To describe the promotion of food and beverage and marketing strategies used by online food delivery services (OFDS) in a social media platform before and during the pandemic in Brazil.

Publicly available data were extracted from OFDS Instagram accounts. Posts published 6 months immediately before and after the first case of COVID-19 in Brazil were randomly sampled. Two independent authors coded the posts’ content. Food and beverage items featured in posts were classified according to the NOVA food system classification. Marketing strategies were coded according to protocols from previous studies.

Top three OFDS Instagram accounts in Brazil.

Posts published in the period studied (n 304).

During the pandemic, the proportion of posts featuring at least one food item decreased from 71·6 % to 40·2 %, and the proportion of ultra-processed foods decreased from 57·6 % to 27·9 %. Before the pandemic, the most widely used marketing strategies were branding elements (80·7 %), product imagery (unbranded) (48·9 %) and partnerships/sponsorship (35·2 %). While during the pandemic, branding elements (62·2 %) continued to be the most applied, but were followed by the use of videos/graphics interchange format/boomerangs (34·1 %) and corporate social responsibility (31·7 %). The most frequent COVID-19 marketing strategies were ‘social responsibility in the pandemic’ (30·5 %), ‘combatting the pandemic’ (28·0 %) and ‘accelerating digitalisation’ (20·7 %).

OFDS advertisements on a social media platform placed less emphasis on food items, but improved the nutritional quality of foods and beverages featured in posts. A COVID-washing approach was highlighted, especially through the use of social responsibility marketing during the pandemic.

The relative contribution of health promotion models (HPM) to improve health-related behaviours in intervention programmes is still limited. Here, we tested whether Pender’s HPM operationalised in the educational intervention was effective to modify nutrition and physical activity (PA) behaviours among Iranian women.

A randomised controlled field trial evaluating the efficacy of an educational intervention based on Pender’s HPM to improve PA and nutrition behaviours from August 2016 to October 2016. R version 3.0.2 and SPSS version 16 were used to conduct multiple statistical analyses.

Ten public healthcare centres in Bojnourd, Iran were randomly divided into intervention and control groups. The experimental group received the full intervention programme, which included nine 4-h training sessions and consulting support via phone contact and social media group. The control group did not receive any intervention.

Women aged 4–6 years (n 202) were randomised to intervention (n 102) and control conditions (n 100) and completed baseline and 3-month follow-up.

In the experimental group, the intervention programme had a significant effect (P < 0·05) on all construct of Pender’s HPM and behaviour outcome, and the estimates for prior behaviours, self-efficacy, interpersonal influences, feeling, perceived benefits and barriers, commitment and behaviour outcomes in the intervention group were 0·72 (95 % CI 0·31, 0·98), 0·54 (95 % CI 0·27, 0·71), 0·74 (95 % CI 0·27, 0·91), 0·52 (95 % CI 0·19, 0·75), 0·62 (95 % CI 0·22, 0·91), 0·63 (95 % CI 0·30, 0·86) and 0·56 (95 % CI 0·37, 0·85), respectively.

Educational intervention based on Pender’s HPM was feasible and highly acceptable to modify PA and nutrition behaviours in the women population.

The present study examines the association between mild and moderate-to-severe household food insecurity and school readiness among a nationally representative sample of preschool-aged children.

Cross-sectional data pertaining to household food availability as well as four domains of school readiness – early learning skills, self-regulation, social-emotional development and physical health & motor development – were employed.

The USA.

15 402 children aged 3–5 years from the 2016–2018 National Survey of Children’s Health.

Both mild and moderate-to-severe food insecurity are associated with an increase in needing support or being at-risk in each of the four school readiness domains, particularly Self-Regulation (IRR = 4·31; CI 2·68, 6·95) and Social-Emotional Development (IRR = 3·43; CI 2·16, 5·45). Furthermore, while nearly half of the children in food-secure households are on-track across all four school readiness domains (47·49 %), only one in four children experiencing moderate-to-severe household food insecurity is on-track across all domains (25·26 %).

