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Many children with type 1 diabetes do not meet nutritional guidelines. Little is known about how caregivers perceive the necessity of registered dietitian (RD) visits or how satisfied they are with nutrition care. This study aimed to evaluate nutrition experiences and perceptions of care among caregivers of children with type 1 diabetes at an academic medical center. We analyzed 159 survey responses. Using multivariable logistic regression, we assessed factors associated with the perception of need for annual nutrition visits, satisfaction with RD care, and encouragement from a nurse or doctor to meet with an RD. Covariates included age (<13 vs. ≥13 years), type 1 diabetes duration (≤3 vs. >3 years), sex, race/ethnicity, and insulin pump and continuous glucose monitoring use. More than half of caregivers (56%) considered annual visits necessary. Shorter type 1 diabetes duration (odds ratio [OR] 1.92, 95% CI 1.02–3.63) was associated with this finding. Less than half (46.5%) reported satisfaction with nutrition care; higher satisfaction was also correlated with shorter type 1 diabetes duration (OR 2.20, 95% CI 1.17–4.15). Although 42% reported meeting with an RD in the past year, less than two-thirds (62%) reported receiving a medical provider recommendation for nutrition care. Leading reasons for not meeting with an RD were "I am knowledgeable in nutrition and do not need to see an [RD]" (41%) and "I had a past visit with an [RD] that was not helpful" (40%). Our findings suggest that satisfaction with and perceived need for nutrition care may wane with longer type 1 diabetes duration. Improved strategies for therapeutic alliance between caregivers and RDs and engagement of families at later stages of type 1 diabetes are needed. [ABSTRACT FROM AUTHOR]

Context: Anaemia is one leading cause of morbidity among adolescent girls. Prevention, early detection, and treatment can break the intergeneration cycle of malnutrition. Aims/Objectives: The aim of the study was to estimate the prevalence of anaemia and assess its sociodemographic determinants and understand its association with the dietary pattern of rural adolescent girls. Settings and Design: A cross-sectional study was conducted among 350 adolescent girls studying in the school of Kalgatigi Taluk, Dharwad district. The school girls were interviewed using a predesigned structured questionnaire by interview method. A food frequency questionnaire was used to assess the dietary pattern. Haemoglobin levels were estimated using Sahli’s method. Statistical Analysis Used: Data were entered in Microsoft Excel and analysed using SPSS version 19 and the Chi-square test was applied to study the significance. Results: Rural adolescent school girls between the age group of 13–16 years were included. The prevalence of anaemia among them was found to be 47.4% and was significantly associated with the educational status of the mother, their socioeconomic status (SES), and type of diet. Vegetarian girls had a higher prevalence of anaemia. The frequency of meat and egg consumption was significantly associated with anaemia. The prevalence of anaemia was higher in thin and severely thin girls based on WHO-BMI. Conclusions: Anaemia in rural adolescent girls is of high burden and public health importance with a prevalence of 47.4% and significant association with dietary habits, SES, and BMI.

Despite the establishment of the Healthy, Hunger-Free Kids Act (HHFKA) in 2010, child nutrition programs continue to experience challenges impacting participation. Prior qualitative studies have explored how to reduce barriers to implementation of these programs in schools, but few studies have examined attitudes held by students, who are the ultimate stakeholders in school lunch programs and their success. The present study explored children's attitudes about food at school and suggestions for improving the school lunch program. This qualitative study was conducted during the 2018–2019 school year in five middle schools. Students (N = 21) participating in a larger study were invited to take part in focus groups at school. Qualitative analyses revealed that children were knowledgeable about healthy eating but had strong opinions about disliking some foods served at school. Children had thoughtful ideas about improving school food and recommendations to encourage healthy eating among students. Insights from this qualitative investigation highlight the importance of considering the child's perspective when implementing food nutrition programs. Health promotion efforts to improve the school nutrition environment include engaging families in school nutrition policy decisions and improved training and resources for food service staff. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI) [ABSTRACT FROM AUTHOR]

Objectives: This is the protocol for a Campbell systematic review. The objectives are as follows: The aim of this systematic review is to examine the scientific evidence available from low‐ and middle‐income countries on the association of breakfast consumption habits and anthropometry/adiposity‐ and nutrition‐related outcomes in adolescents aged 10–19 years old. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Health Academics / Sağlık Akademisyenleri Dergisi is the property of Journal of Health Academics 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.)

Nutritional impairment during adolescence may result in adverse physical and reproductive health outcomes. We investigated the prevalence and determined the factors associated with underweight and overweight/obesity among ever-married adolescent girls in Bangladesh. We used Bangladesh Demographic and Health Surveys data conducted in 2004, 2007, 2011, 2014, and 2017. A total of 7040 ever-married adolescent girls aged 15–19 years were included in this analysis. Prevalence of underweight (body mass index [BMI]<18.5 kg/m2) significantly decreased from 39.53% (95% CI = 36.71, 42.43) to 23.62% (95% CI = 21.35, 26.05) during 2004–2017 (p < 0.001). However, prevalence of overweight/obesity (BMI ≥ 23 kg/m2) significantly increased from 5.9% (95% CI = 4.67, 7.43) to 22.71% (95% CI = 20.39, 25.20) during the same period (p < 0.001). The girls with higher age (OR = 0.94, 95% CI = 0.90, 0.99, p = 0.023), higher level of education (OR = 0.60, 95% CI = 0.43, 0.83, p = 0.002), and richest wealth quintile (OR = 0.78, 95% CI = 0.62, 0.98, p = 0.035) had significantly lower risk of being underweight. Adolescent girls having more than one child (OR = 1.41, 95% CI = 1.15, 1.73, p = 0.001) were more likely to be underweight. Elderly adolescents with better economic status were more at risk of being overweight/obese (OR = 2.57, 95% CI = 1.86, 3.55, p < 0.001). Girls married to skilled/unskilled workers (OR = 0.58, 95% CI = 0.44, 0.77, p < 0.001) and persons involved in small businesses (OR = 0.66, 95% CI = 0.49, 0.89, p = 0.007) had lower risk of having a high BMI. Using contraceptive (OR = 0.8, 95% CI = 0.69, 0.94, p = 0.006) was negatively associated with overweight/obese. Although prevalence of undernutrition among ever-married adolescent girls is declining, the proportion of being overweight/obese is increasing in Bangladesh warranting effective strategies to improve adolescent nutrition. [ABSTRACT FROM AUTHOR]

Pelvic pain in adolescents, especially during the menstrual period, is often underestimated as a health problem and significantly impacts quality of life. The objective was to evaluate the clinical and nutritional profile of adolescents with dysmenorrhea. 40 adolescents were selected, aged between 11 and 19 years old, treated at a teaching clinic in São Paulo, as well as using the snowball technique. Pelvic pain was assessed using a validated pain scale questionnaire and food consumption was assessed using a 24-hour dietary recall and Food Frequency Questionnaire. All participants had adequate height for their age and 72.5% were eutrophic. Thirty-five patients (87.5%) had moderate to severe pain, while five (12.5%) had mild or no pain. Practicing physical activity was less common among the group with moderate to severe pain (34.3%). There was no significant difference in the length of menstrual cycles between the groups. Lower calcium intake was observed in the group with more intense menstrual pain. Furthermore, there was a lower consumption of 'fresh' and "processed" foods in the group with moderate to severe pain during lunch and dinner meals, respectively. A negative correlation was identified between calcium and folate consumption and the duration of pain in days. The sample studied suggests that a balanced diet, rich in calcium, folate and natural foods, may be important in the management of dysmenorrhea. However, more research is needed to fully understand this relationship and develop effective interventions to treat this common condition among adolescents.

