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To address the rising incidence of non-communicable diseases (NCDs) and promote healthier eating habits, Japan requires a culturally tailored Nutrient Profile Model. This study aimed to develop a Nutrient Profile Model for Dishes in Japan version 1.0 (NPM-DJ (1.0)) that corresponds to the nutritional issues and food culture in Japan. The aim of the NPM-DJ (1.0) was to promote the health of the general population, and to prevent the increase in NCDs in Japan. The NPM-DJ (1.0) categorizes dishes into staples, sides, mains, mixed dishes, and mixed dishes with staples. The model evaluates dishes based on energy, saturated fats, sugars, and sodium as restricted nutrients, while considering protein, dietary fiber, and the weight of certain food groups as recommended nutrients. The distribution of the overall score for each dish category was analyzed and a rating algorithm was created. The baseline, modification points, and final scores were significantly lower for side dishes than for staple dishes. In contrast, the baseline points and final scores were significantly higher for mixed dishes with staple. The model effectively differentiated nutritional profiles across five dishes categories, which may promote healthier dish reformulation by food businesses operators and encourage consumers to select healthier dishes. [ABSTRACT FROM AUTHOR]

Abstract Background Supermarket interventions are promising to promote healthier dietary patterns, but not all individuals may be equally susceptible. We explored whether the effectiveness of nudging and pricing strategies on diet quality differs by psychological and grocery shopping characteristics. Methods We used data of the 12-month Supreme Nudge parallel cluster-randomised controlled supermarket trial, testing nudging and pricing strategies to promote healthier diets. Participants were Dutch speaking adults aged 30–80 years and regular shoppers of participating supermarkets (n = 12) in socially disadvantaged neighbourhoods. Data on psychological characteristics (food-related behaviours; price sensitivity; food decision styles; social cognitive factors; self-control) and grocery shopping characteristics (time spent in the supermarket; moment of the day; average supermarket visits; shopping at other retailers; supermarket proximity) were self-reported at baseline. These characteristics were tested for their moderating effects of the intervention on diet quality (scored 0–150) in linear mixed models. Results We included 162 participants from intervention supermarkets and 199 from control supermarkets (73% female, 58 (± 10.8) years old, 42% highly educated). The interventions had no overall effect on diet quality. Only five out of 23 potential moderators were statistically significant. Yet, stratified analyses of these significant moderators showed no significant effects on diet quality for one of the subgroups and statistically non-significant negative effects for the other. Negative effects were suggested for individuals with lower baseline levels of meal planning (β − 2.6, 95% CI − 5.9; 0.8), healthy shopping convenience (β − 3.0, 95% CI − 7.2; 1.3), and healthy food attractiveness (β − 3.5, 95% CI − 8.3; 1.3), and with higher levels of price consciousness (β − 2.6, 95% CI − 6.2; 1.0) and weekly supermarket visits (β − 2.4, 95% CI − 6.8; 1.9). Conclusions Adults with varying psychological and grocery shopping characteristics largely seem equally (un)susceptible to nudging and pricing strategies. It might be that certain characteristics lead to adverse effects, but this is not plausible, and the observed negative effects were small and statistically non-significant and may be explained by chance findings. Verification of these findings is needed in real-world trials based on larger sample sizes and with the use of more comprehensive interventions. Trial registration Dutch Trial Register ID NL7064, 30th of May, 2018, https://onderzoekmetmensen.nl/en/trial/20990

Spatial mapping of food demand is essential for understanding and addressing disparities in food accessibility, which significantly impact public health and nutrition. This research presents an innovative geospatial framework designed to map food demand, integrating individual dietary behaviors with advanced spatial analysis techniques. This study analyzes the spatial distribution of eating habits across Lithuania using a geospatial approach. The methodology involves dividing Lithuania into 60,000 points and interpolating survey data with Shepard's operator, which relies on a weighted average of values at data points. This flexible approach allows for adjusting the number of points based on spatial resolution and sample size, enhancing the reliability and applicability of the generated maps. The procedure includes generating a structured grid system, incorporating measurements into the grid, and applying Shepard's operator for interpolation, resulting in precise representations of food demand. This framework provides a comprehensive understanding of dietary behaviors, informing targeted policy interventions to improve food accessibility and nutrition. Traditional food spatial mapping approaches are often limited to specific polygons and lack the flexibility to achieve high granular detail. By applying advanced interpolation techniques and ensuring respondent location data without breaching privacy concerns, this study creates high-resolution maps that accurately represent regional differences in eating habits. The methodology's flexibility allows for adjustments in spatial resolution and sample size, enhancing the maps' validity and applicability. This novel approach facilitates the creation of detailed food demand maps at any granular level, providing valuable insights for policymakers and stakeholders. These insights enable the development of targeted strategies to improve food accessibility and nutrition. Additionally, the obtained information can be used for computer simulations to further analyze and predict food demand scenarios. By leveraging spatial data integration, this study contributes to a deeper understanding of the complex dynamics of food demand, identifying critical areas such as food deserts and swamps, and paving the way for more effective public health interventions and policies aimed at achieving equitable food distribution and better nutritional outcomes. [ABSTRACT FROM AUTHOR]

This study aims to evaluate the impact of a novel multicomponent nutrition education program (United for Healthier Kids; U4HK) on the diet consumed during school lunch among preschool children. The program comprised four tools: hero plates, hero content, hero menus, and hero books and stickers. The program was implemented for 16 weeks. Food consumption and the quality of the menus were examined pre- and post-intervention. The lunch nutrient profiling scores for fat and vitamin C improved from moderate (9.95) to good (10.87) and moderate (9.50) to very good (13.83), respectively. Vegetable and fruit consumption also increased significantly by 127.2% (6.0 (3.2, 12.9) grams to 13.7 (6.7, 18.9) grams, p<0.001) and 44.8% (8.1 (3.9, 12.4) grams to 11.7 (5.4, 21.8) grams, p<0.001), respectively. Compared to those in the Thai school lunch guidelines, the percentages of vegetable and fruit consumed increased by 16.0% (12.1% (6.4, 25.9) to 28.1% (13.4, 43.4)) and 8.8% (14.0% (6.8, 28.3) to 22.8% (8.5, 33.4)), respectively. Energy, carbohydrate, and fat intake increased significantly by 13.2% (179.1 (137.9, 220.8) to 202.7 (163.0, 243.2) kcal), 18.9% (18.1 (14.3, 21.7) to 21.6 (17.2, 25.6) grams), and 23.2% (6.7 (4.9, 9.9) to 8.2 (6.7, 10.2) grams), respectively. The U4HK program adopted all aspects that foster healthy eating, including a healthy environment, an attractive role model and increased repeatability of the exposure to healthy foods. [ABSTRACT FROM AUTHOR]

