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BACKGROUND: Consuming ultra-processed foods may increase exposure to phthalates, a group of endocrine disruptors prevalent in food contact materials. OBJECTIVES: Investigate associations between ultra-processed food intake and urinary phthalates during pregnancy, and evaluate whether ultra-processed foods mediate socioeconomic disparities in phthalate exposures. METHODS: In a socioeconomically diverse sample of 1031 pregnant women from the Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) Study in the urban South, the Block Food Frequency Questionnaire was administered and urinary phthalate metabolites were measured in the second trimester. Linear regressions modeled associations between phthalates and overall ultra-processed food consumption, individual ultra-processed foods, and exploratory factor analysis dietary patterns. Causal mediation analyses examined whether ultra-processed food intake mediates relationships between socioeconomic disparities and phthalate exposures. RESULTS: Ultra-processed foods constituted 9.8-59.0 % (mean = 38.6 %) of participants diets. 10 % higher dietary proportion of ultra-processed foods was associated with 13.1 % (95 %CI: 3.4 %-22.9 %) higher molar sum concentrations of di(2-ethylhexyl) phthalate metabolites (ΣDEHP). 10 % higher consumption of minimally-processed foods was associated with lower ΣDEHP (10.8 %: 3.4 %-22.9 %). Ultra- and minimally-processed food consumption were not associated with non-DEHP metabolites. Standard deviation higher consumptions of hamburger/cheeseburger, French fries, soda, and cake were associated with 10.5 % (4.2 %-17.1 %), 9.2 % (2.6 %-16.2 %), 7.4 % (1.4 %-13.6 %), and 6.0 % (0.0 %-12.4 %), respectively, higher ΣDEHP. Exploratory factor analysis corroborated positive associations of processed food with ΣDEHP, and uncovered a healthy dietary pattern associated with lower urinary ΣDEHP, mono(2-ethyl-5-hydroxyhexyl) (MEHHP), mono(2-ethyl-5-carboxypentyl) (MECPP), mono(2-carboxymethylhexyl) (MCMHP), and mono-isononyl (MINP) phthalates. Significant indirect effects indicated that lower income and education levels were associated with 1.9 % (0.2 %-4.2 %) and 1.4 % (0.1 %-3.3 %) higher ΣDEHP, respectively, mediated via increased ultra-processed food consumption. CONCLUSIONS: Consumption of ultra-processed foods may increase exposure to phthalates. Policies to reduce dietary phthalate exposures from food packaging and processing are needed, as socioeconomic barriers can preclude dietary recommendations as a sole means to reduce phthalate exposures.

Depression is a significant mental health concern, and the ubiquitous presence of fast-food in modern diets raises questions about its impact on mental well-being. Understanding the intricate relationship between fast-food consumption, obesity, and depression is essential for addressing the complex web of factors contributing to this public health issue. In this study, we analyzed data from the National Health and Nutritional Examination Surveys (NHANES) spanning from 2008 to 2018, involving 31,460 participants. Among the 31,460 subjects in the survey, 2871 exhibited signs of depression, with an average age of 48.2 years. Each additional weekly fast-food meal was linked to 4 % higher odds of depression, with consuming over two such meals increasing the odds by 24 %. Adjusted models exploring the relationship between body mass index (BMI), fast-food consumption, and depression indicated an increased risk with greater fast-food intake, especially within subgroups based on obesity status. Mediation analysis revealed that fast-food consumption and depression were largely independent of obesity, with obesity accounting for only 6.5 % of the total effect. No significant mediation effect was found in the overweight subgroup, but the mediated effect was increased with higher BMI in more obese patients, notably in those with BMI ≥ 30 or ≥40. Sensitivity analysis confirmed these findings with more conservative estimates across all subgroups. This study highlights a substantial connection between fast-food consumption and depression. While obesity plays a role, it does not fully mediate the relationship, suggesting the presence of other contributing factors. • Each fast-food meal raised depression odds by 5 %. • Fast-food consumption behavior increased depression odds by 24 %. • No significant mediation effect was found in the overweight subgroup. • The mediating effect significantly increased with higher BMI in more obese patients. [ABSTRACT FROM AUTHOR]

US schools have fast-food restaurants nearby, encouraging student patronage, unhealthy consumption, and weight gain. Geographers have developed an activity space framework which suggests this nearby location effect will be moderated by whether people perceive the location as their activity space. Therefore, we study whether students perceive a fast-food restaurant near school as their activity space, and whether social marketing messages can change that perception. We conducted six studies: a secondary data analysis with 5986 students, a field experiment with 188 students, and four lab experiments with 188, 251, 178, and 379 students. We find that students who strongly identify with their student community patronize a fast-food restaurant near school (vs. farther away) because they view it as their activity space, while students who weakly identify do not. For example, in our field experiment, 44% vs. 7% of students who strongly identified with the student community patronized the near versus farther restaurant, while only 28% versus 19% of students who weakly identified patronized the near and farther restaurants comparably. We also find that to deter the strong identifiers, messages should convey that patronage is a social liability, e.g., portray student activism against fast food. We show that standard health messages do not change perceptions of restaurants as social activity spaces. Thus, to combat the problem of fast-food restaurants near schools causing unhealthy consumption, policy and educational interventions should focus on students who strongly identify with their student community and find ways to weaken their perceptions that fast-food restaurants near schools are their activity spaces.

Purpose of reviewThe purpose of this review is to provide an update on the available data regarding the associations of Ultra-processed food (UPF) consumption with food intake and possible underlying mechanisms relating UPF consumption to weight gain and co-morbidities.Recent findingsIn primarily observational studies, UPF consumption is consistently associated with an increased risk for weight gain among adults and children and increased risk for adiposity-related co-morbidities in adults. In a single mechanistic study, consumption of UPFs led to increased energy intake and weight gain relative to whole foods. UPFs tend to be more energy-dense than nutrient-dense, and UPF consumption is associated with increased adiposity and co-morbidity risk. These data suggest that recommendations to limit UPF consumption may be beneficial to health - though further mechanistic studies are needed.

The COVID-19 pandemic caused widespread non-essential business closures in the U.S., which may have disproportionately impacted food consumption in lower-income communities, in part due to reduced access to healthy and affordable foods, as well as occupations that may have required working outside the home. The aims of this study were to examine restaurant dining behaviors (including drive-through, takeout, and delivery) at fast-food and non-fast-food (i.e., fast casual and full-service ['other']) restaurants and the impact on diet quality among racially/ethnically diverse low-income adults during the early months of the pandemic. Participants completed an online survey using CloudResearch regarding restaurant dining behaviors in the past week (during June 2020) and during a typical week prior to the pandemic. Diet quality was measured using the Prime Diet Quality Score (PDQS). Surveys from 1,756 low-income adults (incomes

Background Commercial advertising and sponsorship drive the consumption of harmful commodities. Local authorities (LAs) have considerable powers to reduce such exposures. This study aimed to characterize local commercial policies across all English LAs. Methods We conducted a census of all English LAs (n  = 333) to identify local commercial policies concerning advertising and sponsorship of tobacco, alcohol, less healthy foods and gambling, through online searches and Freedom of Information requests. We explored policy presence, commodity frequency and type, and associations with LA characteristics (region, urban/rural and deprivation). Results Only a third (106) of LAs in England had a relevant policy (32%). These included restrictions on tobacco (91%), gambling (79%), alcohol (74%) and/or less healthy foods (24%). Policy prevalence was lowest in the East of England (22%), North East (25%) and North West (27%), higher in urban areas (36%) than rural areas (28%) and lower in the least (27%) compared with the most (38%) deprived areas. Definitions in policies varied, particularly for alcohol and less healthy foods. Conclusions English LAs currently underutilize their levers to reduce the negative impacts of harmful commodity industry marketing, particularly concerning less healthy foods. Standardized guidance, including clarity on definitions and application, could inform local policy development. [ABSTRACT FROM AUTHOR]

Food delivery apps (FDAs) and smartphones in Saudi Arabia have become ubiquitous and increasingly popular methods for food ordering and consumption. Such app use during the COVID-19 pandemic has become a convenient and popular response to pandemic restrictions. However, the motivations and preferences behind FDA use are complex, as are the perceptions of FDA users regarding nutrition and healthy foods. To explore FDA usage, motivations, perceptions, and food behaviours in the unique cultural context of Saudi Arabia at the intersection of two epidemics, COVID-19 and obesity, a convergent parallel mixed-methods study design was used with 566 Saudis in the quantitative phase and 17 continuing to the qualitative phase. Of the respondents, 71.9 % reported using FDA typically once a week. Frequent FDA usage was reported by 33.3 % of the participants aged 30–40 years (P = .049). Nearly two-thirds of the sample (62 %) reported that time and convenience were the driving factors in using FDAs. Qualitatively, six main themes were identified: ‘Perceived benefits and drawbacks’, ‘Effects of Promotions and Food Preferences’, ‘Nutritional information and dietary guidelines’, ‘Concepts of healthy food’, ‘Obstacles to healthy food consumption’, and ‘Maintaining Customs and Traditions’. Although convenience and taste were the primary drivers of FDA usage, the roles of tradition and culture in Saudi Arabia were also important FDA usage factors. Overall, understanding the determinants of how Saudis engage with FDAs, in concert with a deeper understanding of food preferences, perceptions, and nutritional knowledge, should help guide future efforts in nutrition education, app development, and public health policy.