Background: One of the target groups at risk of becoming overweight and obese is teenagers. East Kalimantan is one of the largest provinces in Indonesia with a prevalence of overweight and obesity in children aged 13-15 years with a body massa indeks for age (BMI/A) indicator of 19.1% in 2018, where overweight was 12.0% and obesity was 7.1%. Objectives: To analyze the factors that influence nutritional status in overweight and obese adolescents aged 11-15 years. Methods: This study is a cross-sectional survey conducted at State Junior High Schools in Samarinda City from January to March 2021. The sample size was 290 students, determined using the Lemeshow and David formula, and selected through simple random sampling. Data collection includes the characteristics of the subject and their parents, measurement of body weight and height, food consumption, nutritional behavior, physical activity, and exercise habits using interviews using questionnaires. Data were analyzed using the Kruskal-Wallis test and Logistic Regression test. Results: There are differences in the nutritional status of boys and girls (p=0.006), mother's education and occupation (p=0.007; p=0.007), father's and mother's nutritional status (p=0.001; p=0.014), exercise habits (p=0.009), protein adequacy level (p=0.000), and fat adequacy level (p=0.016). Conclusions: Gender, occupation, education, nutritional status, eating habits, exercise habits, level of protein adequacy, and level of fat adequacy influence the occurrence of overweight and obesity in adolescents. It is necessary to increase sports activities which must be done at least 3-5 times a week for 30 minutes intensively and get used to consuming 3-4 portions of vegetables and fruit daily, as well as paying attention to appropriate meal portions. [ABSTRACT FROM AUTHOR]

Background: Malnutrition during adolescence can slow growth and delay puberty. Adequate nutritional knowledge, attitudes, and behavior among adolescents are crucial to prevent health issues that can continue into adulthood. Objectives: To assess the knowledge, attitudes, and behaviors related to balanced nutrition and nutritional status among adolescents at the Yayasan Bandung Senior High School, Deli Serdang Regency. Methods: The research design used was a cross-sectional design with a total of 80 adolescents aged 14 to 18 years at the Yayasan Bandung Senior High School, Deli Serdang Regency. The subject taking technique was stratified random sampling. Knowledge, attitudes, and behaviors of balanced nutrition were obtained through questionnaires. Height and weight data were analyzed using WHO Anthro Plus to determine the Z-score of Body Mass Index according to age. Data analysis used the Spearman test to determine the relationship between variables. Results: Most adolescents had good nutritional status, namely 68.8%, while the percentage of overnutrition and obesity was 18.8% and undernutrition was 12.5%. Adolescents have a high level of knowledge of balanced nutrition of 20 adolescents (25%). Balanced nutrition attitudes were categorized as high, namely 43 adolescents (53.8%), while high category balanced nutritional behaviors were only 6 adolescents (7.5%). The results of the bivariate test (Spearman Correlation) showed a relationship between attitudes and behavior-balanced nutrition (p<0.05). Conclusions: There is a relationship between attitudes and behavior of balanced nutrition in adolescence the Bandung Higher Education Foundation High School, Deli Serdang Regency. [ABSTRACT FROM AUTHOR]

Background: Increased adolescent social media use can lead to lower physical activity. In addition, the growth of marketing of unhealthy foods and drinks is inevitable. In short, excessive social media use may negatively impact nutrition problems, eating behavior, and physical activities. Objectives: This study aimed to determine the relationship between patterns of social media use and nutrition status, eating behavior, and physical activity among adolescents in DKI Jakarta. Methods: The study was cross-sectional and involved 187 students from public high schools in Jakarta. Data was collected using the Food Frequency Questionnaire (FFQ), the International Physical Activity Questionnaire (IPAQ), the use of social media questionnaire, and an anthropometric assessment to measure body mass index for age. The statistical analysis used was the chi-square test. Results: No significant association were found between the frequency and duration of social media use and nutrition status. The type of exposure to social media content does not show a significant relationship with nutrition status, eating behavior, and physical activity. However, there were significant associations between frequency (p=0.022) and duration (p=0.003) of social media use and eating behavior. Likewise, there was a significant relationship between frequency (p=0.021) and duration (p=0.005) of social media use with physical activity. Conclusions: Duration and frequency of social media use are associated with riskier eating patterns and lower adolescent physical activity. Therefore, nutrition education in adolescents should also include topics on social media use. [ABSTRACT FROM AUTHOR]

ContextApproximately 7.3 million births occur annually among adolescents in low- and middle-income countries. Pregnant adolescents constitute a nutritionally vulnerable group that could benefit from intervention to mitigate the mortality and adverse birth outcomes associated with adolescent pregnancy.ObjectiveThe aim of this systematic review and meta-analysis was to assess the following: (1) the effect of multiple-micronutrient (MMN) supplementation vs iron and folic acid (IFA) supplementation among adolescents on maternal morbidity, birth outcomes, and mortality outcomes, (2) the effects of MMN supplementation in adolescents compared with the effects in adult women, and (3) the effect modification, if any, of MMN supplementation by baseline and geographic characteristics of adolescents.Data sourcesMEDLINE and Cochrane databases were searched, along with the reference lists of relevant reviews.Study selectionMultiple-micronutrient supplementation trials in pregnancy that were conducted in a low- or middle-income country and had included at least 100 adolescents (10-19 years of age) were eligible for inclusion. Two independent reviewers assessed study eligibility.Data extractionThirteen randomized controlled trials conducted in Africa and Asia were identified from 1792 reviews and 1578 original trials. Individual-level data was shared by study collaborators and was checked for completeness and extreme values. One- and two-stage individual participant data meta-analyses were conducted using data from randomized controlled trials of MMN supplementation.ResultsA total of 15 283 adolescents and 44 499 adult women with singleton births were included in the individual participant data meta-analyses of MMN supplementation vs IFA supplementation. In adolescents, MMN supplementation reduced low birth weight (1-stage OR = 0.87, 95%CI 0.77-0.97; 2-stage OR = 0.81; 95%CI 0.74-0.88), preterm birth (1-stage OR = 0.88, 95%CI 0.80-0.98; 2-stage OR = 0.86, 95%CI 0.79-0.95), and small-for-gestational-age births (1-stage OR = 0.90, 95%CI 0.81-1.00; 2-stage OR = 0.86, 95%CI 0.79-0.95) when compared with IFA supplementation. The effects of MMN supplementation did not differ between adolescents and older women, although a potentially greater reduction in small-for-gestational-age births was observed among adolescents. Effect modification by baseline characteristics and geographic region was inconclusive.ConclusionsMultiple-micronutrient supplementation can improve birth outcomes among pregnant adolescents in low- and middle-income countries. Policy related to antenatal care in these settings should prioritize MMN supplementation over the currently recommended IFA supplementation for all pregnant women, especially adolescents.

