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The objective of this study was to study the association between total sugar intake (TSI) levels of children aged 6−8 years old, nutrient intake and anthropometry. Food and beverage intakes were collected by a prospective three-day recall questionnaire. The 2237 children were distributed into three groups according to TSI percentiles. Mean TSI was 93.77 ± 25.72 g/day, 22%−25% of total caloric intake, with boys presenting an intake of 96.24 ± 24.34 g/day and girls 91.38 ± 26.78 g/day. Greater TSI was associated with higher body fat, parental education, energy intake, nutrients/1000 kcal, and lower weight z-scores, BMI z-scores, waist circumferences, and hip circumferences. Weight, height, and waist circumference had the highest R2 while body fat had the lowest. The percentage of total energy derived (%E) from protein decreased as the %E from TSI increased, while the opposite was true for carbohydrates and saccharides, while for fiber intake, the medium groups presented the highest intake/1000 kcal. For the remaining macronutrients studied, intake/1000 kcal decreased when the %E from TSI increased. Calcium, iodine, magnesium, vitamin B2, folate, and vitamin C intake increased as the %E from TSI increased, while the opposite was true for vitamin B12. Fiber, ω-6 PUFA, iodine, folate, vitamin D, and vitamin E intakes were insufficient across most of the sample. TSI levels in children were identified to exceed adult recommendations. It is not clear what the effect of up to an average of 21% of energy coming from total sugars has on childhood obesity and further research is needed in the pediatric population, however, opportunities exist to improve sugar intake patterns.

Background: Capacity building in nutrition has been viewed as an important strategy in accelerating undernutrition reduction in low and middle income countries. This paper investigates whether current nutrition programmes in India are aligned well enough to tackle the nutrition needs of the community. Objective: Nutrition curricula of postgraduate modules in India are analyzed to examine whether the current nutrition programs are in accord with the three pillars of nutrition (nutrition specific, nutrition sensitive and nutrition enabling environments). Methods: Combination of internet search, email and telephonic enquiries were used to collect the names of universities offering master's degree in nutrition in India. The variables quantified include types of modules taught with respect to three nutrition pillars (nutrition specific, sensitive and enabling environment), quality of teaching materials, and reading lists and institutional attributes. Descriptive and bivariate analyses were used to accomplish the objectives of the study. Results: 116 universities in India offered 146 masters' programmes in nutrition. Each program's modules were listed (duplicates removed). Of these 680 modules, about two thirds were nutrition specific, 5% were underlying / basic and merely one tenth focused on public health nutrition. Further analysis of reading list available for 186 modules, suggests that of the total 2235 reading lists, only 4.2% were published in journals and 9.2% were recent publications. Conclusions: Nutrition curricula in Indian universities are dated, skewed towards the immediate determinants and over reliant on books. There is an urgent need to update and align readings to current thinking on how best to accelerate undernutrition.

Corporate influence in policy and decision-making is an important public health concern. This Health Policy paper reviews Ecuador's child malnutrition strategy instruments, approved between 2020 and 2023, to identify how private interests are becoming legally integrated into the public sector. Evidence indicates that recent changes are enabling corporations to promote their brands, gain tax deductions, oversee public policy and set priorities, allocate resources, and decide on implementation of the country's child malnutrition strategy. Further, corporate representatives are active members of an advisory council, free from scrutiny or accountability, while being privy to undisclosed government information. Moreover, a UN agency (the World Food Program) engaged in corporate promotion of highly processed foods, illustrating the breadth of Ecuador's corporate influence scheme. Improved regulations should set clear limits to the influence of food and beverage industries in national nutrition policy, while following transparency laws in the composition and operation of Ecuador's child malnutrition strategy and related efforts., Competing Interests: We declare no competing interests., (© 2023 The Author(s).)

Iodine deficiency disorders (IDDs) constitute a significant public health problem globally. In India, the entire population is prone to IDDs due to deficiency of iodine in the soil of the sub-continent and thus both animal and plant source food grown on the iodine-deficient soil. IDDs encompass the spectrum of disability and disease and include goitre, cretinism, hypothyroidism, abortion, stillbirth, brain damage, learning disabilities, mental retardation, psychomotor defects, hearing and speech impairment. Iodine deficiency is known to be the single largest cause of preventable brain damage. IDDs with their causal association with brain development, cognition, and learning disabilities impair the human resource development and progress of the country. The children born in iodine-deficient regions on an average have 13.5 intelligence quotient (IQ) points lesser than children born in iodine-sufficient regions. IDD control programme in India is a public health success story, with 92 per cent of the population consuming iodized salt. The partnership between government agencies, academic institutions, salt industry, development agencies and civil society has been key to achieve this success story. The sustainable elimination of iodine deficiency in India is within reach, what is required is accelerated and coordinated effort by all key stakeholder at national and State level. [ABSTRACT FROM AUTHOR]

