The purpose of this study was to assess the 10-year trend in lipid and antioxidant vitamin levels in the Catalan population from 1992 to 2003.

Two cross-sectional surveys were carried out in Catalonia, Spain, during 1992–93 and 2002–03. A subsample of the individuals participating in the surveys agreed to undergo a biochemical evaluation.

Eight hundred and eighty individuals (393 males and 487 females) in the 1992–93 nutritional survey and 429 individuals (205 males and 224 females) in the 2002–03 nutritional and health survey. The subjects’ ages ranged from 18 to 74 years.

Mean total cholesterol decreased from 5.3 to 5.1 mmol l−1 (P < 0.005), and the prevalence of hypercholesterolaemia decreased, especially in males (from 23% to 10% in males from 50 to 64 years old, P < 0.05). Mean cholesterol high-density lipoprotein (HDL) values decreased in the entire sample (from 1.4 to 1.3 mmol l−1, P < 0.001) and there was an increase in the percentage of population with low values of HDL (from 10% to 19%, P < 0.001). An increase in the percentage of the population with values of α-tocopherol at marginal risk levels (from 6% to 9%) and with low values of β-carotene (from 59% to 66%) was observed. The mean values for retinol increased in both males (from 1.99 to 2.44 μmmol l−1, P < 0.001) and females (from 1.69 to 2.29, P < 0.001).

Although there was a decrease in the percentage of population with hypercholesterolaemia, the decrease in HDL cholesterol worsened the lipid profile of the Catalan population. The increase in the values of some antioxidant vitamins did not affect the entire population since an increase in the number of individuals with marginal values was observed.

Food practices in the early years of life are important to form healthy eating habits; therefore, it is essential for the caregivers of infants to receive appropriate guidance. The present study aimed to investigate the effectiveness of different nutritional interventions on complementary feeding practices in municipal nurseries.

Non-randomized controlled intervention study with education professionals and parents of infants (<2 years). Participants were divided into: control group (CG), standard food and nutrition education in writing; and intervention group (IG), the same information as the CG and face-to-face meetings (professionals, 8 h; parents, 5 h). Changes in professionals’ knowledge on the subject and alterations in parents’ beliefs, attitudes and intentions were assessed using questionnaires before and after the educational activities.

Ten public nurseries in Nova Lima, Belo Horizonte, Minas Gerais, Brazil, 2015.

Ninety professionals (fifty in CG; forty in IG) and 169 parents (ninety-seven in CG; seventy-two in IG).

After the intervention, there was a significant increase in the mean number of correct responses given by professionals in the IG (12·2 v. 10·7; P=0·001). In addition, there were improvements among the parents of the IG in relation to beliefs (soups and broths do not nourish my child: P=0·012), attitudes (offer meat from the sixth month: P=0·032) and intentions (do not offer soups and broths: P=0·003; offer vegetables: P=0·018; offer meat: P<0·001).

Face-to-face nutritional intervention had a significantly greater effect on the parameters evaluated, indicating the importance of adequate guidance in childcare services to support the introduction of complementary feeding.

To describe the feasibility, acceptability and results of Strong Families Start at Home, a 6-month pilot trial of a home-based food parenting/nutrition intervention.

Pilot randomised controlled trial.

Participants received six visits with a community health worker trained in motivational interviewing (three home visits, three phone calls); an in-home cooking or reading activity; personalised feedback on a recorded family meal or reading activity; text messages and tailored printed materials.

Parents and their 2–5-year-old child were randomised into intervention (responsive food parenting practices/nutrition) or control (reading readiness) groups.

Parents (n 63) were mostly mothers (90 %), Hispanic/Latinx (87 %), born outside the USA (62 %), with household incomes <$25 k (54 %). Despite delivery during COVID-19, 63 % of dyads were retained at 6 months. The intervention was delivered with high fidelity. All parents in the intervention group (n 24) expressed high levels of satisfaction with the intervention, which produced positive treatment effects for whole and total fruit component Healthy Eating Index-2015 scores (point estimate (PE) = 2·14, 95 % CI (0·17, 1·48); PE = 1·71, 95 % CI (0·16, 1·47), respectively) and negative treatment effects for sodium (PE = -2·09, 95 % CI (−1·35, −0·04)). Positive treatment effects also resulted for the following food parenting practices: regular timing of meals and snacks (PE = 1·08, 95 % CI (0·61, 2·00)), reducing distractions during mealtimes (PE = -0·79, 95 % CI (−1·52, −0·19)), using food as a reward (PE = -0·54, 95 % CI (−1·35, −0·04)) and providing a supportive meal environment (PE = 0·73, 95 % CI (0·18, 1·51)).

