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Assilian T, Dehove H, Charreire H, Baudry J, Kesse-Guyot E, Péneau S, Julia C, Gross O, Oppert JM, Bellicha A. Improving student diet and food security in higher education using participatory and co-creation approaches: a systematic review. Int J Behav Nutr Phys Act 2024; 21:71. [PMID: 38978008 PMCID: PMC11232249 DOI: 10.1186/s12966-024-01613-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 06/05/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND Higher education students are an important target group for public health nutrition interventions. When designing tailored and contextually relevant interventions, participatory and co-creation approaches are increasingly recognized as promising but their use and effectiveness has not been assessed in this type of population. We systematically reviewed interventions aiming to improve dietary quality and/or food security in higher education settings with the aims 1) to identify and describe their participatory and co-creation approaches and 2) to compare the effectiveness of interventions using or not using participatory and co-creation approaches. METHODS Our search in PubMed, Google Scholar, Web of Science, EMBASE was performed in January 2023 and yielded 3658 unique records, out of which 42 articles (66 interventions) were included. Effectiveness of interventions was assessed at the individual level (longitudinal evaluations) or at the group level (repeated cross-sectional evaluations). A five-level classification was used to describe a continuum of engagement from students and other partners in the intervention design and implementation: no participation (level one), consultation, co-production, co-design and co-creation (levels two to five). To synthetize effectiveness, comparisons were made between studies without participation (level one) or with participation (levels two-five). RESULTS Ten (24%) out of 42 studies used a participatory and co-creation approach (levels two-five). Studies using a participatory and co-creation approach reported a positive finding on individual-level outcome (i.e. overall diet quality or food group intake or food security) in 5/13 (38%) intervention arms (vs 13/31 or 42% for those without participation). Studies using a participatory and co-creation approach reported a positive finding on group-level outcomes (i.e. food choices in campus food outlets) in 4/7 (57%) (vs 8/23 or 35% in those without participation). CONCLUSIONS Participatory and co-creation approaches may improve the effectiveness of nutrition interventions in higher education settings but the level of evidence remains very limited. More research is warranted to identify best co-creation practices when designing, implementing and evaluating nutritional interventions in the higher education setting. TRIAL REGISTRATION PROSPERO registration number CRD42023393004.
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Affiliation(s)
- Tamar Assilian
- Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Bobigny, 93017, France
| | - Henri Dehove
- Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Bobigny, 93017, France
| | - Hélène Charreire
- MoISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France
- Univ Paris Est Créteil, LabUrba, Créteil, 94010, France
| | - Julia Baudry
- Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Bobigny, 93017, France
| | - Emmanuelle Kesse-Guyot
- Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Bobigny, 93017, France
| | - Sandrine Péneau
- Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Bobigny, 93017, France
| | - Chantal Julia
- Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Bobigny, 93017, France
| | - Olivia Gross
- Health Education and Practices Laboratory, University Sorbonne Paris Nord, Bobigny, 93017, France
| | - Jean-Michel Oppert
- Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Bobigny, 93017, France
- Department of Nutrition, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne University, CRNH-Ile de France, Paris, France
| | - Alice Bellicha
- Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Bobigny, 93017, France.
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Pushpa BS, Abdul Latif SN, Sharbini S, Murang ZR, Ahmad SR. Nutrition education and its relationship to body image and food intake in Asian young and adolescents: a systematic review. Front Nutr 2024; 11:1287237. [PMID: 38585614 PMCID: PMC10995287 DOI: 10.3389/fnut.2024.1287237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 02/21/2024] [Indexed: 04/09/2024] Open
Abstract
Background The literature brings to light the unhealthy nutritional habits prevalent among Asian adolescents and their high level of body image dissatisfaction. This study aims to conduct a systematic review of the literature on the effect of nutritional education interventions on their nutritional knowledge and food intake behavior, attitude, practice, and body image. Methods We searched relevant published studies in PubMed, Web of Science, Scopus, Science Direct, and Springer using the PICO framework and performed a quality assessment using the 10-point checklist adapted from the National Institutes for Health tool. Results The majority of the nutritional education interventions improve unhealthy food intake and body image misperception, particularly on nutritional knowledge/self-efficacy, healthy dietary habits, physical activities, and fruit and vegetable intake. We also found a negative association with excess weight gain, obesity, and unethical weight reduction practices, leading to dissatisfaction with body image. Conclusion These interventions can help address dietary problems and body image perception and support the development of future interventions.
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Affiliation(s)
| | | | - Sharimawati Sharbini
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Gadong, Brunei
| | | | - Siti Rohaiza Ahmad
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Gadong, Brunei
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Zhixue L, Ying X, Zheng L, Yan M, Yanfang G, Dewang W, Weijun Y, Rencheng Z, Qing Y, Meihong X. Status and associated factors of food and nutrition literacy among young adults aged 15-44 years in Shenzhen City, China. Front Public Health 2024; 11:1329241. [PMID: 38292389 PMCID: PMC10826416 DOI: 10.3389/fpubh.2023.1329241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 12/11/2023] [Indexed: 02/01/2024] Open
Abstract
Background Food and nutrition literacy (FNL) plays an important role in young adults' dietary habits and nutrition. This study aimed to investigate FNL status and its associated factors among young adults aged 15-44 years in Shenzhen. Methods A cross-sectional survey of 5,390 participants was conducted in June 2021. FNL was measured using the Food and Nutrition Literacy Questionnaire for Chinese Adults (FNLQ). A generalized linear model was employed to analyze the factors associated with FNL. Results The median FNL score (total score = 100) was 68.00, which was below the adequate level of 80. FNL was divided into the two different domains of knowledge and skills, with significantly different scoring rate of 85.30 and 67.77%, respectively. The overall proportion of respondents with adequate FNL was 19.52%. The FNL score was significantly higher among the participants who were female (β = 2.665; 95% confidence interval [CI]: 2.031-3.299) and with higher education levels (β ranging from 5.632 [CI: 3.845-7.419] to 10.756 [CI: 8.973-12.538]), healthcare-related work experience (β = 4.197; CI: 3.557-4.837) and a higher economic status (β ranging from 0.753 [CI: 0.079-1.426] to 6.217 [CI: 5.208-7.227]). Those who were divorced or with an unknown marital status (β = -8.438; CI: -9.701, -7.175), abnormal body mass index (thin [β = -2.115; CI: -3.063, -1.166], overweight [β = -1.427; CI: -2.254, -0.600]), and suffering from chronic diseases (single disease [β = -3.483; CI: -4.485, -2.480], multimorbidity [β = -5.119; CI: -5.912, -4.327]) had significantly lower FNL scores. Conclusion Generally, the level of FNL among young adults in Shenzhen, China, was relatively low. Thus, nutrition education programs targeted at promoting improved FNL status call for additional emphasis, especially in subgroups with lower scores.
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Affiliation(s)
- Li Zhixue
- Department of Chronic Disease Prevention and Control, Shenzhen Baoan Center for Chronic Diseases Control, Shenzhen, China
| | - Xu Ying
- Department of Chronic Disease Prevention and Control, Shenzhen Baoan Center for Chronic Diseases Control, Shenzhen, China
| | - Liu Zheng
- Department of Chronic Disease Prevention and Control, Shenzhen Baoan Center for Chronic Diseases Control, Shenzhen, China
| | - Ma Yan
- Department of Chronic Disease Prevention and Control, Shenzhen Baoan Center for Chronic Diseases Control, Shenzhen, China
| | - Guo Yanfang
- Department of Chronic Disease Prevention and Control, Shenzhen Baoan Center for Chronic Diseases Control, Shenzhen, China
| | - Wang Dewang
- Department of Chronic Disease Prevention and Control, Shenzhen Baoan Center for Chronic Diseases Control, Shenzhen, China
| | - Yu Weijun
- Department of Chronic Disease Prevention and Control, Shenzhen Baoan Center for Chronic Diseases Control, Shenzhen, China
| | - Zhao Rencheng
- Department of Chronic Disease Prevention and Control, Shenzhen Baoan Center for Chronic Diseases Control, Shenzhen, China
| | - Yuan Qing
- Department of Chronic Disease Prevention and Control, Shenzhen Baoan Center for Chronic Diseases Control, Shenzhen, China
| | - Xu Meihong
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
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Kaur S. Barriers to consumption of fruits and vegetables and strategies to overcome them in low- and middle-income countries: a narrative review. Nutr Res Rev 2023; 36:420-447. [PMID: 36004512 DOI: 10.1017/s0954422422000166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This review provides an overview of the barriers to the consumption of fruits and vegetables (FVs) as well as strategies to improve the intake of FVs in low- and middle-income countries (LMICs). The importance of the consumption of FVs and its role in disease prevention are discussed briefly. Trends in the consumption of FVs in LMICs are also summarised. The WHO recommends that every individual should consume at least five servings or 400 grams of FVs per day. Epidemiological and clinical investigations have demonstrated that FVs contain numerous bioactive compounds with health-protecting activities. Despite their health benefits, the intake of FVs in LMICs remains low. Major barriers identified were socio-demographic factors, environmental conditions, individual and cultural factors, and macrosystem influences. These barriers may be lowered at the household, school, community, and national level through multi-component interventions including behaviour change communication (BCC) initiatives, nutrition education (NE), gardening initiatives, farm to institution programs (FIPs), food baskets, cash transfers, nutrition-agriculture policy and program linkages, and food-market environment-based strategies. This review has research implications due to the positive outcomes of strategies that lower such barriers and boost consumption of FVs in LMICs.