The National Institute of Nutrition (NIN) has reached a remarkable milestone of completing 100 years of exemplary service to the nation. The long journey that started in a humble one-room laboratory at Coonoor (now in Tamil Nadu) in 1918 to a colossus of the nutrition research in the country today is dotted with several interesting vignettes. The NIN has always been at the forefront of need-based, pragmatic research. Its large-scale community-based interventions have been of great practical value in the nation's fight against malnutrition. The evolution of nutrition as a modern science almost coincides with the growth of the Institute. Being the oldest in the fraternity of institutes under the Indian Council of Medical Research (ICMR), the NIN has grown from strength to strength due to the sheer relevance of its contributions in furthering nutrition science and promoting public health in the country. This article provides a historical overview of the evolution and contributions of ICMR-NIN in the areas of nutrition, food safety, public health and policy. [ABSTRACT FROM AUTHOR]

Copyright of Universidad Médica Pinareña is the property of Editorial Ciencias Medicas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The literacy about nutrition of people with diabetes is important since healthy eating can improve the life quality of these people. Objective: The objective of this study was to create an instrument called "Nutrition Literacy among people with Diabetes (NLD)" and evaluate its validity, reliability and interpretability. Method: Methodological study with verification of content validity; pre-test; reliability estimation (internal consistency: Cronbach's alpha; reproducibility: kappa-K, Intraclass Correlation Coefficient - ICC); estimation of the validity of concurrent criterion and interpretability made by counting the correct words associations with scores from 0 to 24 (cut = 18) and hypothesis test in sample for infinite population through logistic regression p=0.05; (OR / CI 95%). Results: The content validity was satisfactory. Reliability (alpha = 0.68, K=0.60 and CCI = 0.68) was good. Regarding the concurrent validity, a correlation between NLD and schooling (rs = 0.88, p = 0.000) was found. From the 212 participants, 75.8% presented NLD> 18. In the hypothesis test, it was found that the higher the schooling, the higher the NLD (1.20 / 1.09-1.31); the NLD was lower among men (0.50 / 0.25-1.01). Conclusion: The NLD was considered valid, reliable and easy to interpret, and it could be used in future research or even in health services that provide assistance to people with diabetes. [ABSTRACT FROM AUTHOR]

Evidence-informed guideline development methods underpinned by systematic reviews ensure that guidelines are transparently developed, free from overt bias, and based on the best available evidence. Only recently has the nutrition field begun using these methods to develop public health nutrition guidelines. Given the importance of following an evidence-informed approach and recent advances in related methods, this study sought to describe the methods used to synthesize evidence, rate evidence quality, grade recommendations, and manage conflicts of interest (COIs) in national food-based dietary guidelines (FBDGs). The Food and Agriculture Organization's FBDGs database was searched to identify the latest versions of FBDGs published from 2010 onward. Relevant data from 32 FBDGs were extracted, and the findings are presented narratively. This study shows that despite advances in evidence-informed methods for developing dietary guidelines, there are variations and deficiencies in methods used to review evidence, rate evidence quality, and grade recommendations. Dietary guidelines should follow systematic and transparent methods and be informed by the best available evidence, while considering important contextual factors and managing conflicts of interest. [ABSTRACT FROM AUTHOR]

Malnutrition and depression are of important concern among older adults. We investigated the association between malnutrition and depression among community-dwelling older Chinese adults and how both affect health care costs. Data from 4916 older adults (age ≥60 years) collected as part of 2013-Wave II China Health and Retirement Longitudinal Study (CHARLS) survey were analyzed. Measures of body mass index and weight loss were used as indicators of malnutrition. Malnourished subjects were 31% more likely to be depressed than their non-malnourished counterparts (odds ratio = 1.311, P < .1). Health care–related cost was ¥591.8 higher for malnourished older adult per year compared to a non-malnourished counterpart (P < .1), thus confirming that incidence of depression coupled with malnutrition significantly increases health care–related costs. These results highlight the importance of malnutrition and depression screening and treatment for older Chinese community-dwelling adults, and the importance of community-based nutrition-specific programs that could address the needs of the affected populations. [ABSTRACT FROM AUTHOR]

