweets, sweet drinks and snacks was high. Mean intakes at lunch were: energy 1537 kJ (SD 756), protein 10.4 g (SD 7.6) and iron 1.5 mg (SD 1.2). The mean energy intake was 17–20% of the daily requirement for this age group. Two types of school feeding programmes were available in the schools, one provided a cooked meal and the other a bun and milk. Median availability of school meals (as a percentage of children enrolled in the schools) over three terms was 24.6% (range 0–85.4%). Twenty per cent of the children participated in one or other programme. Poorer children were more likely to participate in the bun and milk programme (odds ratio 2.1, 95% C1 1.3–3.5) but children with more money to purchase food participated in the more costly cooked meal programme (odds ratio 2.4, 95% CI 1.3–4.6).

Energy intakes at lunch in Jamaican children were somewhat below optimal levels and the reliance on sweets and snacks is an area of concern. Programme characteristics such as meal cost, may affect access to school feeding by poor children.

To examine the sociodemographic determinants of fruit and vegetable (F&V) consumption in England and determine the differential effects of socio-economic variables at various parts of the intake distribution, with a special focus on severely inadequate intakes.

Quantile regression, expressing F&V intake as a function of sociodemographic variables, is employed. Here, quantile regression flexibly allows variables such as ethnicity to exert effects on F&V intake that vary depending on existing levels of intake.

The 2003 Health Survey of England.

Data were from 11 044 adult individuals.

The influence of particular sociodemographic variables is found to vary significantly across the intake distribution. We conclude that women consume more F&V than men; Asians and blacks more than whites; co-habiting individuals more than single-living ones. Increased incomes and education also boost intake. However, the key general finding of the present study is that the influence of most variables is relatively weak in the area of greatest concern, i.e. among those with the most inadequate intakes in any reference group.

Our findings emphasise the importance of allowing the effects of socio-economic drivers to vary across the intake distribution. The main finding, that variables which exert significant influence on F&V intake at other parts of the conditional distribution have a relatively weak influence at the lower tail, is cause for concern. It implies that in any defined group, those consuming the least F&V are hard to influence using campaigns or policy levers.

To investigate the relationships between weight reduction behaviour among non-overweight schoolchildren and dietary habits, perception of health, well-being and health complaints.

Analysis of the 2006 Health Behaviour in School-aged Children survey, a cross-sectional study involving schoolchildren aged 10–17 years.

Schools in the Republic of Ireland.

The proportion of children (n 3599) engaged in weight reduction behaviour (‘dieting’ among non-overweight students) was 10·3 %. Older children, females and those from higher social classes (SC) were more likely to report such behaviour. Non-overweight schoolchildren who reported weight reduction behaviour were less likely than those not engaged in such behaviour to frequently consume sweets, soft drinks, crisps and chips/fried potatoes (OR from 0·39 (95 % CI 0·17, 0·89) to 0·72 (95 % CI 0·53, 0·99)); were more likely to consume diet soft drinks (OR 1·50 (95 % CI 1·03, 2·18); and were more likely to miss breakfast during the week (OR 0·62 (95 % CI 0·48, 0·80). The risk of subjective health complaints increased (OR from 1·47 (95 % CI 1·13, 1·91) to 1·92 (95 % CI 1·48, 2·49)); as did body dissatisfaction (OR 9·17 (95 % CI 6·99, 12·02)), while perception of health and well-being decreased (OR 0·47 (95 % CI 0·36, 0·61)) to 0·54 (95 % CI 0·41, 0·70)). All analyses were controlled for age, gender and SC.

Weight reduction behaviour among non-overweight schoolchildren is associated with considerable risk to physical health and emotional well-being. Since the risks associated with such behaviour varies by weight status, health professionals and researchers need to consider these issues in parallel.

To (i) identify the major temporal patterns of energy intake among adults; (ii) examine the association between employment status and the patterns; and (iii) examine the association between dietary quality and the patterns.