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Affiliation(s)
- Sukhdeep Kaur
- Department of Food and Nutrition, Punjab Agricultural University, Ludhiana, Punjab141004, India
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López-Moreno M, Garcés-Rimón M, Miguel-Castro M, Fernández-Martínez E, Iglesias López MT. Effect of Nutrition Education on Health Science University Students to Improve Cardiometabolic Profile and Inflammatory Status. Nutrients 2023; 15:4685. [PMID: 37960339 PMCID: PMC10648054 DOI: 10.3390/nu15214685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/31/2023] [Accepted: 11/03/2023] [Indexed: 11/15/2023] Open
Abstract
The inadequate lifestyle associated with university life may have a negative impact on various cardiometabolic factors. The aim of this study was to evaluate the effect of a one-year nutrition education course on cardiometabolic parameters in undergraduate health science students. During the 2021-22 academic year, 1.30 h nutrition sessions were conducted twice a week. Capillary blood samples were collected and centrifuged to measure cardiometabolic and inflammatory biomarkers in serum. The sample studied consisted of 49 students: 20.4% male and 79.6% female. The nutritional intervention resulted in changes in dietary patterns, with increased consumption of vegetables, nuts and legumes. After the course, females showed an increase in HDL-cholesterol levels (p = 0.007) and no change in LDL-cholesterol levels (p = 0.189). On the other hand, males showed significant changes in HDL-cholesterol (p = 0.001) and LDL-cholesterol (p = 0.043) levels. The atherogenic index was also significantly reduced (p < 0.001) in both males (p = 0.009) and females (p = 0.002). Differences were also observed in the increase in vitamin D levels in both males and females, although the magnitude of the increase was greater in the men (Δ = 7.94, p = 0.016 in men vs. Δ = 4.96, p = 0.001 in women). The monocyte-to-HDL ratio (MHR) showed a significant reduction, although these differences were only significant in males. Students with low vitamin D levels had higher LDL-cholesterol values (p = 0.01) and atherogenic index (p = 0.029). Adjusted linear regression analysis showed a significant association between post-course vitamin D MHR (β = -0.42, IC: -0.29, -0.06, p < 0.01). These findings suggest the importance of including nutrition education programs during the university stage for the prevention of long-term health problems.
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Affiliation(s)
- Miguel López-Moreno
- Instituto de Investigación en Ciencias de Alimentación, Consejo Superior de Investigaciones Científicas, Universidad Autónoma de Madrid, 28049 Madrid, Spain; (M.L.-M.); (M.G.-R.); (M.M.-C.)
- Grupo de Investigación en Biotecnología Alimentaria, Universidad Francisco de Vitoria, 28223 Madrid, Spain
| | - Marta Garcés-Rimón
- Instituto de Investigación en Ciencias de Alimentación, Consejo Superior de Investigaciones Científicas, Universidad Autónoma de Madrid, 28049 Madrid, Spain; (M.L.-M.); (M.G.-R.); (M.M.-C.)
- Grupo de Investigación en Biotecnología Alimentaria, Universidad Francisco de Vitoria, 28223 Madrid, Spain
| | - Marta Miguel-Castro
- Instituto de Investigación en Ciencias de Alimentación, Consejo Superior de Investigaciones Científicas, Universidad Autónoma de Madrid, 28049 Madrid, Spain; (M.L.-M.); (M.G.-R.); (M.M.-C.)
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Wiafe MA, Apprey C, Annan RA. Nutrition Education Improves Knowledge of Iron and Iron-Rich Food Intake Practices among Young Adolescents: A Nonrandomized Controlled Trial. INTERNATIONAL JOURNAL OF FOOD SCIENCE 2023; 2023:1804763. [PMID: 37020950 PMCID: PMC10070029 DOI: 10.1155/2023/1804763] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/16/2023] [Accepted: 03/18/2023] [Indexed: 03/30/2023]
Abstract
Introduction Nutrition education targeting adolescents' health has the potential to enhance their well-being into adulthood. This study assessed the impact of nutrition education on the knowledge of iron and iron-rich food intake practices of adolescents living in rural communities in Ghana. Method An intervention study was conducted among 137 adolescents; 69 were assigned to the intervention group and 68 to the control group. Participants and guardians in the intervention group were involved in the nutrition education programme for six months. Participants in both groups completed sociodemographic, knowledge of iron, and iron-rich food intake practice questionnaires at pre- and postintervention. Data were analyzed by chi-square and t-tests. Results At postintervention, the mean knowledge score (p < 0.05) in the intervention group and control group was 5.3 ± 1.7 and 3.9 ± 1.9, respectively. Interventions (76%) and controls (46%) had good knowledge status. The mean knowledge score of participants with good knowledge status in the intervention group was 6.1 ± 0.8 (p < 0.05), and the control group was 5.6 ± 0.7 (p < 0.05). Forty-two percent of participants in the interventions and 26% in the controls had good food intake status. Participants with good food intake status had mean food intake scores of 3.2 ± 0.4 (p < 0.05) and 3.8 ± 0.7 (p < 0.05) for the intervention and control groups, respectively. Both groups increased and had the same mean food intake score (1.5 ± 1.4, p > 0.05), however, relatively higher in the intervention group. Conclusion Nutrition education improved the knowledge of iron and iron-rich food intake practices of participants in the intervention group compared to the control group. Nutrition education should be a critical component in the management and prevention of micronutrient deficiency in adolescents.
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Affiliation(s)
- Michael Akenteng Wiafe
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, P. O. Box TL, 1350 Tamale, Ghana
| | - Charles Apprey
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Private Mail Bag, Ghana
| | - Reginald Adjetey Annan
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Private Mail Bag, Ghana
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Wiafe MA, Apprey C, Annan RA. Effectiveness of nutrition education and counselling programme on iron deficiency anaemia among adolescents: A study protocol of a randomized trial. Nutr Health 2022; 28:301-309. [PMID: 35617098 DOI: 10.1177/02601060221074433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND [GQ4]Adolescents tend to explore their dietary environment without prior consideration of their nutritional needs. This attitude is due to low nutrition knowledge and it contributes to micronutrient deficiency such as anaemia. The study aims to investigate the effect of nutrition education and counselling on dietary iron intake and iron status of early adolescents. METHODS/DESIGN One hundred and twenty-six early adolescents will be recruited and randomized to receive nutrition education (intervention group) and no nutrition education (control group) in the Asante-Akim South Municipality of Ghana. Data on socio-demographics, dietary factors, dietary intake, knowledge of iron and anaemia will be collected at baseline and post-intervention. Blood samples will be collected for haemoglobin, ferritin and c-reactive protein analyses. The primary outcome measures include haemoglobin and ferritin levels, secondary outcomes such as dietary iron intake, dietary vitamin C intake and knowledge level of iron will be assessed at pre-and post-intervention (6 months). The study will comply with the Consolidated Standards of Reporting Trials (CONSORT) for randomized trials. DISCUSSION The effectiveness of iron dietary guidelines developed will serve as a manual to aid, prevent and manage iron deficiency anaemia as well as reduce the prevalence of anaemia in the long term in Ghana.
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Affiliation(s)
| | - Charles Apprey
- 98763University of Science and Technology, Kumasi, Ghana
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Indriasari R, Nadjamuddin U, Arsyad DS, Iswarawanti DN. School-based nutrition education improves breakfast-related personal influences and behavior of Indonesian adolescents: a cluster randomized controlled study. Nutr Res Pract 2021; 15:639-654. [PMID: 34603611 PMCID: PMC8446687 DOI: 10.4162/nrp.2021.15.5.639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 09/10/2020] [Accepted: 09/23/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND/OBJECTIVES Many adolescents in developing countries skip breakfast. Innovative nutrition education (NE) strategies are needed to enhance knowledge and skills related to the breakfasts of adolescents in a low socioeconomic setting. The objective was to evaluate short- and long-term effects of a multi-strategy, school-based NE intervention on adolescents' breakfast-related personal influences and behaviors. SUBJECTS/METHODS An intervention study with a cluster randomized controlled trial design was conducted in 4 senior high schools in Makassar, Indonesia. The multi-strategy NE intervention was delivered for 3 months. Data were collected using a self-administered questionnaire and a 3-day breakfast recall (face-to-face interview). Wilcoxon, McNemar, and Mann-Whitney tests were used to determine intra- and intergroup differences. RESULTS Unlike knowledge, improvement was observed in attitude and self-efficacy scores in the intervention groups (IGs) (P < 0.01); however, no significant changes were observed in the control group (CG). More students showed improved motivation in the IG than in the CG (P > 0.05). Changes in breakfast frequency and macronutrient intake from breakfast were greater in the IG than in the CG (P < 0.05). CONCLUSIONS A multi-strategy NE intervention is effective in producing positive changes in breakfast-related attitude, self-efficacy, and motivation of adolescents from a low-middle socioeconomic setting. The intervention improved breakfast frequency and nutrient intake. This intervention has promise for sustaining the observed changes over the long-term.