Given the continued disparities in diet quality among low-income and diverse families, continued efforts to improve child diet quality in fully powered intervention trials are needed.

To pilot a global policy scan assessing how governments worldwide regulate weight-loss supplements (WLS).

Experts on WLS policies from thirty countries that varied by World Bank income classification, with five from each of the six WHO regions, completed an online survey on WLS regulation in their country. The survey covered six domains: legal frameworks; pre-market requirements; claims, labelling, and advertisements; product availability; adverse events reporting; and monitoring and enforcement. Percentages were calculated for presence or absence of a type of regulation.

Experts were recruited through websites of regulatory bodies and professional LinkedIn networks and scientific article searches on Google Scholar.

Thirty experts, one from each country (i.e. researchers, regulators, other experts in food and drug regulation).

WLS regulations varied widely across countries, and a number of gaps were identified. One country (Nigeria) has a minimum legal age to purchase WLS. Thirteen countries reported independently evaluating the safety of a new WLS product sample. Two countries have limitations on where WLS can be sold. In eleven countries, reports on adverse events related to WLS are publicly available. In eighteen countries, safety of new WLS is to be established through scientific criteria. Penalties for WLS non-compliance with pre-market regulations exist in twelve countries and labelling requirements in sixteen countries.

Results of this pilot study document wide variability in national WLS regulations globally, exposing many gaps in important components of consumer protection regulatory frameworks for WLS, which likely put consumer health at risk.

To systematically review the literature with the primary aim of identifying behavioural interventions to improve vitamin D stores in children from at-risk ethnic groups.

Review based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PROSPERO registration number: CRD42017080932. Health Behaviour Model and Behaviour Change Wheel framework constructs used to underpin evaluation of interventions. Methodological quality evaluated using Cochrane Risk of Bias, Cochrane ROBINS-I and NHLBI tools.

Databases Cochrane Library, MEDLINE, EMBASE, CINAHL with secondary search of Google Scholar. No country limits set. Papers between January 1990 and February 2018, published in English included. Anticipating study heterogeneity, outcome measures not pre-specified and identified from individual full papers. Updated literature search November 2020.

Patient or population including pregnant women, newborns and children aged under 18 years, from Asian or African ethnic groups.

Of 10 690 articles screened, 298 underwent full-text review, with 24 ultimately included for data extraction. All identified studies conducted a vitamin D pharmacological supplementation intervention, with two also incorporating a behavioural intervention strategy. No study explicitly defined a primary aim of evaluating a behavioural intervention, undertaken to study its effect on vitamin D supplement uptake.

There is a need to address the paucity of data in ethnic at-risk children on how behavioural interventions ideally developed and co-produced with the community under study, affect and help improve vitamin D uptake, within the antenatal and pregnancy phase as well as during childhood.

Thinness is rarely highlighted or regularly monitored among children in developed countries although it may be rather frequent and pose a significant risk to children’s health. We aimed to describe the prevalence of mild, moderate and severe thinness among young Serbian schoolchildren.

Cross-sectional study of schoolchildren aged 6–9 years. Children were assessed for weight, height and BMI as part of the WHO European Childhood Obesity Surveillance Initiative in Serbia. Thinness grades were defined as gender- and age-specific cut-offs for BMI according to the International Obesity Task Force criteria.

Serbia, September to November 2015.

Students (n 4861) in grades 2 and 3 (6–9 years, 2397 girls).

Overall prevalence of thinness in Serbian schoolchildren was 9·6 %. Mild thinness was clearly the largest category with a prevalence of 7·6 %, moderate thinness was present in 1·7 % of children and severe thinness was found in 0·3 % of children. OR indicated a significant risk of being thin for girls (1·44 times higher compared with boys) and children attending schools with no health-focused educational programme (1·57 times more likely to be thin than peers enrolled in schools with such programmes). In addition, OR for thinness tended to be 1·23 times higher in children living in an economically disadvantaged region of Serbia (P=0·06).

