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Abstract Sugar-sweetened beverages (SSBs) are associated with cardiometabolic diseases and social inequities. For most nations, recent estimates and trends of intake are not available; nor variation by education or urbanicity. We investigated SSB intakes among adults between 1990 and 2018 in 185 countries, stratified subnationally by age, sex, education, and rural/urban residence, using data from the Global Dietary Database. In 2018, mean global SSB intake was 2.7 (8 oz = 248 grams) servings/week (95% UI 2.5-2.9) (range: 0.7 (0.5-1.1) in South Asia to 7.8 (7.1-8.6) in Latin America/Caribbean). Intakes were higher in male vs. female, younger vs. older, more vs. less educated, and urban vs. rural adults. Variations by education and urbanicity were largest in Sub-Saharan Africa. Between 1990 and 2018, SSB intakes increased by +0.37 (+0.29, +0.47), with the largest increase in Sub-Saharan Africa. These findings inform intervention, surveillance, and policy actions worldwide, highlighting the growing problem of SSBs for public health in Sub-Saharan Africa.

Abstract Objective: The Global Dietary Database (GDD) expanded its previous methods to harmonise and publicly disseminate individual-level dietary data from nutrition surveys worldwide. Design: Analysis of cross-sectional data. Setting: Global. Participants: General population. Methods: Comprehensive methods to streamline the harmonisation of primary, individual-level 24-h recall and food record data worldwide were developed. To standardise the varying food descriptions, FoodEx2 was used, a highly detailed food classification and description system developed and adapted for international use by European Food Safety Authority (EFSA). Standardised processes were developed to: identify eligible surveys; contact data owners; screen surveys for inclusion; harmonise data structure, variable definition and unit and food characterisation; perform data checks and publicly disseminate the harmonised datasets. The GDD joined forces with FAO and EFSA, given the shared goal of harmonising individual-level dietary data worldwide. Results: Of 1500 dietary surveys identified, 600 met the eligibility criteria, and 156 were prioritised and contacted; fifty-five surveys were included for harmonisation and, ultimately, fifty two were harmonised. The included surveys were primarily nationally representative (59 %); included high- (39 %), upper-middle (21 %), lower-middle (27 %) and low- (13 %) income countries; usually collected multiple recalls/ records (64 %) and largely captured both sexes, all ages and both rural and urban areas. Surveys from low- and lower-middle v. high- and upper-middle income countries reported fewer nutrients (median 17 v. 30) and rarely included nutrients relevant to diet-related chronic diseases, such as n-3 fatty acids and Na. Conclusions: Diverse 24-h recalls/records can be harmonised to provide highly granular, standardised data, supporting nutrition programming, research and capacity development worldwide.

The challenges in the characterization of the nutritional quality of grain foods comprise obstacles to public health actions toward promotion of healthier grain-based foods. The present study investigated how carbohydrate metrics related to glycemic index (GI), glycemic load (GL), and warning labels of grain foods consumed by individuals living in São Paulo, Brazil. Information on intake of grain foods at individual level was obtained using 24 h recalls within a cross-sectional population-based survey conducted in 2015. There were 244 unique grain products reported by individuals in the survey, assessed through four metrics of carbohydrate quality, considering contents per 10 g of total carbohydrate: (1) ≥1 g fiber, (2) ≥1 g fiber and p-values < 0.001]), and GL (−12.5 to −10.3 [p-values < 0.001]). Warning systems showed a certain degree of discrimination between products according to the metrics (p-value < 0.01 each); however, >50% of products with good nutritional quality according to the carbohydrate metrics still would receive warnings. Findings suggest that carbohydrate metrics identified products with lower GI and GL, and current warning labels may not adequately capture overall nutritional quality of grain foods.

Background: The aim of this study was to assess smoking prevalence among Greek adults and in sub-populations with specific sociodemographic and lifestyle determinants. Moreover, to explore the association between smoking and weight status and specific stress-related states. Methods: Data from 3,820 adults (47.5% males), included in the Hellenic National Nutrition and Health Survey, were used. Information was obtained on sociodemographic, lifestyle, anthropometric factors, and stress-related states. Results were obtained using survey-specific analysis. Results: Smoking prevalence was 33.5% in total and was significantly higher in males 39.1% (95%CI: 36.3%–41.8%) compared to females 29.4% (95%CI: 27.4%–31.6%; p

Background: Evidence points to adverse effects of trans fatty acids (TFA) on health. The aim of this study was to estimate total TFA intake, evaluate major food contributors and its effect on dyslipidemia. Methods: A total of 3537 adults (48.3% males) were included. Total TFA intake was assessed using two 24-hour dietary recalls. Foods were categorized into specific food groups. Adjusted Logistic Regression analysis was performed to assess the likelihood of dyslipidemia by tertile of TFA aand Saturated Fatty Acid (SFA) level. Results: Median TFA intake was 0.53% of energy (from 0.34 to 0.81) ranging from 0.27 (Q1) to 0.95 (Q3) (p < 0.001, for trend), and 16% of individuals consumed TFA above 1% of their total energy. Cheese was the main contributor to TFA intake, with processed/refined grains and fried fish following. The latter was the main contributor in older adults (51+ years). Adjusted logistic regression analysis showed that individuals at the highest tertile of trans consumption were 30% more likely to have dyslipidemia compared to the lowest (OR(Q⁢3-Q⁢1): 1.3; 95% CI: 1.02–1.66 and OR(Q⁢2-Q⁢1): 1.3; 95% CI:1.01–1.66, respectively). This increased by 10% when stratified by SFA intake (OR: 1.4; 95% CI: 1.061–1.942) and remained significant only in individuals at the highest tertile and with higher than recommended SFA intake. Conclusions: A high intake of TFA combined with high SFA intakes further increase the likelihood of dyslipidemia and should be accounted for in public health prevention programs. Monitoring and evaluation of the recent EU legislative measures on TFA levels in foods is also necessary.