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Affiliation(s)
- Rahayu Indriasari
- Department of Nutrition Science, Faculty of Public Health, Hasanuddin University, Makassar, South Sulawesi 90245, Indonesia.,Southeast Asian Ministers of Education Organization Regional Center for Food and Nutrition (SEAMEO RECFON)-Pusat Kajian Gizi Regional (PKGR) Universitas Indonesia, DKI Jakarta 10430, Indonesia
| | - Ulfah Nadjamuddin
- Department of Nutrition Science, Faculty of Public Health, Hasanuddin University, Makassar, South Sulawesi 90245, Indonesia
| | - Dian Sidik Arsyad
- Department of Epidemiology, Faculty of Public Health, Hasanuddin University, Makassar, South Sulawesi 90245, Indonesia
| | - Dwi Nastiti Iswarawanti
- Southeast Asian Ministers of Education Organization Regional Center for Food and Nutrition (SEAMEO RECFON)-Pusat Kajian Gizi Regional (PKGR) Universitas Indonesia, DKI Jakarta 10430, Indonesia.,Institute of Health Science of Kuningan, Kuningan, West Java 45561, Indonesia
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Zeynalzadeh Borjloo F, Dehdari T, Abolghasemi J, Amiri F, Vasheghani-Farahani A. The effect of a nutrition education intervention on knowledge, attitude, and intake of foods high in fats in women. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:216. [PMID: 34395653 PMCID: PMC8318140 DOI: 10.4103/jehp.jehp_1045_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 11/24/2020] [Indexed: 06/13/2023]
Abstract
BACKGROUND Given that many Iranian were interested in the consumption of foods that are high in fats, the present study was done to determine the effect of a nutrition education intervention on knowledge, attitude, and intake of foods high in fat among a sample of women in Tehran. MATERIALS AND METHODS In this quasi-experimental study, 92 female referrals to the health houses affiliated to Tehran municipal were selected and assigned to either intervention (n = 46) or control (n = 46) groups. Information (data) regarding women's knowledge, attitude, and practice in terms of foods rich in fat intake was collected by three questionnaires. Then, a nutrition education intervention included four 40-60 min training sessions over 4 weeks was designed and conducted to the study participants in the intervention group. Two groups were followed up 2 months after the intervention. Finally, all data were analyzed by using the independent-samples t-tests, Student's paired-samples t-test, and Pearson correlation analysis on the R software (version 6.3.2). RESULTS The results showed that there were significant reductions in a positive attitude towards food with high fat content and intake of these foods in the intervention group compared with the control group after the intervention (P < 0.001). Furthermore, following the intervention, the intervention group reported a significant increase in dietary fat nutrition knowledge than the control group (P < 0.001). CONCLUSION Developing nutrition education interventions is an effective strategy for reducing the consumption of foods rich in fat in Iranian women.
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Affiliation(s)
- Fatemeh Zeynalzadeh Borjloo
- Department of Health Education and Health Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Tahereh Dehdari
- Department of Health Education and Health Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Jamileh Abolghasemi
- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemehsadat Amiri
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Vasheghani-Farahani
- Department of Electrophysiology, Tehran Heart Center and Cardiac Primary Prevention Research Center, Cardiovascular Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Ng WWM, Wong ASW, Cheung K. A Cluster Randomized Controlled Trial Feasibility Study of a WhatsApp-Delivered Intervention to Promote Healthy Eating Habits in Male Firefighters. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126633. [PMID: 34203034 PMCID: PMC8296461 DOI: 10.3390/ijerph18126633] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 06/15/2021] [Accepted: 06/17/2021] [Indexed: 11/16/2022]
Abstract
This cluster randomized controlled trial (CRCT)-designed study aimed to explore the feasibility of a promotion pamphlet and/or WhatsApp as a suitable mode of delivery to promote healthy eating habits with fruit and vegetables (F&V) among firefighters. Convenience and snowball sampling methods were used. Forty-five firefighters from 23 fire stations were recruited and they all received the printed pamphlet, while the intervention group participants (n = 20) received additional teaching material through WhatsApp every two weeks for eight weeks. Feasibility outcomes included retention, practicality, and implementation. The participants reported high levels of satisfaction with the intervention. There were significant improvements in the mean numbers of days consuming F&V (p = 0.002; p = 0.031) in the intervention group, and for fruit consumption (p = 0.033) in the control group between the baseline (T0) and 3 months after completion of intervention (T1). High levels of participants’ satisfaction with the intervention revealed that a full-scale CRCT of the WhatsApp-delivered intervention promoting healthy eating could be feasible, especially as a means of increasing the numbers of days they consumed F&V and the numbers of servings of these consumed per day.
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Affiliation(s)
- Winnie Wing Man Ng
- Division of Science, Engineering and Health Studies, College of Professional and Continuing Education, No. 8 Hung Lok Road, Hung Hom, Hong Kong, China
- Correspondence: (W.W.M.N.); (K.C.)
| | - Anthony Siu Wo Wong
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China;
| | - Kin Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
- Correspondence: (W.W.M.N.); (K.C.)
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Nho JH, Chae SW. Effects of a Lifestyle Intervention on Health-Promoting Behavior, Psychological Distress and Reproductive Health of Overweight and Obese Female College Students. Healthcare (Basel) 2021; 9:309. [PMID: 33802119 PMCID: PMC8001345 DOI: 10.3390/healthcare9030309] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/05/2021] [Accepted: 03/08/2021] [Indexed: 12/02/2022] Open
Abstract
This study aimed to examine the effect of a lifestyle intervention (LSI) on overweight or obese female university students. Participants: A total of 53 overweight or obese female college students participated. This study was conducted from May to December 2017 in Jeonbuk Province, South Korea. A quasi-experimental design using a non-equivalent control group pretest-posttest was used. The LSI consisted of providing health information, individual health counseling, lifestyle monitoring, and effective support based on the interaction model of client health behavior, which was implemented for 12 weeks. Significant group differences were found in health-promoting behavior, psychological distress, reproductive health, body weight, body fat, and triglyceride level among participants. LSIs are effective in improving health-promoting behavior, psychological distress, reproductive health, and body composition. Therefore, healthcare providers should develop and apply LSIs through interaction for overweight or obese female college students.
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Affiliation(s)
- Ju-Hee Nho
- College of Nursing, Jeonbuk National University, Jeonju 54896, Korea
| | - Soo-Wan Chae
- Clinical Trial Center for Functional Foods, Jeonbuk National University Hospital, Jeonju 54907, Korea;
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Suliga E, Cieśla E, Michel S, Kaducakova H, Martin T, Śliwiński G, Braun A, Izova M, Lehotska M, Kozieł D, Głuszek S. Diet Quality Compared to the Nutritional Knowledge of Polish, German, and Slovakian University Students-Preliminary Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17239062. [PMID: 33291705 PMCID: PMC7730789 DOI: 10.3390/ijerph17239062] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/19/2020] [Accepted: 12/02/2020] [Indexed: 12/16/2022]
Abstract
The eating habits of students differ significantly from those recommended by health practitioners. The aim of this study was to find differences related to diet quality and knowledge on nutrition among Polish, German, and Slovakian students as well as to examine which factors differentiate the diet quality of students from these three countries. The study was conducted on a group of 394 university students from Poland, Germany, and Slovakia. The assessment of diet quality and knowledge on food and nutrition was done with the use of the Dietary Habits and Nutrition Beliefs Questionnaire. The diet of German students was characterized by a significantly higher consumption of legume-based foods, vegetables, and fruit compared to Polish students and Slovakian participants (p < 0.001). The diet of the Poles was characterized by a high consumption of cured meat, smoked sausages, hot dogs, white bread and bakery products, butter, fried foods, and energy drinks. The most important factors significantly associated with diet quality involved the country, place of residence, Body Mass Index (BMI), physical activity, and time spent watching TV or using a computer. Polish students were characterized by the highest level of knowledge on food and nutrition (p < 0.001). However, it was not reflected in their diet. The authorities of universities should aim to provide students with access to canteens on campuses which would offer the possibility of consumption of both affordable and healthy meals.