A rather high prevalence of thinness highlights this malnutrition disorder as an emerging health issue that should trigger public health policies to tackle thinness, especially in girls of young age and children living in economically disadvantaged areas.

To examine how food insecurity in childhood up to adolescence relates to eating habits and weight status in young adulthood.

A longitudinal study design was used to derive trajectories of household food insecurity from age 4·5 to 13 years. Multivariable linear and logistical regression analyses were performed to model associations between being at high risk of food insecurity from age 4·5 to 13 years and both dietary and weight outcomes at age 22 years.

A birth cohort study conducted in the Province of Quebec, Canada.

In total, 698 young adults participating in the Québec Longitudinal Study of Child Development.

After adjusting for sex, maternal education and immigrant status, household income and type of family, being at high risk (compared with low risk) of food insecurity in childhood up to adolescence was associated with consuming higher quantities of sugar-sweetened beverages (ßadj: 0·64; 95 % CI (0·27, 1·00)), non-whole-grain cereal products (ßadj: 0·32; 95 % CI (0·07, 0·56)) and processed meat (ßadj: 0·14; 95 % CI (0·02, 0·25)), with skipping breakfast (ORadj: 1·97; 95 % CI (1·08, 3·53)), with eating meals prepared out of home (ORadj: 3·38; 95 % CI (1·52, 9·02)), with experiencing food insecurity (ORadj: 3·03; 95 % CI (1·91, 4·76)) and with being obese (ORadj: 2·01; 95 % CI (1·12, 3·64)), once reaching young adulthood.

Growing up in families experiencing food insecurity may negatively influence eating habits and weight status later in life. Our findings reinforce the importance of public health policies and programmes tackling poverty and food insecurity, particularly for families with young children.

B-vitamins affect brain function through multiple pathways. Given limited evidence on the relationship between dietary intake of these vitamins and psychological disorders, we examined dietary intake of vitamin B6-9-12 in relation to psychological disorders among Iranian women.

Cross-sectional study. Dietary intake was assessed using a valid and reliable FFQ. To assess psychological disorders, we used a version of the Depression Anxiety Stress Scale-21 validated in Iran.

Ten public health centres in southern Tehran, Iran.

A total of 447 female participants aged 20–50 years.

The median values of vitamin B6 (pyridoxine), B9 (folate) and B12 (cobalamin) were 1·30 mg/d, 313·89 µg/d and 3·99 µg/d, respectively. After adjustment for potential confounders, dietary vitamin B6 intake was associated with lower odds of depression (OR: 0·54; 95 % CI: 0·31, 0·95; Ptrend: 0·03). However, there was a positive association between dietary vitamin B12 intake with the odds of depression (OR: 2·05; 95 % CI: 1·17, 3·60; Ptrend: 0·01) and psychological distress (OR: 2·00; 95 % CI: 1·17, 3·41; Ptrend: 0·01). No association was found between vitamin B9 with any psychological disorders.

Women with higher dietary intakes of vitamin B6 had lower likelihood of depression. However, women with higher dietary intake of vitamin B12 had higher odds of depression and psychological distress. Future prospective studies in different populations are needed to clarify whether B-vitamin deficiency is a cause or consequence of psychological disorders.

To consider the principal effect of an interaction between year (pre- and post-Universal Infant Free School Meals (UIFSM)) and school on pupil’s dietary intakes.

A repeated cross-sectional survey using dietary data from 2008 to 2009 (pre-) and 2017 to 2018 (post-UIFSM)

Two primary schools, NE England.

Pupils aged 4–7 years (2008–2009 n 121; 2017–2018 n 87).