ObjectiveTo examine whether the density of neighbourhood restaurants affected the frequency of eating restaurant meals and subsequently affected diet quality.DesignCross-sectional and longitudinal designs. Structural equation models assessed the indirect relationship between restaurant density (≤3 miles (4·8 km) of participant addresses) and dietary quality (Healthy Eating Index 2010 (HEI)) via the frequency of eating restaurant meals, after adjustment for sociodemographics, select health conditions, region, residence duration and area-level income.SettingUrbanised areas in multiple regions of the USA, years 2000-2002 and 2010-2012.ParticipantsParticipants aged 45-84 years were followed for 10 years (n 3567).ResultsMedian HEI (out of 100) was fifty-nine at baseline and sixty-two at follow-up. The cross-sectional analysis found that residing in areas with a high density of restaurants (highest-ranked quartile) was associated with 52 % higher odds of frequently eating restaurant meals (≥3 times/week, OR: 1·52, 95 % CI 1·18, 1·98) and 3 % higher odds of having lower dietary quality (HEI lowest quartile < 54, OR: 1·03, 95 % CI 1·01, 1·06); associations were not sustained in longitudinal analyses. The cross-sectional analysis found 34 % higher odds of having lower dietary quality for those who frequently ate at restaurants (OR: 1·34, 95 % CI 1·12, 1·61), and more restaurant meals (over time increase ≥ 1 time/week) were associated with higher odds of having worse dietary quality at follow-up (OR: 1·21, 95 % CI 1·00, 1·46).ConclusionsRestaurant density was associated with frequently eating out in cross-sectional and longitudinal analyses but was associated with the lower dietary quality only in cross-sectional analyses. Frequent restaurant meals were negatively related to dietary quality. Interventions that encourage less frequent eating out may improve population dietary quality.

Shc expression rises in human nonalcoholic steatohepatitis (NASH) livers, and Shc-deficient mice are protected from NASH-thus Shc inhibition could be a novel therapeutic strategy for NASH. Idebenone was recently identified as the first small-molecule Shc inhibitor drug. We tested idebenone in the fibrotic methionine-choline deficient (MCD) diet and the metabolic fast food diet (FFD) mouse models of NASH. In the fibrotic MCD NASH model, idebenone reduced Shc expression and phosphorylation in peripheral blood mononuclear cells and Shc expression in the liver; decreased serum alanine aminotransferase and aspartate aminotransferase; and attenuated liver fibrosis as observed by quantitative polymerase chain reaction (qPCR) and hydroxyproline quantification. In the metabolic FFD model, idebenone administration improved insulin resistance, and reduced inflammation and fibrosis shown with qPCR, hydroxyproline measurement, and histology. Thus, idebenone ameliorates NASH in two mouse models. As an approved drug with a benign safety profile, Idebenone could be a reasonable human NASH therapy.

Background: Understanding the factors that influence adolescent's perception of fast food and their fluid consumption is crucial for designing effective nutrition education programs tailored to this population. This study aimed to evaluate the associations of sex and the use of media and the internet with adolescents' perception of fast foods and the amount of fluid consumption. Methods: A cross-sectional survey was conducted on school adolescents between the ages of 15 and 18 years in Kuwait, using a multistage stratified random sampling method (N = 706 adolescents; 343 boys and 363 girls). A pre-tested and specifically designed self-report questionnaire covering several measures such as: (a) types of foods that are considered fast foods; and (b) participant's fluid consumption. Body weight and height were measured using calibrated medical scales. Body mass index (BMI) was computed. The adolescents were stratified by sex into two groups: boys and girls, for the purpose of analysis. Results: Seven out of 14 food choices showed significant sex differences (p values ranged from 0.016 to < 0.001) in the adolescents' responses to whether they perceived such food choice as fast food or not. Although differences were found between sexes, the majority of the listed fast foods were correctly recognized as fast foods by the adolescents. In addition, there were significant differences between males and females in the amount of daily drinks (ml/week) consumed from full fat milk (males = l197.1 ± 27,652.1 and females = 1662.8 ± 2221, p = 0.013), sugar-sweetened beverage (males = 2350.8 ± 3324.3 and females = 3088.9 ± 3701.1, p = 0.004), and energy drinks (males = 429.5 ± 1117.2 and females = 267.6 ± 733.8, p = 0.037). Compared to adolescents who seldom or do not watch TV or use the internet, those who engage in these sedentary activities are less likely to classify pizza (aOR (95% CI) = 0.660 (0.440–0.990), p = 0.045), grilled meat (aOR (95% CI) = 0.674 (0.477–0.954), p = 0.026), fried egg sandwiches (aOR (95% CI) = 0.617 (0.425–0.894–0.189), p = 0.011), and rice (aOR (95% CI) = 0.598(0.409–0.875), p = 0.008) as fast foods. Conclusion: The influence of TV and internet use on adolescent's ability to accurately identify fast foods has been observed. Findings indicate the need for increased fast food nutrition education programs that are tailored towards adolescents. The study recommends further research to enhance consumer awareness of foods and drinks among adolescents in the State of Kuwait. [ABSTRACT FROM AUTHOR]

The aim of this study was to characterize the sodium content in commonly consumed away-from-home food in three areas of Metropolitan Lima. We conducted a cross-sectional study, in which twenty frequently consumed foods were identified according to the place of sale. Sodium content was determined through atomic absorption spectroscopy in preparations collected in 2019. The median sodium content in street food products was 492.36 mg/100g (IQR: 83.93 - 918.78), 471.37 mg/100 g in artisanal food (IQR: 76.04 - 765.39) and 471.06 mg/100 g in fast food (IQR: 115.31 - 695.18). Sixty-five percent of the foods were classified as having high sodium content according to Peruvian regulations, while 30% of the preparations had high sodium content, according to UK parameters. Most food sold and consumed away from home have high sodium content. It is essential to engage all stakeholders involved in food preparation for away-from-home consumption in order to raise awareness and involve them in the promotion of policies aimed at reducing sodium intake. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Fast foods are often responsible for staphylococcal foodborne illness. The present study was carried out to isolate Staphylococcus spp. from various fast foods sold in Mymensingh and to determine their antibiogram. MATERIALS AND METHODS: Overall, 60 samples of fast foods sold in different restaurants were screened by culture, biochemical tests, and polymerase chain reaction (PCR) to isolate and identify Staphylococcus spp., followed by employing of disk diffusion method to determine their antibiotic resistance patterns. RESULTS: Among these 60 samples, 8 [13.33%, 95% confidence interval (CI): 6.91%-24.17%] were positive for Staphylococcus spp. by cultural and biochemical properties. By PCR, four (6.67%, 95% CI: 2.62%-15.93%) isolates were confirmed as Staphylococcus aureus by targeting nuc gene. Additionally, all the S. aureus isolates were coagulase-positive. By antibiogram profiles, all the Staphylococcus isolates exhibited resistance to azithromycin and erythromycin (95% CI: 67.56%-100.00%), and frequently resistance to cefixime (75%, 95% CI: 40.93%-95.56%), ampicillin (50%, 95% CI: 21.52%-78.48%), and amoxicillin (37.5%, 95% CI: 13.68%-69.43%); moderate to lower resistance was found against cefotaxime, gentamicin, and doxycycline. In addition, all the isolates were sensitive to ciprofloxacin and chloramphenicol. Interestingly, 75% (6/8; 95% CI: 40.93%-95.56%) isolates were multidrug-resistant (MDR) in nature. Furthermore, the indices of multiple antibiotic resistance (MAR) were ranged from 0.2 to 0.6. CONCLUSION: This study revealed that fast foods sold in restaurants were contaminated with MDR and MAR Staphylococcus isolates, having potential public health significance.

