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Background: The COVID-19 pandemic has impacted children’s lifestyles, including dietary behaviors. Of particular concern among these behaviors is the heightened prevalence of ultra-processed food (UPF) consumption, which has been linked to the development of obesity and related non-communicable diseases. The present study examines the changes in (1) UPF and (2) vegetable and/or fruit consumption among school-aged children in Greece and Sweden before and during the COVID-19 pandemic. Methods: The analyzed dataset consisted of main meal pictures (breakfast, lunch, and dinner) captured by 226 Greek students (94 before the pandemic and 132 during the pandemic) and 421 Swedish students (293 before and 128 during the pandemic), aged 9–18, who voluntarily reported their meals using a mobile application. The meal pictures were collected over four-month periods over two consecutive years; namely, between the 20th of August and the 20th of December in 2019 (before the COVID-19 outbreak) and the same period in 2020 (during the COVID-19 outbreak). The collected pictures were annotated manually by a trained nutritionist. A chi-square test was performed to evaluate the differences in proportions before versus during the pandemic. Results: In total, 10,770 pictures were collected, including 6474 pictures from before the pandemic and 4296 pictures collected during the pandemic. Out of those, 86 pictures were excluded due to poor image quality, and 10,684 pictures were included in the final analyses (4267 pictures from Greece and 6417 pictures from Sweden). The proportion of UPF significantly decreased during vs. before the pandemic in both populations (50% vs. 46%, p = 0.010 in Greece, and 71% vs. 66%, p < 0.001 in Sweden), while the proportion of vegetables and/or fruits significantly increased in both cases (28% vs. 35%, p < 0.001 in Greece, and 38% vs. 42%, p = 0.019 in Sweden). There was a proportional increase in meal pictures containing UPF among boys in both countries. In Greece, both genders showed an increase in vegetables and/or fruits, whereas, in Sweden, the increase in fruit and/or vegetable consumption was solely observed among boys. Conclusions: The proportion of UPF in the Greek and Swedish students’ main meals decreased during the COVID-19 pandemic vs. before the pandemic, while the proportion of main meals with vegetables and/or fruits increased.

Background Ultra-processed food consumption is a risk factor for obesity and has a negative environmental impact. Food companies spend billions of dollars on advertisements each year to increase the consumption of ultra-processed food. In Australia, USA, and New Zealand, most food advertisements around schools and in train stations promote ultra-processed food, but no similar studies have been conducted in Sweden. The aim of this study was to explore the proportion of ultra-processed food advertisements in two districts of Stockholm, Sweden with low vs. high socioeconomic status (SES). Methods Two independent researchers (per area) mapped all advertisements, including storefronts, in two Stockholm districts. During consecutive days, all advertisements were photographed in Skärholmen (low SES district), and Östermalmstorg (high SES district), on the streets inside and outside the subway stations, as well as inside and outside of local shopping malls. Advertisements promoting food products were identified and a trained dietician categorized whether they promoted ultra-processed foods. Chi-Square test was conducted to test for differences in the proportion of ultra-processed food advertisements between the two study areas. Results In total, 4092 advertisements were photographed in Skärholmen (n = 1935) and Östermalm (n = 2157). 32.8% of all advertisements promoted food, while 65.4% of food advertisements promoted ultra-processed foods. A significantly higher proportion of ultra-processed food advertisements out of total food advertisements was identified in the low SES area, irrespective of the researcher taking the pictures (74.6% vs. 61.8%, p p = 0.001). There was no significant difference in the proportion of food advertisements out of total advertisements between the two areas. Conclusions This study provides initial evidence about the scale and the differences in exposure to food advertisements across areas in Stockholm. The observed high proportion of ultra-processed food advertisements is concerning and is in sharp contrast to the Swedish dietary guidelines that recommend reduced consumption of such foods. Based on our results, residents in low SES areas might be more exposed to ultra-processed food advertisements than those in high SES areas in Stockholm. If such findings are confirmed in additional areas, they should be considered during the deployment of food advertisement regulatory actions.