Background: Front-of-pack graphical nutritional rating of products is becoming an important strategy in many countries to improve healthy food purchases by consumers. Evidence of the effectiveness of such on facilitating healthy food choices by school food service providers has not been reported. The primary aim of the study was to assess the impact of providing front-of-pack nutritional rating information on school canteen managers' likely food selections. Secondary outcomes were canteen manager awareness, attitudes and reported barriers to using the front-of-pack information.Methods: A randomised controlled trial involving primary school canteen managers was conducted in a single region in New South Wales, Australia. Eligible participants were randomised to an intervention or control group and asked in a telephone interview which of 12 common food products sold in school canteens they would sell. Both groups received product name and brand information. The intervention group also received information regarding the nutritional rating of products.Results: Canteen managers in the intervention group were significantly more likely than those in the control group to indicate they would sell three of the six 'healthier' products (p = 0.036, 0.005, 0.009). There was no difference between groups in the likelihood of making available for sale any of the six 'less healthy' products. The majority of canteen managers who had heard of a product nutritional rating system agreed that it was helpful in identifying 'healthier' foods (88%, n = 31).Conclusions: The inclusion of product nutritional rating information has the potential to improve the availability of some 'healthier' items on canteen menus and contribute to improving child dietary intake. Further research is required to determine whether the use of product nutritional rating information actually makes a difference to canteen manager choices. [ABSTRACT FROM AUTHOR]

Summary: Supermarkets have been described as having unprecedented and disproportionate power in the food system. This scoping review synthesized the literature that describes the position and power of supermarkets in the Australian food system, and the implications for public health. A systematic search of peer‐reviewed and grey literature identified 68 documents that described supermarket power. Implications for public health were also recorded. Data revealed that supermarkets hold a powerful position in the Australian food system, acting as the primary gatekeepers. Supermarkets have obtained instrumental, structural and discursive power from many sources that overlap and reinforce each other. Few positive public health impacts of supermarket power were identified, providing many opportunities for improvement in the domains of food governance, the food system and public health nutrition. There is very little public health research examining the impact of supermarket power in Australia. More research is needed, and examination of supermarket own brands is of particular importance owing to their pivotal role as a source of power and their potential to improve public health outcomes, such as obesity. [ABSTRACT FROM AUTHOR]

Background: Much of the food available from takeaways, pubs and restaurants particularly that sold by independent outlets, is unhealthy and its consumption is increasing. These food outlets are therefore important potential targets for interventions to improve diet and thus prevent diet related chronic diseases. Local authorities in England have been charged with delivering interventions to increase the provision of healthy food choices in independent outlets, but prior research shows that few such interventions have been rigorously developed or evaluated. We aimed to learn from the experiences of professionals delivering interventions in independent food outlets in England to identify the operational challenges and their suggestions for best practice.Methods: We used one-to-one semi-structured qualitative interviews to explore the views and experiences of professionals who were either employees of, or contracted by, a local authority to deliver interventions to increase the provision of healthier food choices in independent food outlets. Purposive sampling was used to recruit a sample which included men and women, from a range of professional roles, across different areas of England. Interviews were informed by a topic guide, and proceeded until no new themes emerged. Interviews were recorded, transcribed verbatim and analysed using the Framework method.Results: We conducted 11 individual interviews. Participants focussed on independent takeaways and their unhealthy food offerings, and highlighted the advantages and disadvantages of intervention delivery methods, their evaluation and impact. The main barriers to implementation of interventions in independent takeaways were identified as limited funding and the difficulties of engaging the food outlet owner/manager. Engagement was thought to be facilitated by delivering intensive, interactive and tailored interventions, clear and specific information, and incentives, whilst accounting for practical, primarily financial, constraints of food businesses. Alternative intervention approaches, targeting suppliers or customers, were suggested.Conclusions: Participants emphasised independent takeaways as particularly challenging, but worthwhile intervention targets. Participants perceived that interventions need to take account of the potentially challenging operating environment, particularly the primacy of the profit motive. Upstream interventions, engaging suppliers, as well as those that drive consumer demand, may be worth exploring. Rigorous, evidence-informed development and evaluation of such interventions is needed. [ABSTRACT FROM AUTHOR]

Governmental and commercial lists of food retailers are often used to measure food environments and foodscapes for health and nutritional research. Information about the validity of such secondary food source data is relevant to understanding the potential and limitations of its application. This study assesses the validity of two government lists of food retailer locations and types by comparing them to direct field observations, including an assessment of whether pre-classification of the directories can reduce the need for field observation. Lists of food retailers were obtained from the Central Business Register (CVR) and the Smiley directory. For each directory, the positive prediction value (PPV) and sensitivity were calculated as measures of completeness and thematic accuracy, respectively. Standard deviation was calculated as a measure of geographic accuracy. The effect of the pre-classification was measured through the calculation of PPV, sensitivity and negative prediction value (NPV). The application of either CVR or Smiley as a measure of the food environment would result in a misrepresentation. The pre-classification based on the food retailer names was found to be a valid method for identifying approximately 80% of the food retailers and limiting the need for field observation.

