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Objective: The Caribbean has seen a dramatic shift in the obesity and chronic disease prevalence over the past decades, suggesting a nutrition transition. Simultaneously, Martinique has faced a demographic transition marked by significant population ageing. We aimed to differentiate the contribution of changes in health status and dietary intakes due to shifts in demographic and socio-economic characteristics (DSEC) from that due to unobserved factors. Design: Two cross-sectional surveys conducted in 2003 (n 743) and 2013 (n 573) on representative samples were used. Dietary intakes were estimated by 24-h recalls. The contribution of changes in health status and dietary intakes due to shifts in observed DSEC was differentiated from that due to unobserved factors over a 10-year interval, using Oaxaca–Blinder decomposition models. Setting: Martinique, French region in the Caribbean. Participants: Martinican adults (≥16 years). Results: Over the study period, health status deteriorated, partly owing to shifts in DSEC, explaining 62 % of the change in the prevalence of hypertension (+13 percentage points (pp)) and 48 % of waist circumference change (+3 cm). Diet quality decreased (mean adequacy ratio –2pp and mean excess ratio + 2 pp) and energy supplied by ultra-processed food increased (+4 pp). Shifts in DSEC marginally explained some changes in dietary intakes (e.g. increased diet quality), while the changes that remained unexplained were of opposite sign, with decreased diet quality, lower fruits, tubers and fish intakes and higher energy provided by ultra-processed foods. Conclusion: Explained dietary changes were of opposite sign to nutrition transition conceptual framework, probably because unobserved drivers are in play, such as food price trends or supermarkets spread. [ABSTRACT FROM AUTHOR]

Objective: To evaluate changes in ultra-processed food (UPF) intake and its major correlates during the first Italian lockdown (9 March-3 May 2020).Design: Retrospective observational study.Setting: Italy.Participants: We analysed 2992 subjects (mean age 57·9 ± 15·3 years, 40·4 % men). Individual participant data were pooled from two retrospective cohorts: (1) The Moli-LOCK cohort consists of 1501 adults, a portion of the larger Moli-sani study (n 24 325; 2005-2010) who were administered a phone-based questionnaire to assess lifestyles and psychological factors during confinement and (2) the Analysis of Long Term Risk of Covid-19 Emergency is a web-based survey of 1491 individuals distributed throughout Italy who self-responded to the same questionnaire by using Google forms.UPF was defined according to NOVA classification based on degree of food processing. An UPF score was created by assigning 1 point to increased consumption, -1 to decreased and 0 point for unchanged intakes of nineteen food items, with higher values indicating an increase in UPF during confinement.Results: Overall, 37·5 % of the population reported some increase in UPF (UPF score ≥1). Adults were more likely to decrease UPF (multivariable regression coefficient β = -1·94; 95 % CI -2·72, -1·17 for individuals aged >75 years as compared with 18-39 years) as did individuals from southern Italian regions as compared with Northern inhabitants (β = -1·32; 95 % CI -1·80, -0·84), while UPF lowering associated with increased exercise (β = -0·90; 95 % CI -1·46, -0·35) and weight loss (β = -1·05; 95 % CI -1·51, -0·59) during confinement.Conclusions: During the first Italian lockdown, about 40 % of our population switched to unfavourable eating as reflected by increased UPF intake and this may have long-term effects for health. [ABSTRACT FROM AUTHOR]