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Affiliation(s)
- Edyta Suliga
- Institute of Health Sciences, Medical College, Jan Kochanowski University, 25-369 Kielce, Poland; (E.S.); (D.K.)
| | - Elżbieta Cieśla
- Institute of Health Sciences, Medical College, Jan Kochanowski University, 25-369 Kielce, Poland; (E.S.); (D.K.)
- Correspondence:
| | - Sven Michel
- Institute of Ergonomics and Social Sciences, Faculty of Social Work, Health and Music, Brandenburg University of Technology Cottbus-Senftenberg, 03048 Cottbus, Germany; (S.M.); (T.M.); (A.B.)
| | - Helena Kaducakova
- Department of Nursing, Faculty of Health, Catholic University in Ružomberok, 03401 Ružomberok, Slovakia; (H.K.); (M.I.); (M.L.)
| | - Titus Martin
- Institute of Ergonomics and Social Sciences, Faculty of Social Work, Health and Music, Brandenburg University of Technology Cottbus-Senftenberg, 03048 Cottbus, Germany; (S.M.); (T.M.); (A.B.)
| | - Grzegorz Śliwiński
- Institute of Biomedical Engineering, Technical University in Dresden, 01069 Dresden, Germany;
| | - Alexander Braun
- Institute of Ergonomics and Social Sciences, Faculty of Social Work, Health and Music, Brandenburg University of Technology Cottbus-Senftenberg, 03048 Cottbus, Germany; (S.M.); (T.M.); (A.B.)
| | - Marcela Izova
- Department of Nursing, Faculty of Health, Catholic University in Ružomberok, 03401 Ružomberok, Slovakia; (H.K.); (M.I.); (M.L.)
| | - Maria Lehotska
- Department of Nursing, Faculty of Health, Catholic University in Ružomberok, 03401 Ružomberok, Slovakia; (H.K.); (M.I.); (M.L.)
| | - Dorota Kozieł
- Institute of Health Sciences, Medical College, Jan Kochanowski University, 25-369 Kielce, Poland; (E.S.); (D.K.)
| | - Stanisław Głuszek
- Institute of Medical Sciences, Medical College, Jan Kochanowski University, 25-369 Kielce, Poland;
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Ng WM, Cheung K. A feasibility study of a WhatsApp-delivered Transtheoretical Model-based intervention to promote healthy eating habits for firefighters in Hong Kong: a cluster randomized controlled trial. Trials 2020; 21:518. [PMID: 32532313 PMCID: PMC7291567 DOI: 10.1186/s13063-020-04258-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 03/15/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Firefighters' health is often affected by a high prevalence of obesity and cardiovascular diseases, which are common risk factors for sudden cardiac death. The aim of this study is to investigate the feasibility of enhancing healthy eating habits in firefighters through an education programme. METHODS This will be a cluster randomized control trial study. The participants will be assigned randomly into either control (health promotion pamphlet) or intervention (health promotion pamphlet and education materials through WhatsApp) groups. Changes in healthy eating habits will be assessed by a self-administered questionnaire and anthropometric measurements at three different time points. DISCUSSION More education is required in order to improve firefighters' eating habits. TRIAL REGISTRATION ISRCTN registry identifier: Registered on 8 April 2019 ISRCTN95472464.
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Affiliation(s)
- Wing Man Ng
- Division of Science, Engineering and Health Studies, College of Professional and Continuing Education, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
| | - Kin Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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Rouf A, Nour M, Allman-Farinelli M. Improving Calcium Knowledge and Intake in Young Adults Via Social Media and Text Messages: Randomized Controlled Trial. JMIR Mhealth Uhealth 2020; 8:e16499. [PMID: 32044755 PMCID: PMC7055802 DOI: 10.2196/16499] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 11/04/2019] [Accepted: 11/13/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Calcium is an important nutrient for the attainment of peak bone mass during adolescence and young adulthood. However, these life phases are characterized as hard to reach for health promotion. Social media platforms offer a promising channel as they are relatively low cost but used ubiquitously by youth. OBJECTIVE The aim of the CAlcium Nutrition-Dietary Opportunities (CAN-DO) study was to conduct a randomized controlled trial to test the effectiveness of Facebook alone or with text messaging as channels to deliver a theory-based program to encourage optimal calcium intake. METHODS The intervention was a 3-arm parallel trial. Young adults aged 18 to 25 years were recruited through university and social media for a 6-week trial. Participants were randomized to 1 of the 3 arms (ie, Facebook posts, Facebook posts plus text messages, and control group that received an electronic leaflet containing information on calcium intake). The primary outcome was change in intake of milk and other calcium-rich foods, and secondary outcomes were knowledge, self-efficacy, motivation, and habit formation concerning calcium-rich foods. Changes were assessed before and after the intervention, and the differences in change between groups were compared using multivariate regression models with multiple imputations for missing data. RESULTS A total of 211 participants (64/211, 30.3% males) participated (mean age 21.4 years, SD 2.1) in this study. At the end of the program, no increase in milk intake (odds ratio [OR] 1.51, 95% CI 0.61-3.75 Facebook; OR 1.77, 95% CI 0.74-4.24 Facebook plus text messages; P=.41) nor calcium-rich food was detected (P=.57). There was a significant improvement in knowledge in the Facebook plus text messages group (P<.001), but habit formation improved less than that in the other 2 groups (P=.01). Our results showed a moderate level of engagement with intervention content and positive qualitative feedback from participants. CONCLUSIONS The CAN-DO study delivered via Facebook (with the additional support of text messages) was found to improve knowledge and was acceptable among young adults. However, further research is needed to better understand social media engagement and how to optimize the program for participants to be sufficiently motivated to increase their intake of calcium-rich foods. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12620000097943; http://www.anzctr.org.au/ACTRN12620000097943.aspx.
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Affiliation(s)
- Anika Rouf
- The University of Sydney, School of Life and Environmental Sciences, Camperdown, Australia
| | - Monica Nour
- The University of Sydney, School of Life and Environmental Sciences, Camperdown, Australia
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von Philipsborn P, Stratil JM, Burns J, Busert LK, Pfadenhauer LM, Polus S, Holzapfel C, Hauner H, Rehfuess E. Environmental interventions to reduce the consumption of sugar-sweetened beverages and their effects on health. Cochrane Database Syst Rev 2019; 6:CD012292. [PMID: 31194900 PMCID: PMC6564085 DOI: 10.1002/14651858.cd012292.pub2] [Citation(s) in RCA: 104] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Frequent consumption of excess amounts of sugar-sweetened beverages (SSB) is a risk factor for obesity, type 2 diabetes, cardiovascular disease and dental caries. Environmental interventions, i.e. interventions that alter the physical or social environment in which individuals make beverage choices, have been advocated as a means to reduce the consumption of SSB. OBJECTIVES To assess the effects of environmental interventions (excluding taxation) on the consumption of sugar-sweetened beverages and sugar-sweetened milk, diet-related anthropometric measures and health outcomes, and on any reported unintended consequences or adverse outcomes. SEARCH METHODS We searched 11 general, specialist and regional databases from inception to 24 January 2018. We also searched trial registers, reference lists and citations, scanned websites of relevant organisations, and contacted study authors. SELECTION CRITERIA We included studies on interventions implemented at an environmental level, reporting effects on direct or indirect measures of SSB intake, diet-related anthropometric measures and health outcomes, or any reported adverse outcome. We included randomised controlled trials (RCTs), non-randomised controlled trials (NRCTs), controlled before-after (CBA) and interrupted-time-series (ITS) studies, implemented in real-world settings with a combined length of intervention and follow-up of at least 12 weeks and at least 20 individuals in each of the intervention and control groups. We excluded studies in which participants were administered SSB as part of clinical trials, and multicomponent interventions which did not report SSB-specific outcome data. We excluded studies on the taxation of SSB, as these are the subject of a separate Cochrane Review. DATA COLLECTION AND ANALYSIS Two review authors independently screened studies for inclusion, extracted data and assessed the risks of bias of included studies. We classified interventions according to the NOURISHING framework, and synthesised results narratively and conducted meta-analyses for two outcomes relating to two intervention types. We assessed our confidence in the certainty of effect estimates with the GRADE framework as very low, low, moderate or high, and presented 'Summary of findings' tables. MAIN RESULTS We identified 14,488 unique records, and assessed 1030 in full text for eligibility. We found 58 studies meeting our inclusion criteria, including 22 RCTs, 3 NRCTs, 14 CBA studies, and 19 ITS studies, with a total of 1,180,096 participants. The median length of follow-up was 10 months. The studies included children, teenagers and adults, and were implemented in a variety of settings, including schools, retailing and food service establishments. We judged most studies to be at high or unclear risk of bias in at least one domain, and most studies used non-randomised designs. The studies examine a broad range of interventions, and we present results for these separately.Labelling interventions (8 studies): We found moderate-certainty evidence