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ObjectivesDietary surveys are essential for guiding national efforts to reduce the burden of non-communicable disease, but individual-level dietary data are lacking in many low- and middle-income countries. We aimed to estimate the prevalence of inadequate and excessive intakes of specific nutrients in Bosnia and Herzegovina.MethodsA dietary survey among 853 adults using two 24-h recalls.ResultsThe majority of men (73%) and women (66%) were overweight/obese, and gt 50% of participants had elevated blood pressure. Low intakes of N-3 polyunsaturated fatty acids, specifically alpha-linolenic acid (men: 94.4mg/day among, women: 96.6mg/day) and DHA+EPA (men: 18.2mg/day, women: 16.0mg/day), low fiber intake (women: 21.5g/day), and high sodium (men: 3244mg/day, women: 2291mg/) and saturated fatty acids intakes (men: 29.2g/day) were reported. There was also a suggestion of low intakes of vitamins A, B6, C and D (in both sexes), and of riboflavin, folate, B12 and calcium (in women).ConclusionsOur findings provide initial evidence on the Bosnian population's dietary habits and identify aspects that need attention. As the survey evolves into a continuing surveillance system, it will allow evaluation of dietary changes over time.

BackgroundValid and efficient tools for measuring and tracking diet quality globally are lacking.ObjectiveThe objective of the study was to develop and evaluate a new tool for rapid and cost-efficient diet quality assessment.DesignTwo screener versions were designed using Prime Diet Quality Score (PDQS), one in a 24-hour recall (PDQS-24HR) and another in a 30-day (PDQS-30D) food frequency format. Participants completed two 24-hour diet recalls using the Automated Self-Administered 24-hour Dietary Assessment Tool (ASA24) and 2 web-based diet quality questionnaires 7 to 30 days apart in April and May 2019. Both dichotomous/trichotomous and granular scoring versions were tried for each screener.Participants/settingThe study included 290 nonpregnant, nonlactating US women (mean age ± standard deviation 41 ± 11 years) recruited via Amazon Mechanical Turk.Main outcome measuresThe main outcome measures were Spearman rank correlation coefficients and linear regression beta-coefficients between ASA24 nutrient intakes from foods and beverages and PDQS values.Statistical analyses performedThe Spearman rank correlation and linear regression were used to evaluate associations of the PDQS values with ASA24 nutrient intakes from food, both crude and energy-adjusted. Correlations were de-attenuated for within-person variation in 24-hour recalls. Wolfe’s test was used to compare correlations of the 2 screening instruments (PDQS-24HR and PDQS-30D) with the ASA24. Associations between the ASA24 Healthy Eating Index 2015 and the PDQS values were also evaluated.ResultsPositive, statistically significant rank correlations between the PDQS-24HR values and energy-adjusted nutrients from ASA24 for fiber (r = 0.53), magnesium (r = 0.51), potassium (r = 0.48), vitamin E (r = 0.40), folate (r = 0.37), vitamin C (r = 0.36), vitamin A (r = 0.33), vitamin B6 (r = 0.31), zinc (r = 0.25), and iron (r = 0.21); and inverse correlations for saturated fatty acids (r = –0.19), carbohydrates (r = –0.22), and added sugar (r = –0.34) were observed. Correlations of nutrient intakes assessed by ASA24 with the PDQS-30D were not significantly different from those with the PDQS-24HR. Positive, statistically significant correlations between the ASA24 Healthy Eating Index 2015 and the PDQS-24HR (r = 0.61) and the PDQS-30D (r = 0.60) were also found.ConclusionsThe results of an initial evaluation of the PDQS-based diet quality screeners are promising. Correlations and associations between the PDQS values and nutrient intakes were of acceptable strength and in the expected directions, and the PDQS values had moderately strong correlations with the total Healthy Eating Index 2015 score. Future work should include evaluating the screeners in other population groups, including men, and piloting it across low- and middle-income countries.