Resumo Introdução O processamento de alimentos pode causar alterações que os transformam em fatores de risco para doenças crônicas. Um maior grau de processamento de alimentos está associado ao desenvolvimento de doenças crônicas não transmissíveis (DCNT), incluindo a síndrome metabólica (SM). O objetivo deste estudo foi analisar a relação entre o consumo de alimentos ultraprocessados (AUP) e a prevalência de SM e seus fatores de risco, com foco em um grupo populacional especialmente submetido a precárias condições de vida e insegurança alimentar. Método Estudo transversal de base populacional com mulheres (19 a 59 anos) de comunidades Quilombolas de Alagoas. Foram analisadas as variáveis socioeconômicas, demográficas, antropométricas, estado de saúde, estilo de vida e ingestão alimentar (recordatório de 24 horas). A variável dependente foi a SM, definida a partir dos critérios de harmonização do Joint Interim Statement, e seus componentes. Os alimentos consumidos foram categorizados de acordo com a Classificação Nova, assumindo como exposição de risco o maior consumo de AUP. A medida de associação foi a razão de prevalência (RP) e respectivo IC 95%, calculado por regressão de Poisson com variância robusta. Também analisou-se a associação com o Escore Nova de consumo de AUP. Resultados Foram investigadas 895 mulheres (38,9 ± 11,0 anos), das quais 48,3% tinham SM. Em média, 15,9% da ingestão total de energia provinham de AUP. Escores Nova mais baixos foram associados a uma menor prevalência de diabetes e HDL baixo. O maior consumo de AUP se associou a uma prevalência 30% maior de hipertensão arterial (RP = 1,30; IC95%: 1,06-1,61). Conclusão O maior consumo de AUP se associou positivamente à prevalência de hipertensão, enquanto o menor escore Nova foi fator de proteção contra diabetes e baixo HDL. O consumo de AUP nas comunidades Quilombolas é relevante, mas inferior ao observado na população brasileira em geral. Sugere-se a implementação de programas de saúde pública que promovam a alimentação saudável, valorizando os hábitos e tradições alimentares existentes entre os remanescentes Quilombolas brasileiros.

The quality and the safety of the foods that are served at fast foods restaurants and their effect on the consumer health could become a matter of concern during COVID-19. Therefore, the objectives of this study were i) to evaluate the quality and safety of raw foods, suitability and availability of manufacturing places, physical facilities, drinking water and waste management system, and processing conditions, and ii) to assess the knowledge, attitudes, practices regarding food safety and hygienic practices among food handlers at fast foods restaurants in the different universities in Jordan during COVID-19. The study was conducted in 12 fast foods restaurants of 3 different universities in Jordan which are located in different places in Jordan. A desirable practice was given a score of one while no score will be allotted for an undesirable practice through using a standard questionnaire for all the food establishments. This was used to compare with the maximum score obtainable for that relevant operation and the percentage scores was calculated for each operation. Analysis of Variance (ANOVA) of the data was performed to study the significant differences at P ≤ 0.05 in all the evaluated properties among the food establishments in the different universities. The results showed that low percentage scores were obtained with 68%, 75%, 32% and 56% for the production area, waste management, product evaluation (chemical, microbial) and food safety program application, respectively. Also, it was found that there were insignificant differences at P ≤ 0.05 among different food serving establishments in different universities in all the safety properties. This means that all the food establishments in all the universities suffer from the same problems with the same degree. As a conclusion, more work should be done to produce safe food in the different food establishments that were studied in the different universities.

Diets rich in animal source foods vs plant-based diets have different macronutrient composition, and they have been shown to have differential effects on the gut microbiome. In this study, we hypothesized that diets with very different nutrient composition are able to change gut microbiome composition and metabolites in a very short period. We compared a fast food (FF) diet (ie, burgers and fries) with a Mediterranean (Med) diet, which is rich in vegetables, whole grains, olive oil, nuts, and fish. Ten healthy subjects participated in a controlled crossover study in which they consumed a Med diet and FF diet in randomized order for 4 days each, with a 4-day washout between treatments. Fecal DNA was extracted and the 16S V4 region amplified using polymerase chain reaction followed by sequencing on an Illumina MiSeq. Plasma metabolites and bile acids were analyzed using liquid chromatography-mass spectrometry. Certain bile-tolerant microbial genera and species including Collinsella, Parabacteroides, and Bilophila wadsworthia significantly increased after the FF diet. Some fiber-fermenting bacteria, including Lachnospiraceae and Butyricicoccus, increased significantly after the Med diet and decreased after the FF diet. Bacterially produced metabolites indole-3-lactic acid and indole-3-propionic acid, which have been shown to confer beneficial effects on neuronal cells, increased after the Med diet and decreased after the FF diet. Interindividual variability in response to the treatments may be related to differences in background diet, for example as shown by differences in Bilophila response in relationship to the saturated fat content of the baseline diet. In conclusion, an animal fat-rich, low-fiber FF diet v. a high-fiber Med diet altered human gut microbiome composition and its metabolites after just 4 days.

We investigated the associations between maternal dietary patterns during pregnancy and early childhood growth trajectories and overweight/obesity risk in offspring. Maternal diet was assessed using a food frequency questionnaire during the second trimester, and dietary patterns were derived by reduced rank regression. The associations between maternal dietary pattern scores and body mass index (BMI) trajectories from birth to age four (rising-high, moderate, and low BMI trajectories) as well as overweight/obesity risk at age four were analyzed (n = 1257). Two maternal dietary patterns were identified. The fast food pattern included a higher intake of fried chicken and fish, fruit juices, mayonnaise, and sugar-sweetened beverages, while the processed food pattern included a higher intake of dairy, salad dressing, processed meat, and cold breakfast cereal. Women with greater adherence to the fast food pattern were more likely to have children in the rising-high BMI trajectory group [OR (95% CI) = 1.32 (1.07-1.62); p = 0.008] or having overweight/obesity at age four [OR (95% CI) = 1.31 (1.11-1.54); p = 0.001]. The processed food pattern was not associated with these outcomes. The maternal dietary pattern during pregnancy represented by fried foods and sugar-sweetened beverages may contribute to rapid early childhood growth and increased risk for obesity in offspring.

Since high-density lipoprotein (HDL) glycoprofiles are associated with HDL functional capacity, we set out to determine whether diet can alter the glycoprofiles of key HDL-associated proteins, including ApoE, a potent driver of chronic disease risk. Ten healthy subjects consumed a fast food (FF) and a Mediterranean (Med) diet for 4 days in randomized order, with a 4-day wash-out between treatments. A multiple reaction monitoring method was used to characterize the site-specific glycoprofiles of HDL proteins, and HDL functional capacity was analyzed. We describe for the first time that ApoE has 7 mucin-type O-glycosylation sites, which were not affected by short-term diet. The glycoprofiles of other HDL-associated proteins were also unaffected, except that a disialylated ApoC-III glycan was enriched after Med diet, and a nonsialylated ApoC-III glycan was enriched after FF diet. Twenty-five individual glycopeptides were significantly correlated with cholesterol efflux capacity and 21 glycopeptides were correlated with immunomodulatory capacity. Results from this study indicate that the glycoprofiles of HDL-associated proteins including ApoE are correlated with HDL functional capacity but generally unaffected by diet in the short term, except ApoC-III sialylation. These results suggest that HDL protein glycoprofiles are affected by both acute and long-term factors and may be useful for biomarker discovery.

