To date, there have been few studies on dietary supplement (DS) use in Korean children and adolescents, using nationally representative data. This study aimed to investigate the current status of DS use and its related factors, among Korean children and adolescents from the Korean National Health and Nutrition Examination Survey (KNHANES) data.

A cross-sectional study.

Data from the KNHANES 2015–2017. Participants completed 24-h dietary recall interviews, including DS products that the subjects consumed.

The study population was 4380 children and adolescents aged 1–18 years.

Approximately 2013 % of children and adolescents were using DS; the highest use was among children aged 1–3 years old, and the lowest use was among adolescents aged 16–18 years. The most frequently used DS was prebiotics/probiotics, followed by multivitamin/mineral supplements. Factors that were associated with DS use were lower birth weight in children aged <4 years; younger age, higher household income, regular breakfast intake and lower BMI in children aged 4–9 years; and regular breakfast intake and use of nutrition facts label in adolescents aged 10–18 years. Feeding patterns in infancy and having chronic diseases were not associated with DS use.

We report that over 20 % of children and adolescents use DS. Nutritional education for parents and children about proper DS consumption is needed.

We aimed at evaluating the association of maternal pre-pregnancy nutritional status with offspring anthropometry and body composition. We also evaluated whether these associations were modified by gender, diet and physical activity and mediated by birth weight.

Birth cohort study.

Waist circumference was measured with an inextensible tape, and fat and lean mass were measured using dual-energy X-ray absorptiometry. Multiple linear regression was used to adjust for possible confounders and allele score of BMI. We carried out mediation analysis using G-formula.

In 1982, 1993 and 2004, all maternity hospitals in Pelotas (South Brazil) were visited daily and all live births whose families lived in the urban area of the city were evaluated. These subjects have been followed up at different ages.

Offspring of obese mothers had on average higher BMI, waist circumference and fat mass index than those of normal weight mothers, and these differences were higher among daughters. The magnitudes of the association were similar in the cohorts, except for height, where the association pattern was not clear. In the 1982 cohort, further adjustment for a BMI allele score had no material influence on the magnitude of the associations. Mediation analyses showed that birth weight captured part of this association.

Our findings suggest that maternal pre-pregnancy nutritional status is positively associated with offspring BMI and adiposity in offspring. And this association is higher among daughters whose mother was overweight or obese and, birth weight explains part of this association.

To identify the association of individual and school environment factors with overweight among adolescents.

Cross-sectional study. Sociodemographic and behavioural information was collected using an anonymous self-administered questionnaire. Indicators on human and physical resources of the schools were based on information collected in interviews with school principals. Overweight was defined based on the BMI Z-score for age and sex recommended by WHO. Logistic regression models were used for statistical analysis.

Rio de Janeiro, Brazil.

By means of a two-stage (classrooms and students) probabilistic sampling, subjects comprised 1632 students enrolled in the last year of primary education of the municipal public school network, stratified by city region.

The mean prevalence of overweight at schools was 17·2 %, ranging from 0 % to 50 %. Adolescents more likely to be overweight were those who attended schools without knives and forks or ceramic/glass plates for students in the school refectory (prevalence odds ratio (POR) = 1·40; P = 0·04), those whose head of household had completed between 8 and 10 years of schooling (POR = 1·46; P = 0·03), those who did not live with both parents (POR = 1·24; P = 0·06) and those who had not practised physical activity outside school on at least 1 d in the 7 d before the study (POR = 1·56; P = 0·04).

Sociodemographic and behavioural variables of adolescents and school characteristics were associated with overweight, confirming individual and context effects on this health disorder. Studies such as the present one, identifying variables in context, may support actions to prevent overweight among adolescents.

To identify facilitators and barriers that Health Canada’s (HC) cross-sector partners experienced while implementing the Eat Well Campaign: Food Skills (EWC; 2013–2014) and describe how these experiences might differ according to distinct partner types.

A qualitative study using hour-long semi-structured telephone interviews conducted with HC partners that were transcribed verbatim. Facilitators and barriers were identified inductively and analysed according partner types.

Implementation of a national mass-media health education campaign.

Twenty-one of HC’s cross-sector partners (food retailers, media and health organizations) engaged in the EWC.