SummaryBackground A quantitative content analysis of research on parenting and childhood obesity was conducted to describe the recent literature and to identify gaps to address in future research. Methods Studies were identified from multiple databases and screened according to an a priori defined protocol. Eligible studies included non-intervention studies, published in English (January 2009–December 2015) that focused on parenting and childhood obesity and included parent participants. Results Studies eligible for inclusion (N = 667) focused on diet (57%), physical activity (23%) and sedentary behaviours (12%). The vast majority of studies used quantitative methods (80%) and a cross-sectional design (86%). Few studies focused exclusively on fathers (1%) or included non-residential (1%), non-biological (4%), indigenous (1%), immigrant (7%), ethnic/racial minority (15%) or low-socioeconomic status (19%) parents. Discussion While results illustrate that parenting in the context of childhood obesity is a robust, global and multidisciplinary area of inquiry, it is also evident that the vast majority of studies are conducted among Caucasian, female, biological caregivers living in westernized countries. Expansion of study foci and design is recommended to capture a wider range of caregiver types and obesity-related parenting constructs, improve the validity and generalizability of findings and inform the development of culture-specific childhood obesity prevention interventions and policies. © 2016 World Obesity

Background We conducted a systematic review to obtain studies on childhood obesity and parenting published between 2009 and 2015, and draw out those studies with a particular focus on media parenting. Our analysis addresses two major aims: 1) to describe how media use and media-related parenting practices and skills are operationalized in studies and 2) to explore whether studies measured ecological factors (e.g. individual-, family-, and community-level factors), which could be associated with media parenting practices. Methods Using a standardized, multi-stage process, we identified and screened articles focused on parenting and childhood obesity (N = 667). Studies were eligible for this analysis if they measured media parenting and/or the home media environment, resulting in a sample of 103 studies. We used quantitative content analysis to code the full text articles for content related to our study aims; analyses were performed using SAS 9.4. Results Seventy nine percent of studies measured media use, 82 % measured media parenting, and 65 % measured the home media environment. Studies measuring media use focused on a limited number of devices; while all studies measured child/parent use of televisions, only 3 % measured use of smartphones, 1 % measured use of laptops, and no studies measured use of tablets. Measures of parenting practices focused largely on rules specific to limiting screen time. Although 60 % of studies measured at least one ecological factor, child-specific and neighborhood/community-level factors were rarely measured. Conclusions More detailed measurements of media use that reflects current technology trends and diverse contexts of use are needed to better understand media use and parent regulation of child media exposure. Measures of the ecological context can more fully assess factors impacting media parenting and, subsequently, child risk for overweight and obesity. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-2981-5) contains supplementary material, which is available to authorized users.

National dietary surveillance systems are necessary for monitoring people's intake of foods and nutrients associated with health and disease, and for implementing national and global dietary goals. However, these systems do not exist in many low- and middle-income countries. The development of a model of dietary surveillance for Bosnia and Herzegovina, described here, provides insights into the feasibility and sustainability of dietary surveillance systems in resource-constrained settings and illustrates the challenges involved. In 2016, a year-long dietary survey was initiated in collaboration with the country's Institute for Statistics using a subsample of households that participated in the 2015 national Household Budget Survey. Interviewers collected lifestyle, anthropometric and health data and participants answered two 24-hour dietary recall questionnaires. The survey included a representative sample of 853 participants and was performed