that traffic-light labelling is associated with decreasing sales of SSBs, and low-certainty evidence that nutritional rating score labelling is associated with decreasing sales of SSBs. For menu-board calorie labelling reported effects on SSB sales varied.Nutrition standards in public institutions (16 studies): We found low-certainty evidence that reduced availability of SSBs in schools is associated with decreased SSB consumption. We found very low-certainty evidence that improved availability of drinking water in schools and school fruit programmes are associated with decreased SSB consumption. Reported associations between improved availability of drinking water in schools and student body weight varied.Economic tools (7 studies): We found moderate-certainty evidence that price increases on SSBs are associated with decreasing SSB sales. For price discounts on low-calorie beverages reported effects on SSB sales varied.Whole food supply interventions (3 studies): Reported associations between voluntary industry initiatives to improve the whole food supply and SSB sales varied.Retail and food service interventions (7 studies): We found low-certainty evidence that healthier default beverages in children's menus in chain restaurants are associated with decreasing SSB sales, and moderate-certainty evidence that in-store promotion of healthier beverages in supermarkets is associated with decreasing SSB sales. We found very low-certainty evidence that urban planning restrictions on new fast-food restaurants and restrictions on the number of stores selling SSBs in remote communities are associated with decreasing SSB sales. Reported associations between promotion of healthier beverages in vending machines and SSB intake or sales varied.Intersectoral approaches (8 studies): We found moderate-certainty evidence that government food benefit programmes with restrictions on purchasing SSBs are associated with decreased SSB intake. For unrestricted food benefit programmes reported effects varied. We found moderate-certainty evidence that multicomponent community campaigns focused on SSBs are associated with decreasing SSB sales. Reported associations between trade and investment liberalisation and SSB sales varied.Home-based interventions (7 studies): We found moderate-certainty evidence that improved availability of low-calorie beverages in the home environment is associated with decreased SSB intake, and high-certainty evidence that it is associated with decreased body weight among adolescents with overweight or obesity and a high baseline consumption of SSBs.Adverse outcomes reported by studies, which may occur in some circumstances, included negative effects on revenue, compensatory SSB consumption outside school when the availability of SSBs in schools is reduced, reduced milk intake, stakeholder discontent, and increased total energy content of grocery purchases with price discounts on low-calorie beverages, among others. The certainty of evidence on adverse outcomes was low to very low for most outcomes.We analysed interventions targeting sugar-sweetened milk separately, and found low- to moderate-certainty evidence that emoticon labelling and small prizes for the selection of healthier beverages in elementary school cafeterias are associated with decreased consumption of sugar-sweetened milk. We found low-certainty evidence that improved placement of plain milk in school cafeterias is not associated with decreasing sugar-sweetened milk consumption. AUTHORS' CONCLUSIONS The evidence included in this review indicates that effective, scalable interventions addressing SSB consumption at a population level exist. Implementation should be accompanied by high-quality evaluations using appropriate study designs, with a particular focus on the long-term effects of approaches suitable for large-scale implementation.
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Affiliation(s)
- Peter von Philipsborn
- Ludwig‐Maximilians‐University MunichInstitute for Medical Informatics, Biometry and Epidemiology, Pettenkofer School of Public HealthMarchioninistr. 15MunichBavariaGermany81377
| | - Jan M Stratil
- Ludwig‐Maximilians‐University MunichInstitute for Medical Informatics, Biometry and Epidemiology, Pettenkofer School of Public HealthMarchioninistr. 15MunichBavariaGermany81377
| | - Jacob Burns
- Ludwig‐Maximilians‐University MunichInstitute for Medical Informatics, Biometry and Epidemiology, Pettenkofer School of Public HealthMarchioninistr. 15MunichBavariaGermany81377
| | - Laura K Busert
- University College LondonGreat Ormond Street Institute of Child HealthLondonUK
| | - Lisa M Pfadenhauer
- Ludwig‐Maximilians‐University MunichInstitute for Medical Informatics, Biometry and Epidemiology, Pettenkofer School of Public HealthMarchioninistr. 15MunichBavariaGermany81377
| | - Stephanie Polus
- Ludwig‐Maximilians‐University MunichInstitute for Medical Informatics, Biometry and Epidemiology, Pettenkofer School of Public HealthMarchioninistr. 15MunichBavariaGermany81377
| | - Christina Holzapfel
- School of Medicine, Technical University of MunichInstitute of Nutritional Medicine, Else Kroener‐Fresenius Centre for Nutritional MedicineMunichGermany
| | - Hans Hauner
- School of Medicine, Technical University of MunichInstitute of Nutritional Medicine, Else Kroener‐Fresenius Centre for Nutritional MedicineMunichGermany
| | - Eva Rehfuess
- Ludwig‐Maximilians‐University MunichInstitute for Medical Informatics, Biometry and Epidemiology, Pettenkofer School of Public HealthMarchioninistr. 15MunichBavariaGermany81377
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16
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Uma E, Theng KS, Yi LLH, Yun LH, Varghese E, Soe HHK. Comparison of Salivary pH Changes after Consumption of Two Sweetened Malaysian Local Drinks among Individuals with Low Caries Experience: A Pilot Study. Malays J Med Sci 2019; 25:100-111. [PMID: 30914852 PMCID: PMC6422535 DOI: 10.21315/mjms2018.25.4.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 07/12/2018] [Indexed: 11/13/2022] Open
Abstract
Background Regular consumption of sweetened beverages has been associated with dental caries, which is mediated through salivary pH. The salivary pH changes among individuals with low caries experience after consumption of two local sweetened drinks is compared. Methods In this block randomised controlled parallel group, an open-label pilot study of 49 participants aged 21–25 were selected. The participants were randomised into three groups: mineral water, chocolate drink and sirap bandung. One day prior to the test, scaling was done and the participants did not eat or drink anything on the test day till the saliva sample collection was done. Salivary pH was measured at baseline and after the consumption of the drinks with a glass electrode digital pH meter at five-minute interval for half an hour. The statistical significance was assessed at the level of 5%. Results After consumption of chocolate drink and sirap bandung, the salivary pH dropped from a baseline of 7.09 for chocolate drink and 7.13 for sirap bandung to 6.69 for chocolate and 6.86 for sirap bandung. This difference was statistically significant (P < 0.001). Conclusion Sweetened milk based local drinks can increase the caries susceptibility. In the community, information about limiting the intake of sweetened drinks should be reinforced.
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Affiliation(s)
- Eswara Uma
- Department of Pediatric Dentistry, Faculty of Dentistry, Melaka Manipal Medical College (MMMC), Manipal Academy of Higher Education (MAHE), Malaysia
| | - Kan Sze Theng
- Tiew Dental Clinic, Petaling Jaya, Kuala Lumpur, Malaysia
| | | | | | - Eby Varghese
- Department of Pediatric Dentistry, Faculty of Dentistry, Melaka Manipal Medical College (MMMC), Manipal Academy of Higher Education (MAHE), Malaysia
| | - Htoo Htoo Kyaw Soe
- Research Methodology and Biostatistics Unit, Department of Community Medicine, Faculty of Medicine, Melaka Manipal Medical College (MMMC), Manipal Academy of Higher Education (MAHE), Malaysia
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Hallit S, Hallit R, Haddad C, Youssef L, Zoghbi M, Costantine R, Kheir N, Salameh P. Previous, current, and cumulative dose effect of waterpipe smoking on LDL and total cholesterol. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:8194-8201. [PMID: 30694434 DOI: 10.1007/s11356-019-04311-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 01/22/2019] [Indexed: 06/09/2023]
Abstract
The popularity of waterpipe smoking is dramatically increasing in Lebanon, reaching 36.9%, the highest among countries in the region. To the best of our knowledge, no studies have assessed the impact of waterpipe smoking on lipid levels in the Lebanese population. Therefore, the objective of the study was to evaluate the correlation between waterpipe smoking and LDL-C and total cholesterol levels in exclusive Lebanese waterpipe smokers compared to non-smokers. This cross-sectional study was conducted between October 2016 and February 2017, enrolling 308 patients (156 non-smokers and 147 waterpipe smokers) from four laboratories. Current and previous WS (beta = 66.64 and beta = 71.49) were significantly associated with higher LDL scores. Current WS was significantly associated with and total cholesterol levels (beta = 34.12). Cumulative WS (number of waterpipes per week × duration in years) was significantly associated with higher LDL-C and total cholesterol levels respectively (p < 0.001 for all 3 variables). The university level of education (beta = 8.89) and current alcohol drinking (beta = 8.81) were significantly associated with higher LDL scores. Our study demonstrated an association between previous or current waterpipe smoking and lipid level. Future research are needed to detect the direct cause of the relation between waterpipe smoking and CVD. Concerned authorities should set up awareness campaigns to increase alertness on dangers of WS and dependence, and encourage these young adults to embrace health-promoting behaviors.