Household food insecurity is associated with reductions in school readiness among preschool-aged children.

To investigate the relationship between nutrient intake and a straightforward Japanese nutritional goal of consuming a meal that includes staple, main and side dishes (SMS meal) more than twice a day.

This was a cross-sectional, observational study using the data from de-identified records of the 2012 National Health and Nutrition Survey. Dietary assessment was conducted using semi-weighed dietary records that were completed on one weekday.

A home-based setting in Japan.

30 269 subjects (male n 14 284; female n 15 985) aged ≥6 years (6–103 years, mean 50·4 (sd 22·3) years).

As the frequency of SMS meals increased, we found a higher intake of most nutrients and each food group. Subjects who consumed SMS meals at least twice a day were more likely to meet the Dietary Reference Intakes (DRI) for Japan compared with subjects who consumed an SMS meal once a day or less. However, the frequency of SMS meals did not necessarily ensure that DRI for Japan for saturated fatty acid, vitamin A, vitamin B1, calcium, iron and salt were met.

Consuming SMS meals at least twice a day is a useful and straightforward nutrition goal to achieve adequate intake of some nutrients. However, it is necessary to provide the public with more information on foodstuff choice to ensure an adequate intake of all nutrients.

This study aimed to characterise the availability, the nutritional composition and the processing degree of industrial foods for 0–36-month-old children according to the neighbourhoods affluence.

A cross-sectional exploratory study.

All food products available in retail stores for children aged 0–36 months were analysed. Data collection took place in two neighbourhoods, comparing two different sociodemographic districts (high v. low per capita income), Campanhã and Foz do Douro in Porto, Portugal.

A total of 431 commercially processed food products for children aged 0–36 months which are sold in 23 retail stores were identified. Food products were classified according to their processing degree using the NOVA Food Classification System.

For NOVA analysis, of the 244 food products that were included 82 (33·6 %) were minimally processed, 25 (10·2 %) processed and 137 (56·1 %) ultra processed. No food product was classified as a culinary ingredient. The products included mostly cereals, yogurts, prevailed in high-income neighbourhoods for the 0–6-month-old group. It was observed that some categories of ultra-processed food (UPF) presented higher amounts of energy, sugars, saturated fat and salt than unprocessed/minimally processed products.

The high availability of UPF offered for 0–36-month-old children should be considered when designing interventions to promote a healthy diet in infancy.

This study sought to explain results of the Water Up!@Home randomised controlled trial where low-income parents were randomised to receive an educational intervention +a low-cost water filter pitcher or only the filter. Parents in both groups had reported statistically significant reductions in sugar-sweetened beverages (SSB) and increases in water intake post-intervention.

Qualitative explanatory in-depth interviews analysed thematically and deductively.

Washington, DC metropolitan area, USA.

Low-income Latino parents of infants/toddlers who had participated in the Water Up! @Home randomised controlled trial.

The filter-stimulated water consumption in both groups by (1) increasing parents’ perception of water safety; (2) acting as a cue to action to drink water; (3) improving the flavour of water (which was linked to perceptions of safety) and (4) increasing the perception that this option was more economical than purchasing bottled water. Safe and palatable drinking water was more accessible and freely available in their homes; participants felt they did not need to ration their water consumption as before. Only intervention participants were able to describe a reduction in SSB intake and described strategies, skills and knowledge gained to reduce SSB intake. Among the comparison group, there was no thematic consensus about changes in SSB or any strategies or skills to reduce SSB intake.

A low-cost water filter facilitated water consumption, which actively (or passively for comparison group) displaced SSB consumption. The findings have implications for understanding and addressing the role of water security on SSB consumption.