Secondary analysis based on the cross-sectional population-based nutrition survey in Taiwan, 2005–2008. Based on energy intake levels at six time intervals of a day derived from 24 h recall data, we applied cluster analysis to identify major temporal patterns of energy intake. Self-reported employment status was categorized into six groups: full-time, part-time, no job, student, homemaker and retired. Multinomial logistic regression models were fitted to test the association between temporal patterns of energy intake and employment groups.

Non-institutionalized community dwellers.

Non-pregnant adults (≥19 years old) with total energy intake between 2092 and 20920 kJ/d (500 and 5000 kcal/d; n 4508).

Five major patterns were identified, which can be seen as the traditional meal pattern and its variants. About 20 % of adults had the traditional pattern. The most prevalent pattern was the delayed morning meal pattern (33 %), which had lower Ca and P intakes than the traditional pattern. About 14 % of adults had the delayed lunchtime pattern, which had lower protein, PUFA, fibre, Ca, P, vitamin D and vitamin E intakes than the traditional. Adjusted prevalence of the delayed lunchtime pattern was highest among full-time students (34 %), followed by part-time workers (24 %), and was lower in retired (8 %), homemakers (11 %) and full-time employed adults (12 %).

Adults’ temporal patterns of energy intake, which varied with their employment status, affected their dietary quality.

To update the estimation of the prevalence of anaemia in Brazilian children according to four different epidemiological scenarios.

A new systematic review was conducted with a meta-analysis of the results published between 2007 and May 2019. Literature search was carried out in the PubMed and LILACS databases using keywords anaemia, child and Brazil. A total of thirty-seven articles (17 741 children) were selected and categorised according to the origin of their respective samples: childcare centres (Childcare; n 13 studies/2697 individuals), health services (Services; n 4/755), populations with social inequities (Inequities, n 7/6798) and population-based studies (Populations; n 13/7491). Assuming a prevalence of 20·9 % as reference (Health National Survey; n 3455), the combined prevalence ratios (PR) were calculated. A random-effects model was used.

Brazilian children 6–60 months of age.

The prevalence of anaemia, by scenario, was: Childcare 24·8 % (PR 1·06; 95 % CI 0·81, 1·40); Services 39·9 % (PR 1·76, 95 % CI 1·33, 2·35); Inequities 51·6 % (PR 2·02, 95 % CI 1·87, 2·18); and Populations 35·8 % (PR 1·42, 95 % CI 1·23, 1·64). Therefore, the values were all higher than the national prevalence; the Inequities had the highest prevalence, and only Childcare did not reach statistical significance. Concerning the previous meta-analysis, there was a reduction in anaemia prevalence in all scenarios: –52·3, –33·7, –22·4 and –10·7 %, respectively.

Compared to the situation revealed in the previous meta-analysis, anaemia, although observed to a lesser extent, remains an important public health problem in the different scenarios analysed, especially for children living in Inequities. Access to Childcare mitigates the risk for this condition.

To determine the presence of nutrition labels on pre-packaged food products, as well as to analyse the types of presentation.

This was a descriptive study. The following characteristics were analysed: (i) presence and placement of the nutrition declaration (either as front-of-pack (FOP) or back-of-pack (BOP)); (ii) content of the presented information; (iii) presence of nutrition and health claims; and (iv) legibility of the written information.

Three different types of retailers in Belgrade, Serbia.

A total of 2138 pre-packaged food products from ten categories.

A nutrition declaration was found on 65·9 % of all tested products. It was displayed on the back of the packaging of 62·7 % of products and on the front of the packaging of 19·1 % of products. BOP was the most commonly observed in breakfast cereals, soft drinks, milk and instant soups (in total over 90 %), and the least common in meat products (21·5 %). FOP was predominantly displayed on breakfast cereals (65·0 %) and the least frequently on milk products (2·4 %). The ‘Big 4’ (energy value, protein, carbohydrate and fat contents) and the ‘Big 4 with additional information’ figured on 40·9 % of products. The ‘Big 8’ (‘Big 4’ plus sugar, saturated fat, fibre and sodium contents) and the ‘Big 8 with additional information’ were present less frequently (20·5 %). Nutrition claims and health claims appeared on very few products (6·6 % and 6·3 %, respectively). The proportion of products with insufficient legibility was 31·5 %.

