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Abstract Objectives: To implement and evaluate the effectiveness of the community participatory program between school and family based on ecological system theory and participatory action research. The intervention covers three levels at the individual, family and school levels and involves educating students and parents by using technology, reducing sedentary behaviours, increasing exercise and changing to healthy food environments at school and at home. Design: A quasi-experimental design was used in this study. Setting: Public primary school in Thailand. Subjects: The participants in the study included 138 school-age children in grades 2–6 with their parents/guardians. The control group consisted of 134 school-age children at a school of the same size with their parents/guardians. Results: Results show that nutritional status was significantly improved within the experimental group (P value = 0·000) and between groups during follow-up (P value = 0·032). Students’ knowledge about obesity and non-communicable chronic diseases (NCD) prevention, as well as physical activity and exercise behaviours, in the experimental group was significantly higher than that in the control group (P value = 0·000 and 0·044, respectively). Parents’ perceptions of child obesity and family modelling behaviours in the experimental group were also significantly higher than that in the control group; P value = 0·013 and 0·000, respectively). Conclusion: The community participation program was found to be successful. Not only students, families and schools improved health behaviours and healthy food environments at home and school, but the students’ long-term nutritional status also improved.

Objectives: To implement and evaluate the effectiveness of the community participatory program between school and family based on ecological system theory and participatory action research. The intervention covers three levels at the individual, family and school levels and involves educating students and parents by using technology, reducing sedentary behaviours, increasing exercise and changing to healthy food environments at school and at home. Design: A quasi-experimental design was used in this study. Setting: Public primary school in Thailand. Subjects: The participants in the study included 138 school-age children in grades 2–6 with their parents/guardians. The control group consisted of 134 school-age children at a school of the same size with their parents / guardians. Results: Results show that nutritional status was significantly improved within the experimental group (P value = 0·000) and between groups during follow-up (P value = 0·032). Students' knowledge about obesity and non-communicable chronic diseases (NCD) prevention, as well as physical activity and exercise behaviours, in the experimental group was significantly higher than that in the control group (P value = 0·000 and 0·044, respectively). Parents' perceptions of child obesity and family modelling behaviours in the experimental group were also significantly higher than that in the control group; P value = 0·013 and 0·000, respectively). Conclusion: The community participation program was found to be successful. Not only students, families and schools improved health behaviours and healthy food environments at home and school, but the students' long-term nutritional status also improved. [ABSTRACT FROM AUTHOR]

Objective: To compare temporal trends, over a 20-year period, in dietary habits between a county (Västerbotten) with a CVD prevention programme and a county (Norrbotten) without such a programme. Design: Cross-sectional data from the Northern Sweden MONICA study (survey period 1994, 1999, 2004, 2009 and 2014). Dietary habits were assessed by a semi-quantitative FFQ. Setting: Counties of Norrbotten and Västerbotten, Northern Sweden. Participants: Five thousand four hundred Swedish adults (mean age 56·9 years; 51·2 % women) from Västerbotten (47 %) and Norrbotten (53 %). Results: No differences in temporal trend for estimated percentage of energy intake from total carbohydrates, total fat, total protein and alcohol were observed between the counties (Pfor interaction ≥ 0·33). There were no between-county difference in temporal trends for overall diet quality (assessed by the Healthy Diet Score; Pfor interaction = 0·36). Nor were there any between-county differences for the intake of whole grain products, fruits, vegetables, fish, sweetened beverages or fried potatoes (Pfor interaction ≥ 0·09). Consumption of meat (Pfor interaction = 0·05) increased to a greater extent in Norrbotten from 2009 and onwards, mainly in men (sex-specific analyses, Pfor interaction = 0·04). Men in Västerbotten decreased their intake of sweets to a greater extent than men in Norrbotten (Pfor interaction < 0·01). Conclusions: Over a 20-year period in northern Sweden, only small differences in dietary habits were observed in favour of a county with a CVD prevention programme compared with a county without such a programme. [ABSTRACT FROM AUTHOR]