efficiently by a small team of highly motivated, well-trained staff. Conducting a high-quality dietary survey was found to be feasible despite constrained resources. In addition, the ability to link dietary intake and regular household survey data provided an effective way of associating dietary variables with socioeconomic determinants of health. This dietary survey, the first conducted by an official institution in Bosnia and Herzegovina, represents an important starting point for building a sustainable nutritional surveillance system for the country. The cost-effective, low-burden approach to dietary surveillance described here could be applied in other low- and middle-income countries, many of which already carry out regular economic surveys.Les systèmes nationaux de surveillance alimentaire sont nécessaires pour contrôler la consommation par la population des aliments et nutriments liés à la santé et aux maladies, mais aussi pour réaliser les objectifs nationaux et internationaux relatifs à l'alimentation. Or, il n'existe aucun système de la sorte dans nombre de pays à revenu faible et intermédiaire. La conception d'un modèle de surveillance alimentaire pour la Bosnie-Herzégovine que nous décrivons ici permet de mieux comprendre la faisabilité et la durabilité des systèmes de surveillance alimentaire dans les régions aux ressources limitées et illustre les défis à relever. En 2016, une enquête sur l'alimentation a été menée pendant une année, en collaboration avec l'institut national de la statistique de Bosnie-Herzégovine, auprès d'un sous-échantillon de ménages qui avaient pris part à l'enquête nationale de 2015 sur le budget des ménages. Les enquêteurs ont collecté des informations sur le mode de vie, des données anthropométriques et des données de santé, et les participants ont répondu à deux questionnaires fondés sur le rappel de leur consommation au cours des dernières 24 heures. Cette enquête a inclus un échantillon représentatif de 853 participants et a été efficacement menée par une petite équipe de personnes extrêmement motivées et bien formées. La réalisation d'une enquête de grande qualité sur l'alimentation s'est avérée faisable, malgré des ressources limitées. Par ailleurs, la possibilité de relier les données concernant les consommations alimentaires et les données des enquêtes régulièrement menéessur les ménages a fourni un moyen efficace d'associer les variables relatives à l'alimentation avec les déterminants socioéconomiques de la santé. Cette enquête sur l'alimentation (la toute première menée par un institut officiel en Bosnie-Herzégovine) constitue un bon point de départ pour l'élaboration d'un système de surveillance nutritionnelle durable pour le pays. L'approche de la surveillance alimentaire décrite ici, qui s'est avérée rentable et relativement peu pesante, pourrait être appliquée dans d'autres pays à revenu faible et intermédiaire, dont la plupart réalisent déjà régulièrement des enquêtes économiques.Los sistemas nacionales de vigilancia de la alimentación son necesarios para controlar la ingesta de alimentos y nutrientes asociados con la salud y las enfermedades, así como para alcanzar los objetivos alimentarios nacionales y mundiales. Sin embargo, estos sistemas no existen en muchos países de ingresos bajos y medios. La elaboración de un modelo de vigilancia alimentaria para Bosnia y Herzegovina, que se describe aquí, permite comprender mejor la viabilidad y la sostenibilidad de los sistemas de vigilancia alimentaria en entornos con recursos limitados e ilustra los problemas que se plantean. En 2016, se inició una encuesta alimentaria de un año de duración en colaboración con el Instituto de Estadística del país a partir de una submuestra de hogares que participaron en la Encuesta nacional de presupuestos familiares de 2015. Los entrevistadores recopilaron datos de estilo de vida, antropométricos y de salud y los participantes respondieron a dos cuestionarios de recordatorio alimentario de 24 horas. La encuesta incluyó una muestra representativa de 853 participantes y fue realizada eficazmente por un pequeño equipo de personal altamente motivado y bien capacitado. La realización de una encuesta alimentaria de alta calidad resultó factible a pesar de la escasez de recursos. Además, la capacidad de vincular la ingesta alimentaria con los datos de las encuestas periódicas en los hogares era una manera eficaz de asociar las variables alimentarias con los factores socioeconómicos determinantes de la salud. Esta encuesta sobre la alimentación, la primera realizada por una institución oficial de Bosnia y Herzegovina, representa un punto de partida importante para la creación de un sistema sostenible de vigilancia alimentaria para el país. El enfoque rentable y de baja carga de la vigilancia alimentaria que aquí se describe podría aplicarse en otros países de ingresos bajos y medios, muchos de los cuales ya llevan a cabo encuestas económicas periódicas.