Nutrition labelling in Belgrade, Serbia is not satisfactory. Mandatory regulations may be the best way to improve the current situation.

To determine whether the prevalence of stunting differed between an intervention group and a control group and to identify factors associated with the children’s linear growth.

This was a follow-up study of mother–child pairs who participated in a 2012–2015 cluster randomised controlled trial. Linear mixed effects models were performed to model the children’s linear growth and identify the determinants of child linear growth.

The study was conducted in two slums in Nairobi. The intervention group received monthly nutrition education and counselling (NEC) during pregnancy and infancy period.

A birth cohort of 1004 was followed up every 3 months after delivery to the 13th month. However, as a result of dropouts, a total of 438 mother–child pairs participated during the 55-month follow-up. The loss to follow-up baseline characteristics did not differ from those included for analysis.

Length-for-age z-scores decreased from birth to the 13th month, mean –1·42 (sd 2·04), with the control group (33·5 %) reporting a significantly higher prevalence of stunting than the intervention group (28·6 %). Conversely, the scores increased in the 55th month, mean –0·89 (sd 1·04), with significantly more males (16·5 %) stunted in the control group than in the intervention group (8·3 %). Being in the control group, being a male child, often vomiting/regurgitating food, mother’s stature of <154 cm and early weaning were negatively associated with children’s linear growth.

Home-based maternal NEC reduced stunting among under five years; however, the long-term benefits of this intervention on children’s health need to be elucidated.

To assess viewer engagement of a food advertising campaign on the live streaming platform Twitch.tv, a social media platform that allows creators to live stream content and communicate with their audience in real time.

Observational analysis of chat comments across the Twitch platform containing the word ‘Wendy’s’ or ‘Wendys’ during a 5-day ad campaign compared with two 5-day non-campaign time periods. Comments were categorised as positive, negative or neutral in how their sentiment pertained to the brand Wendy’s.

Twitch chatrooms.

None.

There were significantly more chatroom messages related to the Wendy’s brand during the campaign period. When considering all messages, the proportion of messages was statistically different (x2 = 1417·41, P < 0·001) across time periods, with a higher proportion of neutral and positive messages and a lower proportion of negative messages during the campaign compared with the comparison periods. Additionally, the proportion of negative messages following the campaign was lower than before the campaign. When considering only positive and negative messages, the proportion of messages was statistically different (x2 = 366·38, P < 0·001) across each time period with a higher proportion of positive messages and a lower proportion of negative messages during the campaign when compared with the other time periods. Additionally, there was a higher proportion of positive messages and a lower portion of negative messages following the campaign when compared with before the campaign.

This study demonstrates the impact and sustained impact of a fast-food brand ad campaign on brand engagement on the live streaming platform Twitch.

To investigate the relationship between the intake of sugar-containing beverages (SCB) at the age of 13 years and adult weight status 24–30 years later.

A longitudinal study with 30 years of follow-up from adolescence (age 13 years in 1976) to adulthood (up to 2000 and 2006). Dietary intake was assessed through cross-check dietary history face-to-face interviews by a dietitian. Beverages were divided into two categories: (i) total SCB and (ii) SCB excluding 100 % fruit juices. Percentage of total fat (%total fat) and percentage of trunk fat (%trunk fat) were obtained through dual-energy X-ray absorptiometry measurements; body weight and height were measured by trained staff.

Amsterdam Growth and Health Longitudinal Study, the Netherlands.

One hundred and fourteen males and 124 females.

In males, but not in females, each additional daily serving of SCB excluding 100 % fruit juices at 13 years was associated with 1·14 % higher %total fat (95 % CI 0·04, 2·23 %; P = 0·04) and 1·62 % higher %trunk fat (95 % CI 0·14, 3·10 %; P = 0·03) in adulthood after correction for confounders. No statistically significant relationship was found between the intake of SCB excluding 100 % fruit juices at the age of 13 and BMI in both sexes. In addition, no statistically significant relationships were found between the intake of total SCB and all measures of adult weight status in both sexes.