Adolescent and young women face grave nutrition challenges, but limited evidence exists on solutions to improve their diets. Action‐research was done over 3 years (2020–2022) in secondary cities of Colombia (Medellin) and Vietnam (Thai Nguyen) to identify nutrient deficits in adolescent and young women diets; elaborate food‐based recommendations to improve their nutritional status using Optifood linear programming; and engage respondents in incorporating suggested recommendations to their diet using a Social Innovation Challenge approach. A total of 1001 respondents were interviewed in Vietnam, 793 in Colombia. The probability of nutrient inadequacy in both locations was highest for iron and calcium, followed by the risk of deficiency for several other vitamins and minerals. Social Innovation Challenge teams (11 in Vietnam, 9 in Colombia) were created and supported in developing solutions to improve diets and tackle those deficiencies. Awards and resources were transferred to the most promising solutions to enable their implementation. Pre/post measurements of the interventions' impact using the Global Diet Quality Score as outcome metric showed significant improvement in the diets of Challenge participants. After introducing a series of companion articles that offer detailed results on those various steps, this paper draws strategic lessons from an action‐research perspective. [ABSTRACT FROM AUTHOR]

Unhealthy eating habits are common among adolescents in Vietnam, where transitioning food environments increasingly offer energy‐dense micronutrient‐poor foods. Successful behavior change approaches must be feasible and acceptable, promoting local foods that are available, accessible, and preferred. Yet, few studies have investigated the potential of food‐based approaches for adolescents. We used linear programming to identify problem nutrients, local nutrient sources, and realistic food‐based recommendations (FBRs) to improve nutrient intake among girls 16–22 years in Thai Nguyen, Vietnam. We then identified a reduced set of FBRs to prioritize the most critical micronutrient gaps. Calcium and iron targets could not be met in any realistic diet modeling scenario. The best set of FBRs included seven recommendations which could meet intake targets for 9 of 11 modeled micronutrients. The best reduced set of three FBRs targeting iron and calcium only—although more feasible for behavior change—was less effective at improving intake of these nutrients since fewer foods were recommended. Given the difficulty of meeting calcium and iron targets using local foods within acceptable dietary patterns, additional interventions, such as supplementation, staple food fortification, or increasing the availability of affordable calcium‐ and iron‐rich foods, may be necessary to promote dietary adequacy for adolescent girls. [ABSTRACT FROM AUTHOR]

Purpose: Internet use, which has become an integral part of life all over the world, causes some eating and nutritional disorders, especially in adolescents. This study aims to determine the relationship between problematic internet use (PIU) and nutrition/eating awareness in adolescents. Methods: This study was applied on 11th and 12th grade students studyingat three high schools in Turkey. 390 students participated in the study. During data collection, Generalized Problematic Internet Use Scale 2 (GPIUS2) and Mindful Eating Questionnaire (MEQ) were used.Frequency, percentage, arithmetic mean, and standard deviation were used for descriptive data. Chi-square test, t-test, ANOVA, Kruskal Wallis variance analysis, Pearson correlation analysis, and multiple linear regression analysis wereemployed for data analysis. Results: The mean of the GPIUS scores of the students participating in the study is 52.5±21.5. 28.5% of the adolescents have stated that they daily use the internet for 5 hours or more. In the study, the adolescents who have stated that they consume energy drinks have higher PIU scores than those who do not consume (P<0.05). The PIU scores of the adolescents who have stated that they are influenced by food advertisements on the internet are found to be significantly higher (P<0.05). In the study, an opposite correlation is determined between GPIUS and subscale scores, and MEQ and its subscales (P<0.05). Conclusion: Adolescents with higher PIU scores have stated that they are influenced by food advertisements more, those who consume energy drinks have higher PIU scores and, as PIU scores increase, eating awareness decreases. [ABSTRACT FROM AUTHOR]

Abstract Objective: School lunches represent a key opportunity to improve diets and health of schoolchildren. No recent nationally representative studies have examined the nutritional differences between school meals and packed lunches in the UK. This study aimed to characterise and compare the nutritional quality of school meals and packed lunches among primary and secondary school-age children. Design: A pooled cross-sectional analysis of the UK’s National Diet and Nutrition Survey (2008–2017). Setting: United Kingdom. Participants: 3001 children (aged 4–16 years) who completed a 3/4-d food diary which recorded meal type (school meal/packed lunch). Multivariable logistic regression models assessed associations of meeting food and nutrient recommendations by meal type. Analyses were stratified by academic key stages (KS). Results: KS-1 (4–7 years) and 2 (8–11 years) children consuming school meals were more likely to meet minimum recommendations for vegetables, protein-rich foods and fibre, and not exceed maximum recommendations for salt, savoury and sweet snacks compared with pupils consuming packed lunches. However, in KS-3 (12–14 years) and 4 (14–16 years), these effects were reduced. As children aged, the median weight of fruits, vegetables, protein-rich foods and dairy products consumed typically decreased for both school meals and packed lunches, and generally an increasing proportion of school meals contained sweet and savoury snacks. Conclusion: These findings suggest school meals are nutritionally superior to packed lunches but are not yet optimal. Quality declined at higher KS. Actions to improve lunches of primary and secondary schoolchildren across the UK are needed, with attention to KS-3 and 4 in secondary schools.

Abstract Background Empowering adolescent girls is an important component of combating malnutrition in this age group. Because empowerment is multidimensional and context specific, it can be difficult for policymakers and practitioners to target the dimensions of empowerment associated with adolescent girls’ nutrition in a particular setting. This study sought to identify the empowerment dimensions significantly associated with married adolescent girls' nutritional status in East Africa; a region where malnutrition and gender inequality stubbornly persist. Methods We used cross-sectional Demographic and Health Survey (DHS) data from Ethiopia (2016), Kenya (2014), Tanzania (2015–16) and Uganda (2016) to construct and test theoretically informed structural equation models of the relationship between six dimensions of empowerment and BMI-for-age and haemoglobin levels for married adolescent girls aged 15–19 years. Results Our models were found to be a good fit for the data. Married adolescent girls’ access to information, measured by their education level and mass media use, was directly and positively associated with their BMI-for-age (p

Given the role of malnutrition in childhood morbidity and mortality, the prioritisation of maternal and child nutrition programmes has grown significantly in the 21st century. Policies and programmes aim to improve infant and young child feeding, but questions persist about the most effective combination of interventions to achieve desired behaviour change. There is increasing interest in mobile‐based interventions globally, but scant evidence exists to guide donors, policymakers and programme implementers on their effectiveness. Formative research was conducted to assess the feasibility and acceptance of text message‐based interventions and to guide the final design of the text message intervention. This protocol is for a cluster‐randomised controlled trial to test the effectiveness of adding text messaging to other ongoing SBC interventions to promote egg consumption, dietary diversity and other ideal dietary practices, particularly among children 12–23 months of age in Kanchanpur, Nepal. The trial findings will contribute to the emerging body of evidence on the effectiveness of using text messages for behaviour change, specifically for young child dietary outcomes in South Asia. Recent studies have suggested that mobile‐based interventions alone may be insufficient but valuable when added to other social and behavioural interventions; this trial will help to provide evidence for or against this emerging theory. This trial was registered at ClinicalTrials.gov on 11 March 2019 (ID: NCT03926689) and has been updated twice. Key messages: Multiple rounds of formative research can facilitate higher‐quality interventions including optimal wording, timing and reach of short message service to target audiences to improve nutrition‐related behaviours.Experimental studies are needed to guide decision‐making around the use of technology‐based behaviour change interventions to improve diets.This trial to test the effectiveness of text messaging to improve young child diets, and its process evaluation, will inform future mNutrition interventions. [ABSTRACT FROM AUTHOR]

