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Obesity and diet-related health problems are complex, multi-factorial issues. Individual food choices are shaped by the wider context, and food environment level change is needed to support individual behaviour change. The food service sector can play an integral role, changing aspects of the food environment and contributing to improved consumer health. This systematic review aimed to analyse food service schemes that aimed to improve consumer health. Ten electronic databases were systematically searched to identify articles, supplemented with checking of reference lists from similar reviews and forward and backward searches to identify articles describing food service sector schemes. Sixteen schemes were identified, documented in 36 articles/reports. The schemes aimed to improve consumer health through one of three approaches— informing , enabling or engineering. In this order, these approaches involved increasing levels of effort from food services, corresponding with decreasing levels of effort for consumers. Half the schemes were informing , relying on an informed consumer to make a healthy choice. Most informing schemes had been evaluated to determine their impact on consumer choice and/or health, the evidence showed these schemes were generally ineffective. The effect of the enabling or engineering schemes on consumer choice and health had not been measured. Instead, evaluations focussed on process or business engagement rather than behavioural change assessments. This review indicates the food sector has the potential to contribute to consumer health through enabling and engineering ; however, detailed outcome assessments are needed to draw definitive conclusions. [ABSTRACT FROM AUTHOR]

Objective: Research has begun to take a more ecological view of eating behaviour, examining multiple levels of influence: personal, social and environmental. The food environment is a major influence on eating behaviour, attracting the attention of researchers who have measured it in a number of ways. The present paper examines the short-form version, in comparison to the long-form version, of the Nutrition Environment Measures Survey (NEMS) - an observational food outlet audit tool.Design: Both the short-form and long-form were examined to qualitatively appraise the dimensions of the food environment assessed by each measure. Data from 135 food outlets in Australia were then used to compare results obtained using the short-form with the results from the long-form method, to consider the utility of the short-form measure.Setting: The retail food environment in Australia.ParticipantsOne hundred and thirty-five food outlets in Australia.Results: Results indicate that the short-form predominantly assessed availability of healthful foods (one aspect of the food environment). Several critical dimensions of the food environment known to influence eating behaviour were not assessed. For this data set, the short-form produced scores inconsistent with the longer version of the measure, delivering inflated estimates for stores and deflated estimates for restaurants.Conclusions: Scores between the long-form and short-form versions were not comparable in this Australian study. Further development of food environment measures is recommended and must balance instrument brevity with the need to accurately capture important aspects of the food environment known to influence eating behaviour. [ABSTRACT FROM AUTHOR]

Introduction: Military personnel need to eat healthfully to enable peak performance and sustain health. Poor dietary habits and a rising rate of obesity among military personnel indicate a need for programs to improve food choices. This study evaluated two programs conceived under a dual-process model (consumer-focused communications only and a broader social marketing program including communications and environmental changes). Methods: Programs were implemented and evaluated over a 6-week period in two military dining halls in Australia. Food selections were measured before and after program implementation using plate photography (N = 673 meals). Outcome variables included a healthy plate index (HPI), number of selections for food types, number of selections from three healthfulness categories (most healthful, moderately healthful, and least healthful), and a measure of how diner selections differed from the proportions of each healthfulness category available on the menu. Independent t tests were used to assess the difference between diner selections before and after program implementation. Results: Significant differences (p < .05) in diner selections were observed after implementation of both programs, all in a healthful direction. When communications were used in isolation, the HPI was higher, with more selections made, and more moderately healthful selections chosen. When communications and environmental changes were combined, the number of choices remained stable but the HPI increased, and more of the most healthful foods were chosen. Conclusions: The eating behavior of military personnel can be improved using consumer-focused communications. However, by altering the environment as well, a greater change in behavior can be realized. [ABSTRACT FROM AUTHOR]

Background: Physical training by female military trainees can put them at risk of iron deficiency and inferior health and performance. Purpose: To determine the effect of iron supplementation on iron status, fitness, fatigue, and leisure activities. Material and Methods: In this randomised, double-blind, placebo-controlled trial, female officers-in-training were randomly allocated to treatment (n = 25, 18 mg iron) or placebo tablets (n = 24). Outcomes were iron status, fitness, fatigue, and leisure activity at baseline, seven weeks and 13 weeks. Results: Ferritin declined by midpoint in the placebo group (P = 0.001). There was a treatment effect in the second half of the trial in emotional fatigue (-4.2 to -0.6 95% CI, P = 0.04). There was a negative relationship with iron intake for emotional fatigue (OR 0.61; 0.44 to 0.87 95% CI; P = 0.006) and positive for vigour (OR 1.51; 1.08 to 2.11 95%CI; P = 0.016) and small negative association between initial dietary iron intake and initial serum ferritin (0.2 to 9.2 μg/L 95% CI; P = 0.042). Conclusion: Officer training affects iron status and iron supplementation improves indicators of iron status and emotional fatigue in female officers-in-training. [ABSTRACT FROM AUTHOR]