Intake of SCB excluding 100 % fruit juices at the age of 13 years was positively associated with adult %total fat and %trunk fat in males, but not in females.

To investigate (i) changes in stakeholder commitment and (ii) perceptions of the purpose, challenges and benefits of healthy food and beverage provision in community sports settings during the stepwise implementation of a healthy beverage policy.

Convergent, parallel, mixed-methods design complemented (i) repeat semi-structured interviews with council stakeholders (n 17 interviews, n 6 interviewees), with (ii) repeat quantitative stakeholder surveys measuring Commitment to Organisational Change; (iii) weekly sales data examining health behaviour and revenue effects (15 months pre-intervention; 14 months post-intervention); (iv) customer exit surveys (n 458); and (v) periodic photographic audits of beverage availability. Interviews were analysed inductively. Stakeholder surveys, sales data, customer surveys and audits were analysed descriptively.

Four local government-owned sports and recreation centres in Melbourne, Australia, completed a 3-month trial to increase the availability of healthy beverages and decrease the availability of unhealthy beverages in food outlets.

Interviews were conducted with council managers and those involved in implementation (September 2016–October 2017). Customers were surveyed (September–October 2017).

Interviews and surveys indicated that stakeholders’ commitment to policies varied such that, over time, optimism that changing beverage availability could increase the healthiness of customers’ purchases became more widespread among interviewees. Stakeholder focus generally progressed from anticipatory concern to solutions-focused discussions. Sales, audit and customer survey data supported interview findings.

We found a general increase in optimism regarding policy outcomes over time during the implementation of a healthy beverage policy. Stepwise trials should be further explored as an engagement tool within community retail settings.

To describe the extent of use of medicines by older people living in Britain, and to explore relationships with vitamin status indices.

The National Diet and Nutrition Survey of people aged 65 years and over collected data from a British sample during 1994–95. The present study has made novel use of it, to relate medicine use with biochemical indices of vitamin status.

Eighty postcode areas, selected randomly from mainland Britain.

1506 people, 65 years and over gave information about use of medication, and a 4-day weighed food record. Three-quarters gave blood for status indices.

78% of those living in the community and 93% of those in institutions were using medication. Certain vitamin status indices: plasma retinol, erythrocyte folate and riboflavin, paradoxically suggested better status in users than in non-users of antihypertensive, gastrointestinal, central nervous system, corticosteroid or diabetic drugs. There was evidence of a link with renal insufficiency, especially for plasma retinol, but neither this nor increased nutrient intake, acute phase effects or haemoconcentration could explain the paradoxical associations.

Caution is needed in interpreting certain vitamin status indices, especially in older people who are extensively using medicines. New vitamin indices are needed, to avoid confounding interferences.

The objectives of the study were to describe outcomes of children with uncomplicated severe acute malnutrition (SAM) attending community-based management of acute malnutrition (CMAM) treatment centres in Accra Metropolitan Area (AMA) and explore factors associated with non-adherence to clinic visits and defaulting from the treatment programme.

A retrospective cohort study analysing routinely collected data on children with uncomplicated SAM enrolled into CMAM in 2017 was conducted.

Study was conducted at seven sites comprising Princess Marie Louise Children’s Hospital, three sub-metropolitan health facilities and three community centres, located in five sub-metropolitan areas in AMA.

Children with uncomplicated SAM aged 6–59 months, enrolled from community-level facilities (pure uncomplicated SAM, PUSAM) or transferred after completing inpatient care (post-stabilisation uncomplicated SAM, PSSAM), participated in the study.