Middle childhood and early adolescence have received disproportionately low levels of scientific attention relative to other life stages, especially as related to nutrition and health. This is partly due to the justified emphasis on the first 1000 days of life, and the idea that early deficits and consequences may not be fully reversible. In addition, these stages of life may superficially appear less "eventful" than infancy or late adolescence. Finally, there has been historical ambiguity and inconsistency in terminology, depending on whether viewing "childhood" through physiologic, social, legal, or other lenses. Nevertheless, this age bracket, which encompasses most of the primary education and basic schooling years for most individuals, is marked by significant changes, inflection points, and sexually driven divergence in somatic and brain growth and development trajectories. These constitute transformative changes, and thus middle childhood and early adolescence represents a major and last opportunity to influence long-term health and productivity. This review highlights the specificities of growth and development in school age, with a focus on middle childhood and early adolescence (5 years–15 years of age, for the purposes of this review), the role of nutrition, the short- and long-term consequences of inadequate nutrition, and the current global status of nutrition in this age group. Adequate attention and emphasis on nutrition in the school-age years is critical: (a) for maintaining an adequate course of somatic and cognitive development, (b) for taking advantage of this last major opportunity to correct deficits of undernutrition and "catch-up" to normal life course development, and (c) for addressing the nutritional inadequacies and mitigating the longer-term consequences of overnutrition. This review summarizes and provides a rationale for prioritizing nutrition in school-age children, and for the need to revisit priorities and focus on this part of the life cycle to maximize individuals' potential and their contribution to society. [ABSTRACT FROM AUTHOR]

BACKGROUND: Little is known about how school breakfast programs are associated with school attendance and academic performance. This study evaluated Dallas Independent School District's (DISD) breakfast after the bell (BATB) program that provides breakfast for both habitually tardy and non‐tardy students on (1) academic performance and (2) student attendance over 2 school years. METHODS: A pre‐post study design evaluated the impact of the BATB program in elementary/middle/high schools on student attendance and academic outcomes. Paired t‐tests evaluated changes in outcomes between 2017 to 2018 and 2018 to 2019 school years. RESULTS: The analytical sample consisted of 30,493 students (70.32% BATB participants, 50.47% male, 68.78% Hispanic). BATB participants were over 2.5 times more likely to attend school versus non‐BATB participants (aOR = 2.55; 95% confidence interval [CI]: 2.23‐2.92; p <.001). Compared to pre‐participation (2017‐2018), unadjusted models showed 2018 to 2019 BATB participants' mean reading scores increased from 1502.72 to 1545.76 during the 2018 to 2019 academic year (p <.001). There were no significant changes in reading and math scores over the 2‐year implementation after adjustment. CONCLUSIONS: Results here showed that a school breakfast program that is housed in a large public school system that serves predominantly low resource, ethnically diverse students is associated with increased student attendance. [ABSTRACT FROM AUTHOR]

This implementation research study sought to examine the impact of the COVID‐19 pandemic on adolescent nutrition practices and related behaviors in Nairobi and Uasin Gishu Counties, Kenya. Eight focus group discussions (FGDs) were conducted with adolescents 10–19 years of age, in‐depth interviews with 10 health facility providers, and a combination of FGDs (n‐4) and key informant interviews with government stakeholder and implementing partners (n = 9). During the pandemic, adolescents tended to avoid commonly consumed junk foods, in favor of "immune boosting, protective" foods. Widespread unemployment and reductions in parental income rendered some food items such as meat, eggs, and fruits unaffordable for families of adolescents. Adolescents relayed experiences of skipping meals and reducing the amount and variety of foods consumed. Adolescents also described employing strategies such as working in the informal sector and selling personal items to support families financially, in response to rising food insecurity. School closures mandated during the pandemic likely contributed to reductions in overall physical activity. To improve the diets of adolescents, programs should build on the healthy mindset brought on by the pandemic, while strengthening, targeting, and improving access to social protection measures and agricultural initiatives for vulnerable families with adolescents to cushion them from rising food insecurity as an effect of COVID‐19. Building practical adolescent life skills to encourage healthy nutrition actions will also be key to building forward from the COVID‐19 pandemic in Kenya. [ABSTRACT FROM AUTHOR]

Background: Empowering adolescent girls is an important component of combating malnutrition in this age group. Because empowerment is multidimensional and context specific, it can be difficult for policymakers and practitioners to target the dimensions of empowerment associated with adolescent girls' nutrition in a particular setting. This study sought to identify the empowerment dimensions significantly associated with married adolescent girls' nutritional status in East Africa; a region where malnutrition and gender inequality stubbornly persist. Methods: We used cross-sectional Demographic and Health Survey (DHS) data from Ethiopia (2016), Kenya (2014), Tanzania (2015–16) and Uganda (2016) to construct and test theoretically informed structural equation models of the relationship between six dimensions of empowerment and BMI-for-age and haemoglobin levels for married adolescent girls aged 15–19 years. Results: Our models were found to be a good fit for the data. Married adolescent girls' access to information, measured by their education level and mass media use, was directly and positively associated with their BMI-for-age (p < 0.05). Asset ownership, measured by owning a house or land alone or jointly, was directly and positively associated with haemoglobin (p < 0.05) and reduced odds of being moderately to severely anemic. Rejecting justifications for intimate partner violence, a measure of respondents' intrinsic agency, was directly and positively associated with the odds of being overweight or obese. Adolescent girls' level of empowerment across all dimensions had a direct relationship with their country of residence and household wealth. Conclusions: Our findings suggest that investment in girls' access to information through education and mass/social media and their economic empowerment may be important contributors to their overall empowerment and nutritional status. However, caution is needed as greater autonomy may contribute to increased consumption of unhealthy foods that can contribute to overweight and obesity. Strategies to empower married adolescent girls should be tailored to their specific circumstances. There is an urgent need for better data on adolescent empowerment and health, including increased research into age-, sex- and gender-appropriate empowerment measures and longitudinal data to assess causality. The use of statistical models should be complemented by robust qualitative research to further results interpretation. [ABSTRACT FROM AUTHOR]

Objective: School lunches represent a key opportunity to improve diets and health of schoolchildren. No recent nationally representative studies have examined the nutritional differences between school meals and packed lunches in the UK. This study aimed to characterise and compare the nutritional quality of school meals and packed lunches among primary and secondary school-age children. Design: A pooled cross-sectional analysis of the UK's National Diet and Nutrition Survey (2008–2017). Setting: United Kingdom. Participants: 3001 children (aged 4–16 years) who completed a 3/4-d food diary which recorded meal type (school meal/packed lunch). Multivariable logistic regression models assessed associations of meeting food and nutrient recommendations by meal type. Analyses were stratified by academic key stages (KS). Results: KS-1 (4–7 years) and 2 (8–11 years) children consuming school meals were more likely to meet minimum recommendations for vegetables, protein-rich foods and fibre, and not exceed maximum recommendations for salt, savoury and sweet snacks compared with pupils consuming packed lunches. However, in KS-3 (12–14 years) and 4 (14–16 years), these effects were reduced. As children aged, the median weight of fruits, vegetables, protein-rich foods and dairy products consumed typically decreased for both school meals and packed lunches, and generally an increasing proportion of school meals contained sweet and savoury snacks. Conclusion: These findings suggest school meals are nutritionally superior to packed lunches but are not yet optimal. Quality declined at higher KS. Actions to improve lunches of primary and secondary schoolchildren across the UK are needed, with attention to KS-3 and 4 in secondary schools. [ABSTRACT FROM AUTHOR]

Copyright of Acta Agriculturae Slovenica is the property of Biotechnical Faculty of the University of Ljubljana 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.)