Previous studies have shown that intake of sugary drinks in Mexico has increased, while intake of whole milk has decreased. Yet, in-depth analyses of the changes in solid foods, overall and in specific generations and urban/rural subpopulation, are scarce. We aimed to analyse changes in solid foods intake in Mexican children, adolescent girls and adult women through a single 24-h dietary recall from the Mexican Nutrition Survey 1999 (n 5627) and 2012 (n 6712). Foods were classified into twenty-two healthy and unhealthy food groups without considering beverages. We estimated the crude and adjusted change in the energy contribution of solid foods by age group and birth cohort and tested if the changes differed by urban/rural area. The contribution of fruits, vegetables and unsweetened dairy increased, while sweet bread from bakery decreased. However, the total contribution of healthy food groups (67–70 % kj in 1999) decreased −4·3 and −7·2 percentage points (pp) (P < 0·05) among children and adolescents, respectively, but only −1·7 pp (P > 0·05) among adult women. Likewise, those born in 1980–1984 changed little in comparison with those born in 1993–1997, and there were greater increases in unhealthy foods in urban compared with rural areas. In conclusion, from 1999 to 2012, there were negative changes in the intake of foods, specifically healthy foods, which mainly affected Mexican youth. These findings, along with previous reports on the increased intake of sugary drinks in the same population, that emphasise the need to reinforce strategies aimed at improving dietary intake of the Mexican population need to be reinforced. [ABSTRACT FROM AUTHOR]

The global pandemic of paediatric overweight and obesity, along with undernutrition among children in low-income countries pose challenges for future health. Unhealthy dietary intake among children is of great concern(1). The aim of this study was to determine the association between intakes from healthy and unhealthy food groups and adiposity among 5- to 9-year-old South African children (n = 920). Conventional dietary intake assessment methods are burdensome; therefore, a short unquantified food frequency questionnaire was developed based on the WHO Global school-based student health survey, which focused on healthy and unhealthy food groups. The new questionnaire includes four healthy food groups (fruits, vegetables, milk, meats) and six unhealthy food groups (hot sugar-sweetened beverages (SSBs), cold SSBs, cookies, candies, salty snacks, fast foods) with five different responses of frequency of intake per week. The food groups reflect foods generally eaten by South African school children. The questionnaire was completed by the parents. Weight and height were measured and WHO BMI z-score (BAZ) was calculated(2). Descriptive statistics were reported using median and interquartile range. Frequency of intakes from food groups were compared across tertiles of BAZ using the Kruskal-Wallis test. The correlation between frequency of intakes from different food groups, and between the food groups and BAZ was calculated. The children reported similar daily intakes from the milk (35.3%), cold SSBs (33%) and hot SSBs groups (27%). Fruit (14%) and vegetables (9.6%) were consumed daily by a small percentage of children, while animal source protein foods (meat, fish, poultry, eggs) were consumed daily by 39% of children. The most frequent daily consumed snacks were salty snacks, e.g. crisps (13.2%), candy (11.1%) and cookies (5.3%), while fast foods were consumed once per week by the largest proportion of children (60.7%). Based on the WHO BMI z-scores, 15.2% of children were overweight, 4.4% were obese and 3.8% were underweight. Children in the highest two tertile groups of BAZ had a higher median weekly frequency of SSB intake (5, IQR 1,7), compared to those in the lowest BAZ tertile (3, IQR 1,7). No other differences were found between frequency of food group intake across BAZ tertiles. There was a weak positive correlation between BAZ and the frequency of SSB intake (r = 0.08, = 0.015), as well as between frequency of milk intake and frequency of SSB intake (r = 0.13, P<0.001), but a weak negative correlation between the frequency of vegetable intake and frequency of SSB intake (r = −0.08, P = 0.01). In conclusion, low fruit and vegetable intakes, combined with regular SSB intakes are evident in this group of children. The frequency of SSB intake was positively associated with adiposity, and SSB intake apparently replaced vegetable intake, but not milk intake among the children. [ABSTRACT FROM AUTHOR]