Abstract Background Evidence on the association between the presence of fast-food outlets and Body Mass Index (BMI) is inconsistent. Furthermore, mechanisms underlying the fast-food outlet presence-BMI association are understudied. We investigated the association between the number of fast-food outlets being present and objectively measured BMI. Moreover, we investigated to what extent this association was moderated by neighbourhood socio-economic status (NSES) and healthy food outlets. Additionally, we investigated mediation by frequency of fast-food consumption and amount of fat intake. Methods In this cross-sectional study, we used baseline data of adults in Lifelines (N = 149,617). Geo-coded residential addresses were linked to fast-food and healthy food outlet locations. We computed the number of fast-food and healthy food outlets within 1 kilometre (km) of participants’ residential addresses (each categorised into null, one, or at least two). Participants underwent objective BMI measurements. We linked data to Statistics Netherlands to compute NSES. Frequency of fast-food consumption and amount of fat intake were measured through questionnaires in Lifelines. Multivariable multilevel linear regression analyses were performed to investigate associations between fast-food outlet presence and BMI, adjusting for individual and environmental potential confounders. When exposure-moderator interactions had p-value

Abstract Background Food prepared out-of-home is typically energy-dense and nutrient-poor. This food can be purchased from multiple types of retailer, including restaurants and takeaway food outlets. Using online food delivery services to purchase food prepared out-of-home is increasing in popularity. This may lead to more frequent unhealthy food consumption, which is positively associated with poor diet and living with obesity. Understanding possible reasons for using online food delivery services might contribute to the development of future public health interventions, if deemed necessary. This knowledge would be best obtained by engaging with individuals who use online food delivery services as part of established routines. Therefore, we aimed to investigate customer experiences of using online food delivery services to understand their reasons for using them, including any advantages and drawbacks. Methods and results In 2020, we conducted telephone interviews with 22 adults living in the UK who had used online food delivery services on at least a monthly basis over the previous year. Through codebook thematic analysis, we generated five themes: ‘The importance of takeaway food’, ‘Less effort for more convenience’, ‘Saving money and reallocating time’, ‘Online food delivery service normalisation’ and ‘Maintained home food practices’. Two concepts were overarching throughout: ‘Place. Time. Situation.’ and ‘Perceived advantages outweigh recognised drawbacks’. After considering each of the accessible food purchasing options within the context of their location and the time of day, participants typically selected online food delivery services. Participants reported that they did not use online food delivery services to purchase healthy food. Participants considered online food delivery service use to be a normal practice that involves little effort due to optimised purchasing processes. As a result, these services were seen to offer convenient access to food aligned with sociocultural expectations. Participants reported that this convenience was often an advantage but could be a drawback. Although participants were price-sensitive, they were willing to pay delivery fees for the opportunity to complete tasks whilst waiting for delivery. Furthermore, participants valued price-promotions and concluded that receiving them justified their online food delivery service use. Despite takeaway food consumption, participants considered home cooking to be irreplaceable. Conclusions Future public health interventions might seek to increase the healthiness of food available online whilst maintaining sociocultural values. Extending restrictions adopted in other food environments to online food delivery services could also be explored.

Background: The processing of food can cause changes that turn them into risk factors for chronic diseases. A higher degree of food processing is associated with the development of chronic non-communicable diseases (NCDs), including the metabolic syndrome (MetS). The objective of this study was to analyze the relationship between ultra-processed food (UPF) consumption and the prevalence of MetS and its risk factors, focusing on a population group especially subjected to precarious living conditions and food insecurity. Method: Cross-sectional population-based study with women (19 to 59 years) from Quilombola communities of Alagoas. The socioeconomic, demographic, anthropometric, health status, lifestyle, and food intake (24-h recall) variables were analyzed. The dependent variable was the MetS, defined using the harmonization criteria of the Joint Interim Statement, and its components. The foods consumed were categorized according to the Nova Classification, assuming the highest UPF consumption as risk exposure. The measure of association was the prevalence ratio (PR) and respective 95%CI, calculated by Poisson regression with robust variance. We also analyzed the association with the Nova score of UPF consumption. Results: We investigated 895 women (38.9 ± 11.0 years), of whom 48.3% had MetS. On average, 15.9% of the total energy intake came from UPF. Lower Nova scores were associated with a lower prevalence of diabetes and low HDL. Higher UPF consumption was associated with a 30% higher prevalence of hypertension (PR = 1.30; 95%CI: 1.06–1.61). Conclusion: The highest UPF consumption was positively associated with the prevalence of hypertension, while a lower Nova score was a protective factor against diabetes and low HDL. UPF consumption in Quilombola communities is important but lower than that observed in the Brazilian population in general. It is suggested that public health programs be implemented to promote healthy eating while valuing the existing eating habits and traditions among the remaining Brazilian Quilombola people. [ABSTRACT FROM AUTHOR]

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IntroductionHDL is associated with increased longevity and protection from multiple chronic diseases. The major HDL protein ApoA-I has a half-life of about 4 days, however, the effects of diet on the composition of HDL particles at this time scale have not been studied.ObjectivesThe objective of this study is to investigate the short term dietary effect on HDL lipidomic composition.MethodsIn this randomized order cross-over study, ten healthy subjects consumed a Mediterranean (Med) and a fast food (FF) diet for 4 days, with a 4-day wash-out between treatments. Lipidomic composition was analyzed in isolated HDL fractions by an untargeted LC-MS method with 15 internal standards.ResultsHDL phosphatidylethanolamine (PE) content was increased by FF diet, and 41 out of 170 lipid species were differentially affected by diet. Saturated fatty acids (FAs) and odd chain FA were enriched after FF diet, while very-long chain FA and unsaturated FA were enriched after Med diet. The composition of phosphatidylcholine (PC), triacylglycerol (TG) and cholesteryl ester (CE) were significantly altered to reflect the FA composition of the diet whereas the composition of sphingomyelin (SM) and ceramides were generally unaffected.ConclusionResults from this study indicate that the HDL lipidome is widely remodeled within 4 days of diet change and that certain lipid classes are more sensitive markers of diet whereas other lipid classes are better indicators of non-dietary factors.

ObjectiveTo examine the relationship between food swamps and hospitalization rates among adults with diabetes.Data sourcesBlue Cross Blue Shield Association Community Health Management Hub® 2014, AHRQ Health Care Cost and Utilization Project state inpatient databases 2014, and HHS Area Health Resources File 2010-2014.Study designCross-sectional analysis of 784 counties across 15 states. Food swamps were measured using a ratio of fast food outlets to grocers. Multivariate linear regression estimated the association of food swamp severity and hospitalization rates. Population-weighted models were controlled for comorbidities; Medicaid; emergency room utilization; percentage of population that is female, Black, Hispanic, and over age 65; and state fixed effects. Analyses were stratified by rural-urban category.Principal findingsAdults with diabetes residing in more severe food swamps had higher hospitalization rates. In adjusted analyses, a one unit higher food swamp score was significantly associated with 49.79 (95 percent confidence interval (CI) = 19.28, 80.29) additional all-cause hospitalizations and 19.12 (95 percent CI = 11.09, 27.15) additional ambulatory care-sensitive hospitalizations per 1000 adults with diabetes. The food swamp/all-cause hospitalization rate relationship was stronger in rural counties than urban counties.ConclusionsFood swamps are significantly associated with higher hospitalization rates among adults with diabetes. Improving the local food environment may help reduce this disparity.

Introdução. Em 2009, foi proposta uma classificação de alimentos, denominada classificação NOVA. Países da América Latina tem se destacado em seu uso nas recomendações nutricionais e agenda regulatória. Objetivo. Avaliar como a produção científica em alimentação e nutrição na América Latina tem incorporado a classificação NOVA. Materiais e métodos. A análise da produção científica foi realizada a partir de trabalhos apresentados no Congresso Latinoamericano de Nutrição (SLAN) nos anos de 2012, 2015 e 2018. Os termos utilizados para a busca foram: NOVA, ultraprocessado, processado, processamento e guia alimentar, nos idiomas português, inglês e espanhol. Após a busca, foram aplicados os critérios de exclusão e inclusão e os resumos selecionados foram descritos de acordo com variáveis analíticas previamente definidas. Resultados. Foram analisados 153, sendo 24 publicados em 2012, 20 em 2015 e 109 em 2018. A maioria dos estudos foram desenvolvidos no Brasil (56,2%) e no México (12,4%) e envolvia adolescentes (28,8%), adultos (21,6%) e alimentos (19,6%) como sujeito/unidade de análise. A maioria dos trabalhos foi classificada na área de Nutrição em Saúde Pública (88,9%), era de natureza observacional (82,3%) e empregava método quantitativo (76,5%). A venda e/ou consumo de alimentos (46,4%) e o ambiente alimentar (24,2%) foram os objetos de estudo mais frequentes. Conclusão. A produção científica que considera a classificação NOVA na América Latina aumentou em 2018, com Brasil e México liderando o desenvolvimento dos estudos. Estudos que explorem a relação da classificação NOVA com o preço dos alimentos, habilidades culinárias e políticas públicas são oportunidades de pesquisa.