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Affiliation(s)
- Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
- INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie - Liban, Beirut, Lebanon.
| | - Rabih Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Chadia Haddad
- Research Department, Psychiatric Hospital of the Cross, P.O. Box 60096, Jal Eddib, Lebanon
| | - Lara Youssef
- Department of Nursing and Health Sciences, Notre-Dame University, Shouf, Lebanon
| | - Marouan Zoghbi
- Research Department, Psychiatric Hospital of the Cross, P.O. Box 60096, Jal Eddib, Lebanon
- Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
| | | | - Nelly Kheir
- Faculty of Pedagogy, Université de la Sainte Famille, Batroun, Lebanon
| | - Pascale Salameh
- INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie - Liban, Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
- Faculty of Medicine, Lebanese University, Beirut, Lebanon
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18
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Combest S, Warren C. Perceptions of college students in consuming whole grain foods made with Brewers' Spent Grain. Food Sci Nutr 2019; 7:225-237. [PMID: 30680176 PMCID: PMC6341135 DOI: 10.1002/fsn3.872] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 10/02/2018] [Accepted: 09/21/2018] [Indexed: 12/21/2022] Open
Abstract
One-third of all food produced for human consumption is wasted producing landfill accumulation and greenhouse gas emissions. Brewers' Spent Grains (BSGs) are the leftover grains from beer production, and each year approximately 30 million tons of BSG is generated globally by the brewing industry. Reclaiming BSG as a potential human food source is an opportunity for reducing food waste in the food supply chain. Six focus groups were conducted using 37 college students to determine their consumption of whole grains, perceptions of whole grains versus refined grains, and interest in or barriers related to consuming and purchasing foods made with BSG. Focus groups were transcribed verbatim and analyzed using constant comparative analysis to identify themes and discover relationships among the study aims. Thirteen themes emerged from focus group discussions with Concept of Health, Sensory, and Experience with BSG representing the top three discussed. Participants believed whole grains are healthier and contain more nutrients than refined grains. Most participants enjoyed the BSG foods provided; however, some noted a darker appearance and lingering fiber particles or aftertaste. Findings indicate participants who are hereditary whole grain consumers are acculturated to whole grain sensory attributes and nutritional benefits and would be more receptive to consuming BSG foods in future studies. We concluded most focus group participants were open to tasting BSG foods, but hereditary whole grain consumers should be the target consumer audience, and educating consumers on sensory attributes, potential health benefits, and environmental benefits is necessary to overcome the barriers associated with BSG.
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Affiliation(s)
- Shannon Combest
- Department of Nutrition and Food SciencesTexas Woman's UniversityDentonTexas
| | - Cynthia Warren
- Department of Nutrition and Food SciencesTexas Woman's UniversityDentonTexas
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19
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Adherence of Malaysian Adults' Energy and Macronutrient Intakes to National Recommendations: A Review and Meta-Analysis. Nutrients 2018; 10:nu10111584. [PMID: 30373303 PMCID: PMC6266340 DOI: 10.3390/nu10111584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 10/05/2018] [Accepted: 10/16/2018] [Indexed: 01/22/2023] Open
Abstract
The present study examined the best available evidence regarding energy and macronutrient intake during adulthood (age 19 to 59 years) in Malaysia and assessed whether intakes adhere to national recommendations, in order to develop recommendations for dietary improvement based on population consumption patterns. A literature review and meta-analysis evaluated intake based on the following characteristics, using information from food balance sheets, national surveys, and individual studies: (1) levels of intake, (2) proportion of the population whose diets adhere to/exceed/fail to meet Malaysian Recommended Nutrient Intake (RNI) levels, and (3) sources of macronutrients observed in these studies. Food balance data suggested high levels of available energy, animal source protein, vegetable fat, and refined carbohydrates. Twenty studies (five nationwide, 15 individual) indicated that Malaysian adults generally met or exceeded recommendations for fat and protein, but were inconsistent with respect to energy and carbohydrates. Information on dietary sources was limited. Due to methodological limitations, insufficient evidence exists regarding energy and macronutrient intakes of Malaysian adults. Improved dietary assessment methods (including use of biomarkers), better data analysis, and updated food composition data, will provide more reliable information on which to base policy decisions and recommendations for improvement.
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20
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Vargas-Garcia EJ, Evans CEL, Prestwich A, Sykes-Muskett BJ, Hooson J, Cade JE. Interventions to reduce consumption of sugar-sweetened beverages or increase water intake: evidence from a systematic review and meta-analysis. Obes Rev 2017; 18:1350-1363. [PMID: 28721697 DOI: 10.1111/obr.12580] [Citation(s) in RCA: 126] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 05/12/2017] [Accepted: 05/15/2017] [Indexed: 12/13/2022]
Abstract
A systematic review and meta-analyses were conducted to evaluate the effects of interventions to reduce sugar-sweetened beverages (SSB) or increase water intakes and to examine the impact of behaviour change techniques (BCTs) in consumption patterns. Randomized and nonrandomized controlled trials published after January 1990 and until December 2016 reporting daily changes in intakes of SSB or water in volumetric measurements (mL d-1 ) were included. References were retrieved through searches of electronic databases and quality appraisal followed Cochrane principles. We calculated mean differences (MD) and synthesized data with random-effects models. Forty studies with 16 505 participants were meta-analysed. Interventions significantly decreased consumption of SSB in children by 76 mL d-1 (95% confidence interval [CI] -105 to -46; 23 studies, P < 0.01), and in adolescents (-66 mL d-1 , 95% CI -130 to -2; 5 studies, P = 0.04) but not in adults (-13 mL d-1 , 95% CI -44 to 18; 12 studies, P = 0.16). Pooled estimates of water intakes were only possible for interventions in children, and results were indicative of increases in water intake (MD +67 mL d-1 , 95% CI 6 to 128; 7 studies, P = 0.04). For children, there was evidence to suggest that modelling/demonstrating the behaviour helped to reduce SSB intake and that interventions within the home environment had greater effects than school-based interventions. In conclusion, public health interventions - mainly via nutritional education/counselling - are moderately successful at reducing intakes of SSB and increasing water intakes in children. However, on average, only small reductions in SSBs have been achieved by interventions targeting adolescents and adults. Complementary measures may be needed to achieve greater improvements in both dietary behaviours across all age groups.
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Affiliation(s)
- E J Vargas-Garcia
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - C E L Evans
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - A Prestwich
- School of Psychology, University of Leeds, Leeds, UK
| | | | - J Hooson
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - J E Cade
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
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21
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Yahia N, Brown CA, Rapley M, Chung M. Level of nutrition knowledge and its association with fat consumption among college students. BMC Public Health 2016; 16:1047. [PMID: 27716127 PMCID: PMC5050673 DOI: 10.1186/s12889-016-3728-z] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 09/22/2016] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Intake of saturated fat, trans fat, and cholesterol has been associated with increased risk of coronary heart disease. The aim of this study was to explore whether increased nutrition knowledge is associated with a reduction in the consumption of unhealthy fats in a sample of university students. METHODS A sample of 231 students, with a mean age of 20 years, was recruited from university campus during spring 2012. Students completed a validated questionnaire related to students' demographic, nutrition knowledge, and daily fat consumption. Weight, height, and waist circumference were measured. Data were analyzed using one-way ANOVA, chi-square, and student's t-test. RESULTS Results indicate that female students have greater nutrition knowledge than male students (the mean nutrition score for women was 5 points higher than that of men (P = 0.01)). Nutrition knowledge was negatively correlated with fat and cholesterol intake. Students who consumed more than 35 % calories from fat or >300 mg of cholesterol daily had lower mean nutrition scores than those students with lower fat or cholesterol intake (8 points lower and 7.9 points lower, respectively). Using linear regression for nutrition scores on estimated saturated fat intake and cholesterol intake (controlling for gender, height, weight, age, and dieting), nutrition scores were negatively associated with saturated fat intake (-0.15, P <0.0001) and cholesterol intake (-1.38, P <0.0001). CONCLUSION Students with greater nutritional knowledge consumed less unhealthy fats and cholesterol. This finding magnifies the role of nutrition education as a potential tool in health campaigns to promote healthy eating patterns among college students. Results of this pilot study can inform the design of future nutrition education intervention studies to assess the efficacy of nutrition knowledge on pattern of fat consumption among college students.