Background: There is a dearth of information on existing nutrition training programs in West Africa. A preliminary step in the process of developing a comprehensive framework to strengthen human capacity for nutrition is to conduct an inventory of existing training programs. Objective: This study was conducted to provide baseline data on university-level nutrition training programs that exist in the 16 countries in West Africa. It also aimed to identify existing gaps in nutrition training and propose solutions to address them. Design: Participating institutions were identified based on information provided by in-country key informants, UNICEF offices or through internet searches. Data were collected through semi-structured interviews during on-site visits or through self-administered questionnaires. Simple descriptive and bivariate analyses were performed. Results: In total, 83 nutrition degree programs comprising 32 B.Sc. programs, 34 M.Sc. programs, and 17 Ph.D. programs were identified in the region. More than half of these programs were in Nigeria. Six countries (Cape Verde, Guinea-Bissau, Liberia, Mali, The Gambia, and Togo) offered no nutrition degree program. The programs in francophone countries were generally established more recently than those in anglophone countries (age: 3.5 years vs. 21.4 years). Programs were predominantly (78%) run by government-supported institutions. They did not provide a comprehensive coverage of all essential aspects of human nutrition. They were heavily oriented to food science (46%), with little emphasis on public health nutrition (24%) or overnutrition (2%). Annual student intakes per program in 2013 ranged from 3 to 262; 7 to 40; and 3 to 10, respectively, for bachelor's, master's, and doctoral programs while the number of graduates produced annually per country ranged from 6 to 271; 3 to 64; and 1 to 18, respectively. External collaboration only existed in 15% of the programs. In-service training programs on nutrition existed in less than half of the countries. The most important needs for improving the quality of existing training programs reported were teaching materials, equipment and infrastructures, funding, libraries and access to advanced technology resources. Conclusions: There are critical gaps in nutrition training in the West Africa region. The results of the present study underscore the urgent need to invest in nutrition training in West Africa. An expanded set of knowledge, skills, and competencies must be integrated into existing nutrition training curricula. Our study provides a basis for the development of a regional strategy to strengthen human capacity for nutrition across the region.

Improving population diets is a public health priority, and calls have been made for corporations such as supermarkets to contribute. Supermarkets hold a powerful position within the food system, and one source of power is supermarket own brand foods (SOBFs). Many of the world’s largest supermarkets have corporate social responsibility (CSR) policies that can impact public health, but little is known about their quality or practical application. This study examines the nature and quality of Australian supermarkets’ CSR policies that can impact public health nutrition, and provides evidence of practical applications for SOBFs. A content analysis of CSR policies was conducted. Evidence of supermarkets putting CSR policies into practice was derived from observational audits of 3940 SOBFs in three large exemplar supermarkets (Coles, Woolworths, IGA) in Perth, Western Australia (WA). All supermarkets had some CSR policies that could impact public health nutrition; however, over half related to sustainability, and many lacked specificity. All supermarkets sold some nutritious SOBFs, using marketing techniques that made them visible. Findings suggest Australian supermarket CSR policies are not likely to adequately contribute to improving population diets or sustainability of food systems. Setting robust and meaningful targets, and improving transparency and specificity of CSR policies, would improve the nature and quality of supermarket CSR policies and increase the likelihood of a public health benefit.

Malnutrition and poor diet are the largest risk factors responsible for the global burden of disease. Therefore, ending all forms of malnutrition by 2030 is a global priority. To achieve this goal, a key element is to design and implement nutrition policies based on the best available scientific evidence. The demand for evidence-based nutrition policies may originate directly from policymakers or through social actors. In both cases, the role of research institutions is to generate relevant evidence for public policy. The two key objects of analysis for the design of an effective policy are the nutrition conditions of the population and the policies and programs available, including the identification of delivery platforms and competencies required by personnel in charge of the provision of services (social response). In addition, systematic literature reviews about risk factors of malnutrition, as well as the efficacy and effectiveness of policy actions, lead to evidence-based policy recommendations. Given the multifactorial nature of malnutrition, the drivers and risk factors operate in several sectors (food and agriculture, health, education, and social development) and may be immediate, underlying or basic causes. This multilevel complexity should be considered when developing nutrition policy. In this article, we show two models for the evidence-based design of nutrition policies and programs that may be useful to academia and decision makers demonstrated by two examples of policy design, implementation and evaluation in Mexico.