Background: Supermarket interventions are promising to promote healthier dietary patterns, but not all individuals may be equally susceptible. We explored whether the effectiveness of nudging and pricing strategies on diet quality differs by psychological and grocery shopping characteristics. Methods: We used data of the 12-month Supreme Nudge parallel cluster-randomised controlled supermarket trial, testing nudging and pricing strategies to promote healthier diets. Participants were Dutch speaking adults aged 30–80 years and regular shoppers of participating supermarkets (n = 12) in socially disadvantaged neighbourhoods. Data on psychological characteristics (food-related behaviours; price sensitivity; food decision styles; social cognitive factors; self-control) and grocery shopping characteristics (time spent in the supermarket; moment of the day; average supermarket visits; shopping at other retailers; supermarket proximity) were self-reported at baseline. These characteristics were tested for their moderating effects of the intervention on diet quality (scored 0–150) in linear mixed models. Results: We included 162 participants from intervention supermarkets and 199 from control supermarkets (73% female, 58 (± 10.8) years old, 42% highly educated). The interventions had no overall effect on diet quality. Only five out of 23 potential moderators were statistically significant. Yet, stratified analyses of these significant moderators showed no significant effects on diet quality for one of the subgroups and statistically non-significant negative effects for the other. Negative effects were suggested for individuals with lower baseline levels of meal planning (β − 2.6, 95% CI − 5.9; 0.8), healthy shopping convenience (β − 3.0, 95% CI − 7.2; 1.3), and healthy food attractiveness (β − 3.5, 95% CI − 8.3; 1.3), and with higher levels of price consciousness (β − 2.6, 95% CI − 6.2; 1.0) and weekly supermarket visits (β − 2.4, 95% CI − 6.8; 1.9). Conclusions: Adults with varying psychological and grocery shopping characteristics largely seem equally (un)susceptible to nudging and pricing strategies. It might be that certain characteristics lead to adverse effects, but this is not plausible, and the observed negative effects were small and statistically non-significant and may be explained by chance findings. Verification of these findings is needed in real-world trials based on larger sample sizes and with the use of more comprehensive interventions. Trial registration: Dutch Trial Register ID NL7064, 30th of May, 2018, https://onderzoekmetmensen.nl/en/trial/20990 [ABSTRACT FROM AUTHOR]

Adherence to the Mediterranean diet has been shown to lower the risk of developing chronic non-communicable diseases like cardiovascular and neurodegenerative diseases and cancer. Improvements in depression, participation in daily activities in older individuals, weight loss and a reduction in adverse pregnancy outcomes are associated with adherence to the Mediterranean diet. The number of studies that have evaluated barriers to adherence to the Mediterranean diet in the US and, in particular, in racial and ethnic minority populations within the US are few. Among Native American and Alaskan Native populations, studies evaluating traditional or alternative Mediterranean diet adherence for chronic non-infectious diseases is unavailable. Mediterranean diet scoring instruments used in studies in European and Mediterranean countries and among white participants in the US fail to capture the dietary patterns of racial and ethnic minority populations. In this narrative review, the food components of the traditional Mediterranean diet are discussed, adherence to the Mediterranean diet is examined in Mediterranean and non-Mediterranean countries and barriers preventing adherence to the Mediterranean diet in the US and among racial and ethnic minority populations is reviewed. Recommendations for improving nutrition education and intervention and for increasing adherence and cultural adaptions to the Mediterranean diet are provided. [ABSTRACT FROM AUTHOR]

ObjectiveSeveral studies suggest that during the early pandemic, amidst socioeconomic instability, children from underserved families were more likely to resort to consuming cheaper, lower-quality foods with longer shelf lives. This study investigated the change in unhealthy food consumption across different phases (pre, early, mid) of the COVID-19 pandemic, and whether the strength of association between unhealthy food consumption and household socioeconomic disadvantage (HSED) varied across phases of the pandemic.MethodsThis study utilized serial cross-sectional data collected from low-income families enrolled in a school-based food co-op, Brighter Bites. Secondary data analysis included 5,384 surveys from families who had complete data: 3422 pre-pandemic, 944 from the early pandemic, and 1,018 mid-pandemic. Outcome measures included sugary food intake and convenience/fast food intake, each of which was operationalized as a scale using pre-validated items from the surveys. HSED was operationalized as a composite of parent employment, parent education, food insecurity, and participation in government programs; responses were categorized into low, medium, and high HSED groups for analysis. We examined the interaction between HSED and time period to explore how HSED and its association with dietary measures changed over the course of the pandemic.ResultsA significant linear negative trend, i.e., a decrease in consumption from pre-to-mid-pandemic period was seen in sugary food intake (p

Abstract Background Early initiation of breastfeeding (EIBF) is a starting point that lays the foundation for breastfeeding and bonding between mother and baby. Meanwhile, working mothers are one of the vulnerable groups for the success of exclusive breastfeeding (EBF). The study analyzed the role of EIBF on EBF among Indonesian working mothers. Methods The cross-sectional study examined secondary data from the 2021 Indonesian National Nutritional Status Survey. The study analyzed 4,003 respondents. We examined EBF practice as an outcome variable and EIBF as an exposure variable. We included nine control variables (residence, maternal age, marital, education, prenatal classes, wealth, infant age, sex, and birth weight). All variables were assessed by questionnaire. The study employed a binary logistic regression test in the last stage. Results The result showed that the proportion of EBF among working mothers in Indonesia in 2021 was 51.9%. Based on EIBF, Indonesian working mothers with EIBF were 2.053 times more likely than those without to perform EBF (p

Background: Early initiation of breastfeeding (EIBF) is a starting point that lays the foundation for breastfeeding and bonding between mother and baby. Meanwhile, working mothers are one of the vulnerable groups for the success of exclusive breastfeeding (EBF). The study analyzed the role of EIBF on EBF among Indonesian working mothers. Methods: The cross-sectional study examined secondary data from the 2021 Indonesian National Nutritional Status Survey. The study analyzed 4,003 respondents. We examined EBF practice as an outcome variable and EIBF as an exposure variable. We included nine control variables (residence, maternal age, marital, education, prenatal classes, wealth, infant age, sex, and birth weight). All variables were assessed by questionnaire. The study employed a binary logistic regression test in the last stage. Results: The result showed that the proportion of EBF among working mothers in Indonesia in 2021 was 51.9%. Based on EIBF, Indonesian working mothers with EIBF were 2.053 times more likely than those without to perform EBF (p < 0.001; AOR 2.053; 95% CI 2.028–2.077). Moreover, the study also found control variables related to EBF in Indonesia: residence, maternal age, marital, education, prenatal classes, wealth, infant age, sex, and birth weight. Conclusion: The study concluded that EIBF was related to EBF. Indonesian working mothers with EIBF were two times more likely than those without to perform EBF. The government needs to release policies that strengthen the occurrence of EIBF in working mothers to increase EBF coverage. [ABSTRACT FROM AUTHOR]

This study investigates the implementation of national policies and strategies to control unhealthy diets, which are pivotal in the global surge of non-communicable diseases. Leveraging data from the World Health Organization's Non-Communicable Diseases Progress Monitors and Country Capacity Surveys, we calculated aggregate implementation scores for 13 diet-related policies across 194 countries from 2017 to 2021. We used descriptive statistics and linear regression to investigate the implementation trends and associations between key national-level factors and implementation scores. The mean score in 2021 was 52% (SD = 24), with no statistical differences in the 5-year period. Stark disparities in implementation efficacy were noted, ranging from comprehensive adoption in some nations to minimal application in others. Our analysis also highlights a shifting focus in policy adoption: notably, an increased commitment to taxing sugar-sweetened beverages juxtaposed with a decline in dietary awareness initiatives. Significant predictors of policy implementation include the Human Development Index, the cost of a healthy diet, and health service coverage. These findings suggest a complex interdependence of socioeconomic factors influencing policy implementation. Our research underscores the need for multifaceted, globally collaborative strategies to effectively combat diet-related diseases, emphasizing the importance of comprehensive policy frameworks in public health interventions. [ABSTRACT FROM AUTHOR]