In recent decades, changes in food consumption among adolescents in Arabic speaking countries, including The Kingdom of Saudi Arabia (KSA), has resulted in increased burden of overweight and obesity. COVID-19 related restrictions have further impacted lifestyle and diet among adolescents in KSA. The present study aimed to assess the knowledge, attitude, behaviour and dietary patterns of adolescents and the impact of the COVID-19 pandemic related restrictions on these behaviours. A cross-sectional study was conducted in six intermediate schools among 1500 adolescents (11-15 years) via an anonymous online survey. The Chi Square test was used to compare gender stratified nutritional knowledge, attitude and behaviour of adolescents and the impact of COVID-19 related restrictions. To determine the factors associated with nutritional change during COVID-19 lockdown, logistic regression was employed using the categorisation of nutritional change during COVID-19 restrictions versus no change in univariate and multivariate analyses. A good level of nutritionrelated knowledge and attitude was demonstrated both by female and male students, with 66% and 57% of participants scoring above the median of the total possible knowledge and attitude score, respectively. After adjusting for all variables, higher nutrition knowledge score predicted students to be less likely to report increased food consumption during COVID-19 restrictions, whereas students with higher nutrition attitude scores and with a higher risk of increased food consumption were more likely to increase food consumption during COVID-19 restrictions. Unhealthy dietary habits among Saudi adolescents are of paramount public health concern and the COVID-19 restriction period exacerbated the pre-pandemic nutritionrelated unhealthy behaviours. Therefore, school-based interventions aiming to promote healthy lifestyles and the wellbeing of Saudi adolescents anduse of qualitative recall dietary diary is also crucial to develop programs that prevent unhealthy lifestyles in adolescents in Saudi Arabia. [ABSTRACT FROM AUTHOR]

Somen Saha,1 Apurvakumar Pandya,2 Yogini Kandre,1 Devang Raval,1 Deepak Saxena1 1Department of Public Health, Indian Institute of Public Health, Gandhinagar, Gujarat, India; 2Parul Institute of Public Health, Parul University, Vadodara, Gujarat, IndiaCorrespondence: Somen SahaDepartment of Public Health, Indian Institute of Public Health, Opp. Air Force Headquarter, Gandhinagar-Chiloda Highway, Near Lekawada Bus Stop, Gandhinagar, Gujarat, IndiaTel +91-968-7207549Email ssaha@iiphg.orgPurpose: Malnutrition status of adolescent girls remains a major public health problem in India. The present study assessed nutritional status, associated factors contributing to malnutrition and their access to health-care services in Dev Bhumi Dwarka district of Gujarat situated in western part of India.Materials and Methods: The study was carried out using descriptive cross-sectional design. A total of 1252 adolescent girls from all four blocks of Dev Bhumi Dwarka district were interviewed by field investigators. The data were collected on socio-demographic characteristics, physical activities, diet, and anthropometry. The WHO classification for body mass index (BMI) was used to assess underweight, overweight, and obesity among adolescent girls. Chi-square analyses were performed to identify significant determinants of under-nutrition.Results: Mean age of the study population was 13.82± 2.31. Of the total, around 34% of the adolescent girls were out-of-school. The prevalence of underweight (

Between 1895 and 1908, Britain's prison administration introduced reforms aimed at 'reclaiming' male adolescent offenders. These included a significant rethinking of the dietary. Drawing on the sciences of nutrition and of adolescent development, the prison experimented with the rations for juvenile–adults, a new category of inmate defined by age and by gender. For the first time, the state explicitly used prison rations in the service of sovereignty: it sought to fashion working‐class male adolescents into well‐developed specimens of British manhood able to contribute to the increasingly democratic polity and to defend and populate the nation and its empire. [ABSTRACT FROM AUTHOR]

To examine the feasibility and acceptability of a remote-based nutrition education program during COVID-19 for adolescents with autism spectrum disorder (ASD). Ten adolescents with ASD participated in a 4-week nutrition education program utilizing Zoom software during COVID-19. Topics included shopping for healthy food, and food preparation safety measures. Attendance was collected for each session. Participants, parents, and the classroom teacher completed post-program surveys and interviews. The course attendance rate was 97%. Every adolescent reported they would participate in similar future programs, and the teacher/parents felt the program was a positive experience for the participants. The remote-based nutrition education program appeared to be feasible and acceptable to participants. Future research should focus on program efficacy. [ABSTRACT FROM AUTHOR]

Dietary diversity is considered a key indicator in assessing access, utilization and quality of diet and lack of dietary diversity is strongly associated with an inadequate intake of essential micronutrients. A cross- sectional study was conducted to determine the dietary diversity among adolescents aged 11-13 in the city of Colombo. A sample of 634 subjects was recruited using the multi stage stratified cluster sampling technique. A three-day diet diary was used to collect types and quantities of food items consumed. The dietary diversity score was determined based on Food and Agriculture Organization nine (9) food groups and the food variety score was calculated by a simple count of the number of food items consumed in a single day. Socio-demographic data were gathered using a general questionnaire and height, weight and waist circumference were measured. Household food security status data were gathered using the United States Department of Agriculture 18-item questionnaire. The mean (±SD) dietary diversity score was 4.36 (±1.28) and the mean food variety score was 9.69 (±2. 82). Dietary diversity score and food variety score were high among boys and adolescents in national schools who were food secure. Percentages of adolescents who consumed Vitamin A and Iron rich foods were 41.1 % and 78.2 % respectively. The dietary diversity of adolescents aged 11-13 years in the city of Colombo is adequate and categorized as medium dietary diversity. [ABSTRACT FROM AUTHOR]

Examine the impact of a virtual nutrition education program, Bringing Adolescent Learners with Autism Nutrition and Culinary Education (BALANCE), on dietary intake and psychosocial determinants of healthy eating in adolescents and young adults (AYA) with autism spectrum disorder (ASD). A sample of AYA with ASD aged 12–21 years (n = 27; 6 groups of 2–7 adolescents) participated in BALANCE, a Social Cognitive Theory-based intervention, for eight 30–45-minute lessons. Outcomes were compared using a pre-post design and included dietary intake (assessed using a food frequency questionnaire) and psychosocial determinants of healthy eating (assessed by a validated survey). Wilcoxon signed-rank tests compared preintervention and postintervention medians with an alpha level of 0.05. Mean added sugar intake (P = 0.026) decreased, and behavioral strategies (P = 0.010), self-efficacy (P < 0.001), and outcome expectations (P = 0.009) improved. There was no difference in fruit or vegetable intake or other psychosocial determinants. The BALANCE intervention may improve psychosocial determinants and dietary behaviors in AYA with ASD. Future virtual programs may incorporate more assistance and support to be accessible for AYA with ASD of varying severity levels. [ABSTRACT FROM AUTHOR]