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Affiliation(s)
- Najat Yahia
- Department of Human Environmental Studies, Central Michigan University, Wightman 108, Mt. Pleasant, MI 48859 USA
| | - Carrie A. Brown
- Jean Mayer USDA Human Nutrition Center on Aging at Tufts University, Boston, MA USA
- Department of Biostatistics, Boston University, 801 Massachusetts Avenue, Boston, MA 02118 USA
| | - Melyssa Rapley
- Department of Human Environmental Studies, Central Michigan University, Wightman 108, Mt. Pleasant, MI 48859 USA
| | - Mei Chung
- Department of Public Health and Family Medicine, Tufts University School of Medicine, 136 Harrison Avenue, Jaharis 264, Boston, MA 02111 USA
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Abulmeaty MM. Multimodal-lifestyle intervention produces reduction of the fat mass rather than body weight loss in men with obesity: A prospective cohort study. NUTR CLIN METAB 2016. [DOI: 10.1016/j.nupar.2016.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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23
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Jih J, Le G, Woo K, Tsoh JY, Stewart S, Gildengorin G, Burke A, Wong C, Chan E, Fung LC, Yu F, Pasick R, McPhee SJ, Nguyen TT. Educational Interventions to Promote Healthy Nutrition and Physical Activity Among Older Chinese Americans: A Cluster-Randomized Trial. Am J Public Health 2016; 106:1092-8. [PMID: 26985605 PMCID: PMC4880259 DOI: 10.2105/ajph.2016.303111] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2016] [Indexed: 12/25/2022]
Abstract
OBJECTIVES To evaluate the efficacy of an in-language intervention of 2 lectures plus printed materials versus printed materials alone on knowledge and adherence to nutrition and physical activity guidelines among older Chinese Americans in San Francisco, California. METHODS From August 2010 to September 2013, we randomized 756 Chinese Americans aged 50 to 75 years to either lectures plus print (n = 361) or print (n = 357). Clusters were the participants recruited by each lay health worker. Intervention outcomes were changes in knowledge of recommended vegetable intake, fruit intake, and physical activity level and adherence to those recommendations from pre- to 6 months postintervention. RESULTS The retention rate was 99%. At baseline, knowledge and adherence to recommendations were low. Print yielded increases in knowledge of recommended vegetable intake and physical activity level and adherence to fruit intake and physical activity recommendations. Lectures plus print had significant increases in all 6 outcomes. In multivariable models, lectures plus print was superior to print for knowledge of vegetable (adjusted odds ratio [AOR] = 12.61; 95% confidence interval [CI] = 6.50, 24.45) and fruit (AOR = 16.16; 95% CI = 5.61, 46.51) intake recommendations and adherence to vegetable intake recommendations (AOR = 5.53; 95% CI = 1.96, 15.58). CONCLUSIONS In-language print materials, alone and combined with lectures, increased nutrition and physical activity knowledge and behaviors among older Chinese Americans.
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Affiliation(s)
- Jane Jih
- Jane Jih, Gem Le, Ginny Gildengorin, Ching Wong, Filmer Yu, Rena Pasick, Stephen J. McPhee, and Tung T. Nguyen are with the Division of General Internal Medicine, University of California, San Francisco. Kent Woo and Elaine Chan are with the NICOS Chinese Health Coalition, San Francisco, CA. Janice Y. Tsoh is with the Department of Psychiatry, University of California, San Francisco. Susan Stewart is with the Department of Public Health Sciences, University of California, Davis. Adam Burke is with the Department of Health Education, San Francisco State University, San Francisco. Lei-Chun Fung is with the Chinatown Public Health Center, San Francisco.Department of Public Health, San Francisco
| | - Gem Le
- Jane Jih, Gem Le, Ginny Gildengorin, Ching Wong, Filmer Yu, Rena Pasick, Stephen J. McPhee, and Tung T. Nguyen are with the Division of General Internal Medicine, University of California, San Francisco. Kent Woo and Elaine Chan are with the NICOS Chinese Health Coalition, San Francisco, CA. Janice Y. Tsoh is with the Department of Psychiatry, University of California, San Francisco. Susan Stewart is with the Department of Public Health Sciences, University of California, Davis. Adam Burke is with the Department of Health Education, San Francisco State University, San Francisco. Lei-Chun Fung is with the Chinatown Public Health Center, San Francisco.Department of Public Health, San Francisco
| | - Kent Woo
- Jane Jih, Gem Le, Ginny Gildengorin, Ching Wong, Filmer Yu, Rena Pasick, Stephen J. McPhee, and Tung T. Nguyen are with the Division of General Internal Medicine, University of California, San Francisco. Kent Woo and Elaine Chan are with the NICOS Chinese Health Coalition, San Francisco, CA. Janice Y. Tsoh is with the Department of Psychiatry, University of California, San Francisco. Susan Stewart is with the Department of Public Health Sciences, University of California, Davis. Adam Burke is with the Department of Health Education, San Francisco State University, San Francisco. Lei-Chun Fung is with the Chinatown Public Health Center, San Francisco.Department of Public Health, San Francisco
| | - Janice Y Tsoh
- Jane Jih, Gem Le, Ginny Gildengorin, Ching Wong, Filmer Yu, Rena Pasick, Stephen J. McPhee, and Tung T. Nguyen are with the Division of General Internal Medicine, University of California, San Francisco. Kent Woo and Elaine Chan are with the NICOS Chinese Health Coalition, San Francisco, CA. Janice Y. Tsoh is with the Department of Psychiatry, University of California, San Francisco. Susan Stewart is with the Department of Public Health Sciences, University of California, Davis. Adam Burke is with the Department of Health Education, San Francisco State University, San Francisco. Lei-Chun Fung is with the Chinatown Public Health Center, San Francisco.Department of Public Health, San Francisco
| | - Susan Stewart
- Jane Jih, Gem Le, Ginny Gildengorin, Ching Wong, Filmer Yu, Rena Pasick, Stephen J. McPhee, and Tung T. Nguyen are with the Division of General Internal Medicine, University of California, San Francisco. Kent Woo and Elaine Chan are with the NICOS Chinese Health Coalition, San Francisco, CA. Janice Y. Tsoh is with the Department of Psychiatry, University of California, San Francisco. Susan Stewart is with the Department of Public Health Sciences, University of California, Davis. Adam Burke is with the Department of Health Education, San Francisco State University, San Francisco. Lei-Chun Fung is with the Chinatown Public Health Center, San Francisco.Department of Public Health, San Francisco
| | - Ginny Gildengorin
- Jane Jih, Gem Le, Ginny Gildengorin, Ching Wong, Filmer Yu, Rena Pasick, Stephen J. McPhee, and Tung T. Nguyen are with the Division of General Internal Medicine, University of California, San Francisco. Kent Woo and Elaine Chan are with the NICOS Chinese Health Coalition, San Francisco, CA. Janice Y. Tsoh is with the Department of Psychiatry, University of California, San Francisco. Susan Stewart is with the Department of Public Health Sciences, University of California, Davis. Adam Burke is with the Department of Health Education, San Francisco State University, San Francisco. Lei-Chun Fung is with the Chinatown Public Health Center, San Francisco.Department of Public Health, San Francisco
| | - Adam Burke
- Jane Jih, Gem Le, Ginny Gildengorin, Ching Wong, Filmer Yu, Rena Pasick, Stephen J. McPhee, and Tung T. Nguyen are with the Division of General Internal Medicine, University of California, San Francisco. Kent Woo and Elaine Chan are with the NICOS Chinese Health Coalition, San Francisco, CA. Janice Y. Tsoh is with the Department of Psychiatry, University of California, San Francisco. Susan Stewart is with the Department of Public Health Sciences, University of California, Davis. Adam Burke is with the Department of Health Education, San Francisco State University, San Francisco. Lei-Chun Fung is with the Chinatown Public Health Center, San Francisco.Department of Public Health, San Francisco
| | - Ching Wong
- Jane Jih, Gem Le, Ginny Gildengorin, Ching Wong, Filmer Yu, Rena Pasick, Stephen J. McPhee, and Tung T. Nguyen are with the Division of General Internal Medicine, University of California, San Francisco. Kent Woo and Elaine Chan are with the NICOS Chinese Health Coalition, San Francisco, CA. Janice Y. Tsoh is with the Department of Psychiatry, University of California, San Francisco. Susan Stewart is with the Department of Public Health Sciences, University of California, Davis. Adam Burke is with the Department of Health Education, San Francisco State University, San Francisco. Lei-Chun Fung is with the Chinatown Public Health Center, San Francisco.Department of Public Health, San Francisco
| | - Elaine Chan
- Jane Jih, Gem Le, Ginny Gildengorin, Ching Wong, Filmer Yu, Rena Pasick, Stephen J. McPhee, and Tung T. Nguyen are with the Division of General Internal Medicine, University of California, San Francisco. Kent Woo and Elaine Chan are with the NICOS Chinese Health Coalition, San Francisco, CA. Janice Y. Tsoh is with the Department of Psychiatry, University of California, San Francisco. Susan Stewart is with the Department of Public Health Sciences, University of California, Davis. Adam Burke is with the Department of Health Education, San Francisco State University, San Francisco. Lei-Chun Fung is with the Chinatown Public Health Center, San Francisco.Department of Public Health, San Francisco
| | - Lei-Chun Fung