Introduction: Exposure to marketing for foods high in sugar, salt, and fat is considered a key risk factor for childhood obesity. To support efforts to limit such marketing, the World Health Organization Regional Office for Europe has developed a nutrient profile model (WHO NPM). Germany's Federal Ministry of Food and Agriculture plans to use this model in proposed new food marketing legislation, but it has not yet been tested in Germany. The present study therefore assesses the feasibility and implications of implementing the WHO NPM in Germany. Methods: We applied the WHO NPM to a random sample of 660 food and beverage products across 22 product categories on the German market drawn from Open Food Facts, a publicly available product database. We calculated the share of products permitted for marketing to children based on the WHO NPM, both under current market conditions and for several hypothetical reformulation scenarios. We also assessed effects of adaptations to and practical challenges in applying the WHO NPM. Results: The median share of products permitted for marketing to children across the model's 22 product categories was 20% (interquartile range (IQR) 3–59%) and increased to 38% (IQR 11–73%) with model adaptations for fruit juice and milk proposed by the German government. With targeted reformulation (assuming a 30% reduction in fat, sugar, sodium, and/or energy), the share of products permitted for marketing to children increased substantially (defined as a relative increase by at least 50%) in several product categories (including bread, processed meat, yogurt and cream, ready-made and convenience foods, and savoury plant-based foods) but changed less in the remaining categories. Practical challenges included the ascertainment of the trans-fatty acid content of products, among others. Conclusion: The application of the WHO NPM in Germany was found to be feasible. Its use in the proposed legislation on food marketing in Germany seems likely to serve its intended public health objective of limiting marketing in a targeted manner specifically for less healthy products. It seems plausible that it may incentivise reformulation in some product categories. Practical challenges could be addressed with appropriate adaptations and procedural provisions. [ABSTRACT FROM AUTHOR]

Abstract Background Nutrition in the first 1000 days of life, from conception to age 2 years, plays a critical role in shaping offspring's physical and mental development, yet many families from underserved backgrounds suffer from nutrition inequity during this important stage of development. The objective of this study is to assess nutrition services and resources provided to families during the first 1000 days across diverse settings in California. Methods A semistructured survey was disseminated to healthcare and educational providers who offer services to pregnant and/or postpartum women and children up to age 2 years. Perspectives about five domains of early‐life nutrition services and resources were assessed: (1) accessibility, (2) mode of content delivery, (3) content of messages, (4) breastfeeding support, and (5) professional development on early‐life nutrition. Mixed methodology was used to conduct descriptive and thematic analyses for closed and open‐ended survey questions, respectively. Results Survey respondents (n = 148) worked in healthcare (37%), governmental (20%), community (20%), and childcare settings (23%). Over 60% primarily served low‐income families. Less than 9% reported that their organizations provide prenatal nutrition messaging about critical micronutrients required to support foetal neurodevelopment, highlighting an opportunity for professional development training in nutrition. Need for equitable access to nutrition education and resources by addressing Language, Income, Food resources, Time and Transportation (LIFTT) was a cross‐cutting theme that emerged. Conclusion Providers perceive a need to enhance LIFTT accessibility and improve delivery of early‐life nutrition‐related services for families in the first 1000 days by providing topic‐specific education and culturally responsive resources with consistent, evidence‐based messages.

Stunting reduction is one of Indonesia’s major projects. While one-size-fits-all regulations were no longer promoted, understanding the characteristics of each region imposed a strong policy foundation. Many studies had been conducted in rural areas, but the analysis of urban areas was scarce. A study was conducted in Yogyakarta City to understand the characteristics of stunting intervention, despite the high human development index, education level, and access to health facilities. This made it important to examine the characteristics of stunting reduction efforts, based on the analysis of the contents, contexts, processes, and actors involved, in Yogyakarta City, to help with its ambition for zero stunting. A desk review and focus group discussion were conducted involving four local government staff, consisting of the Regional Planning and Development Agency, Health Office, and Office of Women's Empowerment, Child Protection, and Population Control and Family Planning, which were elaborated with literature following the policy triangle framework. A total of 13 open-access official documents and dashboards were obtained for analysis. Decrees from the local government showed a strong commitment to ending malnutrition. While most intervention packages were similar to those across Indonesia, targeted interventions for specific subjects were needed to support people who were unable to be covered by general services. Furthermore, Yogyakarta City has smaller open spaces than other districts in the province, a contradictory low nutrition awareness despite high school participation, and other factors were cross-linked with its culture in the community, implementer, to the authority levels. Stunting reduction programs were multisectoral, involving not only government offices but also non-government, mass media, community, private sectors, and academia. This study is expected to provide lessons learned for decision-makers, private sectors, academia, and public health practitioners to implement good collaboration in stunting reduction efforts.

To address the rising incidence of non-communicable diseases (NCDs) and promote healthier eating habits, Japan requires a culturally tailored Nutrient Profile Model. This study aimed to develop a Nutrient Profile Model for Dishes in Japan version 1.0 (NPM-DJ (1.0)) that corresponds to the nutritional issues and food culture in Japan. The aim of the NPM-DJ (1.0) was to promote the health of the general population, and to prevent the increase in NCDs in Japan. The NPM-DJ (1.0) categorizes dishes into staples, sides, mains, mixed dishes, and mixed dishes with staples. The model evaluates dishes based on energy, saturated fats, sugars, and sodium as restricted nutrients, while considering protein, dietary fiber, and the weight of certain food groups as recommended nutrients. The distribution of the overall score for each dish category was analyzed and a rating algorithm was created. The baseline, modification points, and final scores were significantly lower for side dishes than for staple dishes. In contrast, the baseline points and final scores were significantly higher for mixed dishes with staple. The model effectively differentiated nutritional profiles across five dishes categories, which may promote healthier dish reformulation by food businesses operators and encourage consumers to select healthier dishes.