ObjectiveThe present study sought to identify both the ingredients for success and the potential impediments to social marketing effectiveness for healthy eating behaviour, focusing on studies conducted over the last 10 years.DesignA comprehensive literature review was undertaken examining seventeen databases to identify studies reporting the use of social marketing to address healthy eating. Thirty-four empirical studies were analysed to examine the effectiveness of social marketing interventions to improve healthy eating behaviour using Andreasen's (2002) social marketing benchmark criteria. Statistical analysis was undertaken to quantitatively evaluate whether effectiveness varied between study categories (subsets).SettingHealthy eating empirical studies published from 2000 onwards.SubjectsEmpirical studies that self-identified as social marketing.ResultsSixteen social marketing studies (subset 1) were identified in the review. These were systematic studies which sought to change behaviour through tailored solutions (e.g. use of marketing tools beyond communication was clearly evident) that delivered value to the target audience. For these sixteen studies, the mean number of criteria identified was five. Six studies met all six criteria. Positive change to healthy eating behaviour was found in fourteen of sixteen studies. The sixteen studies that met the definition of social marketing used significantly more of Andreasen's (2002) criteria and were more effective in achieving behavioural change than the eighteen studies in subset 2.ConclusionsSocial marketing is an involved process and it is important that studies identifying as social marketing adopt social marketing benchmark criteria. Social marketing when employed to its full extent offers the potential to change healthy eating. [ABSTRACT FROM PUBLISHER]

• Military ration pack foods are often under consumed by personnel. • Underconsumption increases the risk of diminished health and performance. • Modifications are commonly informed by hedonic ratings. • This study examined Best-Worst Scaling (BWS) to extend measurement beyond liking. • Results indicate BWS provided better discrimination between products than liking. • BWS could be used as a decision-making tool during military ration pack development. Packaged military foods are often under consumed by personnel during training and operational situations, increasing the risk of diminished health and performance. Considerable effort is therefore committed to selecting or improving foods to increase the likelihood of consumption. These decisions are commonly informed by hedonic liking—a single, but important influence on choice and consumption. This paper examined the utility of Best-Worst Scaling (BWS) in a military context as a measure of choice to extend measurement beyond liking and closer to the desired goal of consumption. Two studies (involving n = 303 civilians; n = 300 military personnel) compared ratings of liking and choice (BWS) and examined choice patterns across evoked military scenarios. Results confirmed hedonic liking was a poor predictor of choice at a product level (50% of the variance explained) and at an individual level (26% of the variance explained). BWS provided better discrimination between products than liking. At a group level, choice patterns were relatively consistent across scenarios. BWS was used to identify most preferred and least preferred products. When there was variation in choice patterns within the group, 'certain winners', 'polarising products' and 'definite losers' could be identified. This demonstrates how Best-Worst Scaling could be used as a decision making tool during military ration pack development. [ABSTRACT FROM AUTHOR]

Dietary supplements (DSs) and nutritional supplements (NSs) can enhance performance, recovery or training adaptations, however, some substances, dosages, and usage protocols are unsafe. Knowledge of the type and extent of use within populations enables strategies to be formulated to promote safe and effective use (where needed) and to avoid adverse side effects. The purpose of this study was to understand DS and NS use by active-duty Australian soldiers. Surveys were distributed by e-mail and hard copy to eligible participants (n = 23,195). Respondents (males n = 1833; females n = 296) comprised 9.3% of the total population. Use of ≥1 DSs/week was reported by 76.4% of males and 86.8% of females, and use of ≥1 NSs/week was reported by 21.7% of males and 20.9% of females. The most commonly used supplements were protein or amino acids (55.6%), multivitamins and minerals (38.2%), other DSs (37.8%), individual vitamins and minerals (33.0%), and combination products (32.8%). Logistic regression revealed the number of DSs respondents used simultaneously was significantly different between males and females, age groups, BMI ranges, and body weight actions. Engagement in special operations was a significant predictor of the use of any DS, individual vitamin and minerals and multivitamin and minerals. Approximately 16% of regular DS users reported experiencing one or more side effects, with the most common being palpitations (10.6%), tingling or numbness in the face, fingers, arms, or legs (5.5%), tremors or shaking (2.9%), flushing (2.3%), headache (2.0%), abdominal pain (1.6%), anxiety (1.4%), and dizziness or confusion (0.9%). The results revealed more prevalent use of several categories of DSs and NSs among some subgroups. Ongoing surveillance of DS and NS use is important for tracking trends in use over time and gauging the effectiveness of any strategies employed to enhance the quality of supplement use. [ABSTRACT FROM AUTHOR]

New army recruits undertake initial training to develop their skillset and physical and mental preparedness for military service. Recruits experience a range of stressors both physical and psychological, often at extremes, and in combination. These stressors place recruits at risk of suboptimal energy and macronutrient intakes, which may negatively influence their performance. The objectives of this systematic literature review are to examine, against the Military Recommended Dietary Intakes (MRDIs), the energy, carbohydrate, protein, and fat intakes of army recruits and trainees undertaking initial training internationally, and identify any associated influence on their performance. A systematic literature review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses guidelines. Information sources were searched from their inception until May 2019. Outcome data included dietary intakes of energy, carbohydrate, protein, and fat before, during, and/or after army initial training, as well as measures of physical fitness and performance. A custom tool was used to assess the quality of included studies. The results of 14 studies were synthesized. Six were conducted in the United States and four in each of Australia and Israel. Average energy intake represented 69% to 120% of the MRDIs before training commencement, 69% to 106% of the MRDIs in the early weeks of training and 56% to 77% of the MRDIs in the later weeks of training. Average carbohydrate and protein intakes represented 49% to 121% and 64% to 143% of the MRDIs, respectively, across the various time points. Three studies measured physical fitness and/or performance outcomes, with one showing a significant improvement in push-up performance when extra protein was provided. The novel findings of this systematic literature review are that army recruits, internationally, are likely to be underconsuming energy for extended periods of their initial training, with greater deficits in carbohydrate intake compared with other macronutrients. Only a handful of studies investigated the subsequent influents on performance, with no definitive conclusions drawn in most instances. Further research is needed to understand the influence of suboptimal dietary intake on military relevant performance indicators to help better inform key stakeholders when devising nutrition guidance and strategies for army recruits in the future. [ABSTRACT FROM AUTHOR]