Out of 174 cases studied (105 PUSAM, sixty-nine PSSAM), 56·3 % defaulted, 34·5 % recovered and 8·6 % were not cured by 16 weeks. No deaths were recorded. Mid-upper arm circumference (MUAC) increased by 2·2 (95 % CI 1·8, 2·5) mm/week with full compliance and 0·9 (95 % CI 0·6, 1·2) mm/week with more than two missed visits. In breast-feeding children, MUAC increased at a slower rate than in other children by 1·3 (95 % CI 1·0, 1·5) mm/week. Independent predictors of subsequent missed visits were diarrhoea and fever, while children with MUAC < 110 mm on enrolment were at increased risk of defaulting.

A high default rate and a long time to recovery are challenges for CMAM in AMA. Efforts must be made to improve adherence to treatment to improve outcomes.

The aim of the study was to examine the daily variations in sales data for individual food items in a supermarket and to assess the usefulness of the computerized sales data of supermarkets for reliable monitoring and evaluation of shopping behaviour.

Longitudinal observational study.

The study was carried out in one supermarket in Mikkeli, Finland. Seventy-nine packed food items from food groups important for salt and fat intake were monitored. In all food groups both ‘healthier’ and ‘reference’ products were included for assessment of both direct sales and proportional sales. The sales data were collected daily for 2 months in May and September 1996 by reading the European Article Numbering (EAN) codes of the packed foods.

The proportional sales turned out to be a more stable and useful measure than the direct sales data and the variation remained the same when the monitoring time was increased from 1 week to 1 month.

Proportional sales data are proposed as a tool for measuring the effect of nutrition interventions and also as a possible indirect assessment for population salt and fat intake.

Some versions of restaurant menu labelling legislation do not require energy information to be posted on menus for drive-through lanes. The present study was designed to quantify the number of customers who purchase fast food through drive-in windows as a means of informing legislative labelling efforts.

This was an observational study.

The study took place at two McDonald’s and Burger King restaurants, and single Dairy Queen, Kentucky Fried Chicken, Taco Bell and Wendy’s restaurants.

The number of customers entering the chain restaurants and purchasing food via the drive-through lane were recorded. A total of 3549 patrons were observed.

The percentage of customers who made their purchases at drive-throughs was fifty-seven. The overall average (57 %) is likely a conservative estimate because some fast-food restaurants have late-night hours when only the drive-throughs are open.

Since nearly six in ten customers purchase food via the drive-through lanes, menu labelling legislation should mandate the inclusion of menu labels on drive-through menu boards to maximise the impact of this public health intervention.

While scholarship has investigated how to provide more healthy food options in choice pantry environments, research has just begun to investigate how pantry users go about making decisions regarding food items when the ability to choose is present. The present analysis sought to investigate the factors prohibiting and inhibiting food decision making in choice pantries from the perspective of frequent pantry users.

Six focus group interviews were conducted with visitors to choice food pantries, to discuss the decision-making process involved in food selection during choice pantry visits. Each was provided a $US 15 remuneration for taking part.

A school-based choice food pantry in Anderson, Indiana, USA, a small Midwestern community.

Thirty-one men and women, largely aged 45–64 years, who made use of choice food pantries at least once monthly to meet their family’s food needs.

Choice pantry visitors indicated that the motivation to select healthy food items was impacted by both individual and situational influences, similar to retail environments. Just as moment-of-purchase and place-of-purchase factors influence the purchasing of food items in retail environments, situational factors, such as food availability and the ‘price’ of food items in point values, impacted healthy food selection at choice pantries. However, the stigmatization experienced by those who visit pantries differs quite dramatically from the standard shopping experience.

Choice pantries would benefit from learning more about the psychosocial factors in their own pantries and adapting the environment to the desires of their users, rather than adopting widely disseminated strategies that encourage healthy food choices with little consideration of their unique clientele.

To assess the nutritional quality of prepared foods available to primary-school children.

Prepared foods available in a public and private school were sampled daily for 4 weeks (a total of forty-five samples) and chemically analysed for protein, fat, carbohydrate, iron, salt and sodium. The results were compared to the nutritional standards for children aged 7–10 years.

Alfenas, south-eastern Brazil.