Background: Tuvalu is a Pacific Island country within the small island developing states that has observed a significant and alarming increase in obesity rates over the past 40 years, affecting ~60 %-70 % of the current population. Objectives: This study aimed to investigate the association between food patterns and the proportion of obesity in a Pacific Island country. Methods: The 2022 COMmunity-based Behavior and Attitude survey in Tuvalu (COMBAT) included 985 adults with complete data on sociodemographic information and the frequency of consumption of 25 common foods. A latent class analysis determined 4 food patterns. Bayesian multilevel logistic and linear regression models estimated the association between food patterns and the proportion of obesity [body mass index (BMI) -30 kg/m2], severe obesity (BMI -40 kg/m2), and weight (kg), adjusting for potential confounders and accounting for clustering by region. Results: The latent class analysis revealed 4 food patterns with an entropy of 0.94 and an average posterior probability of class assignment for each individual of 0.97, described as follows: 1) local: locally produced foods with moderate food diversity (proportion of individuals = 28 %); 2) diverse-local: local with greater food diversity (17 %); 3) restricted-imported: more imported with restricted diversity (29 %); and 4) imported: heavily imported with high diversity (26 %). Compared to those following the diverse-local pattern, the odds of having obesity were greater for those classified with the imported pattern [odds ratio (OR): 2.52; 95 % credible interval (CrI): 1.59, 3.99], restrictedimported pattern (OR: 1.89; 95 % CrI: 1.59, 3.99), and local pattern (OR: 1.54; 95 % CrI: 0.94, 2.50). Similar trends were observed for severe obesity while body weight was positively associated with both restricted-imported and imported food patterns. Conclusions: The high consumption of imported foods, together with the low consumption of plant-based foods and protein-rich foods, could be a relevant modifiable lifestyle factor explaining the high levels of obesity and severe obesity in Tuvalu, a Pacific Island country. [ABSTRACT FROM AUTHOR]

Background: In recent years, various definitions of "added sugars" have emerged across jurisdictions. Although it is clear how these definitions differ, there is limited understanding of the policy implications associated with these variations. Objective: To test the potential policy implications of different definitions of "added sugars" on the Australian packaged food supply, we developed a method to estimate the content of "added sugars" in packaged foods and applied this to 3 different definitions of "added sugars": (i) United States Food and Drug Administration (US FDA) added sugar definition, (ii) the World Health Organization (WHO) free sugar definition, and (iii) a comprehensive definition that was developed from a review of the evidence on "added sugars." Methods: Using a representative sample of 25,323 Australian packaged foods, the "added sugar" content and proportion of products that contain "added sugar" under the 3 definitions were estimated. In addition, a comparative analysis exploring the impact of the US FDA definition (least comprehensive) vs. the comprehensive definition was conducted to understand potential implications of adopting different regulatory definitions in Australia. Results: The US FDA definition identified the lowest number and proportion of products with any "added sugars" at 14,380 products (representing 56.8% of all products), followed by the WHO free sugar definition at 15,168 products (59.9%) and the comprehensive definition at 16,260 products (64.2%). The mean estimates for "added sugars" were 8.5 g/100 g, 8.7 g/100 g, and 9.6 g/100 g for the US FDA, WHO, and comprehensive definitions, respectively. Compared with the US FDA definition, the comprehensive definition captured an additional 7.4% of products, largely driven by nonalcoholic beverages, special foods and fruit, vegetables, nuts, and legumes. Conclusions: Despite small variations in different "added sugars" definitions, their application has some significant policy implications. Findings highlight the importance of applying a comprehensive regulatory definition that adequately captures all sugars that have been linked to poor health. [ABSTRACT FROM AUTHOR]

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Background: School is an important setting for creating healthy and sustainable food environments. Using participatory methods, this pilot study examined food and packaging waste and nutrition quality within the school food system. Methods: One secondary school in Ireland participated in a waste audit. Eleven male students (15–17 years) participated as citizen scientists. Students collected waste over 1 day and documented data on waste categories. Nutrition labels were photographed for analysis. Students created a video and participated in a focus group. Quantitative data were summarised using descriptive frequencies. A Nutrient Profile Model was applied to summarise nutrition quality. The focus group discussion was analysed using content analysis. Results: Highest weights of waste were organic waste (14.2 kg), paper and cardboard (5.0 kg), and hard plastics (4.1 kg). Materials banned by the European Union Single Use Plastics Directive were found. Recycling bins were contaminated with food waste. Nutrition labels from 132 food packages were analysed, of which 115 items (87%) were low‐nutrient, energy dense foods. Confectionary, energy bars and desserts and savoury snacks were the most common packaged food groups. Students were not surprised by the unhealthy food choices; however, they were shocked and saddened at the waste practices. Their proposed solutions mapped across individual, community and organisational levels. Conclusions: The methodologies allowed successful engagement with students on this topic. The use of unnecessary plastics to serve food, poor waste separation practices, and the production of avoidable waste from low‐nutrient, energy‐dense products were key issues identified. Students proposed solutions that are achievable in the short‐term. Key highlights: Eleven 15–17‐year‐old secondary school students successfully participated as citizen scientists in a waste audit at their school that characterised the quantity, type and nutrition quality of waste associated with the food system.Organic waste, paper and cardboard, and hard plastics represented the most frequent waste. Recycling bins were contaminated with organic waste.Confectionary, energy bars and desserts and savoury snacks were the most common packaged food groups.The researchers conduced a focus group with students when they expressed shock and sadness at the waste practices. Their proposed solutions mapped across individual, community and organisational levels. [ABSTRACT FROM AUTHOR]

IntroductionSleep and diet are crucial determinants of overall health and wellbeing, with the potential to mutually influence each other. This study examined the association between sleep duration and fruits and vegetables (FV) consumption among Finnish adults.MethodsThe study analyzed data from the National FinHealth 2017 Study involving 5,043 adults aged 18 years and above. Participants reported their habitual sleep duration, and dietary consumption through a validated self-administered questionnaire. Confounders such as demographic, socio-economic factors, and chronotype were considered. A sensitivity analysis, which excluded energy under-reporters, was conducted to validate the findings.ResultsMean dietary consumption was compared across three sleep duration categories (short, normal, long), revealing that short sleepers consumed 37 g/d fewer FV, and long sleepers consumed 73 g/d fewer FV than normal sleepers. Binary logistic regression analyses consistently demonstrated significant negative association between FV consumption and both short and long sleep duration across all models, even when adjusted for a range of covariates. Linear regression analyses revealed a positive but non-significant association between sleep duration and FV consumption that became significant when excluding energy under-reporters, particularly in model 1.DiscussionThis study suggests a consistent pattern where deviation from normal sleep duration was associated with decreased FV consumption, suggesting the need for considering sleep patterns in dietary intervention. The substantial role of accurate energy reporting in explaining these associations is highlighted. Further research, including longitudinal studies, is needed to better understand the mechanisms underlying these associations.

IntroductionAn important impediment to the large-scale adoption of evidence-based school nutrition interventions is the lack of evidence on effective strategies to implement them. This paper describes the protocol for a “Collaborative Network Trial” to support the simultaneous testing of different strategies undertaken by New South Wales Local Health Districts to facilitate the adoption of an effective school-based healthy lunchbox program (‘SWAP IT’). The primary objective of this study is to assess the effectiveness of different implementation strategies to increase school adoption of the SWAP across New South Wales Local Health Districts.MethodsWithin a Master Protocol framework, a collaborative network trial will be undertaken. Independent randomized controlled trials to test implementation strategies to increase school adoption of SWAP IT within primary schools in 10 different New South Wales Local Health Districts will occur. Schools will be randomly allocated to either the intervention or control condition. Schools allocated to the intervention group will receive a combination of implementation strategies. Across the 10 participating Local Health Districts, six broad strategies were developed and combinations of these strategies will be executed over a 6 month period. In six districts an active comparison group (containing one or more implementation strategies) was selected. The primary outcome of the trial will be adoption of SWAP IT, assessed via electronic registration records captured automatically following online school registration to the program. The primary outcome will be assessed using logistic regression analyses for each trial. Individual participant data component network meta-analysis, under a Bayesian framework, will be used to explore strategy-covariate interactions; to model additive main effects (separate effects for each component of an implementation strategy); two way interactions (synergistic/antagonistic effects of components), and full interactions.DiscussionThe study will provide rigorous evidence of the effects of a variety of implementation strategies, employed in different contexts, on the adoption of a school-based healthy lunchbox program at scale. Importantly, it will also provide evidence as to whether health service-centered, collaborative research models can rapidly generate new knowledge and yield health service improvements.Clinical trial registrationThis trial is registered prospectively with the Australian New Zealand Clinical Trials Registry (ACTRN12623000558628).