Background: Street foods have gained popularity around the world in the past few decades. The current study was carried out in order to quantitative analysis of used cooking oils by Street Food Vendors (SFVs) of Lahore, Pakistan. Methods: Fifty samples of cooking oil used by SFVs were collected. Also, a questionnaire was designed for qualitative assessment that revealed maximum vendors used vegetable ghee because of its low cost and practiced addition of new oil into the used one instead of disposing it. The samples were also quantified for their Moisture Content (MC), Free Fatty Acid (FFA), Peroxide Value (PV), Iodine Value (IV), and Total Polar Compounds (TPC). Statistical analysis was performed with SPSS 21. Results: The survey data indicated poor knowledge regarding the safety and health aspects of cooking oils among SFVs. Moreover, mean values indicated that most of the samples were unhealthy as they exhibited higher MC (>0.10%), TPC (>25%), PV (>10 meq. O2/kg), and FFA (>0.20 mg KOH/g); and very low IV (

Background: High consumption of fatty acids is known as a dietary risk factor for cardiovascular diseases. The aim of study was to survey of fatty acid profiles in the traditional/fast foods commonly consumed in Iran. Methods: Gas chromatography was used in the present study to determine the composition of fatty acids in 40 most popular traditional/fast foods consumed in Isfahan, Iran. The food samples were collected from 19 restaurants. Results: In all the tested samples, palmitic acid was at the highest level of saturated fatty acids (SFAs) (P < 0.05). Although in both groups of foods, the levels of trans fatty acids (TFAs) were above 2% in 30% of examined foods, the higher amounts of TFAs were found in traditional foods (P < 0.05). The results show that traditional foods contain higher levels of SFAs and TFAs than fast foods. Conclusions: The alarming findings of the present study should compel the relevant authorities in Iran to adopt and implement appropriate policies that systematically and continually control the types of food prepared and served in restaurants in order to minimize the intake of SFAs and TFAs.

Background: Schools can play an important role in promoting healthy child diet and body weight. However, this issue is understudied in Latin American and other populations undergoing nutrition and epidemiologic transition.Objectives: 2018 Ecuadorian National Health and Nutrition Survey data were used to examine the association of school food sources with healthy and unhealthy food intake and body mass index (BMI) in primary (n = 12632) and secondary students (n = 6617).Methods: Data on school food environment characteristics were collected by questionnaire, intakes of fruits, vegetables, plain water, sweetened beverages, processed snacks, and fast foods by food frequency questionnaire, and BMI using measured weight and height. Data were analyzed using multivariable methods.Results: The major school food sources were competitive foods sold by commercial outlets (73%), School Breakfast Program (SBP; 52%), and home-packed items (37%). Most (69%) competitive food outlets sold fruits and vegetables but only 44% offered free clean drinking water and 60% sold prohibited "red traffic light" foods. Primary and secondary students who bought competitive foods consumed sweetened beverages, processed snacks, and fast food more frequently than nonpurchasers (P = .0001). Those who packed home foods had higher fruit and vegetable intakes (P = .0001). Plain water intakes were reduced among all SBP participants (P = .0001). However, primary students in the SBP consumed fast foods less frequently (P = .0001) and had lower average BMI and odds for being obese compared to nonparticipants (P = .0001).Conclusion: The findings from this nationally representative study underscore the important contribution of the school food environment to child nutrition. [ABSTRACT FROM AUTHOR]

The obesity epidemic appeared in the USA in 1976–1980 and then spread across Westernized countries. This paper examines the most likely causes of the epidemic in the USA. An explanation must be consistent with the emergence of the epidemic in both genders and in all age groups and ethnicities at about the same time, and with a steady rise in the prevalence of obesity until at least 2016. The cause is closely related to changes in the American diet. There is little association with changes in the intake of fat and carbohydrate. This paper presents the opinion that the factor most closely linked to the epidemic is ultra-processed foods (UPFs) (i.e., foods with a high content of calories, salt, sugar, and fat but with very little whole foods). Of particular importance is sugar intake, especially sugar-sweetened beverages (SSBs). There is strong evidence that consumption of SSBs leads to higher energy intake and more weight gain. A similar pattern is also seen with other UPFs. Factors that probably contributed to the increased intake of UPFs include their relatively low price and the increased popularity of fast-food restaurants. Other related topics discussed include: (1) the possible importance of Farm Bills implemented by the US Department of Agriculture; (2) areas where further research is needed; (3) health hazards linked to UPFs; and (4) the need for public health measures to reduce intake of UPFs. [ABSTRACT FROM AUTHOR]

Abstract Background Fast foods, though very popular, are commonly known as unhealthy foods. However, coronavirus pandemic may have influenced on food choices of the general population. This study investigated the changes in fast food consumption during epidemic lockdown 2020. Materials and Methods This study was part of a nationwide survey having been conducted using a web‐based electronic self‐administered questionnaire. The questionnaire link was extensively distributed among the whole population both through popular social media platforms and by nutrition and health workers of health offices and medical universities of all provinces. The questionnaire included questions about socio‐demographic characteristics, changes in frequency of fast food consumption as compared with before pandemic, and the reasons for these changes. Results A total of 21,290 households took part in the study of whom 89.8% were male‐headed, and almost 74% were from urban areas. Decrease in fast food consumption was reported by 74.8%, while increase in fast food consumption was reported by 2% of the households during the COVID‐19 quarantine. Among those who decreased their fast food consumption, about 82% had completely omitted them from their food baskets. Fear of contamination of fast foods by coronavirus and increase in the number of people at home were the most and the least frequent reasons for decreasing fast food consumption, respectively. Conclusion Fast food consumption has dramatically decreased during the lockdown period in Iranian households. Though it may be considered a pleasant offshoot of disastrous COVID‐19 epidemic, the foods replaced fast foods in Iranian households and the overall health consequences warrant further studies.

AimsLike drug addiction, cues associated with palatable foods can trigger food-seeking, even when sated. However, whether susceptibility to the motivating influence of food-related cues is a predisposing factor in overeating or a consequence of poor diet is difficult to determine in humans. Using a rodent model, we explored whether a highly palatable 'junk food' diet impacts responses to reward-paired cues in a Pavlovian-to-instrumental transfer test, using sweetened condensed milk (SCM) as the reward. The hedonic impact of SCM consumption was also assessed by analyzing licking microstructure.MethodsTo probe the effects of pattern and duration of junk food exposure, we provided rats with either regular chow ad libitum (controls) or chow plus access to junk food for either 2 or 24 h per day for 1, 3, or 6 weeks. We also examined how individual susceptibility to weight gain related to these measures.ResultsRats provided 24 h access to the junk food diet were insensitive to the motivational effects of a SCM-paired cue when tested sated even though their hedonic experience upon reward consumption was similar to controls. In contrast, rats provided restricted, 2 h access to junk food exhibited a cue generalization phenotype under sated conditions, lever-pressing with increased vigor in response to both a SCM-paired cue, and a cue not previously paired with reward. Hedonic response was also significantly higher in these animals relative to controls.ConclusionsThese data demonstrate that the pattern of junk food exposure differentially alters the hedonic impact of palatable foods and susceptibility to the motivating influence of cues in the environment to promote food-seeking actions when sated, which may be consequential for understanding overeating and obesity.