Public health nutrition (PHN) seeks to protect and promote the nutrition-related health and wellbeing of populations. PHN science is dynamic and has evolved over time, helping to inform our understanding of the changing nature, scope, causes and solutions to PHN problems. This scientific basis has informed nutrition guidance and policy. Using a narrative synthesis method and guided by Kuhn’s theory on the structure of scientific revolutions, this paper reviews the historical development of PHN, aiming to understand the emergence of major scientific paradigms, paradigm shifts and evidence-informed guidance and policy. We propose that the development of PHN is characterized by the successive layering of paradigms resulting from interactions between science, social change and policy-making. Four eras of PHN are evident: the foundation, nutrient deficiency, dietary excess and imbalances, and environmental sustainability (ES). Dominant paradigms have been communicated through nutrient reference standards, dietary goals and dietary guidelines. Transitions from one era to the next indicated new ways of thinking about PHN, amounting to a paradigm shift. The bidirectional relationship between nutrition and ES is the latest challenge confronting PHN. Investigating PHN paradigm transitions reveals how we have arrived at current guidance and policies, and how PHN might progress into the future.

The Victorian Salt Reduction Partnership (VicSalt Partnership) was launched in 2015, bringing together health and research organisations to develop an action plan for salt reduction interventions at a state level. A comprehensive evaluation was designed to assess the impact of the resulting four-year intervention strategy. As part of the process evaluation, semi-structured interviews were undertaken with stakeholders in March–May 2017, to understand perceived barriers and enablers to effective strategy implementation. Data were coded in relation to the key topic areas of the interviews with an inductive method used to analyse themes within topics. Seventeen stakeholders were contacted, 14 completed an interview; five from state government or statutory agencies, four from non-government funded organisations, four from research organisations and one from the food industry. Twelve were members of the VicSalt Partnership and two were informal collaborators. Most stakeholders viewed the VicSalt Partnership as a positive example of working collaboratively, and said this was essential for raising awareness of the importance of salt reduction with consumers, the food industry, and the government. Challenges relating to engaging the food industry and federal government through a state-led initiative were identified. New approaches to overcome this, such as forming clear “asks” to government and committing industry to “pledges” on reformulation were suggested. Stakeholder interviews and qualitative analysis have provided a range of important insights into barriers and enablers, many of which have already been used to strengthen intervention implementation. The evaluation of the VicSalt Partnership is ongoing and the program is expected to provide a wealth of lessons for state-led interventions to reduce salt intake in Australia and globally.

Aim: The primary aim of this study was to explore the capacity of community organisations within Australia's charitable food sector to provide nutritious food to people experiencing food insecurity. A secondary aim was to explore their capacity to provide food in an environment that encourages social interaction. Methods: This qualitative research used an exploratory case study design and was informed by a nutrition capacity framework. Participants were recruited through SecondBite, a not-for-profit food rescue organisation in Australia. Convenience sampling methods were used. Semi-structured interviews were conducted to explore the knowledge, attitudes and experiences of people actively involved in emergency food relief provision. Transcripts were thematically analysed using an open coding technique. Results: Nine interviews were conducted. The majority of participants were female (n = 7, 77.8%) and worked or volunteered at organisations within Victoria (n = 7, 77.8%). Results suggest that the capacity for community organisations to provide nutritious food to their clients may be limited by resource availability more so than the nutritionrelated knowledge and attitudes of staff members and volunteers. Conclusions: Australia's charitable food sector plays a vital role in addressing the short-term needs of people experiencing food insecurity. To ensure the food provided to people experiencing food insecurity is nutritious and provided in an environment that encourages social interaction, it appears that the charitable food sector requires additional resources. In order to reduce demand for emergency food relief, an integrated policy approach targeting the underlying determinants of food insecurity may be needed. [ABSTRACT FROM AUTHOR]