Unintentional weight loss has been observed among Parkinson&rsquo, s disease (PD) patients. Changes in energy intake (EI) and eating behavior, potentially caused by fine motor dysfunction and eating-related symptoms, might contribute to this. The primary aim of this study was to investigate differences in objectively measured EI between groups of healthy controls (HC), early (ESPD) and advanced stage PD patients (ASPD) during a standardized lunch in a clinical setting. The secondary aim was to identify clinical features and eating behavior abnormalities that explain EI differences. All participants (n = 23 HC, n = 20 ESPD, and n = 21 ASPD) went through clinical evaluations and were eating a standardized meal (200 g sausages, 400 g potato salad, 200 g apple pur&eacute, e and 500 mL water) in front of two video cameras. Participants ate freely, and the food was weighed pre- and post-meal to calculate EI (kcal). Multiple linear regression was used to explain group differences in EI. ASPD had a significantly lower EI vs. HC (&minus, 162 kcal, p &lt, 0.05) and vs. ESPD (&minus, 203 kcal, p &lt, 0.01) when controlling for sex. The number of spoonfuls, eating problems, dysphagia and upper extremity tremor could explain most (86%) of the lower EI vs. HC, while the first three could explain ~50% vs. ESPD. Food component intake analysis revealed significantly lower potato salad and sausage intakes among ASPD vs. both HC and ESPD, while water intake was lower vs. HC. EI is an important clinical target for PD patients with an increased risk of weight loss. Our results suggest that interventions targeting upper extremity tremor, spoonfuls, dysphagia and eating problems might be clinically useful in the prevention of unintentional weight loss in PD. Since EI was lower in ASPD, EI might be a useful marker of disease progression in PD.

Weight loss and malnutrition among advanced PD patients might be explained by lower food intake, mediated by fewer mouthfuls per meal and more severe tremor symptoms. Our results indicate that interventions to reduce tremor symptoms and to prompt advanced PD patients to take more mouthfuls have the potential to be clinically useful in protecting against unintentional weight loss and malnutrition. Additional data collection might facilitate the creation of early, eating-based, behavioral tests for the evaluation of the disease’s trajectory.

Large portion sizes and a high eating rate are associated with high energy intake and obesity. Most individuals maintain their food intake weight (g) and eating rate (g/min) rank in relation to their peers, despite food and environmental manipulations. Single meal measures may enable identification of &ldquo, large portion eaters&rdquo, and &ldquo, fast eaters,&rdquo, finding individuals at risk of developing obesity. The aim of this study was to predict real-life food intake weight and eating rate based on one school lunch. Twenty-four high-school students with a mean (&plusmn, SD) age of 16.8 yr (&plusmn, 0.7) and body mass index of 21.9 (&plusmn, 4.1) were recruited, using no exclusion criteria. Food intake weight and eating rate was first self-rated (&ldquo, Less,&rdquo, &ldquo, Average&rdquo, or &ldquo, More than peers&rdquo, ), then objectively recorded during one school lunch (absolute weight of consumed food in grams). Afterwards, subjects recorded as many main meals (breakfasts, lunches and dinners) as possible in real-life for a period of at least two weeks, using a Bluetooth connected weight scale and a smartphone application. On average participants recorded 18.9 (7.3) meals during the study. Real-life food intake weight was 327.4 g (&plusmn, 110.6), which was significantly lower (p = 0.027) than the single school lunch, at 367.4 g (&plusmn, 167.2). When the intra-class correlation of food weight intake between the objectively recorded real-life and school lunch meals was compared, the correlation was excellent (R = 0.91). Real-life eating rate was 33.5 g/min (&plusmn, 14.8), which was significantly higher (p = 0.010) than the single school lunch, at 27.7 g/min (&plusmn, 13.3). The intra-class correlation of the recorded eating rate between real-life and school lunch meals was very large (R = 0.74). The participants&rsquo, recorded food intake weights and eating rates were divided into terciles and compared between school lunches and real-life, with moderate or higher agreement (&kappa, = 0.75 and &kappa, = 0.54, respectively). In contrast, almost no agreement was observed between self-rated and real-life recorded rankings of food intake weight and eating rate (&kappa, = 0.09 and &kappa, = 0.08, respectively). The current study provides evidence that both food intake weight and eating rates per meal vary considerably in real-life per individual. However, based on these behaviours, most students can be correctly classified in regard to their peers based on single school lunches. In contrast, self-reported food intake weight and eating rate are poor predictors of real-life measures. Finally, based on the recorded individual variability of real-life food intake weight and eating rate, it is not advised to rank individuals based on single recordings collected in real-life settings.