Abstract Background Online food delivery services facilitate ‘online’ access to food outlets that typically sell lenergy-dense nutrient-poor food. Greater online food outlet access might be related to the use of this purchasing format and living with excess bodyweight, however, this is not known. We aimed to investigate the association between aspects of online food outlet access and online food delivery service use, and differences according to customer sociodemographic characteristics, as well as the association between the number of food outlets accessible online and bodyweight. Methods In 2019, we used an automated data collection method to collect data on all food outlets in the UK registered with the leading online food delivery service Just Eat (n = 33,204). We linked this with contemporaneous data on food purchasing, bodyweight, and sociodemographic information collected through the International Food Policy Study (analytic sample n = 3067). We used adjusted binomial logistic, linear, and multinomial logistic regression models to examine associations. Results Adults in the UK had online access to a median of 85 food outlets (IQR: 34–181) and 85 unique types of cuisine (IQR: 64–108), and 15.1% reported online food delivery service use in the previous week. Those with the greatest number of accessible food outlets (quarter four, 182–879) had 71% greater odds of online food delivery service use (OR: 1.71; 95% CI: 1.09, 2.68) compared to those with the least (quarter one, 0–34). This pattern was evident amongst adults with a university degree (OR: 2.11; 95% CI: 1.15, 3.85), adults aged between 18 and 29 years (OR: 3.27, 95% CI: 1.59, 6.72), those living with children (OR: 1.94; 95% CI: 1.01; 3.75), and females at each level of increased exposure. We found no association between the number of unique types of cuisine accessible online and online food delivery service use, or between the number of food outlets accessible online and bodyweight. Conclusions The number of food outlets accessible online is positively associated with online food delivery service use. Adults with the highest education, younger adults, those living with children, and females, were particularly susceptible to the greatest online food outlet access. Further research is required to investigate the possible health implications of online food delivery service use.

IntroductionSugar-sweetened beverage (SSB) and fast-food consumption is significantly associated with adolescents' poor mental health. Furthermore, sugar-sweetened beverage and fast-food consumption might form clustered diet patterns with significant positive associations in adolescent high school students. Thus, the combined consumption of SSBs and fast foods may have more negative effects on mental health with synergetic effects than the sum of their independent consumption.MethodsThis study aimed to identify the effects of combining the consumption of sugar-sweetened beverages and fast foods on mental health, including stress, depressive symptoms, and suicidal ideation among Korean high school students. Secondary data from 24,006 high school students were analyzed from the 17th Korea Youth Risk Behavior Web-based Survey, 2021. For statistical analysis, complex sampling analysis using the SPSS Statistics 26.0 software was applied for descriptive statistics and logistic regression analysis.ResultsIn Korean adolescents, combining more than medium consumption of sugar-sweetened beverages and fast foods was associated with more stress, depressive symptoms, and suicidal ideation than their independent consumption. In addition, combining high consumption of sugar-sweetened beverages and low to high consumption of fast foods might have dose-dependent negative effects on stress, depressive symptoms, and suicidal ideation in Korean adolescents.DiscussionBased on the results of this study, healthcare providers in schools and communities might develop various interventions including school/community-based feeding programs and policies targeting the restriction of SSB and fast-food consumption to improve adolescents' mental health.

Background: Neighborhoods may play an important role in shaping long-term weight trajectory and obesity risk. Studying the impact of moving to another neighborhood may be the most efficient way to determine the impact of the built environment on health. We explored whether residential moves were associated with changes in body weight.Methods: Kaiser Permanente Washington electronic health records were used to identify 21,502 members aged 18-64 who moved within King County, WA between 2005 and 2017. We linked body weight measures to environment measures, including population, residential, and street intersection densities (800 m and 1,600 m Euclidian buffers) and access to supermarkets and fast foods (1,600 m and 5,000 m network distances). We used linear mixed models to estimate associations between postmove changes in environment and changes in body weight.Results: In general, moving from high-density to moderate- or low-density neighborhoods was associated with greater weight gain postmove. For example, those moving from high to low residential density neighborhoods (within 1,600 m) gained an average of 4.5 (95% confidence interval [CI] = 3.0, 5.9) lbs 3 years after moving, whereas those moving from low to high-density neighborhoods gained an average of 1.3 (95% CI = -0.2, 2.9) lbs. Also, those moving from neighborhoods without fast-food access (within 1600m) to other neighborhoods without fast-food access gained less weight (average 1.6 lbs [95% CI = 0.9, 2.4]) than those moving from and to neighborhoods with fast-food access (average 2.8 lbs [95% CI = 2.5, 3.2]).Conclusions: Moving to higher-density neighborhoods may be associated with reductions in adult weight gain. [ABSTRACT FROM AUTHOR]

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The average American consumes more than 50% of their total dietary energy from ultra‐processed foods (UPFs). From a nutritional standpoint, as UPFs intake increases, fiber, vitamin, and mineral intake decrease. High consumption of UPFs, mainly from fast foods (FF) and ready‐to‐eat (RTE) food items, emerges as a critical public health concern linking nutritional quality and food safety. In the present work, a systematic database of the fatty acid composition of the most consumed UPFs in the Midwest is reported. Saturated and monounsaturated fatty acids were predominant in RTE (42.5%) and FF (43.2%), respectively. In addition, the fatty acid profile in UPFs is reported according to six food categories: meat and poultry, eggs and derivatives, dairy products, seafood, baby foods, and others. Meat and poultry, and dairy products were the dominant food categories among UPFs. Meanwhile, polyunsaturated fatty acids were abundant in the eggs and seafood groups UPFs (61.8% and 46.4%, respectively) regardless of the food group. Furthermore, no significant differences were found in sugar content in UPFs. Caloric content was positively correlated with sodium (ρ = 0.748) and price (ρ = 0.534). The significance of this study relies on providing new quantitative data on the fat, sodium, and sugar contents of the most consumed UPFs in the Midwestern area of the United States. This information suggests paying more attention to these nutritional attributes, aiming to reduce their incorporation in UPF preparations. Additionally, more quantitative data are needed regarding other nutritional parameters such as protein and lipid degradation in UPFs. Practical Application: This study provides a profile of the fatty acid composition of the most consumed UPFs in the Midwestern region of the United States, as well as correlations with fat, sodium, and sugar contents in UPFs. The information offered a new perspective on the nutrition quality of UPFs, suggesting the reduction of the incorporation of these attributes in UPFs. Additionally, it will help define priority interventions for more advanced precision nutrition, especially for vulnerable populations, for example, children and older people. The overall decrease in added sugar and sodium and the service size in UPFs will significantly improve the nutritional quality of the Western diet. [ABSTRACT FROM AUTHOR]

Background: Evidence on the association between the presence of fast-food outlets and Body Mass Index (BMI) is inconsistent. Furthermore, mechanisms underlying the fast-food outlet presence-BMI association are understudied. We investigated the association between the number of fast-food outlets being present and objectively measured BMI. Moreover, we investigated to what extent this association was moderated by neighbourhood socio-economic status (NSES) and healthy food outlets. Additionally, we investigated mediation by frequency of fast-food consumption and amount of fat intake.Methods: In this cross-sectional study, we used baseline data of adults in Lifelines (N = 149,617). Geo-coded residential addresses were linked to fast-food and healthy food outlet locations. We computed the number of fast-food and healthy food outlets within 1 kilometre (km) of participants' residential addresses (each categorised into null, one, or at least two). Participants underwent objective BMI measurements. We linked data to Statistics Netherlands to compute NSES. Frequency of fast-food consumption and amount of fat intake were measured through questionnaires in Lifelines. Multivariable multilevel linear regression analyses were performed to investigate associations between fast-food outlet presence and BMI, adjusting for individual and environmental potential confounders. When exposure-moderator interactions had p-value < 0.10 or improved model fit (∆AIC ≥ 2), we conducted stratified analyses. We used causal mediation methods to assess mediation.Results: Participants with one fast-food outlet within 1 km had a higher BMI than participants with no fast-food outlet within 1 km (B = 0.11, 95% CI: 0.01, 0.21). Effect sizes for at least two fast-food outlets were larger in low NSES areas (B = 0.29, 95% CI: 0.01, 0.57), and especially in low NSES areas where at least two healthy food outlets within 1 km were available (B = 0.75, 95% CI: 0.19, 1.31). Amount of fat intake, but not frequency of fast-food consumption, explained this association for 3.1%.Conclusions: Participants living in low SES neighbourhoods with at least two fast-food outlets within 1 km of their residential address had a higher BMI than their peers with no fast-food outlets within 1 km. Among these participants, healthy food outlets did not buffer the potentially unhealthy impact of fast-food outlets. Amount of fat intake partly explained this association. This study highlights neighbourhood socio-economic inequalities regarding fast-food outlets and BMI. [ABSTRACT FROM AUTHOR]