Facilitators and barriers were grouped into seven major themes: operational elements, intervention factors, resources, collaborator traits, developer traits, partnership factors and target population factors. Four of these themes had dual roles as both facilitators and barriers (intervention factors, resources, collaborator traits and developer traits). Sub-themes identified as both facilitators and barriers illustrate the extent to which a facilitator can easily become a barrier. Partnership factors were unique facilitators, while operational and target population factors were unique barriers. Time was a barrier that was common to almost all partners regardless of partnership type. There appeared to be a greater degree of uniformity among facilitators, whereas barriers were more diverse and unique to the realities of specific types of partner.

Collaborative planning will help public health organizations anticipate barriers unique to the realities of specific types of organizations. It will also prevent facilitators from becoming barriers. Advanced planning will help organizations manage time constraints and integrate activities, facilitating implementation.

This paper reports on the status of lactose digestion during early and late pregnancy and at 8 weeks postpartum in an African-American population. The hypothesis is that lactose digestion and milk tolerance do not change throughout pregnancy anddo not differ from those of non-pregnant African-American women.

This longitudinal study determined lactose digestion after ingesting 240 ml of 1% fat milk containing 12g of lactose at: (1) early pregnancy, prior to 16 weeks (n = 148); (2) late pregnancy, 30–35 weeks (n = 77); and (3) 8 weeks postpartum (n = 93). One hundred and one comparably matched non-pregnant African-American women served as controls.

Prevalence of lactose digestion, as measured by breath hydrogen, was 80.2% in the control women, 66.2% in early pregnancy, 68.8% in late pregnancy and 75.3% postpartum. The prevalence of women reporting symptoms was approximately 20% regardless of lactose absorption status. However, the control women reported significantly more symptoms than did the pregnant women.

This study indicates that there is no significant change in lactose digestion during pregnancy. The prevalence of lactose intolerance for the pregnant African-American women studied is similar to that for non-pregnant African-American women and similar to previous prevalence reports in adult African-Americans. There was no change in the tolerance of lactose noted during pregnancy in these women. There were, however, fewer symptoms reported by the lactose-maldigesting pregnant women.

We analysed the impact of the national general truck drivers’ strike on the availability, variety and price of foods sold by a food supply centre.

Descriptive study using secondary data to examine the percentage change in the mean price of fruits, vegetables and eggs before, during and after the strike. The strike in Brazil lasted 10 d from 21 to 30 May 2018. The drivers were on strike in order to make diesel oil tax-free and to obtain better working conditions.

The food supply centre, named CEASA-Minas Grande BH, was located in the metropolitan area of a Brazilian city.

We examined twenty types of foods.

After 10 d, there was a ~30 % reduction in the availability of all types of foods and prices increased. Foods with the highest price increases included cabbage (233·3 %), potatoes (220·0 %), papaya (160·0 %) and oranges (78·6 %). At the end of the strike, we observed reductions in the price of eggs, fruits, vegetables, roots and tubers; however, some foods remained more expensive than before the strike, including chayote (203·2 % higher), cucumber (66·7 % higher) and potatoes (60·0 % higher).

The general truck drivers’ strike was correlated with a reduction in the availability of food and, consequently, increases in price and possibly restrictions on access. The strike demonstrated the dependence of metropolises on road transportation and the conventional market. We speculate that initiatives aiming to shorten the food supply chain and promote food sovereignty and resilience of the supply circuits could be important.

To identify ingredients from products and by-products derived from GM crops in packaged food products and to analyse the presence of these ingredients in the foods most commonly consumed by the Brazilian population.

Cross-sectional study.

A search of the scientific literature to identify the use of products and by-products derived from GM crops in foods in Brazil and a study of food labels in a supermarket belonging to one of the ten largest supermarket chains in Brazil.

To identify the ingredients present in packaged food products and their nomenclatures, the labels of all packaged food products available for sale in a supermarket were analysed. Subsequently, the presence of potential GM ingredients in the foods most commonly consumed by the Brazilian population was analysed.

A total of twenty-eight GM crops’ by-products with applications in the food industry (from soyabeans, corn, cotton and a yeast) were identified. Such by-products are presented as food ingredients or additives on food labels with 101 distinct nomenclatures. Most of the variety (63·8 %) and the quantity (64·5 %) of the foods most commonly consumed by Brazilians may contain a least one GM ingredient.

The presence of at least one potential GM ingredient was observed in more than half of the variety of foods most commonly consumed by the Brazilian population. Such ingredients were identified with distinct nomenclatures and incomplete descriptions, which may make it difficult to identify potential GM foods and confuse consumers when making food choices.