Supplemental Nutrition Assistance Program (SNAP) benefits are rapidly depleted after distribution. This phenomenon, known as the benefit cycle, is associated with poor nutrition and health outcomes. However, to date, no study has evaluated trends in food expenditures before and after households receive benefits using prospective data, and whether these trends vary by household characteristics.

Generalised estimating equations were used to model weekly household food expenditures during baseline (pre-benefit) and intervention months by vendor (restaurants and food retailers). Food retailer expenditures were further evaluated by food category (fruits and vegetables and foods high in added sugar). All expenditures were evaluated by household composition, demographics and economic means.

Minneapolis-St. Paul, Minnesota, metropolitan area.

Low-income households (n 249) enrolled May 2013–August 2015.

Weekly food retailer expenditures did not vary during baseline (pre-benefit), but demonstrated a cyclical pattern after households received benefits across all household characteristics and for both food categories, particularly for fruits and vegetables. Households with greater economic resources spent more throughout the month compared with those with fewer resources. Households with lower food security status experienced more severe fluctuations in spending compared with more food secure households.

Cyclical food purchasing was observed broadly across different household characteristics and food categories, with notable differences by household economic means and food security status. Proposed SNAP policy changes designed to smooth food expenditures across the benefit month, such as increased frequency of benefit distribution, should include a focus on households with fewest resources.

To determine if 7 d physical activity (PA) predicts energy intake over the same days and if PA on a given day predicts energy intake on the same day, the next day or subsequent days.

A 7 d prospective investigation. PA was measured using accelerometers worn for seven consecutive days. During the same week, total energy intake (including alcohol) was assessed using weighed food records.

Twenty cities in the USA.

Three hundred middle-aged women.

After controlling for the covariates, energy intake was 36 (se 8) kJ higher for each additional 100000 activity counts (F=19·0, P<0·0001), based on the entire week of monitoring. Women with Low PA (n 75) had a mean energy intake of 8364 (sd 1235) kJ/d (1998 (sd 295) kcal/d), those with Moderate PA (n 150) consumed 8523 (sd 1264) kJ/d (2036 (sd 302) kcal/d) and those with High PA (n 75) consumed 9079 (sd 1473) kJ/d (2169 (sd 352) kcal/d; F=6·4, P=0·0019), a 5023 kJ/d (1200 kcal/d) difference between the High and Low PA groups. PA on a given day was predictive of energy consumption on the same day on four of the seven monitored days, and was predictive of energy intake the next day, with five of six associations significant. PA was not consistently predictive of energy intake on days beyond the next day.

Over 7 d, PA and energy consumption tend to be positively related. Considered day to day, increased PA is weakly associated with increased energy intake the following day and, to a lesser extent, the same day. Therefore, managing weight by increasing PA may not result in the energy deficit expected.

To assess the impact of the complex survey design used in the 2007 Australian National Children's Nutrition and Physical Activity Survey (ANCNPAS07) on prevalence estimates for intakes of groups of foods in the population of children.

The impacts on prevalence estimates were determined by calculating design effects for values for food group consumption. The implications of ignoring elements of the sample design including stratification, clustering and weighting are discussed.

The ANCNPAS07 used a complex sample design involving stratification, a high degree of clustering and estimation weights.

Australian children aged 2–16 years.

Design effects ranging from <1 to 5 were found for the values of mean consumption and proportion of the population consuming the food groups. When survey weights were ignored, prevalence estimates were also biased.

Ignoring the complex survey design used in the ANCNPAS07 could result in underestimating the width of confidence intervals, higher mean square errors and biased estimators. The magnitude of these effects depends on both the parameter under consideration and the chosen estimator.

To analyse usual intakes of energy, macronutrients and micronutrients, and their percentage of inadequacy, in a Brazilian population at severe food insecurity (SFI) risk, determined from a predictive model using two national databases.

Cross-sectional study. Our study used a statistical model to predict SFI using the 2009 National Sample Household Survey, where the Brazilian Food Insecurity Scale measured SFI.

Brazil.