At lunchtime, there was a statistically significant decrease in pupils non-milk extrinsic sugars intake (%E NMEs) pre- to post-UIFSM (mean change –4·6 %; 95 % CI –6·3, –2·9); this was reflected in total diet (–3·8 %; –5·2, –2·7 %). A year and school interaction was found for mean Ca intakes: post-UIFSM pupils in School 2 had a similar mean intake as pre; in School 1 intakes had increased (difference of difference: –120 mg; 95 % CI –179, –62); no reflection in total diet. Post-UIFSM mean portions of yogurt decreased in School 2 and remained similar in School 1 (–0·25; –0·46, –0·04); this was similar for ‘cake/pudding’ and fruit.

Within the limitations, these findings highlight positives and limitations following UIFSM implementation and demonstrate the role of school-level food practices on pupil’s choices. To facilitate maximum potential of UIFSM, national levers, such as discussions on updating school food standards, including sugars, could consider removing the daily ‘pudding’ option and advocate ‘fruit only’ options 1 d/week, as some schools do currently. Small school-level changes could maximise positive health impacts by decreasing NMEs intake. A more robust evaluation is imperative to consider dietary impacts, equitability and wider effects on schools and families.

To examine the effect of the intervention implemented in the ToyBox-study on changes observed in age- and sex-specific BMI percentile and investigate the role of perinatal factors, parental perceptions and characteristics on this change.

A multicomponent, kindergarten-based, family-involved intervention with a cluster-randomised design. A standardised protocol was used to measure children’s body weight and height. Information was also collected from parents/caregivers via the use of validated questionnaires. Linear mixed effect models with random intercept for country, socio-economic status and school were used.

Selected preschools within the provinces of Oost-Flanders and West-Flanders (Belgium), Varna (Bulgaria), Bavaria (Germany), Attica (Greece), Mazowieckie (Poland) and Zaragoza (Spain).

A sample of 6268 preschoolers aged 3·5–5·5 years (51·9 % boys).

There was no intervention effect on the change in children’s BMI percentile. However, parents’ underestimation of their children’s actual weight status, parental overweight and mothers’ pre-pregnancy overweight/obesity were found to be significantly and independently associated with increases in children’s BMI percentile in multivariate modelling.

As part of a wide public health initiative or as part of a counseling intervention programme, it is important to assist parents/caregivers to correctly perceive their own and their children’s weight status. Recognition of excessive weight by parents/caregivers can increase their readiness to change and as such facilitate higher adherence to favourable behavioural changes within the family.

Evidence suggests that the rate of glucose release following consumption of carbohydrate-containing foods, defined as the glycaemic index (GI), is inversely associated with cognitive function. To date, most of the evidence stems from either single-meal studies or highly heterogeneous cohort studies. We aimed to study the prospective associations of diet GI at age 53 years with outcomes of verbal memory and letter search tests at age 69 years and rate of decline between 53 and 69 years.

Longitudinal population-based birth cohort study.

MRC National Survey for Health and Development.

Cohort members (n 1252).

Using multivariable linear and logistic regression, adjusted for potential confounders, associations of higher-GI diet with lower verbal memory, lower letter search speed and lower number of hits in a letter search test were attenuated after adjustments for cognitive ability at age 15 years, educational attainment, further training and occupational social class. No association was observed between diet GI at 53 years and letter search accuracy or speed–accuracy trade-off at 69 years, or between diet GI at 53 years and rate of decline between 53 and 69 years in any cognitive measure.

Diet GI does not appear to predict cognitive function or decline, which was mainly explained by childhood cognitive ability, education and occupational social class. Our findings confirm the need for further research on the association between diet and cognition from a life-course perspective.

The aim of the paper is to describe the formative evaluation of the feedback component of an online nutrition tailoring instrument, the Children's and Adolescents’ Nutrition Assessment and Advice on the Web (CANAA-W), among parents of schoolchildren.

Parents of pre-primary and primary-school children recorded their child's food intake over 3 d with CANAA-W and completed the evaluation questionnaire online. A subsample participated in focus group discussions.

Parents completed CANAA-W at home.

Forty-six parents completed the evaluation questionnaire. Seventeen parents participated in three focus group discussions.

Parents were enthusiastic: the majority (81 % or more) found the advice comprehensible, interesting, logical, useful, believable, well formulated, correct, personal, relevant, complete, attractive, containing enough and not too much information; they indicated that it is helpful to improve their children's eating habits and that they intend to use it. The qualitative analyses revealed that the respondents appreciated the confrontation with their child's diet and the visualization (i.e. traffic light colours, pictograms, food models, diagrams). The length of the feedback was rather a drawback, but it was useful nevertheless.