To assess dietary fatty acid intakes and to examine the relationship between dietary sources of n-3 and n-6 PUFA and red-blood-cell (RBC) n-3 and n-6 PUFA composition.

A cross-sectional study. Dietary intakes were assessed with a 24 h dietary recall. A second recall was performed for 44 % of the children. Usual dietary intakes were estimated with the Software for Intake Distribution Estimation (SIDE). The fatty acid composition was measured in RBC membranes. Multivariate linear regression analyses were performed to explain RBC n-3 and n-6 PUFA concentrations.

Child-care centres in Nunavik, northern Québec, Canada.

One hundred and sixty-seven Inuit children aged 11–53 months.

A high proportion of the participants had inadequate n-3 and n-6 PUFA intakes (47·9 % and 93·5 %, respectively). Breast-feeding status and consumption of traditional food during the first 24 h dietary recall were significantly associated with RBC n-3 PUFA levels. Older children also tended to have higher RBC n-3 PUFA levels (P = 0·0528), whereas sex, infant formula status and n-3 PUFA dietary intakes were not associated with RBC n-3 PUFA concentrations. RBC n-6 PUFA concentrations were positively associated with breast-feeding status and n-6 PUFA dietary intakes, whereas age, sex and infant formula status were not.

The present findings highlight the fact that Inuit pre-school children are not consuming enough n-3 and n-6 PUFA for optimum health. These observations call for actions to increase traditional food intake among Inuit children and to help them and their parents make healthier store-bought food choices.

The effects of adverse childhood experiences (ACE) on children and adolescents’ health status such as obesity are understudied. The current study addressed the effect of ACE on obesity status during childhood utilising multiple waves of national panel data.

Longitudinal survey.

Data were drawn from three waves of the second cohort of the National Survey of Child and Adolescent Well-Being (NSCAW II). NSCAW II study sampled cases from Child Protective Services investigations that were closed between February 2008 and April 2009 nationwide. We measured ACE cumulatively and as separate events and stratified by gender.

Totally, 3170 youth births to 14 years of age at baseline.

A count measure of ACE is indeed associated with greater odds of obesity during childhood. Differential effects for different types of ACE were also found, most notably neglect. For girls, physical and psychological neglect increased odds of obesity.

Findings support evidence for the importance of using both a count measure of ACE as well as separating out single events by gender.

The present study aimed to compare different indicators of obesity in the Serbian adult population.

Cross-sectional study. A stratified, two-stage, national-representative random sampling approach was used for the selection of the survey sample. Data sources were questionnaires created according to the European Health Interview Survey questionnaire. Measurements of weight, height and waist circumference (WC) were performed using standard procedures. Anthropometric measures included BMI, WC and waist-to-height ratio (WHtR).

Data for the study were obtained from the 2013 National Health Survey, performed in line with the EUROSTAT recommendations for performance of the European Health Interview Survey.

Adults aged ≥20 years.

According to BMI, out of the whole studied population (12 460 adults of both sexes) 2·4 % were underweight, 36·4 % overweight and 22·4 % obese. Using WC and WHtR as measures of adiposity showed that 22·5 % and 42·8 % of participants were overweight and 39·8 % and 25·3 % were obese, respectively. Men and women differed significantly in all variables observed. Overweight was more frequent in men and obesity in women regardless of adiposity measure used.

In spite of strong correlations between BMI, WC and WHtR, substantial discrepancies between these three measures in the assessment of overweight and obesity were found, especially in some age groups. Which of these anthropometric measures should be used, or whether two or all three of them should be applied, depends on their associations with cardiovascular or some other disease of interest.

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 and evaluate a Nutrition Transition-FFQ (NT-FFQ) to measure nutrition transition among adolescents in South India.

We developed an interviewer-administered NT-FFQ comprising a 125-item semi-quantitative FFQ and a twenty-seven-item eating behaviour survey. The reproducibility and validity of the NT-FFQ were assessed using Spearman correlations, intra-class correlation coefficients (ICC), and levels of agreement using Bland–Altman and cross-classification over 2 months (NT-FFQ1 and NT-FFQ2). Validity of foods was evaluated against three 24-h dietary recalls (24-HR). Face validity of eating behaviours was evaluated through semi-structured cognitive interviews. The reproducibility of eating behaviours was assessed using weighted kappa (κw) and cross-classification analyses.