Manipulating food properties and serving environment during a meal can significantly change food intake at group level. However, the evaluation of the usefulness of such manipulations requires an understanding of individual behavioural changes. Three studies were conducted to explore the effect of unit size and meal occasion on eating behaviour characteristics (food intake, meal duration, number of bites and chews). All studies used a randomised crossover design, with a one-week wash-out period, starting with a familiarisation meal, with the participation of healthy, normal weight females between the ages of 18&ndash, 35 years. In Study 1 (n = 19) three cube sizes (0.5, 1.0 and 1.5 cm3) of vegetable hash and chicken were compared. In Study 2 (n = 18) mashed potatoes and mincemeat were compared to whole potatoes and meatballs. In Study 3 (n = 29) meals served at lunch time (11:00&ndash, 13:00) were compared to identical meals served at dinner time (17:00&ndash, 19:00). The largest food unit size lead to significantly increased meal duration in Study 2 (mean difference 0.9 min, 95% confidence interval (CI) 0.0&ndash, 1.8), but not in Study 1 (mean difference 1 min, 95% CI 0.1&ndash, 2.0). There was a significant increase in number of chews in the large unit size condition of both Study 1 (mean difference 88, 95% CI 12&ndash, 158) and Study 2 (mean difference 95, 95% CI 12&ndash, 179). Different serving occasions did not significantly change any of the eating behaviours measured. Except for number of bites in Study 2 (R2 = 0.60), most individuals maintained their eating behaviour relative to the group across unit sizes and serving occasions conditions (R2 &gt, 0.75), which suggests single meal testing can provide information about the behavioural characteristics of individual eating styles under different conditions.

Energy availability (EA) is a scientific concept describing how much energy is available for basic metabolic functions such as reproduction, immunity, and skeletal homeostasis. Carefully controlled studies on women have shown pathological effects of EA 40% of total weight loss) with EA 25 kcal/kg FFM) might result in less muscle loss among natural male bodybuilders who prepare for contest, but more research is needed.

School lunches contribute significantly to students&rsquo, food intake (FI) and are important to their long-term health. Objective quantification of FI is needed in this context. The primary aim of this study was to investigate how much eating rate (g/min), number of food additions, number of spoonfuls, change in fullness, food taste, body mass index (BMI), and sex explain variations in school lunch FI. The secondary aim was to assess the reliability of repeated FI measures. One hundred and three (60 females) students (15&ndash, 18 years old) were monitored while eating lunch in their normal school canteen environment, following their usual school schedules. A subgroup of students (n = 50) participated in a repeated lunch (~3 months later). Linear regression was used to explain variations in FI. The reliability of repeated FI measurements was assessed by change in mean, coefficient of variation (CV), and intraclass correlation (ICC). The regression model was significant and explained 76.6% of the variation in FI. Eating rate was the strongest explanatory variable, followed by spoonfuls, sex, food additions, food taste, BMI, and change in fullness. All explanatory variables were significant in the model except BMI and change in fullness. No systematic bias was observed in FI (&minus, 7.5 g (95% CI = &minus, 43.1&ndash, 28 g)) while individual students changed their FI from &minus, 417 to +349 g in the repeated meal (CV 26.1% (95% CI = 21.4&ndash, 33.5%), ICC 0.74 (95% CI = 0.58&ndash, 0.84)). The results highlight the importance of objective eating behaviors for explaining FI in a school lunch setting. Furthermore, our methods show promise for large-scale quantification of objectively measured FI and eating behaviors in schools.

Close food proximity leads to increased short-term energy intake, potentially contributing to the long-term development of obesity. However, its precise effects on eating behaviour are still unclear, especially with food available for extended periods of time. This study involved two similar high school student groups (15-17 years old), which had ad libitum access to grapes, chocolates and crackers during an hour-long experimental session. In the distal condition the foods were placed 6 meters away from the students (n = 24), in contrast to the proximal condition (n = 17) were the food was placed near the students. The identification of the type and the quantification of the amount of each food selected, for each individual serving, was facilitated through use of food scales and video recording. In the proximal condition individuals served themselves grapes and crackers more often and consumed more chocolate than in the distal condition. In total, participants in the proximal condition ingested significantly more energy (726 kcal vs. 504 kcal; p = 0.029), without reporting higher fullness. Food proximity also affected the temporal distribution of servings, with the first five minutes of the sessions corresponding to 53.1% and 45.6% of the total energy intake for the distal and proximal conditions, respectively. After the first five minutes, the servings in the distal condition were strongly clustered in time, with many students getting food together. In the proximal condition however, students displayed an unstructured pattern of servings over time. In conclusion, this study strengthens past evidence regarding the important role of food proximity on individual energy intake and, for the first time, it associates continuous food proximity to the emergence of unstructured eating over time. These conclusions, expanded upon by future studies, could support the creation of meaningful intervention strategies based on spatially and temporally controlled food availability.