Background: Food prepared out-of-home is typically energy-dense and nutrient-poor. This food can be purchased from multiple types of retailer, including restaurants and takeaway food outlets. Using online food delivery services to purchase food prepared out-of-home is increasing in popularity. This may lead to more frequent unhealthy food consumption, which is positively associated with poor diet and living with obesity. Understanding possible reasons for using online food delivery services might contribute to the development of future public health interventions, if deemed necessary. This knowledge would be best obtained by engaging with individuals who use online food delivery services as part of established routines. Therefore, we aimed to investigate customer experiences of using online food delivery services to understand their reasons for using them, including any advantages and drawbacks.Methods and Results: In 2020, we conducted telephone interviews with 22 adults living in the UK who had used online food delivery services on at least a monthly basis over the previous year. Through codebook thematic analysis, we generated five themes: 'The importance of takeaway food', 'Less effort for more convenience', 'Saving money and reallocating time', 'Online food delivery service normalisation' and 'Maintained home food practices'. Two concepts were overarching throughout: 'Place. Time. Situation.' and 'Perceived advantages outweigh recognised drawbacks'. After considering each of the accessible food purchasing options within the context of their location and the time of day, participants typically selected online food delivery services. Participants reported that they did not use online food delivery services to purchase healthy food. Participants considered online food delivery service use to be a normal practice that involves little effort due to optimised purchasing processes. As a result, these services were seen to offer convenient access to food aligned with sociocultural expectations. Participants reported that this convenience was often an advantage but could be a drawback. Although participants were price-sensitive, they were willing to pay delivery fees for the opportunity to complete tasks whilst waiting for delivery. Furthermore, participants valued price-promotions and concluded that receiving them justified their online food delivery service use. Despite takeaway food consumption, participants considered home cooking to be irreplaceable.Conclusions: Future public health interventions might seek to increase the healthiness of food available online whilst maintaining sociocultural values. Extending restrictions adopted in other food environments to online food delivery services could also be explored. [ABSTRACT FROM AUTHOR]

Background: Considering the increasing prevalence of fast food consumption among teenagers, providing the necessary training and self-awareness is the best solution for institutionalizing the prevention of fast food consumption by this group. Therefore, this issue should be taken seriously, as should the implementation of educational interventions to prevent the consumption of fast food. The theory of planned behavior (TPB) is one of the various health education styles and methods that works well. However, given that a number of local data points are crucial in establishing the efficacy of the model employed, this study looks into the impact of TPB-based education in preventing fast food intake among teenagers., Methods: A total of 180 male students, ages 15 to 18, participated in this quasi-experimental study in Shiraz, Iran. Cluster sampling was used in the study, and participants were randomly assigned to two groups: the experimental group (n = 90) and the control group (n = 90). A theory-based questionnaire was used to gather data, and both the control and experimental groups had to complete it before and three months after the intervention. The data were examined using paired t, independent t, and chi-square statistical tests after being entered into SPSS-24., Results: The results of the independent t-test showed that there was no significant difference between the two study groups before the intervention in terms of knowledge (P = 0.14), attitude (P = 0.57), subjective norms (P = 0.94), perceived behavioral control (P = 0.81), behavioral intention (P = 0.42), or behavior (P = 0.25). However, following the intervention, there was a significant difference between the two groups with regard to the noted variables (P = 0.001). Furthermore, the McNemar test results demonstrated that the experimental group's consumption of fast food varied significantly before and after the intervention (P = 0.001), but not in the control group (P = 0.07)., Conclusion: The study's findings demonstrated that TPB-based treatments are successful in helping male students change their habits of consuming fewer amounts of fast food. This study demonstrated that the instructional techniques employed improved the fast food consumption behavior of the intervention group as well as the TPB's structure (attitude, subjective norms, behavioral intention, and perceived behavioral intention)., (© 2024. The Author(s).)

Background: The use of corporate power to undermine public health policy processes is increasingly well understood; however, relatively little scholarship examines how advocates can leverage power to promote the successful adoption of public health policies. The objective of this paper is to explore how advocates leveraged three forms of power - structural, instrumental and discursive - to promote the passage of the Promotion of Healthy Eating Law (Ley 27,642) in Argentina, one of the most comprehensive policies to introduce mandatory front-of-package (FOP) warning labels and regulate the marketing and sales of ultra-processed foods (UPFs) adopted to date., Methods: We conducted seventeen semi-structured interviews with advocates from different sectors, including civil society, international agencies, and government. Both data collection and analysis were guided by Milsom's conceptual framework for analyzing power in public health policymaking, and the data was analyzed using hybrid deductive and inductive thematic analysis., Results: Advocates harnessed structural power through the leveraging of revolving doors, informal alliances, and formal coalitions, enabling them to convene discussion spaces with decision-makers, make strategic use of limited resources, and cultivate the diverse expertise (e.g., research, nutrition science, advocacy, law, political science, activism and communications) needed to support the law through different phases of the policy process. Advocates wielded instrumental power by amassing an armada of localized evidence to promote robust policy design, building technical literacy amongst themselves and decision-makers, and exposing conflicts of interest to harness public pressure. Advocates exercised discursive power by adopting a rights-based discourse, including of children and adolescents and of consumers to transparent information, which enabled advocates to foster a favorable perception of the law amongst both decision-makers and the public. Key contextual enablers include a political window of opportunity, the COVID-19 pandemic, and the ability to learn from the regional precedent of similar policies., Conclusions: Public health policymaking, particularly when encroaching upon corporate interests, is characterized by stark imbalances of power that hinder policy decisions. The strategies identified in the case of Argentina provide important insights as to how advocates might harness and exercise structural, instrumental, and discursive power to counter corporate influence and promote the successful adoption of comprehensive UPF regulation., (© 2024. The Author(s).)

Dietary patterns contribute to overall health and diseases of ageing but are understudied in older adults. As such, we first aimed to develop dietary indices to quantify Mediterranean Diet Score (MDS) utilisation and Ultra-processed Food (UPF) intake in a well-characterised cohort of relatively healthy community-dwelling older Australian adults. Second, we aimed to understand the relationship between these scores and the association of these scores with prevalent cardiometabolic disease and frailty. Our major findings are that in this population of older adults, (a) pre-frailty and frailty are associated with reduced MDS and increased UPF intake; (b) adherence to MDS eating patterns does not preclude relatively high intake of UPF (and vice versa); and (c) high utilisation of an MDS eating pattern does not prevent an increased risk of frailty with higher UPF intakes. As such, the Mediterranean Diet pattern should be encouraged in older adults to potentially reduce the risk of frailty, while the impact of UPF intake should be further explored given the convenience these foods provide to a population whose access to unprocessed food may be limited due to socioeconomic, health, and lifestyle factors.