PurposeThe dietary practices (DPs) of university students are influenced by many external factors. Therefore, we investigate how the DPs of students in Germany changed during the SARS-CoV-2 pandemic, what the main motivations were for those changes, and what effect the closure of university catering had on the DPs of students.MethodsA total of 560 students from two universities in Lübeck (Germany) were surveyed online during a pilot phase. The final online questionnaire was subsequently administered at 10 other German universities (399 respondents). The questionnaire surveyed sociodemographic factors, dietary habits, food consumption frequencies, and the relevance of university catering before and during the SARS-CoV-2 pandemic.ResultsRegarding changes in DPs, similarities to previous studies were found, especially positive eating behaviors and an increasing interest in health- and nutrition-related sustainability. Students prepared meals freshly more often during the pandemic; consumed legumes, plant-based meats and dairy alternatives more often; and reduced their consumption of meat and milk compared to before the pandemic. The consumption frequency of sweets also decreased. It was observed that students consider eating communal in the university canteen to be highly relevant for their social interactions, which was only possible to a limited extent during the pandemic.ConclusionIn Germany, the DPs of university students as well as criteria regarding health and sustainability changed during the first 2 years of the SARS-CoV-2 pandemic. The social aspect of DPs became evident due to closed university catering. Still, changes in dietary patterns and eating habits were positively related to health and revealed some differences in the cross section of the population.

Abstract Background Fiber, potassium and calcium are nutrients of public health concern and their intakes in the United States are alarmingly low. The usage of nutrition facts labels has been reported to increase the odds for dietary reference intake of fiber in some studies. The overall evidence, however, is mixed, as some studies suggested that nutrition facts panels have little to no effect on average measures of diet quality. Here, we investigated whether the usage of nutrition facts labels was associated with meeting U.S. intake recommendations for three nutrients of public health concern: fiber, potassium and calcium. Methods We used cross-sectional multistage, stratified, clustered and probability sampling design data from the U.S. National Health and Nutrition Examination Surveys 2017–2020 cycle. The sample included 5,416 individuals aged 20 years or older, which may be extrapolated to represent 146,841,866 US Americans. Nutrient intakes were compared among individuals reading nutrition facts panels “frequently”, “sometimes” or “rarely” using applied survey data analyses techniques (including multivariate logistic regression and marginsplots). Results We observed substantial sociodemographic differences between the three groups. Frequent readers were significantly more likely to be female and had higher educational levels. On average, they were also significantly older as compared to rare readers. Fiber intake in g/d was highest in frequent readers (17.09) and lowest in rare readers (14.64). The proportion of participants that met dietary fiber intake recommendations was almost four times higher in the frequent readers group (12.69%) as compared to the rare readers group (3.69%). In a bivariate logistic regression model, frequent label reading significantly increased the odds for meeting the fiber recommendations in Dietary Guidelines for Americans (OR: 2.15, p

Spatial mapping of food demand is essential for understanding and addressing disparities in food accessibility, which significantly impact public health and nutrition. This research presents an innovative geospatial framework designed to map food demand, integrating individual dietary behaviors with advanced spatial analysis techniques. This study analyzes the spatial distribution of eating habits across Lithuania using a geospatial approach. The methodology involves dividing Lithuania into 60,000 points and interpolating survey data with Shepard’s operator, which relies on a weighted average of values at data points. This flexible approach allows for adjusting the number of points based on spatial resolution and sample size, enhancing the reliability and applicability of the generated maps. The procedure includes generating a structured grid system, incorporating measurements into the grid, and applying Shepard’s operator for interpolation, resulting in precise representations of food demand. This framework provides a comprehensive understanding of dietary behaviors, informing targeted policy interventions to improve food accessibility and nutrition. Traditional food spatial mapping approaches are often limited to specific polygons and lack the flexibility to achieve high granular detail. By applying advanced interpolation techniques and ensuring respondent location data without breaching privacy concerns, this study creates high-resolution maps that accurately represent regional differences in eating habits. The methodology’s flexibility allows for adjustments in spatial resolution and sample size, enhancing the maps’ validity and applicability. This novel approach facilitates the creation of detailed food demand maps at any granular level, providing valuable insights for policymakers and stakeholders. These insights enable the development of targeted strategies to improve food accessibility and nutrition. Additionally, the obtained information can be used for computer simulations to further analyze and predict food demand scenarios. By leveraging spatial data integration, this study contributes to a deeper understanding of the complex dynamics of food demand, identifying critical areas such as food deserts and swamps, and paving the way for more effective public health interventions and policies aimed at achieving equitable food distribution and better nutritional outcomes.

Adherence to the Mediterranean diet has been shown to lower the risk of developing chronic non-communicable diseases like cardiovascular and neurodegenerative diseases and cancer. Improvements in depression, participation in daily activities in older individuals, weight loss and a reduction in adverse pregnancy outcomes are associated with adherence to the Mediterranean diet. The number of studies that have evaluated barriers to adherence to the Mediterranean diet in the US and, in particular, in racial and ethnic minority populations within the US are few. Among Native American and Alaskan Native populations, studies evaluating traditional or alternative Mediterranean diet adherence for chronic non-infectious diseases is unavailable. Mediterranean diet scoring instruments used in studies in European and Mediterranean countries and among white participants in the US fail to capture the dietary patterns of racial and ethnic minority populations. In this narrative review, the food components of the traditional Mediterranean diet are discussed, adherence to the Mediterranean diet is examined in Mediterranean and non-Mediterranean countries and barriers preventing adherence to the Mediterranean diet in the US and among racial and ethnic minority populations is reviewed. Recommendations for improving nutrition education and intervention and for increasing adherence and cultural adaptions to the Mediterranean diet are provided.

The integration of social media in higher education may support improved communication among students and instructors and facilitate collaborative learning. Within public health education, the use of social media may enable students to critically reflect on relevant everyday experiences, while the ability to effectively communicate via social media is increasingly viewed as an important public health competency. Although the existing literature suggests benefits of the use of social media in higher education, a lack of attention to potential drawbacks has been raised. The objective of this study was to examine student experiences, including perceived benefits and challenges, of a Twitter-based assessment in a public health nutrition university course. Data consisted of students’ (n=115) written reflections, complemented by transcripts from semi-structured interviews conducted with the instructor and three teaching assistants. Three themes identified by inductive thematic analysis included engaging students with course content and one another, practicing communication skills, and navigating learning curves. Most students noted the assessment provided opportunities to apply course concepts and connect with peers. However, some did not find the assignment’s purpose to be intuitive and some resistance to the use of Twitter was noted, particularly with respect to the constraints associated with tight character limits. Other students noted minimal impact on their learning due to the superficial nature of tweets. The results underscore the importance of tying social media-based assessments to clear and realistic learning goals with appropriate student supports, as well as balancing potential benefits of experimentation with social media with the potential drawbacks.