تعد أنظمة الرقابة الغذائية الوطنية ضرورية لرصد استهلاك الأشخاص للأطعمة والمواد الغذائية المرتبطة بالصحة والمرض، ولتنفيذ الأهداف الغذائية الوطنية والعالمية. ومع ذلك، إلا أن هذه النظم لا تتواجد في العديد من البلدان منخفضة الدخل والبلدان متوسطة الدخل. إن تطوير نموذج للرقابة الغذائية في البوسنة والهرسك، الذي نتناوله بالشرح هنا، يقدم نظرة ثاقبة على مدى جدوى واستدامة نظم الرقابة الغذائية في ظل أوضاع محدودة الموارد، ويوضح التحديات التي تنطوي عليها. في عام 2016، تم إطلاق مسح غذائي لمدة عام بالتعاون مع معهد الإحصاءات بالدولة، باستخدام عينة فرعية من الأسر التي شاركت في مسح ميزانية الأسرة لعام 2015. قام المشرفون على المقابلات الشخصية بتجميع بيانات حول نمط الحياة والبيانات الأنثروبومترية والصحية، وأجاب المشاركون على استبيانين للتذكير الغذائي على مدار 24 ساعة. وشمل المسح عينة تمثيلية من 853 مشاركًا وتم تنفيذه بفعالية بواسطة فريق صغير من الموظفين المتحمسين للغاية والحاصلين على تدريب جيد. تبين أن إجراء مسح غذائي عالي الجودة أمر ممكن رغم الموارد المحدودة. بالإضافة إلى ذلك، فإن القدرة على الربط بين الاستهلاك الغذائي وبيانات المسح الأسري المعتاد، قدمت وسيلة فعالة لربط المتغيرات الغذائية مع المحددات الاجتماعية والاقتصادية للصحة. هذا المسح الغذائي هو الأول من نوعه الذي تقوم به مؤسسة رسمية في البوسنة والهرسك، وهو يمثل نقطة انطلاق مهمة لبناء نظام رقابة غذائية مستدامة للبلد. إن أسلوب الرقابة الغذائية الذي يتميز بالفعالية من حيث التكلفة والعبء المنخفض، والذي نقوم بوصفه هنا، يمكن تطبيقه في البلدان الأخرى ذات الدخل المنخفض، والدخل المتوسط والكثير منها بالفعل يقوم بإجراء مسوحات اقتصادية معتادة.国家膳食监测系统对于监测人们摄入的食物和营养物质与健康和疾病状况之间的关联，以及实施全国性和全球性膳食目标是十分必要的。然而，许多低收入和中等收入国家并没有此类系统。本文描述了波斯尼亚和黑塞哥维那膳食监测系统的发展，提供了膳食监测系统在资源有限的环境下可行性和可持续性的见解，并就所涉及的挑战予以说明。2016 年，与该国统计研究所合作开展了一项为期一年的膳食调查，并使用了参与 2015 年全国家庭预算调查的家庭子样本。采访者收集了生活方式、人体测量和健康数据，同时参与者回答了两份 24 小时膳食回顾调查问卷。本调查纳入了 853 名参与者的代表性样本，并由一小组积极性高、训练有素的员工团队高效完成。尽管资源有限，但进行高质量的膳食调查仍切实可行。此外，能够将膳食摄入量与定期的家庭调查数据相联系为将膳食变量与健康的社会经济决定因素相联系提供了一种有效方法。此项膳食调查——首次由波斯尼亚和黑塞哥维那的官方机构进行——是该国建立可持续营养监测系统的重要基础。本文所述的低成本、低负担的膳食监测方法可应用于其他低收入和中等收入国家，其中许多国家已开展定期经济调查。.Национальные системы надзора за качеством питания необходимы для мониторинга употребления людьми пищевых продуктов и питательных веществ в связи с проблемами со здоровьем или заболеваниями, а также для реализации национальных и глобальных целей в области питания. Однако во многих странах с низким и средним уровнем доходов таких систем не существует. Разработка модели системы надзора за качеством питания в Боснии и Герцеговине, описанная в данном документе, позволяет достоверно представить практическую осуществимость и перспективность систем надзора за качеством питания в условиях ограниченных ресурсов и наглядно демонстрирует связанные с ними проблемы. В 2016 году был проведен годичный опрос для определения характера питания населения. Опрос проводился в сотрудничестве с национальным Институтом статистики на подвыборке семей, участвовавших в национальном опросе по семейному бюджету в 2015 году. Лица, проводившие опрос, собирали данные об образе жизни, антропометрические показатели и данные о здоровье, а участники опроса должны были по памяти дать ответы на две анкеты о своем питании за последние 24 часа. Опросом была охвачена репрезентативная выборка из 853 участников. Опрос проводился небольшой группой заинтересованных и квалифицированных сотрудников. Проведение качественного опроса для определения характера питания населения оказалось возможным, несмотря на ограниченность ресурсов. Кроме того, возможность связать данные рациона питания с данными стандартного опроса о состоянии семьи позволила установить связь между переменными, связанными с качеством питания, и социально-экономическими детерминантами здоровья. Данный опрос для определения характера питания (первое мероприятие подобного рода, проведенное государственным учреждением в Боснии и Герцеговине) является важной отправной точкой для создания надежной системы надзора за качеством питания в стране. Экономичный и сопряженный с небольшими нагрузками подход к надзору за качеством питания, описанный в данном документе, может применяться и в других странах с низким и средним уровнем доходов, многие из которых уже проводят регулярные экономические обследования.