CANAA-W was well received by the parents; the scores on the feasibility questionnaire were high and the qualitative analyses showed that the confrontation with their child's diet, and attractive visualization of the most relevant feedback linked to more elaborated optional feedback, were well appreciated. The major challenge will be to convince parents who are less interested in food habits and less computer-literate to participate in this type of study.

This study aimed to identify correlates of nutrition label awareness and use, particularly subgroup differences among consumers. Two label types were assessed: (1) nutrition facts tables (NFt) in Australia, Canada, Mexico, UK, and USA and (2) front-of-package (FOP) labels, including mandatory Guideline Daily Amounts (Mexico), voluntary Health Star Ratings (Australia) and voluntary Traffic Lights (UK).

Respondents were recruited using Nielsen Consumer Insights Global Panel (n 21 586) and completed online surveys in November–December 2018. Linear regression and generalised linear mixed models examined differences in label use and awareness between countries and label type based on sociodemographic, knowledge-related and dietary characteristics.

Australia, Canada, Mexico, UK and USA.

Adults (≥18 years).

Respondents from the USA, Canada and Australia reported significantly higher NFt use and awareness than those in Mexico and the UK. Mexican respondents reported the highest level of FOP label awareness, whereas UK respondents reported the highest FOP label use. NFt use was higher among females, ‘minority’ ethnic groups, those with higher nutrition knowledge and respondents with ‘adequate literacy’ compared with those with ‘high likelihood of limited literacy’. FOP label use was higher among those with a ‘high likelihood of limited literacy’ compared with ‘adequate literacy’ across countries.

Lower use of mandatory Guideline Daily Amount labels compared with voluntary FOP labelling systems provides support for Mexico’s decision to switch to mandatory ‘high-in’ warning symbols. The patterns of consumer label use and awareness across sociodemographic and knowledge-related characteristics suggest that simple FOP labels may encourage broader use across countries.

We aimed to examine the association of recovery from work and sleep with workers’ dietary habits.

Cross-sectional study. Need for recovery (NFR) from work was assessed with a validated questionnaire. Sleep was assessed with five questions from the Nordic Sleep Questionnaire and sleep quality question. Dietary habits were estimated using a validated sixteen food groups-containing questionnaire. Ordered logistic regression was used to explore the associations of NFR and sleep with dietary habits adjusted for age, education, marital status, work schedule, working full or part time and occupation.

Follow-up visits of type 2 diabetes prevention study cohort in a Finnish airline company

The study included 737 men and 605 women.

Poor recovery from work was associated with a higher eating frequency (OR = 1·03, 95 % CI 1·00, 1·06), higher intake of fast food (OR = 1·05, 95 % CI 1·02, 1·08) and sweets (OR = 1·05, 95 % CI 1·02, 1·08) as well as lower intake of vegetables (OR = 0·96, 95 % CI 0·93, 0·98) and fruits (OR = 0·96, 95 % CI 0·93, 0·98) among men. In women, poor recovery from work was associated with higher fast food (OR = 1·06, 95 % CI 1·02, 1·09) and desserts consumption (OR = 1·04, 95 % CI 1·00, 1·07). Among men and women, sleep problems were associated with higher eating frequency (men: OR = 1·04, 95 % CI 1·00, 1·07, women: OR = 1·06, 95 % CI 1·02, 1·11), consumption of fast food (men: OR = 1·07, 95 % CI 1·04, 1·11, women: OR = 1·06, 95 % CI 1·02, 1·10) and sweets (men: OR = 1·05, 95 % CI 1·01, 1·08, women: OR = 1·04, 95 % CI 1·00, 1·08).

Poor recovery from work and sleep problems were associated with unfavourable dietary habits especially in men.

Ultra-processed foods (UPF), including those containing food additive emulsifiers, have received research attention due to evidence implicating them in the pathogenesis of certain diseases. The aims of this research were to develop a large-scale, brand-level database of UPF in the UK food supply and to characterise the occurrence and co-occurrence of food additive emulsifiers.