Objective: To assess the compatibility between reduction of diet-related greenhouse gas emissions (GHGE) and nutritional adequacy, acceptability and affordability dimensions of diet sustainability.Design: Dietary intake, nutritional composition, GHGE and prices were combined for 402 foods selected among those most consumed by participants of the Individual National Study on Food Consumption. Linear programming was used to model diets with stepwise GHGE reductions, minimized departure from observed diet and three scenarios of nutritional constraints: none (FREE), on macronutrients (MACRO) and for all nutrient recommendations (ADEQ). Nutritional quality was assessed using the mean adequacy ratio (MAR) and solid energy density (SED).Setting: France.Subjects: Adults (n 1899).Results: In FREE and MACRO scenarios, imposing up to 30 % GHGE reduction did not affect the MAR, SED and food group pattern of the observed diet, but required substitutions within food groups; higher GHGE reductions decreased diet cost, but also nutritional quality, even with constraints on macronutrients. Imposing all nutritional recommendations (ADEQ) increased the fruits and vegetables quantity, reduced SED and slightly increased diet cost without additional modifications induced by the GHGE constraint up to 30 % reduction; higher GHGE reductions decreased diet cost but required non-trivial dietary shifts from the observed diet. Not all the nutritional recommendations could be met for GHGE reductions ≥70 %.Conclusions: Moderate GHGE reductions (≤30 %) were compatible with nutritional adequacy and affordability without adding major food group shifts to those induced by nutritional recommendations. Higher GHGE reductions either impaired nutritional quality, even when macronutrient recommendations were imposed, or required non-trivial dietary shifts compromising acceptability to reach nutritional adequacy. [ABSTRACT FROM AUTHOR]

ObjectiveTo examine changes in food consumption during pregnancy and the postpartum period in women of major Asian ethnic groups.DesignUsing interviewer-administered questionnaires, we assessed changes in food consumption during pregnancy (26–28 weeks’ gestation) and the postpartum period (3 weeks after delivery) as compared with the usual pre-pregnancy diet.SettingSingapore.SubjectsPregnant women (n 1027) of Chinese, Malay and Indian ethnicity (mean age 30·4 (sd 5·2) years) who participated in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study.ResultsDuring pregnancy, participants tended to increase their consumption of milk, fruit and vegetables and decrease their consumption of tea, coffee, soft drinks and seafood (all P < 0·001). Most participants reported adherence to traditional restrictions (‘confinement’) during the early postpartum period (Chinese: 94·8 %, Malay: 91·6 %, Indian: 79·6 %). During the postpartum period, participants tended to increase their consumption of fish and milk-based drinks and decrease their consumption of noodles, seafood, and chocolates and sweets (all P < 0·001). Ethnic differences in food consumption were pronounced during the postpartum period. For example, most Chinese participants (87·2 %) increased their ginger consumption during the postpartum period as compared with smaller percentages of Malays (31·8 %) and Indians (40·8 %; P for ethnic difference <0·001). Similar ethnic differences were observed for cooking wine/alcohol, herbs and spices, and herbal tea consumption.ConclusionsMarked changes in food consumption that reflect both modern dietary recommendations and the persistence of traditional beliefs were observed in Singaporean women during pregnancy and the postpartum period. Traditional beliefs should be considered in interventions to improve dietary intakes during these periods. [ABSTRACT FROM AUTHOR]

Objective: Pakistani women in Oslo have high risk of overweight and type 2 diabetes. The objective is to present the effect of an intervention study on Pakistani women's intentions to change dietary behaviour and changes made in dietary intake. Design: The intervention group received culturally adapted lifestyle education, including diet and physical activity. The questionnaire, applied before and after the 7-month intervention, included FFQ and questions on intentions to change. Setting: Oslo, Norway. Subjects: A total of 198 Pakistani women, aged 25-63 years, randomised into control and intervention groups. Results: There was a shift in distribution of intentions to change the intake of selected foods in the intervention group after the intervention, resulting in significant differences between the groups. The daily intake of vegetables, fruits and fruit juice had increased (P=0·043), and the intake of red meats (P=0·001), full fat milk/yoghurt (P=0·027) and sugar-rich drinks (P≤0·007) was reduced in the intervention group. The differences between intervention and control after the intervention were significant for sugar-rich drinks (P≤0·022). More women in the intervention group used olive and rapeseed oil and fewer used 'vegetable' oil after than before intervention (P<0·011). Differences between intervention and control were significant (P=0·001) for rapeseed oil. Comparing those who attended at least 60% of the group sessions with the control group resulted in minor changes in these estimates. Conclusions: Culturally adapted education has the potential to change Norwegian- Pakistani women's intentions to make their diet healthier, and also to induce some beneficial, however modest, self-reported changes in diet. [ABSTRACT FROM AUTHOR]