Background and Aims: Studies have consistently demonstrated associations between ultra-processed food and drink (UPFD) consumption and non-communicable diseases. However, there is a lack of data investigating relationships between UPFD intake and intermediate cardiometabolic disease markers. In this study we explored UPFD associations with lipoprotein subclasses., Methods: This was a cross-sectional study of 1986 middle-to older-aged men and women randomly selected from a large primary care centre. The percentage contribution of UPFDs to total energy intake was calculated for each participant using the NOVA classification. Lipoprotein particle subclass concentrations and size were determined using nuclear magnetic resonance spectroscopy. Correlation and multivariate-adjusted linear regression analyses were performed to examine UPFD intake relationships with lipoprotein subclasses., Results: In fully adjusted regression models, higher UPFD consumption was associated with reduced high-density lipoprotein (HDL) cholesterol concentrations (β = -0.024, p = 0.001), large low-density lipoprotein (LDL) levels (β = -18.645, p = 0.002), total and medium HDL concentrations (β = -0.328, p = 0.012; β = -0.510, p < 0.001), smaller LDL and HDL size (β = -0.026, p = 0.023; β = -0.023, p = 0.024), and increased medium very low-density lipoprotein levels (β = 0.053, p = 0.022), small LDL and HDL concentrations (β = 20.358, p = 0.02; β = 0.336, p = 0.011), and higher lipoprotein insulin resistance scores (β = 0.048, p = 0.012), reflecting greater lipoprotein-related insulin resistance., Conclusions: Findings from this research suggest that increased intake of UPFDs is associated with a more pro-atherogenic, insulin-resistant metabolic profile in middle-to older-aged adults which may be a potential mechanism underlying reported associations between UPFD consumption and chronic disease risk and mortality., Competing Interests: Conflict of interest No competing interests exist., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Studies have shown that prolonged smartphone use is associated with dietary risk behaviors among adolescents. However, little is known about whether the exposure to food-related online media contents, such as mukbang (eating broadcast) and cookbang (cooking broadcast), is associated with unhealthy dietary behaviors, independent of overall duration of smartphone use., Objectives: This study investigated the associations between the frequency of mukbang/cookbang watching and dietary risk behaviors among Korean adolescents, using nationally representative survey data., Methods: In this cross-sectional study, we examined the data from 50,044 middle and high school students in the Korea Youth Risk Behavior Web-based Survey 2022. Participants reported their frequency of mukbang/cookbang watching, mean duration of smartphone use, frequency of breakfast eating, frequency of nighttime eating, and intakes of fast foods, sugar-sweetened beverages (SSBs), and high-caffeine drinks. We performed multivariable logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between mukbang/cookbang watching and dietary risk behaviors, accounting for complex survey sampling and adjusting for potential confounders., Results: Frequent mukbang/cookbang watching (≥5 times/wk compared with never) was positively associated with dietary risk behaviors, including frequent breakfast skipping (OR: 1.20; 95% CI: 1.13, 1.28), frequent nighttime eating (OR: 1.43; 95% CI: 1.33, 1.54), and frequent intakes of fast foods (OR: 1.69; 95% CI: 1.58, 1.80), SSBs (OR: 1.47; 95% CI: 1.30, 1.66), and high-caffeine drinks (OR: 1.41; 95% CI: 1.33, 1.50), adjusting for duration of smartphone use. All mukbang/cookbang viewers, including those who perceived that mukbang/cookbang videos had "no influence" on their dietary behavior, had higher prevalence of dietary risk behaviors than nonviewers (perceived "no influence" compared with nonviewers-OR: 1.18; 95% CI: 1.10, 1.26, breakfast skipping; OR: 1.15; 95% CI: 1.06, 1.24, nighttime eating; OR: 1.40; 95% CI: 1.30, 1.50, fast foods; OR: 1.22; 95% CI: 1.07, 1.38, SSBs; OR: 1.28; 95% CI: 1.20, 1.37, high-caffeine drinks)., Conclusions: Our findings suggest that frequent mukbang/cookbang watching may be associated with unhealthy dietary behaviors among Korean adolescents., (Copyright © 2024 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.)

We investigated whether food shape and its variety within a group affect visual appeal using a four-shaped fast-food chicken product known as Chicken McNuggets®. In Experiment 1, participants rated the visual appeal of each nugget shape both individually and when presented in groups of variously shaped nuggets. The results revealed that the rounder nugget was less visually appealing than those of other shapes. Additionally, assortments featuring various shapes were rated as more appealing than those of a single shape. In Experiment 2, the visual appeal of individual nuggets presented in groups and alone was assessed using a visual analog scale. The visual appeal of one specific nugget (target nugget) was higher when presented in a group than alone. Furthermore, a target nugget presented in a group with various shapes was more visually appealing than when presented in a group with the same shape, regardless of the shape of the target nugget. These results suggest that a food product with low visual appeal can be perceived as more appealing when it is presented alongside various food shapes. Indeed, the variety of food shapes presented in a group affected the perceived appeal both of the group and of the individual food item. These findings offer novel insights into the impact of food's visual variation on its appeal., Competing Interests: Declaration of competing interest One of the authors, Yui Tanaka, is an employee at McDonald's (Japan). McDonald's Japan provided the experimental stimuli., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Increased consumption of ultra-processed foods (UPFs) which have additives such as artificial colours, flavours and are usually high in salt, sugar, fats and specific preservatives, are associated with diet-related non-communicable diseases (NCDs). In India, there are no standard criteria for identifying UPFs using a classification system based on extent and purpose of industrial processing. Scientific literature on dietary intake of foods among Indian consumers classifies foods as unhealthy based on presence of excessive amounts of specific nutrients which makes it difficult to distinguish UPFs from other commercially available processed foods., Methods: A literature review followed by an online grocery retailer scan for food label reading was conducted to map the types of UPFs in Indian food market and scrutinize their ingredient list for the presence of ultra-processed ingredients. All UPFs identified were randomly listed and then grouped into categories, followed by saliency analysis to understand preferred UPFs by consumers. Indian UPF categories were then finalized to inform a UPF screener., Results: A lack of application of a uniform definition for UPFs in India was observed; hence descriptors such as junk-foods, fast-foods, ready-to-eat foods, instant-foods, processed-foods, packaged-foods, high-fat-sugar-and-salt foods were used for denoting UPFs. After initial scanning of such foods reported in literature based on standard definition of UPFs, an online grocery retailer scan of food labels for 375 brands (atleast 3 brands for each food item) confirmed 81 food items as UPFs. A range of packaged traditional recipes were also found to have UPF ingredients. Twenty three categories of UPFs were then developed and subjected to saliency analysis. Breads, chips and sugar-sweetened beverages (e.g. sodas and cold-drinks) were the most preferred UPFs while frozen ready-to-eat/cook foods (e.g. chicken nuggets and frozen kebabs) were least preferred., Conclusion: India needs to systematically apply a food classification system and define Indian food categories based on the level of industrial processing. Mapping of UPFs is the first step towards development of a quick screener that would generate UPF consumption data to inform clear policy guidelines and regulations around UPFs and address their impact on NCDs., (© 2024. The Author(s).)

Severe acute malnutrition (SAM) is a global health concern that affects children and leads to delayed growth. The aim of this study was to compare the impact of F100 milk and Bregas Nutriroll , a local ready-to-use therapeutic food (RUTF), on SAM children. An unmasked, non-blinded, two-group, and simple randomized controlled trial was conducted. Indonesian children aged 12-59 months with SAM were randomly assigned to receive either F100 milk or Bregas Nutriroll . After eight weeks, the increase in the mean weight gain in both groups was assessed. The Bregas Nutriroll group (n=19) had a mean weight gain of 1.07±0.09 kg, while the F100 group (n=17) had a mean weight gain of 1.05±0.11 kg. The Bregas Nutriroll group had a slightly higher gain of mid-upper arm circumference (MUAC) than the F100 group (0.62±0.34 cm vs 0.50±0.37 cm). The gain of children's height of the Bregas Nutriroll group was 0.96±0.42 cm, while the F100 group was shorter at a mean of 0.81±0.44 cm. Statistically significant differences ( p <0.001) in nutritional status were observed based on weight, MUAC, and height/length after F100 and Bregas Nutriroll interventions. The intervention with F100 increased hemoglobin (Hb) levels of 0.71±1.25 mg/dL, while the Bregas Nutriroll intervention led to an increase of 0.11±1.39 mg/dL. In conclusion, our study showed that community-based treatment with F100 milk or Bregas Nutriroll resulted in nutritional status in children with SAM. These findings suggested that both treatments could be effective in treating SAM in improving nutritional status and child health outcomes., Competing Interests: The authors declare no conflicts of interest., (© 2024 The Author(s).)

Bisphenols are endocrine-disrupting chemicals used in plastics and resins for food packaging. This study aimed to evaluate the exposure to bisphenol A (BPA), bisphenol S (BPS), and bisphenol F (BPF) associated with the consumption of fresh, canned, and ready-to-eat meals and determine the effects of bisphenols on blood pressure and heart rate. Forty-eight healthy young adults were recruited for this study, and they were divided into the following three groups: fresh, canned, and ready-to-eat meal groups. Urine samples were collected 2, 4, and 6 h after meal consumption, and blood pressure and heart rate were measured. The consumption of ready-to-eat meals significantly increased urine BPA concentrations compared with canned and fresh meal consumption. No significant difference in BPS and BPF concentrations was observed between the groups. The consumption of ready-to-eat meals was associated with a significant increase in systolic blood pressure and pulse pressure and a marked decrease in diastolic blood pressure and heart rate. No significant differences were noted in blood pressure and heart rate with canned and fresh meal consumption. It can be concluded that total BPA concentration in consumed ready-to-eat meals is high. High BPA intake causes increase in urinary BPA concentrations, which may, in turn, lead to changes in some cardiovascular parameters.