Background Dietary diversity scores (DDS) are considered as metrics for monitoring the implementation of the UN’s Sustainable Development Goals, but they need to be rigorously evaluated. Objective To examine two DDS, the Food Groups Index (FGI), and the Minimum Dietary Diversity-Women (MDD-W), alongside two dietary quality scores, the Alternate Healthy Eating Index (AHEI-2010) and the Prime Diet Quality Score (PDQS), with risks of gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDPs). Design The analysis included 21,312 (GDM) and 19,917 (HDPs) singleton births reported in the Nurses’ Health Study II cohort (1991–2001), among women without major chronic disease or GDM/HDPs. Scores were derived using prepregnancy diet collected by a comprehensive food frequency questionnaire. Multivariable models were utilized to calculate relative risks (RR) and confidence intervals (95%CIs). Results Incident GDM (n = 916) and HDPs (n = 1,421) were reported. The MDD-W and FGI were not associated with risk of GDM or HDPs, but the AHEI-2010 and PDQS were associated with a lower risk of GDM and marginally lower risk of HDP. The RR’s of GDM comparing the highest vs. lowest quintiles were 1.00 (95%CI: 0.79, 1.27; p-trend = 0.82) for MDD-W, 0.96 (95%CI: 0.76, 1.22; p-trend = 0.88) for FGI, 0.63 (95%CI: 0.50, 0.81; p-trend

Background. The involvement of fathers in caregiving has increased substantially over the past 30 years. Yet in child and adolescent psychopathology, few studies include fathers as research participants and few present results for fathers separate from those for mothers. We test for the first time whether a similar pattern exists in research on parenting and childhood obesity. Objectives. To conduct a systematic review and quantitative content analysis of observational studies on parenting and childhood obesity to (1) document the inclusion of fathers, relative to mothers, as research participants and (2) examine characteristics of studies that did and did not include fathers. This study presents new data on the number and gender of parent research participants. Search methods. We searched title, abstract, and Medical Subject Headings term fields in 5 research databases (PubMed, EMBASE, Academic Search Premier, PsycINFO, and CINAHL) using terms combining parents or parenting (e.g., mother, father, caregiver, parenting style, food parenting) and obesity (e.g., obesity, body weight, overweight) or obesity-related lifestyle behaviors (e.g., diet, snacking, physical activity, outdoor play, exercise, media use). Selection criteria. We identified and screened studies as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) published between January 2009 and December 2015, examining links between parenting and childhood obesity, including parents or caregivers as research participants, and written in English. We excluded interventions, nonhuman studies, dissertations, conference abstracts, and studies on youths with specific medical conditions. Of 5557 unique studies, 667 studies were eligible. Data collection and analysis. For each of the 667 studies, 4 coders were trained to code characteristics of the study (e.g., publication year, geographic region, journal, study focus) and parent research participants (e.g., parent gender, demographic background, biological relationship with child, and residential status). We established intercoder reliability before coding the full sample of studies (mean Krippendorf’s alpha = .79; average percentage agreement = 94%). Main results. Of the studies, 1% included only fathers. By contrast, 36% included only mothers. Although slightly more than 50% of studies (n = 347) included at least 1 father, only 57 studies reported results for fathers separate from those for mothers. When we combined them with studies including only fathers, 10% of studies overall reported results for fathers. Samples sizes of fathers were small compared with mothers. Of studies with fathers, 59% included 50 or fewer fathers, whereas 22% of studies with mothers included 50 or fewer mothers. The mean sample size for fathers across all eligible studies was 139, compared with 672 for mothers. Overall, fathers represented 17% of parent participants across all eligible studies. Conclusions. This study unequivocally demonstrates that fathers are underrepresented in recent observational research on parenting and childhood obesity. Public health implications. The underrepresentation of fathers in obesity research compromises the development of effective family interventions for childhood obesity prevention. Targeted opportunities and incentives are needed to support research with fathers.