Adolescents with autism spectrum disorder are at increased risk of unhealthy eating behaviors and obesity. This study examined feasibility of a virtual implementation of Bringing Adolescent Learners with Autism Nutrition and Culinary Education, an 8-week nutrition intervention based on social cognitive theory that addresses autism spectrum disorder– specific eating behaviors and food environment challenges. The implementation process was measured with fidelity checklists, engagement records, and field notes. Feasibility of virtually assessing adolescents’ outcomes (food frequency questionnaire, psychosocial survey, height, and weight) was also evaluated. Adolescents with autism spectrum disorder aged 12–21 years were recruited through a local community partner. Six groups (n=27; group size ranged 2–7) participated. Univariate data analyses were performed. Mean lesson attendance was 88%, participation was 3.5/4 (4=Frequently), homework completion was 51.9%, fidelity was 98.9%, and technical difficulty prevalence was 0.4/2 (2=Major technical difficulties). Assessment completion rate was 100% (98.9%–100%) at baseline and 92.6%–96.3% (99.5%–100%) at post-intervention. Data quality was high for 88% of food frequency questionnaires and 100% of psychosocial surveys. Findings suggest that a virtual implementation and evaluation of Bringing Adolescent Learners with Autism Nutrition and Culinary Education was feasible. Bringing Adolescent Learners with Autism Nutrition and Culinary Education may be implemented virtually to reach diverse populations of adolescents with autism spectrum disorder. Future research should examine the impact of the intervention on dietary behavior and obesity outcomes. [ABSTRACT FROM AUTHOR]

Background: Diversity is a key component of diet quality and health, but no indicator exists for adolescents under the age of 15 y., Objectives: To establish a dichotomous indicator for population-level assessment of adolescent dietary diversity as a proxy for micronutrient adequacy., Methods: We used the probability approach to construct mean probability of adequacy (MPA) of 11 micronutrients from 2 d of 24-h dietary recall data from NHANES, 2007-2018. For each micronutrient, probability of adequacy (PA) was calculated using the best linear unbiased predictor of usual intake. Adolescent dietary diversity score (ADDS) was derived with a maximum score of 10 food groups. Generalized linear mixed models were used to examine associations between ADDS and MPA. Receiver operating characteristic analysis was used to establish a cutoff for minimum dietary diversity for adolescents (MDD-A) using an energy-adjusted logistic model with ADDS predicting MPA > 0.6., Results: PA was >80% for all nutrients except vitamin C (42.1%), folate (65.7%), and calcium (23.8%). Population MPA was 79.4%, and nearly 92% of adolescents had an MPA > 0.6. ADDS was positively associated with MPA, and energy was a significant confounder. The area under the curve was >0.8 on both days with sensitivity and specificity ranging from 0.71 to 0.80. The MDD-A cutoff was calculated as 5.12 and 5.10 food groups on days 1 and 2, respectively., Conclusions: In U.S. adolescents, the best cutoff for a dichotomous indicator of dietary diversity as a proxy for micronutrient adequacy is 6 food groups in a given day. Future research could validate MDD-A and its associated cutoff for use across country contexts., (Copyright © 2024 American Society for Nutrition. All rights reserved.)

Context: Anaemia is one leading cause of morbidity among adolescent girls. Prevention, early detection, and treatment can break the intergeneration cycle of malnutrition., Aims/objectives: The aim of the study was to estimate the prevalence of anaemia and assess its sociodemographic determinants and understand its association with the dietary pattern of rural adolescent girls., Settings and Design: A cross-sectional study was conducted among 350 adolescent girls studying in the school of Kalgatigi Taluk, Dharwad district. The school girls were interviewed using a predesigned structured questionnaire by interview method. A food frequency questionnaire was used to assess the dietary pattern. Haemoglobin levels were estimated using Sahli's method., Statistical Analysis Used: Data were entered in Microsoft Excel and analysed using SPSS version 19 and the Chi-square test was applied to study the significance., Results: Rural adolescent school girls between the age group of 13-16 years were included. The prevalence of anaemia among them was found to be 47.4% and was significantly associated with the educational status of the mother, their socioeconomic status (SES), and type of diet. Vegetarian girls had a higher prevalence of anaemia. The frequency of meat and egg consumption was significantly associated with anaemia. The prevalence of anaemia was higher in thin and severely thin girls based on WHO-BMI., Conclusions: Anaemia in rural adolescent girls is of high burden and public health importance with a prevalence of 47.4% and significant association with dietary habits, SES, and BMI., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Family Medicine and Primary Care.)

This article aimed to analyze the evolution of the prevalence of overweight in adolescents from Piauí, monitored by the Food and Nutrition Surveillance System, in the years 2015 to 2019. This is a quantitative, transversal and analytical study, using secondary data from public domain reports of the Food and Nutrition Surveillance System (SISVAN). To generate the reports, the following search criteria were established: adolescent individuals, BMI index by age, male and female genders, grouped by state (Piauí) and the aforementioned reference years. For associations, the Statistical Package for the Social Sciences software, version 20.0, was used to perform the Chi-Square test, considering a significance level of 5%. Time trend analysis was performed using the Joinpoint Regression Program software, version 4.8.0.1, considering p<0.05. The average number of adolescents followed during the period from 2015 to 2019 was 144,368 adolescents/year. SISVAN revealed an increase in the prevalence of overweight adolescents from Piauí during that same period, from 19.0% in 2015 to 22.5% in 2019. In the last year, higher frequencies of obesity and severe obesity were observed (5.75% and 0.96%, respectively), and a significant association between the presence of overweight and the sex of adolescents, being greater among boys (p <0.001). There was a significant upward trend in the percentage of excess weight in the total population and both sexes during the evaluation period. It highlights the increase of overweight among adolescents from Piaui, making it essential to carry out studies and intervention on the lifestyle of these individuals, especially among males. [ABSTRACT FROM AUTHOR]

Background: Adolescence which is a critical stage for growth and development is influenced by various issues along with maternal nutritional knowledge, control over their earnings, freedom of movement, and participation in household decision-making over child's health care. Objective: This study focused on assessing mothers' nutritional knowledge and hygiene practices and their effect on dietary diversity as well as the nutritional status of school-going adolescents of Dhaka city. Methods: A community-based cross-sectional study was conducted at 44 schools in Dhaka city. A total of 710 school-going adolescents aged 10–17 years were randomly selected and their mothers were interviewed for assessing their knowledge on nutrition and hygiene practices. One-way ANOVA and multivariate linear regression were used to examine the association between dietary diversity and the nutritional status of the adolescents with their mother's nutritional knowledge and hygiene practices. Results: About one-third (35.8%) of the mothers maintained hygiene and sanitation satisfactorily. Although 53.1% of them had satisfactory general knowledge about a healthy diet, only 6.5% showed good knowledge of the nutritional value of food. The prevalence of stunting, thin, and overweight was 8, 4.6, and 5.8%, respectively. Fair hygiene practices were positively associated (P = 0.048) with height for age z-score. Maternal knowledge on the nutritional value of food was positively associated (P = 0.027) with the dietary diversity of the adolescents. Conclusion: Adequate nutritional knowledge and hygiene practices of the mothers have positive effects on children's dietary diversity and nutritional status. Providing nutrition education to mothers would ensure better nutritional status and improved dietary practices for their children. [ABSTRACT FROM AUTHOR]