Abstract Objective: In this paper, we examined whether there are inequalities in access to food retail (by type and healthiness) across local government areas (LGA) in Greater Melbourne and by LGA grouped based on their distance from the central business district and Growth Area designation. We also examined whether these inequalities persisted over time. Design: This is a secondary analysis of a repeated cross-sectional census of food outlets collected at four time points (2008, 2012, 2014 and 2016) across 31 LGA. Using Geographical Information Systems, we present a spatial analysis of food retail environments in Melbourne, Australia, at these four times over eight years. Setting: Greater Melbourne, Australia. Participants: 31 LGA in Greater Melbourne. Results: Findings show significant inequalities in access to healthy food retail persisting over time at the LGA level. Residents in lower density urban growth areas had the least access to healthy food retail. Unhealthy food retail was comparatively more accessible, with a temporal trend indicating increased accessibility over time in urban growth areas only. Conclusion: Accessibility to food outlets, particularly healthy food outlets and supermarkets, in Greater Melbourne is not equal. To identify and address health inequalities associated with rapid urban growth, further understanding of how people interact with the food environment needs to be explored.

Summary: Corporate influence in policy and decision-making is an important public health concern. This Health Policy paper reviews Ecuador’s child malnutrition strategy instruments, approved between 2020 and 2023, to identify how private interests are becoming legally integrated into the public sector. Evidence indicates that recent changes are enabling corporations to promote their brands, gain tax deductions, oversee public policy and set priorities, allocate resources, and decide on implementation of the country’s child malnutrition strategy. Further, corporate representatives are active members of an advisory council, free from scrutiny or accountability, while being privy to undisclosed government information. Moreover, a UN agency (the World Food Program) engaged in corporate promotion of highly processed foods, illustrating the breadth of Ecuador’s corporate influence scheme. Improved regulations should set clear limits to the influence of food and beverage industries in national nutrition policy, while following transparency laws in the composition and operation of Ecuador’s child malnutrition strategy and related efforts.

Research into the link between food environments and health is scarce. Research in this field has progressed, and new comprehensive methods (i.e., incorporating all food retail outlets) for classifying food retail environments have been developed and are yet to be examined alongside measures of obesity. In this study, we examine the association and temporal trends between the food environment and BMI of a repeated cross-sectional sample of the adult population between 2008 and 2016. Methods: Food retail data for 264 postal areas of Greater Melbourne was collected for the years 2008, 2012, 2014, and 2016, and a container-based approach was used to estimate accessibility to supermarkets, healthy and unhealthy outlets. Data on BMI for postal areas was obtained from the Victorian Population Health Survey (n = 47,245). We estimated the association between the food environment and BMI using linear mixed models. Results indicated that BMI increased as accessibility to healthy outlets decreased by up to −0.69 kg/m2 (95%CI: −0.95, −0.44). BMI was lower with high and moderate access to supermarkets compared to low access by −0.33 kg/m2 (−0.63, −0.04) and −0.32 kg/m2 (−0.56, −0.07), and with high access to unhealthy outlets compared to low access (−0.38 kg/m2: −0.64, −0.12) and moderate access (−0.54 kg/m2: −0.78, −0.30). Conclusion: Our results show that increasing access and availability to a diverse range of food outlets, particularly healthy food outlets, should be an important consideration for efforts to support good health. This research provides evidence that Australia needs to follow suit with other countries that have adopted policies giving local governments the power to encourage healthier food environments. [ABSTRACT FROM AUTHOR]

Background: Fiber, potassium and calcium are nutrients of public health concern and their intakes in the United States are alarmingly low. The usage of nutrition facts labels has been reported to increase the odds for dietary reference intake of fiber in some studies. The overall evidence, however, is mixed, as some studies suggested that nutrition facts panels have little to no effect on average measures of diet quality. Here, we investigated whether the usage of nutrition facts labels was associated with meeting U.S. intake recommendations for three nutrients of public health concern: fiber, potassium and calcium. Methods: We used cross-sectional multistage, stratified, clustered and probability sampling design data from the U.S. National Health and Nutrition Examination Surveys 2017–2020 cycle. The sample included 5,416 individuals aged 20 years or older, which may be extrapolated to represent 146,841,866 US Americans. Nutrient intakes were compared among individuals reading nutrition facts panels "frequently", "sometimes" or "rarely" using applied survey data analyses techniques (including multivariate logistic regression and marginsplots). Results: We observed substantial sociodemographic differences between the three groups. Frequent readers were significantly more likely to be female and had higher educational levels. On average, they were also significantly older as compared to rare readers. Fiber intake in g/d was highest in frequent readers (17.09) and lowest in rare readers (14.64). The proportion of participants that met dietary fiber intake recommendations was almost four times higher in the frequent readers group (12.69%) as compared to the rare readers group (3.69%). In a bivariate logistic regression model, frequent label reading significantly increased the odds for meeting the fiber recommendations in Dietary Guidelines for Americans (OR: 2.15, p < 0.001). Rarely reading labels decreased the odds (OR: 0.57, p = 0.003). These odds remained essentially unchanged after adjusting for sociodemographic covariates, diabetes status and body mass index (OR: 1.84, p = 0.004; and OR: 0.62, p = 0.022). Conclusions: Nutrition facts panel reading associates with fiber intake. Our findings have potential implications for public health nutrition strategies that may center around educational work. [ABSTRACT FROM AUTHOR]

The recent Covid-19 pandemic highlighted stark social inequalities, notably around access to food, nutrition and to green or blue space (i.e. outdoor spaces with vegetation and water). Consequently, obesity is socio-economically patterned by this inequality; and while the environmental drivers of obesity are widely acknowledged, there is currently little upstream intervention. We know that living with obesity contributes to increasing health inequalities, and places healthcare systems under huge strain. Our environment could broadly be described obesogenic, in the sense of supporting unhealthful eating patterns and sedentary behaviour. Evidence points to the existence of nearly 700 UK obesity policies, all of which have had little success. Obesity prevention and treatment has focused on educational and behavioural interventions targeted at individual consumers. A more sustainable approach would be to try and change the environments that promote less healthy eating and high energy intake as well as sedentary behaviour. Approaches which modify the environment have the potential to assist in the prevention of this complex condition. This review paper focuses on the role of wider food environments or foodscapes. While there is an imperfect evidence base relating to the role of the foodscape in terms of the obesity crisis, policy, practice, civic society and industry must work together and take action now, in areas where current evidence suggests change is required. Despite the current cost-of-living crisis, shaping the foodscape to better support healthful eating decisions has the potential to be a key aspect of a successful obesity prevention intervention. [ABSTRACT FROM AUTHOR]