Objective: To examine associations between geographic measures of retail food outlets and perceived availability of healthy foods.Design: Cross-sectional.Setting: A predominantly rural, eight-county region of South Carolina, USA.Subjects: Data from 705 household shoppers were analysed using ordinary least-squares regression to examine relationships between geographic measures (presence and distance) of food outlets obtained via a geographic information system and perceived availability of healthy foods (fresh fruits and vegetables and low-fat foods).Results: The presence of a supermarket within an 8·05 km (5-mile) buffer area was significantly associated with perceived availability of healthy foods (β=1·09, P=0·025) when controlling for all other food outlet types. However, no other derived geographic presence measures were significant predictors of perceived availability of healthy foods. Distances to the nearest supermarket (β=-0·16, P=0·003), dollar and variety store (β=-0·15, P=0·005) and fast-food restaurant (β=0·11, P=0·015) were all significantly associated with perceptions of healthy food availability.Conclusions: Our results suggest that distance to food outlets is a significant predictor of healthy food perceptions, although presence is sensitive to boundary size. Our study contributes to the understanding and improvement of techniques that characterize individuals' food options in their community. [ABSTRACT FROM AUTHOR]

The present paper reports on results obtained as part of the economics module of the LIPGENE project. It reviews recent trends in obesity in the fifteen member states of the EU (the member states before enlargement in 2004) and concludes that in 2002 for both adult men and women at least half the fifteen member states of the EU had obesity levels of >20%. In the same year the total direct and indirect annual costs of obesity in the fifteen member states of the EU were euro32 800×106. The provision of ‘healthy’ foods with an adapted lipid profile provides one means of mitigating the impact of obesity. However, there are extra costs associated with the supply of such foods, via additional costs of food ingredients, identity preservation costs for premium-value food products and the penalties caused by the inability to exploit economies of scale. The limited scale of the markets for healthy foods is caused by their high selling prices. Also presented is an analysis of the costs of subsidising, throughout the EU, ingredients that improve the fatty acid profile of beef, eggs, poultry meat and low-fat spreads, so that healthier versions of these products sell at the same price as traditional alternatives. The total costs of such subsidies for these four food products would have been euro10×109/year in 2002, which was 30% of the direct and indirect costs of obesity. [ABSTRACT FROM PUBLISHER]

Objective: To compare temporal trends, over a 20-year period, in dietary habits between a county (Västerbotten) with a CVD prevention programme and a county (Norrbotten) without such a programme., Design: Cross-sectional data from the Northern Sweden MONICA study (survey period 1994, 1999, 2004, 2009 and 2014). Dietary habits were assessed by a semi-quantitative FFQ., Setting: Counties of Norrbotten and Västerbotten, Northern Sweden., Participants: Five thousand four hundred Swedish adults (mean age 56·9 years; 51·2 % women) from Västerbotten (47 %) and Norrbotten (53 %)., Results: No differences in temporal trend for estimated percentage of energy intake from total carbohydrates, total fat, total protein and alcohol were observed between the counties (Pfor interaction ≥ 0·33). There were no between-county difference in temporal trends for overall diet quality (assessed by the Healthy Diet Score; Pfor interaction = 0·36). Nor were there any between-county differences for the intake of whole grain products, fruits, vegetables, fish, sweetened beverages or fried potatoes (Pfor interaction ≥ 0·09). Consumption of meat (Pfor interaction = 0·05) increased to a greater extent in Norrbotten from 2009 and onwards, mainly in men (sex-specific analyses, Pfor interaction = 0·04). Men in Västerbotten decreased their intake of sweets to a greater extent than men in Norrbotten (Pfor interaction < 0·01)., Conclusions: Over a 20-year period in northern Sweden, only small differences in dietary habits were observed in favour of a county with a CVD prevention programme compared with a county without such a programme.