A database was compiled sampling all products from the food categories contributing to energy intake from UPF in the UK from the National Diet and Nutrition Survey (2008–2014). Every food in these categories were identified from online supermarket provision from the ‘big four’ supermarkets that dominate the market share in the UK, comprising Tesco, Sainsbury’s, Asda and Morrisons.

Major supermarkets in the UK.

A total of 32 719 food products in the UK supermarket food supply were returned in searches. Of these, 12 844 products were eligible and manually reviewed for the presence of emulsifiers. Emulsifiers were present in 6642 (51·7 %) food products. Emulsifiers were contained in 95·0 % of ‘Pastries, buns and cakes’, 81·9 % of ‘Milk-based drinks’, 81·0 % of ‘Industrial desserts’ and 77·5 % of ‘Confectionary’. Fifty-one per cent of all emulsifier-containing foods contained multiple emulsifiers. Across emulsifier-containing foods, there were a median of two emulsifiers (IQR 2) per product. The five most common emulsifiers were lecithin (23·4 % of all products), mono- and diglycerides of fatty acids (14·5 %), diphosphates (11·6 %), and xanthan gum and pectin (8·0 %).

Findings from this study are the first to demonstrate the widespread occurrence and co-occurrence of emulsifiers in UPF in the UK food supply.

As Mexico continues to develop, an epidemiological and nutritional transition has led to an increase in infant formula use in its rural and indigenous communities. Our objective was to determine the social and cultural factors that influence the use of formula in such populations in Central Mexico.

Qualitative study using a data collection instrument based on the socio-ecological framework.

Two rural and indigenous communities in Central Mexico.

Mothers, fathers, grandparents and healthcare providers.

Breast-feeding was favoured in both communities; however, several cultural traditions hindered exclusive breast-feeding. As these communities became more developed, emerging ideas of modernity led to negative connotations about breast-feeding and many mothers began to view formula as a complement for breast-feeding. Formula was seen as a convenient solution for breast pain, insufficient milk and body image. Healthcare providers promoted the use of formula through their own beliefs, information, communication and conflicts of interest with formula industry representatives. The recent social and economic changes in these communities combined with the increased advertising and availability of breast milk substitutes have facilitated the preference for formula.

Women in rural, indigenous communities in Central Mexico are increasingly using formula. Efforts at the policy and institutional levels are needed to protect mothers and their children from the detrimental consequences of unregulated formula promotion and the formula culture that it brings with it.

Adolescent girls are at risk for both macro- and micronutrient deficiencies affecting growth, maternal and child health. This study assessed the impact of an adolescent-girl-tailored nutritional education curriculum on nutritional outcomes, including knowledge, dietary behaviour, anthropometry and anaemia.

A cluster-randomised evaluation was conducted with two study arms: girls in mentor-led weekly girls’ groups receiving sexual and reproductive health and life-skills training assigned to an age-appropriate nutritional curriculum and control girls in the weekly girls’ groups without the nutritional education. The primary analysis was intent-to-treat (ITT) generalised least squares regression. Secondary analysis using two-stage, instrumental-variables estimation was also conducted.

The intervention and evaluation were conducted in urban and rural areas across four of ten provinces in Zambia.

In total, 2660 girl adolescents aged 10–19 years were interviewed in 2013 (baseline) and annually through 2017.

ITT results indicate that exposure to the nutritional educational programme did not meaningfully change outcomes for adolescents or their children. Intervention adolescents were no more likely to correctly identify healthy foods (P = 0·51) or proper infant-feeding practices (P = 0·92); were no less likely to be stunted (P = 0·30) or underweight (P = 0·87) and no less likely to be anaemic (P = 0·38). Outcomes for children of intervention participants were not improved, including being breastfed (P = 0·42), stunted (P = 0·21), wasted (P = 0·77) or anaemic (P = 0·51).

Even a high-quality nutritional educational intervention tailored to adolescents within an empowerment programme does not assure improved nutritional outcomes; adolescent preferences, resource control and household dynamics require consideration in the context of nutritional educational programmes.

To examine whether usual beverage intake was associated with sleep timing, duration and fragmentation among adolescents.