Use of body mass index (BMI) to assess the nutritional status of adolescents requires many resources, especially for country-level assessment. This study aimed to determine the relationship between BMI and mid upper arm circumference (MUAC) among adolescent males and females in India and to examine whether MUAC effectively represents the nutritional status of adolescents. The study utilized anthropometric measurement data collected by India's National Family Health Survey-4 (2015–16). The weighted sample for analysis included 91,315 female and 14,893 male adolescents. The BMI and MUAC measurements showed a positive correlation in both female and male adolescents. Using BMI-for-age Z-score classifications, 12.7% of the adolescents were undernourished. Using MUAC (in cm) as per NACS (Nutrition Assessment, Counselling, and Support) guidelines and Mramba et al. (2017) classified 22.9% and 3.7% of the adolescents as undernourished respectively. Finally, using the MUAC-for-age Z-score classification, 98.4% of adolescents were determined to be normal and 1.7% undernourished. Sensitivity and specificity tests of the MUAC cut-offs, in comparison with BMI cut-offs, showed that all three MUAC cut-off classifications had high specificity (NACS cut-off: 81.3%; Mramba et al. cut-off (cm): 97.7%; Mramba et al. cut-off (Z-score): 99.1%). The NACS cut-off had moderately high sensitivity (52.2%) but the Mramba et al. cut-offs had low sensitivity (13.3% for the centimetre cut-off and 6.6% for the Z-score cut-off). Sensitivity and specificity tests proved the relationship between BMI and MUAC, and that MUAC represents adolescent nutritional status with considerable efficiency. With further research, it may be established that MUAC is a better and promising measure of adolescent nutrition, having the advantage of needing fewer resources for data collection. The MUAC has the potential to offer a simple and low-resource alternative to BMI to assess nutritional status among adolescents in poor countries. [ABSTRACT FROM AUTHOR]

Objective: School lunches represent a key opportunity to improve diets and health of schoolchildren. No recent nationally representative studies have examined the nutritional differences between school meals and packed lunches in the UK. This study aimed to characterise and compare the nutritional quality of school meals and packed lunches among primary and secondary school-age children.Design: A pooled cross-sectional analysis of the UK's National Diet and Nutrition Survey (2008-2017).Setting: United Kingdom.Participants: 3001 children (aged 4-16 years) who completed a 3/4-d food diary which recorded meal type (school meal/packed lunch). Multivariable logistic regression models assessed associations of meeting food and nutrient recommendations by meal type. Analyses were stratified by academic key stages (KS).Results: KS-1 (4-7 years) and 2 (8-11 years) children consuming school meals were more likely to meet minimum recommendations for vegetables, protein-rich foods and fibre, and not exceed maximum recommendations for salt, savoury and sweet snacks compared with pupils consuming packed lunches. However, in KS-3 (12-14 years) and 4 (14-16 years), these effects were reduced. As children aged, the median weight of fruits, vegetables, protein-rich foods and dairy products consumed typically decreased for both school meals and packed lunches, and generally an increasing proportion of school meals contained sweet and savoury snacks.Conclusion: These findings suggest school meals are nutritionally superior to packed lunches but are not yet optimal. Quality declined at higher KS. Actions to improve lunches of primary and secondary schoolchildren across the UK are needed, with attention to KS-3 and 4 in secondary schools. [ABSTRACT FROM AUTHOR]

Adolescence is a nutritionally vulnerable and critical life stage. However, few programs and policies focus on improving adolescent nutrition in Indonesia. To address this gap, we implemented a gender-responsive package of interventions: (1) breakfast and weekly iron-folic acid supplementation (WIFS), (2) a school-based nutrition education program, and (3) a social behavior change communication strategy. We surveyed 514 adolescents at baseline (2019) and endline (2020) in Klaten and Lombok Barat districts in Indonesia. The survey included a knowledge assessment on nutrition, as well as indicators of attitudes and behaviors on diet, physical activity, and WIFS. We employed multivariable linear and logistic regression to test for pre–post intervention differences. Overall knowledge was significantly higher post-intervention (β : 3.3; 95% confidence interval [CI]: 2.6, 3.9). Diet diversity was high at both timepoints, however, at post-intervention there was significantly higher odds of consuming vitamin A-rich fruits and vegetables (Odds Ratio [OR]: 1.5; 95% CI: 1.1, 2.0) and lower odds of consuming sugar-sweetened beverages (OR: 0.4; 95% CI: 0.3, 0.5). Post-intervention, there was higher odds of reporting 60 min of daily physical activity (OR: 2.3; 95% CI: 1.7, 3.2) and WIFS among girls (OR: 6.7; 95% CI: 1.5, 30.9). The package of interventions may be a promising first step to improving adolescent nutrition in Indonesia. [ABSTRACT FROM AUTHOR]

This study aimed to compare fruits and vegetables (FV), and carbonated soft drink (CSD) consumption among adolescents from seventy-four countries, according to macroeconomic indicators. This is an ecological study, developed with countries evaluated through the Global School-based Student Health Survey (2003–2014) and the National School Health Survey (PeNSE-Brazil, 2015). The percentages of students in each country who consumed CSD and FV daily and their association with the Human Development Index (HDI) and the Gross National Income per capita (GNIpc) were assessed. Scatter plots were constructed for each marker, and a multilevel model was tested to consider the effects of region in the associations. The overall prevalence of daily CSD consumption was 54·1 %. CSD consumption was positively associated with HDI and GNIpc through multilevel models, and Central and South America showed a considerable higher consumption compared with other regions. Overall, FV daily consumption was 67·9 % and 74·6 %, respectively, and no associations with macroeconomic indicators were found. The study shows concerning rates of CSD consumption among adolescents, and a trend of increased consumption with the improvement of the country's development and GNIpc. This points for the importance of public policies that regulate food and beverage industries to reduce CSD consumption and related co-morbidities among adolescents. [ABSTRACT FROM AUTHOR]

Background: Adolescent health and nutrition contribute to the intergenerational cycle of undernutrition. Objectives: The aim of this study is to examine the effect of audiovisual education on adolescent knowledge and attitude toward the intergenerational cycle of undernutrition. Material and Methods: A clustered quasi-experimental study with a pre-and posttest design in Kulon Progo District, Yogyakarta, Indonesia. Participants were female adolescent students enrolled in Grade 7 at two junior high schools in Sentolo (n = 120) and Kalibawang (n = 96) subdistricts. We provided six topics related to adolescent health and nutrition throughout six online meetings for the intervention and control groups. In addition, the intervention group received audiovisual education through recorded videos, whereas the control group received education through e-leaflets following the online meetings. We assessed adolescent knowledge and attitude during pre-and posttest evaluations using Google Forms. Paired t-test was performed to analyze the data. Results: Both audiovisual and e-leaflet educations increased adolescent knowledge and attitude. Adolescents who received audiovisual education had significantly higher knowledge (P = 0.046) and attitude (P = 0.034) scores than adolescents who received education through e-leaflets. Conclusions: The audiovisual education intervention improved adolescent knowledge and attitude toward the intergenerational cycle of undernutrition than using e-leaflets. [ABSTRACT FROM AUTHOR]

The aim of this review is to summarise the common barriers and motivations for healthy food choice among adolescents, with a specific focus on the Irish context where available. It will also discuss other concerns adolescents have, which may influence their food choices and eating habits. Adolescence represents a period of rapid physical, mental and social development, and many health-related habits developed during adolescence tend to persist into adulthood, making the teenage years an optimal time to encourage healthy eating and health-promoting behaviours. Adolescents are concerned about the health impact of their diet, but their understanding of health is often seen in the context of their physical appearance or body image. Body image concerns are prevalent in adolescents, and this can affect their food choices. Taste, price and convenience are commonly noted factors influencing adolescents' food choices, and as they grow, their level of independence increases and spending more time with their peers means that social desirability and social norms about food become increasingly important factors in adolescent food choice. However, their limited autonomy means their supporting food environment also plays an important role. When developing more targeted interventions in adolescent populations, information on adolescent nutrition needs, their concerns for health and body image, and the barriers and motivations for healthy eating and food choice should be considered. Such a holistic approach should help support healthy eating and the prevention of overweight and obesity in the population, whilst also supporting a healthy relationship with food and their bodies. [ABSTRACT FROM AUTHOR]