Background: School canteens represent an opportune setting in which to deliver public health nutrition strategies because of their wide reach and frequent use by children. Online school-canteen ordering systems, where students order and pay for their lunch online, provide an avenue to improve healthy canteen purchases through the application of consumer-behavior strategies that have an impact on purchasing decisions. Objective: We assessed the efficacy of a consumer-behavior intervention implemented in an online school-canteen ordering system in reducing the energy, saturated fat, sugar, and sodium contents of primary student lunch orders. Design: A cluster-randomized controlled trial was conducted that involved 2714 students (aged 5-12 y) from 10 primary schools in New South Wales, Australia, who were currently using an online canteen ordering system. Schools were randomized in a 1:1 ratio to receive either the intervention (enhanced system) or the control (standard online ordering only). The intervention included consumer-behavior strategies that were integrated into the online ordering system (targeting menu labeling, healthy food availability, placement, and prompting). Results: Mean energy (difference: -567.25 kJ; 95% CI: -697.95, -436.55 kJ; P < 0.001), saturated fat (difference: -2.37 g; 95% CI: -3.08, -1.67 g; P < 0.001), and sodium (difference: -227.56 mg; 95% CI: -334.93, -120.19 mg; P < 0.001) contents per student lunch order were significantly lower in the intervention group than in the control group at follow-up. No significant differences were observed for sugar (difference: 1.16 g; 95% CI: -0.50, 2.83 g; P = 0.17). Conclusions: The study provides strong evidence supporting the effectiveness of a consumer-behavior intervention using an existing online canteen infrastructure to improve purchasing behavior from primary school canteens. Such an intervention may represent an appealing policy option as part of a broader government strategy to improve child public health nutrition. This trial was registered at www.anzctr.org.au as ACTRN12616000499482. [ABSTRACT FROM AUTHOR]

Professionals who provide nutrition education and consulting to the public are encouraged to take into account the health, environmental and social contexts that influence health-related attitudes and behaviours in the population. This paper examined the awareness of shifts in population health outcomes associated with the nutrition transition in Vietnam among university nutrition lecturers, health professionals and school education professionals. Most of these professionals held accurate views of the current population health issues in Vietnam. However, they differed in their awareness of the seriousness of overweight and obesity. Although the majority indicated that the prevalence of obesity and non-communicable diseases (NCDs) had increased, nearly half believed that the government should complete its attempts to control undernutrition before trying to control obesity. More health professionals believed that food marketing was responsible for the growing prevalence of children's obesity, and more of them disapproved of the marketing of less healthy food to children. In contrast, the university nutrition lecturers were least aware of food marketing and the seriousness of obesity. Of the three groups, the university nutrition lecturers held less accurate perceptions of nutrition transition problems and their likely drivers. There is an urgent need for greater provision of public nutrition education for all three groups of professionals. [ABSTRACT FROM AUTHOR]

Availability of less-healthy packaged food and beverage products has been implicated as an important driver of obesity and diet-related disease. An increasing number of packaged foods and beverages are sold in India. Our objective was to evaluate the healthiness of packaged foods sold by India's largest manufacturers. Healthiness was assessed using the Australian Health Star Rating (HSR) system and the World Health Organization's European Regional Office (WHO Euro) Nutrient Profile Model. Sales-value-weighted mean healthiness and the proportions of "healthy" products (using a validated HSR cut-off of ≥3.5, and products meeting WHO Euro criteria as healthy enough to market to children) were calculated overall, by company and by food category. Nutrient information for 943 products sold by the 11 largest Indian manufacturers was obtained from nutrient labels, company websites or directly from the manufacturer. Healthiness was low overall (mean HSR 1.8 out of 5.0 stars) with a low proportion defined as "healthy" by both HSR (17%) and also by WHO Euro criteria (8%). There were marked differences in the healthiness of similar products within food categories. Substantial variation between companies (minimum sales-value-weighted mean HSR 0.5 for Company G, versus maximum HSR 3.0 for Company F) was a result of differences in the types of products sold and the nutritional composition of individual products. There are clear opportunities for India's largest food companies to improve both the nutritional quality of individual products and to improve their product mix to include a greater proportion of healthy products. [ABSTRACT FROM AUTHOR]