Usual beverage intake was assessed with a FFQ. Outcomes included sleep duration, midpoint (median of bed and wake times) and fragmentation, assessed with 7-d actigraphy. Sex-stratified linear regression was conducted with sleep characteristics as separate outcomes and quantiles of energy-adjusted beverage intake as exposures, accounting for age, maternal education, physical activity and smoking.

Mexico City.

528 adolescents residing in Mexico City enrolled in a longitudinal cohort.

The mean age (sd) was 14·4 (2·1) years; 48 % were male. Among males, milk and water consumption were associated with longer weekday sleep duration (25 (95 % CI 1, 48) and 26 (95 % CI 4, 47) more minutes, in the 4th compared to the 1st quartile); and higher 100 % fruit juice consumption was related to earlier weekday sleep timing (−22 (95 % CI −28, 1) minutes in the 1st compared to the last quantile; P = 0·03). Among females, soda was associated with higher sleep fragmentation (1·6 (95 % CI 0·4, 2·8) % in the 4th compared to the 1st), and coffee/tea consumption was related to shorter weekend sleep duration (−23 (95 % CI −44, 2) minutes in the 4th compared to the 1st).

Among females, adverse associations with sleep were observed for caffeinated drinks, while males with higher consumption of healthier beverage options (water, milk and 100 % juice) had evidence of longer and earlier-timed sleep. Potential mechanisms involving melatonin and tryptophan should be further investigated.

To examine household food insecurity and coping mechanisms in two relatively politically stable states of South Sudan.

Cross-sectional assessment including structured interviews and focus group discussions with food aid programme beneficiaries and staff. Structured interview findings were analysed with descriptive statistics using the statistical software package STATA version 11.

Rural households in four payams (sub-county administrative districts) benefiting from a multi-year assistance programme funded by the US Agency for International Development. The study was conducted in January 2012, six months after independence.

Study subjects included eighty mothers of children aged 6–23 months in structured interviews and eight focus groups, each with six to ten participants, of mothers of children aged 6–23 months.

Ninety-three per cent of households surveyed in Warrap and 100 % of households in Northern Bahr el Ghazal states were severely food access insecure. Nearly all households (97·5 %) surveyed in both states reported there were months in 2011 without enough food to eat. The majority of households (88 %) reported sometimes or often going to bed hungry in the month preceding the study. A number of coping mechanisms were used when households did not have enough food, including reduced meal size, skipping meals, selling assets and engaging in some kind business in order to generate money to buy food.

Given the highly volatile political, economic and humanitarian situation in South Sudan, the priorities of the international community are understandably focused on securing greater stability in South Sudan and preventing humanitarian needs from escalating significantly. There is a need, however, for simultaneous emphasis on food assistance and longer-term development strategies throughout South Sudan, particularly in areas of agriculture, livelihoods and food security.

Upper respiratory tract infections (URTI) are the most common and costly condition of childhood. Low vitamin D levels have been hypothesized as a risk factor for URTI. The primary objective was to determine if serum vitamin D levels were associated with health-service utilization (HSU) for URTI including hospital admission, emergency department visits and outpatient sick visits. The secondary objectives were to determine whether oral vitamin D supplementation in pregnancy or childhood was associated with HSU for URTI.

Cohort study. HSU was determined by linking each child’s provincial health insurance number to health administrative databases. Multivariable quasi Poisson regression was used to evaluate the association between 25-hydroxyvitamin D, vitamin D supplementation and HSU for URTI.

Toronto, Canada.

Children participating in the TARGet Kids! network between 2008 and 2013.

Healthy children aged 0–5 years (n 4962) were included; 52 % were male and mean 25-hydroxyvitamin D was 84 nmol/l (range 11–355 nmol/l). There were 105 (2 %), 721 (15 %) and 3218 (65 %) children with at least one hospital admission, emergency department visit or outpatient sick visit for URTI, respectively. There were no statistically significant associations between 25-hydroxyvitamin D or vitamin D supplementation and HSU for URTI.

A clinically meaningful association between vitamin D (continuously and dichotomized at <50 and <75 nmol/l) and HSU for URTI was not identified. While vitamin D may have other benefits for health, reducing HSU for URTI does not appear to be one of them.