Vijayapura, India.

A representative sample of 198 adolescents aged 14–18 years.

Reproducibility of NT-FFQ: Spearman correlations ranged from 0·33 (pulses) to 0·80 (red meat) and ICC from 0·05 (fruits) to 1·00 (tea). On average, concordance (agreement) was 60 % and discordance was 7 % for food groups. For eating behaviours, κw ranged from 0·24 (eating snacks while watching television) to 0·67 (eating lunch at home) with a mean of 0·40. Validity of NT-FFQ: Spearman correlations ranged from 0·11 (fried traditional foods) to 0·70 (tea) and ICC ranged from 0·02 (healthy global foods) to 1·00 (grains). The concordance and discordance were 48 % and 8 %, respectively. Bland–Altman plots showed acceptable agreement between NT-FFQ2 and 24-HR. The eating behaviours had acceptable face validity.

The NT-FFQ has good reproducibility and acceptable validity for food intake and eating behaviours. The NT-FFQ can quantify the nutrition transition among Indian adolescents.

Rice consumption patterns are considered an important risk factor for diabetes in many countries. The present study aimed to model the impact of a shift in consumption of white rice from current to appropriately reduced levels and a shift in rice variety from one with a high glycaemic index to one with a low glycaemic index, on the burden of type 2 diabetes in Cambodia.

Prevent Plus software was used to model the impact of selected changes to white rice consumption on the burden of type 2 diabetes. Data used for modelling included: demographic projections, relative risk estimates for white rice consumption and diabetes, diabetes incidence, rice type and quantities consumed. The 10-year projections were based on different scenarios of changes in risk factors.

With no intervention, 10-year projections showed that total new diabetes cases will increase from 11 315 (9·1 per 10 000 person-years) for the year 2011 to 14 852 new cases (12·4 per 10 000 person-years) in 2020. However, this increase will be reduced by 27 % (average across 10 years) with a change in rice variety from Phka Rumdual to IR66 and by 26 % (average across 10 years) with a 25 % reduction in quantity from current consumption levels.

Changing rice consumption patterns has potential for an important impact on diabetes risk, with a change of rice variety having a similar impact on the burden of diabetes in communities consuming rice with a high glycaemic index as a 25 % reduction in the quantity of rice consumed. Similar effects are likely for other countries with rice as a staple food, diversity in rice varieties and high incidence of diabetes.

The present study investigated whether food package information is legible in a real purchase context; more specifically, it examined the level of legibility of non-mandatory, mandatory and nutritional information as well as the influence of age on legibility. This is an important issue, especially for older consumers who are usually advised to pay attention to their diet.

An in-store study was conducted in a French hypermarket. Descriptive statistics were used to measure the overall level of legibility and then ANOVA tests were carried out to examine the influence of age on the legibility of information. Complementary results included the influence of level of education.

Participants were asked to read information on four food packages when they were food shopping.

The sample included 196 consumers aged 18–82 years.

An asymmetry was observed between the extremely high level of legibility of non-mandatory information and the low level of legibility of mandatory and nutritional information provided on food packages. Elderly respondents performed significantly worse than their younger counterparts. An interaction effect was found between age and level of education on the legibility of mandatory information.

Legibility of mandatory information is clearly unsatisfactory. There appears to be a hierarchy between significant, but non-mandatory, company information and important mandatory and nutritional information. The first type of information is promoted on food packages whereas the last two are all but concealed to older and less educated consumers.

To examine the association between protective lifestyle behaviours (PLB) and depression in middle-aged Irish adults.

Secondary analysis of a cross-sectional study. PLB (non-smoker, moderate alcohol, physical activity, adequate fruit and vegetable intake) were assessed using a general health and lifestyle questionnaire and a validated FFQ. Depression was assessed using the Center for Epidemiologic Studies Depression Scale. A score of 15–21 indicates mild/moderate depression and a score of 22 or more indicates a possibility of major depression. Binary logistic regression was used to examine the association between PLB and depression.

Livinghealth Clinic, Mitchelstown, North Cork, Republic of Ireland.

Men and women aged 50–69 years were selected at random from a list of patients registered at the clinic (n 2047, 67 % response rate).