The Sustainable Development Goals (SDGs) replaced the Millennium Development Goals (MDCs) in 2015, which included several goals and targets primarily related to nutrition: to eradicate extreme poverty and hunger and to reduce child mortality and improve maternal health. In the Asia-Pacific Academic Consortium for Public Health (APACPH) member countries as a group, infant and child mortality were reduced by more than 65% between 1990 and 2015, achieving the MDG target of two-thirds reduction, although these goals were not achieved by several smaller countries. The SDGs are broader in focus than the MDGs, but include several goals that relate directly to nutrition: 2 (zero hunger—food), 3 (good health and well-being—healthy life), and 12 (responsible consumption and production—sustainability). Other SDGs that are closely related to nutrition are 4 and 5 (quality education and equality in gender—education and health for girls and mothers, which is very important for infant health) and 13 (climate action). Goal 3 is “good health and well-being,” which includes targets for child mortality, maternal mortality, and reducing chronic disease. The Global Burden of Disease Project has confirmed that the majority of risk for these targets can be attributed to nutrition-related targets. Dietary Guidelines were developed to address public health nutrition risk in the Asia Pacific region at the 48th APACPH 2016 conference and they are relevant to the achievement of the SDGs. Iron deficiency increases the risk of maternal death from haemorrhage, a cause of 300000 deaths world-wide each year. Improving diets and iron supplementation are important public health interventions in the APACPH region. Chronic disease and obesity rates in the APACPH region are now a major challenge and healthy life course nutrition is a major public health priority in answering this challenge. This article discusses the role of public health nutrition in achieving the SDGs. It also examines the role of APACPH in education and advocacy and in fulfilling the educational needs of public health students in public health nutrition. [ABSTRACT FROM AUTHOR]

Background Primary schools are increasingly used as arenas for public health initiatives. The aim of this study was to assess a primary schoolbased food intervention. Methods The intervention comprised timetabled kitchen classroom sessions (90 min, fortnightly). Pupils prepared and cooked food, which they then ate together. Children's relationship with food, including food enjoyment, experience and food neophobia, were addressed at the intervention school (baseline n = 154; follow-up n = 164) and at a matched control school (baseline n = 171; follow-up n = 174). Results Pupils at the intervention school scored significantly higher (M = 3.90, SD = 1.81) for scores on Kitchen Equipment, compared to the control school (M = 3.06, SD = 2.12); and again scored significantly higher (M = 9.34, SD = 3.79) for the overall Cooking Experience Score compared to the control school (M = 7.98, SD = 4.57). Shifts accompanying the intervention in three outcome measures for pupils (taste description, liking for cooking and helping with cooking at home) were also revealed. No main intervention effect for food neophobia and fussiness was found; a close to significant time by intervention interaction (P = 0.053) was evident. Conclusions The study indicates limited but encouraging changes, and contributes to the growing literature regarding school-based food initiatives. [ABSTRACT FROM AUTHOR]

Background and Objectives: A core challenge for low- and middle-income countries (LMICs) in combating the negative effects of the nutrition transition is to implement appropriate prevention strategies to halt the increasing prevalence of obesity and non-communicable diseases (NCDs), against a background of prevailing under nutrition. There have been several proposals for the enhancement of university nutrition education for future health and related professionals who are expected to communicate knowledge of health risks to the broad community. However, little is known about university nutrition education in LMICs. The present study aimed to investigate professional development opportunities and barriers for university nutrition lecturers to teach public health nutrition (PHN).Methods and Study Design: An online survey was conducted among 242 Vietnamese health and education professionals and university nutrition lecturers across Vietnam. Purposive sampling was used to recruit participants. Comparisons of between the groups' responses were examined via SPSS Crosstabs. The structures of the perceived barriers and desired PHN training topics were examined via factor analyses. Multiple linear regression examined the influences on lecturers' learning interests in nutrition areas.Results: The lecturers' learning interests spanned four areas: basic nutrition, basic food, food policy and 'new' trends (e.g. food policy, marketing). Major impediments to nutrition teaching in universities divided into two groups: resource limitations and professional constraints (e.g. lack of relevant training opportunities). The lecturers' perceptions of professional constraints influenced their interest in learning about 'new' trends.Conclusions: The results highlighted the need and opportunities to enhance PHN professional development for nutrition lecturers in Vietnam. [ABSTRACT FROM AUTHOR]

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To characterize the multiple dimensions and benefits of the Mediterranean diet as a sustainable diet, in order to revitalize this intangible food heritage at the country level; and to develop a multidimensional framework - the Med Diet 4.0 - in which four sustainability benefits of the Mediterranean diet are presented in parallel: major health and nutrition benefits, low environmental impacts and richness in biodiversity, high sociocultural food values, and positive local economic returns.Design: A narrative review was applied at the country level to highlight the multiple sustainable benefits of the Mediterranean diet into a single multidimensional framework: the Med Diet 4.0. Setting/subjects We included studies published in English in peer-reviewed journals that contained data on the characterization of sustainable diets and of the Mediterranean diet. The methodological framework approach was finalized through a series of meetings, workshops and conferences where the framework was presented, discussed and ultimately refined.Results: The Med Diet 4.0 provides a conceptual multidimensional framework to characterize the Mediterranean diet as a sustainable diet model, by applying principles of sustainability to the Mediterranean diet.Conclusions: By providing a broader understanding of the many sustainable benefits of the Mediterranean diet, the Med Diet 4.0 can contribute to the revitalization of the Mediterranean diet by improving its current perception not only as a healthy diet but also a sustainable lifestyle model, with country-specific and culturally appropriate variations. It also takes into account the identity and diversity of food cultures and systems, expressed within the notion of the Mediterranean diet, across the Mediterranean region and in other parts of the world. Further multidisciplinary studies are needed for the assessment of the sustainability of the Mediterranean diet to include these new dimensions. [ABSTRACT FROM AUTHOR]