The model was applied in a probabilistic sample of 34 003 Brazilians aged 10 years or older that participated in a national dietary survey during 2008–2009. The application of the model generated the probability of each individual being in SFI. The probability of SFI was grouped into quartiles (first quartile with the lowest SFI risk, fourth quartile with highest probability of SFI risk).

The intakes of macro- and micronutrients were associated with SFI. The amount of energy and nutrients in the diet tended to be lower among individuals in the fourth quartile, with highest probability of SFI. The average intake of all studied minerals (Ca, Fe, Na, Mg) was less in individuals in the fourth quartile. Only Na presented a higher percentage of inadequacy in the first quartile, the one with a lower chance of SFI.

The food intake of the Brazilian population at higher SFI risk is characterized by energy reduction, reduced consumption of macronutrients and high prevalence of inadequate micronutrient intakes, as well as a lower mean intakes, when compared with the first quartile with the lowest SFI risk.

The present study aimed to characterize the dietary patterns of newlyweds married within one year and to examine the factors associated with weight changes.

A cross-sectional study was carried out in 2009.

Baoshan District, Shanghai, China.

A total of 342 pairs of newlyweds were recruited at their first visit. Weight and height were measured and food intake was measured based on an FFQ with forty-nine items. Dietary patterns were identified through factor analysis, and the factors associated with weight changes were determined by multiple regression models.

Average weight gain of the participants during marital transition was 1·9 kg (2·2 kg for men and 1·6 kg for women). Four major dietary patterns were identified: vegetable pattern, sweets and fats pattern, legume pattern and poultry, beef and mutton pattern. In multivariate analyses, the highest quintile of factor 2 (sweets and fats pattern) was significantly associated with weight gain after marriage in a comparison with the lowest quintile (β = 2·94; 95 % CI 0·75, 5·15; P = 0·01) in men. The highest quintile of factor 4 (poultry, beef and mutton pattern) was inversely associated with weight gain after marriage in a comparison with the lowest quintile (β = −1·21; 95 % CI −2·32, −0·11; P = 0·03).

Our results suggest that a pattern rich in sugar, oil and condiments may lead to greater marital weight gain in men; another pattern rich in poultry, beef and mutton may lead to less marital weight gain in both men and women.

This study aimed to examine age-specific trends in the prevalence of overweight and obesity in schoolchildren in Kuwait over a 13-year period (2007 to 2019) using the WHO, the Centers for Disease Control and Prevention (CDC) and the International Obesity Taskforce (IOTF) definitions.

Using cross-sectional approach, Kuwait Nutrition Surveillance System (KNSS) objectively measured weight and height of schoolchildren over a 13-year period. Log-binomial regression models were used to examine age-specific trends of obesity and overweight over the study period.

Public primary, middle and high schools in all provinces of Kuwait.

Schoolchildren aged 5–19 years (n 172 603).

According to the WHO definition, the prevalence of overweight and obesity in schoolchildren, respectively, increased from 17·73 % and 21·37 % in 2007 to 20·19 % and 28·39 % in 2019 (Pfor trend < 0·001). There is evidence that the obesity in females (but not males) has levelled off in the period 2014–2019 according to the three definitions of obesity, which is corroborated by a similar trend in the mean of BMI-for-age Z-score.

The prevalence of obesity and overweight in schoolchildren in Kuwait has risen over the last 13 years and trends are similar across all definitions. Obesity is no longer increasing at the same pace and there is evidence that the prevalence of obesity in females has plateaued. The current level of childhood overweight and obesity is too high and requires community-based and school-based interventions.

This study aimed to explore the associations between breast-feeding, dietary intakes and other related factors and subclinical vitamin A deficiency (SVAD) in children aged 0–5 years in an area in China where mild vitamin A deficiency (VAD) is found.