The concentration of protein, lipid, iron and sodium and the energy values of the foods at the private school were significantly higher than those at the public school. No differences were seen in the carbohydrate and salt values. The range of macronutrients was more balanced at the public school in relation to fat and protein. Foods at the private school were, in general, energy-dense. At both the public and private school, they provided the minimum energy and iron. Salt content was over twice the maximum amount, and that for sodium was over three times the amount, in both the public and private school.

Overall, foods prepared at the public school were better nutritional quality than those at the private school and those offered in public schools in some developed countries. This finding can probably be explained by the fact that a nutritionist, as required by law, was responsible for planning the menus at the public school. However, corrective action is needed to adjust for the wide variability in energy and nutrient content during weekdays and in the sodium content of prepared foods available in both the public and private school.

Nutrition is one of the modifiable risk factors of atherosclerosis vascular diseases (VD). We aimed to (i) evaluate the dietary patterns associated with VD in clinical practice using a validated FFQ; and (ii) determine potential independent sociodemographic and behavioural factors that are involved in such dietary patterns. The FFQ determined the vascular dietary score (VDS; ranges from −17 to 19) for each subject.

Cross-sectional study.

A general practitioner's (GP) office in 2009.

A total of 250 French subjects (18–84 years old).

A total of 21 % had a favourable vascular diet (VDS ≥ 8), 79 % needed to improve their diet (VDS < 8) and 21 % had a risky vascular diet (VDS ≤ −1). A step-by-step multivariate linear regression analysis with stepwise selection was performed using the VDS as a dependent variable. Significant variables were: age (β = 0·495, P < 0·0001), men (β = −0·282, P < 0·0001), ‘sport ≥1 h/week’ (β = 0·253, P = 0·001), ‘walking 20 min/d’ (β = 0·161, P = 0·012), ‘former smoker’ (β = 0·118, P = 0·029), previous nutritional advice (β = 0·105, P = 0·049), ‘alcohol ≥20 g/d’ (β = −0·216, P < 0·0001) and ‘primary school’ (β = −0·156, P = 0·010). The R2 coefficient of this model was 0·347 (P < 0·0001). In all, 88·7 % of the subjects found the evaluation very interesting and 89·6 % believed that the GP should perform it.

Simple dietary assessment for VD prevention can be easily performed in clinical practice to allow physicians to give objective and rapid advice for each patient. Age, educational status, alcohol consumption, gender and physical activity are associated with the VDS. Compliance with such evaluation was found to be very high, which should encourage larger dietary screening in the population in order to reduce the impact of VD.

The study aimed to evaluate the dietary vitamin B6 intake and determine the vitamin B6 concentration in blood samples of German vegans.

Cross-sectional study with 33 examination sites all over Germany.

Ninety-three vegans (50 females) with a mean (±standard deviation (SD)) age of 43.7 ± 15.7 years who took no vitamin supplements.

Dietary intake was assed using a semi-quantitative food-frequency questionnaire. Erythrocyte aspartate aminotransferase activity coefficient (EAST-AC) was calculated as the ratio of stimulated (pyridoxal 5'-phosphate added) to unstimulated activity in blood samples that were provided after an overnight fast.

Mean ± SD vitamin B6 intake was 2.83 ± 0.98 mg day−1 and mean ± SD protein intake was 56.6 ± 21.7 g day−1. Of the participants 4% showed vitamin B6 intakes lower than daily recommended intakes for Germany, 16% showed EAST-AC > 1.85, and a further 58% showed EAST-AC of 1.5–1-85. Moderate vegans were affected to a lesser extent than strict vegans. None of the established confounders was a significant predictor of EAST-AC. In logistic regression analyses the contribution of nutriments and cereals to pyridoxine intake was the only predictor of EAST-AC classified as < 1.85 and ≥ 1.85, respectively.

In spite of the high total intake of vitamin B6, an adequate concentration in blood samples could not be realised for a majority of the participants. Due to the health implications of a marginal pyridoxine status, vegans should be encouraged to include foods with a high bioavailability of pyridoxine, such as beans, lentils and bananas, in the daily diet.