Over 8 % of participants engaged in zero or one PLB, 24 % and 39 % had two and three PLB respectively, while 28 % had four PLB. Those who practised three/four PLB were significantly more likely to be female, have a higher level of education and were categorised as having no depressive symptoms. Engaging in zero or one PLB was significantly associated with an increased odds of depression compared with four PLB. Results remained significant after adjusting for several confounders, including age, gender, education and BMI (OR=2·2; 95 % CI 1·2, 4·0; P for trend=0·001).

While causal inference cannot be established in a cross-sectional study, the findings suggest that healthy behaviours may play a vital role in the promotion of positive mental health or, at a minimum, are associated with lower levels of depression.

The present study’s aim was to assess the impact of a nutrition-sensitive intervention on dietary diversity and home gardening among non-participants residing within intervention communities.

The study was a cross-sectional risk factor analysis using linear and logistic multivariate models.

In Tanzania, women and children often consume monotonous diets of poor nutritional value primarily because of physical or financial inaccessibility or low awareness of healthy foods.

Participants were women of reproductive age (18–49 years) in rural Tanzania.

Mean dietary diversity was low with women consuming three out of ten possible food groups. Only 23·4 % of respondents achieved the recommended minimum dietary diversity of five or more food groups out of ten per day. Compared with those who did not, respondents who had a neighbour who grew crops in their home garden were 2·71 times more likely to achieve minimum dietary diversity (95 % CI 1·60, 4·59; P=0·0004) and 1·91 times more likely to grow a home garden themselves (95 % CI 1·10, 3·33; P=0·02). Other significant predictors of higher dietary diversity were respondent age, education and wealth, and number of crops grown.

These results suggest that there are substantial positive externalities of home garden interventions beyond those attained by the people who own and grow the vegetables. Cost-effectiveness assessments of nutrition-sensitive agriculture, including home garden interventions, should factor in the effects on the community, and not just on the individual households receiving the intervention.

The present paper aimed to identify the stakeholders, as well as their arguments and recommendations, in the debate on the application of a food processing-based classification system to the new Brazilian Food Guide.

Qualitative approach; an analysis was made of documents resulting from the consultation conducted for the development of the new Brazilian Food Guide, which uses the NOVA classification for its dietary recommendations. A thematic matrix was constructed and the resulting themes represented the main points for discussion raised during the consultation.

Brazil.

Actors from academia, government and associations/unions/professional bodies/organizations related to the area of nutrition and food security; non-profit institutions linked to consumer interests and civil society organizations; organizations, associations and food unions linked to the food industry; and individuals.

Four themes were identified: (i) conflicting paradigms; (ii) different perceptions about the role and need of individuals; (iii) we want more from the new food guide; and (iv) a sustainable guide.

There was extensive participation from different sectors of society. The debate generated by the consultation revealed two main conflicting opinions: a view aligned with the interests of the food industry and a view of healthy eating which serves the interests of the population. The first group was against the adoption of a food processing-based classification system in a public policy such as the new Brazilian Food Guide. The second group, although mostly agreeing with the new food guide, argued that it failed to address some important issues related to the food and nutrition agenda in Brazil.

The European diet is characterized by a wide variation in every aspect of eating from the timing of meals to the composition of meals. In general, there is a tendency in terms of dietary advice towards lower fat intakes in order to reduce saturated fatty acid intake and to reduce the risk of obesity. Such diets are most successful and yield the most favourable metabolic profile when there is an adequate level of physical activity.

The aim of the present paper was to explore how the composition of dietary fat changes across the EU with low- and high-fat diets and to explore levels of physical activity and attitudes to physical activity across the EU.

The paper draws on data contained in reports and supplements of the Institute of European Food Studies in the EU.

There is a clear trend for southern EU states to have higher MUFA intakes and lower SFA intakes than northern EU states. However, for both geographic regions, the fatty acid composition of dietary fat was similar in groups with lower or higher dietary fat intakes. Physical activity was ranked low by consumers (n = 15,000) for its importance in relation to health and the prevention of weight-gain. Some 47% agreed that their present level of physical activity is sufficient. 78% agreed that being 13 kg heavier would not be detrimental to health and 30% agreed that the main benefit of physical activity was to relieve stress.

(i) The present strategy of lowering dietary fat intake does not alter dietary fat composition and (ii) there is a high level of ignorance among consumers of the benefits of physical activity and the adverse effects of excess body-weight.