Background: Although nutrients in fruits and vegetables are necessary for proper development and disease prevention, most US children consume fewer servings than recommended. Prescriptions for fruits and vegetables, written by physicians to exchange for fresh produce, address access and affordability challenges while emphasizing the vital role of diet in health promotion and disease prevention. Michigan's first fruit and vegetable prescription program (FVPP) exclusively for children was introduced in 2016 at one large pediatric clinic in Flint and expanded to a second clinic in 2018. The program provides one $15 prescription for fresh produce to all pediatric patients at every office visit. Prescriptions are redeemable at a year-round farmers' market or a local mobile market. The current study will assess the impact of this FVPP on diet, food security, and weight status of youth.Methods: Demographically similar pediatric patient groups with varying levels of exposure to the FVPP at baseline will be compared: high exposure (> 24 months), moderate exposure (12-24 months), and no previous exposure. Data collection will focus on youth ages 8-16 years. A total of 700 caregiver-child dyads (one caregiver and one child per household) will be enrolled in the study, with approximately 200 dyads at clinic 1 (high exposure); 200 dyads at clinic 2 (moderate exposure), and 300 dyads at clinic 3 (no previous exposure). Children with no previous exposure will be introduced to the FVPP, and changes in diet, food security, and weight status will be tracked over two years. Specific aims are to (1) compare baseline diet, food security, and weight status between pediatric patients with varying levels of exposure to the FVPP; (2) measure changes in diet, food security, and weight status before and after never-before-exposed children are introduced to the FVPP; and (3) compare mean 12- and 24-month follow-up measures of diet, food security, and weight status in the initial no exposure group to baseline measures in the high exposure group.Discussion: Completion of study aims will provide evidence for the effectiveness of pediatric FVPPs and insights regarding the duration and intensity of exposure necessary to influence change.Trial Registration: The study was registered through clinicaltrials.gov [ID: NCT04767282] on February 23, 2021. [ABSTRACT FROM AUTHOR]

South Asia has made significant progress in reducing child undernutrition. The prevalence of stunting declined by one third between 2000 and 2019; as a result, in 2019, there were 34 million fewer stunted children than in 2000, indicating that progress for child nutrition is possible and is happening at scale. However, no country in South Asia is on track for all nutrition targets of Sustainable Development Goal 2, and the region has the highest prevalence of stunting (33.2%) and wasting (14.8%) in the world. Nepal, the best performing country in the region, narrowly missed the Millennium Development Goal (MDG) target to half the prevalence of child underweight between 1990 and 2015 and achieved the fastest recorded reduction in stunting prevalence in the world between 2001 and 2011. In 2019, UNICEF Nepal completed a series of papers to examine Nepal's progress on maternal and child nutrition during the MDG era. The series explores the trends, distribution and disparities in stunting, micronutrient deficiencies and feeding practices in children under 5 years and anaemia in adolescents and women. Besides, it reviews national micronutrient programmes (vitamin A supplementation, iron and folic acid supplementation and universal salt iodization) and Nepal's first Multi‐Sector Nutrition Plan, to illuminate the success factors and enduring challenges in the policy and programme landscape for nutrition. This overview paper summarizes the evidence from these analyses and examines the implications for the direction of future advocacy, policy and programme actions to improve maternal and child nutrition in Nepal and other similar contexts. [ABSTRACT FROM AUTHOR]

Cancer is one of the leading causes of death for children; however, appropriate nutritional status can positively affect survival. The aim of this study was to determine to what extent malnutrition risk screening and intensified nutrition support, provided by a professional team, promoted disease progression and survival in pediatric patients with solid tumors. 145 pediatric cancer patients (average age 6.3 ± 5.6 and 6.7 ± 5.4 years) with solid tumors undergoing chemotherapy participated in the study. Two 3-year periods were studied: 2009-2011 and 2012-2014. Patient characteristics and treatment protocols were identical, but in Period 2, with the foundation of our nutrition support team malnutrition risk screening was made mandatory upon every hospital admission. As a result of intensified nutrition support the time from diagnosis to completion of treatment (802 vs. 512 day, p < 0.001) and the need for antimycotic treatment reduced significantly (47.8% vs. 29.1%, p = 0.036). The total percentage of surviving children was 60.3% and 75.0% in Period 1 and 2 respectively. Decrease in weight-for-height percentile during treatment and central nervous system tumors are significant predictors of a less favorable survival. Malnutrition risk screening and intensified nutrition therapy have positive effects on nutritional status and therefore patient survival in pediatric cancer patients. [ABSTRACT FROM AUTHOR]

Background: National Family Health Surveys in India have not included nutritional status of the crucial age group of 10-14 years, when pubertal growth spurt typically occurs. BMI-for-age is commonly used to assess adolescent nutritional status which may misclassify stunted adolescents as normal or overweight. Objectives: To estimate prevalence and determinants of stunting among adolescents (10 to 19 years) in Bangalore city and to estimate the proportion of adolescents who are stunted, but otherwise assessed as normal or overweight using BMI-for-age. Methods: Cross sectional study conducted in four schools of Bangalore city using a self-administered questionnaire to capture socio-demographic details, dietary patterns and physical activity. WHO Anthroplus software was used to classify nutritional status based on height-for-age and BMI-for- age. Multiple logistic regression analysis was done to calculate adjusted odds ratios of independent co-variates associated with stunting. Results: Overall prevalence of stunting was 14% (95%CI:11.5-16.5%); 14.3% among females (95%CI:10.7-17.9%) and 13.6% among males (95%CI: 10.2-17.0%). Determinants of stunting were late adolescence [AOR=1.90(1.24-2.90),P=0.03], lower socio-economic class [AOR=2.75(1.39-5.41),P=0.03] and not taking weekly iron and folic acid supplements [AOR=2.78(1.48-5.21),P=0.001] Four of every five stunted children (81%) were classified as normal/ overweight/ obese using BMI-for-age. Conclusion: Stunting is a problem among urban adolescents in Bangalore. Height-for-age is a vital metric for assessing nutritional status of adolescents along with other metrics. We recommend strengthening of weekly iron and folic acid supplementation in schools and culturally specific targeted nutritional interventions for adolescents from economically weaker sections of society using a multi-sectoral and participatory approach. [ABSTRACT FROM AUTHOR]

Obesity may cause physiological, psychological, social, and economic problems. Therefore, it is of considerable importance to implement preventive interventions for the factors that may cause obesity. This study aimed to evaluate the effectiveness of the obesity prevention program developed for secondary school students. This study was conducted on 116 students assigned to intervention (n = 58) and control groups (n = 58). Data were collected at baseline and on months 6, 12 and 15 after the intervention. Multivariate analysis of variance, t-test with Bonferroni correction and Multi-chi-square test were used for repeated measurements. No significant difference was found in proportions of body mass index classification of children in the intervention group (p =.991), while a significant difference was found between measurements on month one and 15 in the control group (p <.05). There was no significant difference between mean total scores in the eating behavior questionnaire (p >.05). In this study, it was thought that it would be more effective to add obesity prevention education to the school curriculum and to keep its duration longer and to include families in this education. Parents play an enormous role in the nutrition of children. Therefore, parents should be supported for a healthy diet in children. Moreover, parents should be included in healthy eating initiatives for children. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI) [ABSTRACT FROM AUTHOR]