Food insecurity affects health and wellbeing. Little is known about the relationship between food insecurity across income levels. This study aims to investigate the prevalence and frequency of food insecurity in low-to-middle-income Victorian households over time and identify factors associated with food insecurity in these households. Prevalence and frequency of food insecurity was analysed across household income levels using data from the cross-sectional 2006-09 Victorian Population Health Surveys (VPHS). Respondents were categorised as food insecure, if in the last 12 months they had run out of food and were unable to afford to buy more. Multivariable logistic regression was used to describe factors associated with food insecurity in low-to-middle-income households (A$40 000-$80 000 in 2008). Between 4.9 and 5.5% for total survey populations and 3.9-4.8% in low-to-middle-income respondents were food insecure. Food insecurity was associated with limited help from friends, home ownership status, inability to raise money in an emergency and cost of some foods. Food insecurity exists in households beyond those on a very low income. Understanding the extent and implications of household food insecurity across all income groups in Australia will inform effective and appropriate public health responses. [ABSTRACT FROM AUTHOR]

The implementation of a standardized front-of-pack-labelling (FoPL) scheme would likely be a useful tool for many consumers trying to improve the healthfulness of their diets. Our objective was to examine what the traffic light labelling scheme would look like if implemented in the US. Data were extracted from Label Insight's Open Access branded food database in 2017. Nutrient levels and the proportion of products classified as "Red" (High), "Amber" (Medium) or "Green" (Low) in total fat, saturated fat, total sugar and sodium for food and beverage items were examined. The proportion of products in each category that had each possible combination of traffic light colors, and met the aggregate score for "healthy" was examined. Out of 175,198 products, >50% of all US packaged foods received a "Red" rating for total sugar and sodium. "Confectionery" had the highest mean total sugar (51.9 g/100 g) and "Meat and meat alternatives" the highest mean sodium (781 mg/100 g). The most common traffic light label combination was "Red" for total fat, saturated fat and sodium and "Green" for sugar. Only 30.1% of products were considered "healthy". A wide variety (n = 80) of traffic light color combinations were observed. A color coded traffic light scheme appears to be an option for implementation across the US packaged food supply to support consumers in making healthier food choices. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to describe the intake of sugar-sweetened beverages and to examine of associated factors among schoolchildren from Bogotá, Colombia. Methods: From a total of 8,136 schoolchildren and adolescents (age 9-17.9 years) taking part in the FUPRECOL Study. Sugar-sweetened beverages intake was based on intake from “regular soda”, “drink tea” and/or “concentrated juices”. Body weigth, heigth, body mass index (BMI), waist circumference, and percentage body fat by electrical bioimpedance analysis were measured such as adiposity markers. Associated factors (sex, age, abdominal obesity, BMI classification, mothers’ and fathers’ educational level and nutritional status by “Krece plus” questionnaire), were collected by structured questionnaire. Associations were established through a binary logistic regression. Results: Of the subjects, 58.4% were women. According to sex, boys response highest intake of “regular soda” daily/weekly frequency of the 70.9% and 21.0%, respectively, followed by “concentrated juices” (64.4% weekly vs.11.3% daily). In both gender, the prevalence of abdominal obesity was higher in schoolchildren that responded to intake “regular soda” (23.3%), “concentrated juices” (13.2%) and “drink tea” daily (9.7%). Age [OR 1.15 (95%CI 1.03 to 1.28)], mothers’ [OR 1.30 (95%CI 1.03 to 1.65)], and fathers’ [OR 1.34 (95%CI 1.01 to 1.79) low educational level and nutritional status [OR 2.60 (95%CI 2.09 to 3.25)], were associated with daily intake of “regular soda”. Conclusion: Age, parental education level and dietary patterns were associated with sugar-sweetened beverages in schoolchildren in Bogotá, Colombia. We recommended comprehensive interventions which are involved nutritional and educational component among children and adolescents from Bogotá, Colombia. [ABSTRACT FROM AUTHOR]