Abstract Background The National Health Service (NHS) website gives guidance for pregnant women in England on foods/drinks to avoid or limit because of microbiological, toxicological or teratogenic hazards. These include, for example, some types of soft cheeses, fish/seafood and meat products. This website and midwives are trusted sources of information for pregnant women, but the ways in which midwives can be supported to provide clear and accurate information are unknown. Aims The aims were to: (1) determine midwives’ accuracy of recall of information and confidence in delivering the guidance to women; (2) identify barriers to provision; (3) identify the ways in which midwives provide this information to women. Methods Registered Midwives practicing in England completed an online questionnaire. Questions included those on what information they provided and their confidence in delivering it, the ways they provided information on foods to avoid/limit, their recall of some of the guidance, and what resources they used. Ethics approval was given by the University of Bristol. Results More than 10% of midwives (n = 122) were ‘Not at all confident/Don't know’ in providing advice about ten items, including game meat/gamebirds (42% and 43%, respectively), herbal teas (14%) and cured meats (12%). Only 32% correctly recalled overall advice on eating fish, and only 38% the advice on tinned tuna. The main barriers to provision were lack of time in appointments and lack of training. The most usual methods of disseminating information were verbal (79%) and signposting to websites (55%). Conclusion Midwives were often unconfident about their ability to provide accurate guidance, and recall on items tested was frequently mistaken. Delivery of guidance by midwives on foods to avoid or limit needs to be supported by appropriate training and access to resources, and sufficient time in appointments. Further research on barriers to the delivery and implementation of the NHS guidance is needed.

This study investigates the implementation of national policies and strategies to control unhealthy diets, which are pivotal in the global surge of non-communicable diseases. Leveraging data from the World Health Organization’s Non-Communicable Diseases Progress Monitors and Country Capacity Surveys, we calculated aggregate implementation scores for 13 diet-related policies across 194 countries from 2017 to 2021. We used descriptive statistics and linear regression to investigate the implementation trends and associations between key national-level factors and implementation scores. The mean score in 2021 was 52% (SD = 24), with no statistical differences in the 5-year period. Stark disparities in implementation efficacy were noted, ranging from comprehensive adoption in some nations to minimal application in others. Our analysis also highlights a shifting focus in policy adoption: notably, an increased commitment to taxing sugar-sweetened beverages juxtaposed with a decline in dietary awareness initiatives. Significant predictors of policy implementation include the Human Development Index, the cost of a healthy diet, and health service coverage. These findings suggest a complex interdependence of socioeconomic factors influencing policy implementation. Our research underscores the need for multifaceted, globally collaborative strategies to effectively combat diet-related diseases, emphasizing the importance of comprehensive policy frameworks in public health interventions.

In 2016, Thailand introduced voluntary front-of-pack nutrition labeling, the 'Thailand Healthier Choice' logo (THCL), in order to help consumers make informed, healthier food choices in each food category. This study aimed to assess the uptake of the THCL scheme in Thailand after five years of implementation by analyzing a newly launched product database. Data on the nutritional composition and labeling were obtained from the Mintel Global New Products Database between 2017 and 2021. The product's healthfulness was determined using the Health Star Rating (HSR) algorithm. The numbers and proportions of total, eligible, and labeled products bearing the THCL logo were analyzed and classified by food category, by HSR value, and by manufacturer. After 5 years of implementation, THCL uptake as a proportion of total products and eligible products continues to increase by 3.0% and 10.2% per annum, respectively. The logo has correspondingly appeared on 10.7% and 39.5% of total and eligible products. As a voluntary implementation, 76.1% of products displaying the THCL logo belonged to the 'non-core' group, i.e., non-alcoholic beverages and instant foods. This food category (HSR < 3.0) was more likely to register to bear THCL rather than those 'core' food scoring an HSR ≥ 3.5, which might reflect economic considerations and benefits. The present analysis also found that only 10% of manufacturers in Thailand launched 'healthier' products that display the THCL logo with varied product numbers. To summarize, the initial five-year implementation of the THCL program shows promise, but its adoption remains limited and inconsistent, thereby restricting its influence on public health. Our discoveries highlight the limitations of commercial goodwill in applying THCL voluntarily in Thailand and offer potential suggestions to enhance its adoption in the coming years. [ABSTRACT FROM AUTHOR]

Lifelong education for dietitians in Japan is based mainly on competencies according to years of experience. Because learning content differs depending on the desired position and specialty, training programs that reflect the individual learning needs of public health dietitians are needed. This study aimed to assess the individual learning needs of public health dietitians via years of experience in health promotion. In 2021, an online survey of public health dietitians involved in health promotion in prefectures, designated cities, and other municipalities throughout Japan was conducted. Years of experience in health promotion were categorized as early (<10 years), mid-career (10–19 years), and leadership (≥20 years) periods. To ascertain individual learning needs, the survey asked about respondents' desired final position, career path, and skills they felt they needed to improve in the future. Of the 1649 public health dietitians analyzed, all administrative categories preferred to work as public health generalists in mid-career or leadership periods rather than in the early period. In municipalities, more public health dietitians across all experience categories selected "professional competence", such as knowledge in specialized areas and nutritional guidance techniques. It was suggested that public health dietitians in the mid-career and leadership periods have individual learning needs, in both nutrition specialists and public health generalists. [ABSTRACT FROM AUTHOR]

The Sustainable Development Goals (SDGs) include several nutrition-focused goals. Nutrition has direct effects on the second and third SDGs, namely achieving zero hunger and good health and well-being, as well as indirect effects on the first, fifth, sixth, eighth, and seventeenth. Achievement of SDG goals is a prerequisite for meeting the global nutrition targets by 2025. Despite some improvement, Egypt is falling short of meeting the majority of the nutrition targets. From a public health nutrition perspective, there are several gaps in progress toward the SDGs related to nutrition policies, programs, or intervention levels. Political commitment, multisectoral cooperation, adequate financing, scaling up existing interventions, delivering new policies, and incorporating best practices into national policies are crucial for accelerating nutrition progress. Investing in data needed and the capacity to use it, health system capacity building, service providers training, informing beneficiaries, program monitoring and evaluation, and establishing a nutrition surveillance system to adequately inform policy formation are crucial to achieving the target. In order to provide nutrition interventions in an integrated manner, a multi-systems approach should focus on the food, health, water, and sanitation systems, as well as the education and social protection systems. The food system must support low-cost and nutritionally diverse diets, healthy food environments, and positive practices. In addition, legislation, labeling, taxes, and marketing regulations are significant. In generating evidence, science and academia play a crucial role in accelerating the progress of SDG targets. This article reviews the nutritional problem in Egypt and concludes that long-term sustainable development in Egypt cannot be achieved unless malnutrition is effectively addressed (especially in anemia among preschool and school children, exclusive breastfeeding, and overweight and obesity in adolescents and adults).