Data were from a population-based cross-sectional study with 1052 children aged 0–5 years. SVAD cases were identified by the indicator of serum retinol ≤ 20 μg dl− 1. Breast-feeding status, dietary intakes and other factors were collected through a pre-designed questionnaire.

The prevalence of SVAD in children aged 0–5 years was 6.9%. Logistic regression analysis showed that the odds ratio of SVAD for breastfeeding was 3.56 (95% confidence limits (95% CL) 2.17–5.82). After adjustment for sex, age in categories, residence, mother's education, mother's occupation, vitamin A preparation supplements, rank in siblings and diarrhoea, the odds ratio for breast-feeding fell to 2.38 (95% CL 1.13–4.95). The odds ratios for breast-feeding within children aged 1 year were 5.46 (95% CL 2.07–15.03) and 4.6 (95% CL 1.72–12.82) before and after adjustment of other confounders, respectively. The odds ratios for breast-feeding did not show statistical significance within children aged 0 or 2 years. The odds ratios decreased, but remained statically significant after further adjustments for individual dietary factor or all dietary factors.

Breast-feeding was a risk factor of SVAD for children, especially for those aged 1 year. The differences in dietary intakes and other established risk factors could not fully explain the increased risk. This finding implies that prolonged breast-feeding alone may not ensure protection of children from VAD in an area with mild SVAD.

To verify the previously untested assumption that eating more salad enhances vegetable intake and determine if salad consumption is in fact associated with higher vegetable intake and greater adherence to the Dietary Guidelines for Americans (DGA) recommendations.

Individuals were classified as salad reporters or non-reporters based upon whether they consumed a salad composed primarily of raw vegetables on the intake day. Regression analyses were applied to calculate adjusted estimates of food group intakes and assess the likelihood of meeting Healthy US-Style Food Pattern recommendations by salad reporting status.

Cross-sectional analysis of data collected in 2011–2014 in What We Eat in America, the dietary intake component of the National Health and Nutrition Examination Survey.

US adults (n 9678) aged ≥20 years (excluding pregnant and lactating women).

On the intake day, 23 % of adults ate salad. The proportion of individuals reporting salad varied by sex, age, race, income, education and smoking status (P<0·001). Compared with non-reporters, salad reporters consumed significantly larger quantities of vegetables (total, dark green, red/orange and other), which translated into a two- to threefold greater likelihood of meeting recommendations for these food groups. More modest associations were observed between salad consumption and differences in intake and likelihood of meeting recommendations for protein foods (total and seafood), oils and refined grains.

Study results confirm the DGA message that incorporating more salads in the diet is one effective strategy (among others, such as eating more cooked vegetables) to augment vegetable consumption and adherence to dietary recommendations concerning vegetables.

Household budget surveys (HBSs) have been used to assess nutritional information for epidemiological purposes. The agreement between this information and other comparable data needs to be examined. The aim of this project was to compare household food expenditure data between two British HBSs: the National Food Survey (NFS) and the Family Expenditure Survey (FES).

Household food expenditure data were compared between the NFS and the FES for the years from 1982 to 1993. Differences in expenditure were assessed by year, by household composition, by income group and by region; for trends across time for all households and for regional, household composition and income group variations.

Great Britain.

Approximately 88 000 NFS households and 85 000 FES households surveyed between 1982 and 1993 were used in this analysis.

Marked differences between the food expenditure data provided by the two surveys were observed. Furthermore, differences in time trends were substantial, which can lead to different conclusions regarding changes in consumption patterns.

There is no obvious reason for the differences in household food expenditure between the NFS and the FES. Methodological differences between the two surveys cannot provide a full explanation for these discrepancies. The NFS and FES are now merged into a single survey (the Expenditure and Food Survey). If HBSs are to be used for epidemiological purposes their validity needs to be established.

To assess agreement between established methods of estimating salt intake from spot urine collections and 24 h urinary Na (24hUNa) and then to develop a valid formula that can be used in the Iranian population to estimate salt intake from spot urine samples.