Healthy, diverse diets are vital for life. In low/middle-income countries, however, the focus is more on food quantity rather than diet quality. This study assessed household diet diversity (HDD) in the Vietnamese Mekong Delta and its associations with household food insecurity (HFI) and household food availability (HFA) controlling for socioeconomic factors. Primary food-preparers in 552 randomly selected households in two rural provinces were interviewed about socioeconomic factors, HDD, HFI, and HFA. More than 80% of households predominantly consumed energy-dense foods, whereas less than 20% consumed nutrient-dense foods. Lower HDD was associated with HFI, lower HFA, for the Khmer ethnic minority, and low livelihood capitals (landlessness, low expenditure, debt) and low utensil scores. The study highlighted the need to provide improved food and nutrition policies that increase availability and access to diverse and healthy foods as well as reduce poverty and increase incomes for at-risk rural and ethnic minority groups. [ABSTRACT FROM AUTHOR]

Background: Food-based dietary guidelines (FBDG) are a key public health tool, providing evidence-based recommendations for a healthy and more environmentally sustainable diet. Current adherence to national FBDG in the UK is poor with only 0.1% of the population meeting all of the recommendations set out in the Eatwell Guide. Communication of the Eatwell Guide is one of the many essential strategies needed to improve adherence and to support the necessary shift towards sustainable diets in the UK. An effective strategy is needed to communicate this information to policy makers, the food industry, health professionals and the public in order to drive dietary behaviour change. Methods: The authors conducted a rapid review of the scientific literature available in the SCOPUS database published between 2012 and 2022 (inclusive). Keywords searched related to the communication and implementation of FBDG. Additionally, examples of communication strategies for national FBDG globally are presented to demonstrate examples of good practice in this field. Results: The review highlighted several key themes relating to effective communication of FBDG. As a result, five recommendations are made for how communication of the Eatwell Guide could be improved to drive better adherence to these sustainable healthy guidelines. The recommendations are (1) review of language and tone of nutrition and sustainability related messages; (2) targeting of FBDG and communications to specific population segments; (3) addressing barriers to and benefits of adopting the Eatwell Guide recommendations; (4) development of practical tools and resources to support implementation of the guidelines; and (5) leveraging social media and social marketing techniques to increase public engagement. Conclusions: This research summarises the current scientific literature on the effective communication of FBDG. The recommendations may be used to improve future communication strategies for the Eatwell Guide as well as other national and international sustainable healthy FBDG. [ABSTRACT FROM AUTHOR]

Objectives: In advocating a diet rich in fruit and vegetables, public health authorities emphasise dietary colour variety to ensure adequate nutrient consumption. The relationship between food colour variety and nutritional value in children's lunches attending one school was evaluated. Study design: Observational cross-sectional study. Methods: Eighty-two children had their lunchboxes photographed over one day. Foods were scored using the Nutri-score labelling system, assigning foods a letter based on nutritional content. Composite Nutri-scores were calculated as average total Nutri-score per food per lunchbox. Eleven observers used a colour chart to assign colours to foods from a sample of lunchboxes; intra-class correlation was calculated. Associations between nutrient scores and colour variety were estimated. Results: Lunchboxes contained an average of 4 ± 1 colours. Number of colours did not vary by age or sex. Two thirds of lunches had composite Nutri-scores of C or better, with better scores in older children. There was no association between colour variety and composite Nutri-score. Fruit, vegetables, whole grains and fats were associated with greater colour variety. Vegetables and meat, fish and eggs were associated with better scores; refined grains, dairy, snacks, fats and condiments were associated with worse. Conclusions: Although this study did not demonstrate a relationship between colour variety and nutritional score, findings suggest that lunches containing fruit and vegetables tended towards greater colour variety than those without. This indicates that adjusting guidelines to incorporate food colour variety may be of use in future iterations of dietary guidelines for children.

Several prior studies have found that poverty was a major cause of stunting. However, we discovered stunting in wealthier homes as well. The study analyzes the stunting risk of wealthy families' children in urban Indonesia. This cross-sectional study enrolled 14,259 children under two in urban Indonesia. Aside from stature, the study looked at seven independent variables (maternal age, marital status, education, employment, children's age, gender, and early breastfeeding beginning). In the final exam, the study utilized a binary logistic regression examination. The result showed that children with wealthy families in urban Indonesia still have a stunting risk of around 11.9%. The study indicates that age was related to the stunting risk of children with affluent families. Children with all maternal age groups were more likely than >44 to experience stunting. Divorced/widowed mothers were 1.089 times more likely than married mothers to have stunting children (AOR 1.089; 95% CI 1.051-1.127). The lower the mother's education, the higher the possibility of stunting children. Unemployed mothers were 1.018 times more likely than employed mothers to have stunting children (AOR 1.018; 95% CI 1.009-1.026). Based on children's age, 12-23 was 2.993 more likely than <12 to experience stunting (AOR 2.993; 95% CI 2.967-3.020). Regarding children's gender, boys were 1.376 times more likely than girls to experience stunting (AOR 1.376; 95% CI 1.365-1.387). Children without early initiation of breastfeeding (EIBF) were 1.008 times more likely than those with EIBF (AOR 1.008; 95% CI 1.001-1.016). The study concluded that children with wealthy families in urban Indonesia still have a stunting risk. [ABSTRACT FROM AUTHOR]

Hunger and food insecurity have been on the national and international public agenda for several decades; however, the most recent estimates indicate that these phenomena are worsening rather than improving. Public policies, including those related to food and nutrition, serve as functional devices within the neoliberal model, which reduces social concerns to the mitigation of monetary poverty. Objective : To understand the meanings of food and nutrition policies for participating mothers and technicians, as well as to respond to the expectations and enable the capacities of rights holders. Method : Grounded theory and a constructivist approach, with simultaneous data collection and constant comparison analysis. The analysis was guided by open, axial, and selective coding and categorization. The participants included 34 mothers and nine technicians involved in the policies. Results : Food policies become devices for welfare by configuring the subject as a "recipient." Interactions revolve around operational aspects such as verifying program inclusion requirements and subsidy delivery processes. This logic disregards the voices and cultural practices of the participants and overwhelms them due to excessive intervention. Conclusions : Food and nutrition policies in the neoliberal context fall short of the subjects' aspirations; therefore, there is tension between the subject conceived by policy and the expectations they build based on their program experience. [ABSTRACT FROM AUTHOR]

The Sustainable Development Goals (SDGs) include several nutrition-focused goals. Nutrition has direct effects on the second and third SDGs, namely achieving zero hunger and good health and wellbeing, as well as indirect effects on the first, fifth, sixth, eighth, and seventeenth. Achievement of SDG goals is a prerequisite for meeting the global nutrition targets by 2025. Despite some improvement, Egypt is falling short of meeting the majority of the nutrition targets. From a public health nutrition perspective, there are several gaps in progress toward the SDGs related to nutrition policies, programs, or intervention levels. Political commitment, multisectoral cooperation, adequate financing, scaling up existing interventions, delivering new policies, and incorporating best practices into national policies are crucial for accelerating nutrition progress. Investing in data needed and the capacity to use it, health system capacity building, service providers training, informing beneficiaries, program monitoring and evaluation, and establishing a nutrition surveillance system to adequately inform policy formation are crucial to achieving the target. In order to provide nutrition interventions in an integrated manner, a multi-systems approach should focus on the food, health, water, and sanitation systems, as well as the education and social protection systems. The food system must support low-cost and nutritionally diverse diets, healthy food environments, and positive practices. In addition, legislation, labeling, taxes, and marketing regulations are significant. In generating evidence, science and academia play a crucial role in accelerating the progress of SDG targets. This article reviews the nutritional problem in Egypt and concludes that long-term sustainable development in Egypt cannot be achieved unless malnutrition is effectively addressed (especially in anemia among preschool and school children, exclusive breastfeeding, and overweight and obesity in adolescents and adults). [ABSTRACT FROM AUTHOR]