A validation study. Three spot urine samples were collected (fasting second-void morning; afternoon; evening) on the same day as a 24 h urine collection. We estimated 24hUNa from spot specimens using the Kawasaki, Tanaka and INTERSALT equations. Two new formulas were developed, the Iran formula 1 (Iran 1) and Iran formula 2 (Iran 2), based on our population characteristics.

Iranian adults recruited in 2014–2015.

Healthy volunteer adults aged ≥18 years.

With all three spot urine specimens, predicted population 24hUNa was underestimated based on the INTERSALT equation (−469 to −708 mg/d; all P < 0·05) and conversely overestimation occurred with the Kawasaki equation (926 to 1080 mg/d; all P < 0·01). The Tanaka equation produced comparable estimates to measured 24hUNa (–151 to 86 mg/d; all P > 0·49). The newly derived formulas, Iran 1 and Iran 2, showed less mean bias than the established equations (Iran 1: 43 to 80 mg/d, all P > 0·55; Iran 2: 22 to 90 mg/d, all P > 0·50).

In this Iranian sample, the Tanaka equation and newly derived formulas produced group-level estimates comparable to measured 24hUNa. The newly developed formulas showed less mean bias than established equations; however, they need to be tested for generalization in a larger sample.

A Knowledge, Attitudes and Practices (KAP) study was conducted in three villages of Bekily District in southern Madagascar prior to the implementation of a health education programme with children. The participatory learning concept of the Child-to-Child approach was followed to involve the children in the planning and implementation of the programme, which was covered by the German Agency for Technical Cooperation.

To this effect, qualitative research methods such as Participatory Learning and Action techniques (focus group discussions, mapping and matrix ranking, etc.) were applied.

The survey was conducted between August and December 1999. It involved a total of 55 school-aged children (6–14 years) along with 21 mothers and 34 fathers, representing different ethnic groups and educational backgrounds.

The results show that children's KAP related to health and nutrition strongly reflect those of adults. They are not aware of a possible link between bad hygiene and the occurrence of diseases. According to them, diarrhoea or malaria is caused by consuming too large amounts of certain foods. Even if they know about certain elementary hygiene behaviours, they do not practise this in their everyday life.

A major objective of the health education programme for children should be to tackle the discrepancy between hygiene-related knowledge and behaviour. Through the participatory study approach the children revealed their ability to contribute to the programme development. In using appropriate communication channels, the Child-to-Child health education programme is expected to influence the health behaviours of both adults and children. The health education programme should be combined with a literacy programme to address the children's desire to learn reading and writing.

The main purpose of this study was to evaluate the modification of knowledge, opinions and attitudes to healthy eating, weight perception and dieting practices and preventive habits over a 10-year trend in the Catalan population from 1992 to 2003.

Two cross-sectional surveys were carried out in Catalonia, Spain, during 1992–93 and 2002–03.

In all, 2361 individuals in the ENCAT 1992–93 nutritional survey and 2061 individuals in the ENCAT 2002–03 health survey. The subjects’ ages ranged from 10 to 75 years old.

Lettuce and carrots, fish and olive oil were chosen as the healthiest foods in the two Catalan Nutritional Surveys. Although some improvement was reported, a high percentage of the population still thought that bread (31%), potatoes (23%) or olive oil (19%) should be moderated to prevent high blood cholesterol, especially among the youngest individuals. The perception of being overweight increased among males and decreased among females. There was an increase in the percentage of the population following a diet (from 13% to 17%). An increase in the consumption of iodine-enriched salt (from 26% to 40%) was observed as well as of diet supplements, especially among females (from 6% to 13%). The prevalence of males with diabetes increased from 3.4% to 4.5% and the number of individuals with diabetes not following any treatment decreased.

The Catalan population has improved their knowledge of healthy food and health-related attitudes. Nutrition policy should focus on young adults as a key age group for primary prevention of future nutrition-related chronic diseases.