- Jane Jih, Gem Le, Ginny Gildengorin, Ching Wong, Filmer Yu, Rena Pasick, Stephen J. McPhee, and Tung T. Nguyen are with the Division of General Internal Medicine, University of California, San Francisco. Kent Woo and Elaine Chan are with the NICOS Chinese Health Coalition, San Francisco, CA. Janice Y. Tsoh is with the Department of Psychiatry, University of California, San Francisco. Susan Stewart is with the Department of Public Health Sciences, University of California, Davis. Adam Burke is with the Department of Health Education, San Francisco State University, San Francisco. Lei-Chun Fung is with the Chinatown Public Health Center, San Francisco.Department of Public Health, San Francisco
| | - Filmer Yu
- Jane Jih, Gem Le, Ginny Gildengorin, Ching Wong, Filmer Yu, Rena Pasick, Stephen J. McPhee, and Tung T. Nguyen are with the Division of General Internal Medicine, University of California, San Francisco. Kent Woo and Elaine Chan are with the NICOS Chinese Health Coalition, San Francisco, CA. Janice Y. Tsoh is with the Department of Psychiatry, University of California, San Francisco. Susan Stewart is with the Department of Public Health Sciences, University of California, Davis. Adam Burke is with the Department of Health Education, San Francisco State University, San Francisco. Lei-Chun Fung is with the Chinatown Public Health Center, San Francisco.Department of Public Health, San Francisco
| | - Rena Pasick
- Jane Jih, Gem Le, Ginny Gildengorin, Ching Wong, Filmer Yu, Rena Pasick, Stephen J. McPhee, and Tung T. Nguyen are with the Division of General Internal Medicine, University of California, San Francisco. Kent Woo and Elaine Chan are with the NICOS Chinese Health Coalition, San Francisco, CA. Janice Y. Tsoh is with the Department of Psychiatry, University of California, San Francisco. Susan Stewart is with the Department of Public Health Sciences, University of California, Davis. Adam Burke is with the Department of Health Education, San Francisco State University, San Francisco. Lei-Chun Fung is with the Chinatown Public Health Center, San Francisco.Department of Public Health, San Francisco
| | - Stephen J McPhee
- Jane Jih, Gem Le, Ginny Gildengorin, Ching Wong, Filmer Yu, Rena Pasick, Stephen J. McPhee, and Tung T. Nguyen are with the Division of General Internal Medicine, University of California, San Francisco. Kent Woo and Elaine Chan are with the NICOS Chinese Health Coalition, San Francisco, CA. Janice Y. Tsoh is with the Department of Psychiatry, University of California, San Francisco. Susan Stewart is with the Department of Public Health Sciences, University of California, Davis. Adam Burke is with the Department of Health Education, San Francisco State University, San Francisco. Lei-Chun Fung is with the Chinatown Public Health Center, San Francisco.Department of Public Health, San Francisco
| | - Tung T Nguyen
- Jane Jih, Gem Le, Ginny Gildengorin, Ching Wong, Filmer Yu, Rena Pasick, Stephen J. McPhee, and Tung T. Nguyen are with the Division of General Internal Medicine, University of California, San Francisco. Kent Woo and Elaine Chan are with the NICOS Chinese Health Coalition, San Francisco, CA. Janice Y. Tsoh is with the Department of Psychiatry, University of California, San Francisco. Susan Stewart is with the Department of Public Health Sciences, University of California, Davis. Adam Burke is with the Department of Health Education, San Francisco State University, San Francisco. Lei-Chun Fung is with the Chinatown Public Health Center, San Francisco.Department of Public Health, San Francisco
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Nour M, Chen J, Allman-Farinelli M. Efficacy and External Validity of Electronic and Mobile Phone-Based Interventions Promoting Vegetable Intake in Young Adults: Systematic Review and Meta-Analysis. J Med Internet Res 2016; 18:e58. [PMID: 27059765 PMCID: PMC4841894 DOI: 10.2196/jmir.5082] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 11/07/2015] [Accepted: 01/22/2016] [Indexed: 11/28/2022] Open
Abstract
Background Young adults (18–35 years) remain among the lowest vegetable consumers in many western countries. The digital era offers opportunities to engage this age group in interventions in new and appealing ways. Objective This systematic review evaluated the efficacy and external validity of electronic (eHealth) and mobile phone (mHealth) -based interventions that promote vegetable intake in young adults. Methods We searched several electronic databases for studies published between 1990 and 2015, and 2 independent authors reviewed the quality and risk of bias of the eligible papers and extracted data for analyses. The primary outcome of interest was the change in vegetable intake postintervention. Where possible, we calculated effect sizes (Cohen d and 95% CIs) for comparison. A random effects model was applied to the data for meta-analysis. Reach and representativeness of participants, intervention implementation, and program maintenance were assessed to establish external validity. Published validation studies were consulted to determine the validity of tools used to measure intake. We applied the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to evaluate the overall quality of the body of evidence. Results Of the 14 studies that met the selection criteria, we included 12 in the meta-analysis. In the meta-analysis, 7 studies found positive effects postintervention for fruit and vegetable intake, Cohen d 0.14–0.56 (pooled effect size 0.22, 95% CI 0.11–0.33, I2=68.5%, P=.002), and 4 recorded positive effects on vegetable intake alone, Cohen d 0.11–0.40 (pooled effect size 0.15, 95% CI 0.04–0.28, I2=31.4%, P=.2). These findings should be interpreted with caution due to variability in intervention design and outcome measures. With the majority of outcomes documented as a change in combined fruit and vegetable intake, it was difficult to determine intervention effects on vegetable consumption specifically. Measurement of intake was most commonly by self-report, with 5 studies using nonvalidated tools. Longer-term follow-up was lacking from most studies (n=12). Risk of bias was high among the included studies, and the overall body of evidence was rated as low quality. The applicability of interventions to the broader young adult community was unclear due to poor description of external validity components. Conclusions Preliminary evidence suggests that eHealth and mHealth strategies may be effective in improving vegetable intake in young adults; whether these small effects have clinical or nutritional significance remains questionable. With studies predominantly reporting outcomes as fruit and vegetable intake combined, we suggest that interventions report vegetables separately. Furthermore, to confidently establish the efficacy of these strategies, better-quality interventions are needed for young adults, using valid measures of intake, with improved reporting on costs, sustainability and long-term effects of programs. Trial registration PROSPERO International Prospective Register of Systematic Reviews: CRD42015017763; http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42015017763 (Archived by WebCite at http://www.webcitation.org/6fLhMgUP4)
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Affiliation(s)
- Monica Nour
- School of Life and Environmental Sciences, University of Sydney, Sydney, NSW, Australia.
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Vakili M, Abedi P, Afshari P, Kaboli NE. The effect of mobile phone short messaging system on healthy food choices among Iranian postmenopausal women. J Midlife Health 2016; 6:154-9. [PMID: 26903754 PMCID: PMC4743276 DOI: 10.4103/0976-7800.172295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Introduction: Central adiposity and metabolic syndrome are quite common among postmenopausal women. Dietary diversity and healthy food choices have essential role in health and also in prevention of obesity. The main objective of this study was to evaluate the impact of mobile phone short messaging system on healthy food choices among Iranian postmenopausal women. Materials and Methods: This was a randomized controlled trial in which 100 postmenopausal women aged 40-60 years were recruited and assigned to two groups (50 each in the intervention and control groups). Food frequency consumption was measured using a questionnaire. A total of 16 text messages including information about modification of food selection (healthy choices, benefits, methods, etc.,) were sent to participants in the intervention group during 4 months follow-up (1/week). The Chi-square and independent t-test used for data analysis. Ninety-two women completed the study. Results: The consumption of Vitamin A rich fruits and vegetables significantly increased in the intervention group compared to the control group (P < 0.001). More women in the intervention group consumed fish after intervention (P = 0.02). The consumption of green leafy vegetables showed a nonsignificant increase in the intervention group. Conclusion: Using mobile phone short messaging system can improve the healthy food choices regarding Vitamin A rich fruits and vegetables and fish among postmenopausal women.
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Affiliation(s)
- Mahdis Vakili
- Department of Nutrition, School of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Parvin Abedi
- Department of Midwifery, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Poorandokht Afshari
- Department of Midwifery, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nayereh Esmael Kaboli
- Department of Nutrition, School of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Yahia N, Wang D, Rapley M, Dey R. Assessment of weight status, dietary habits and beliefs, physical activity, and nutritional knowledge among university students. Perspect Public Health 2015; 136:231-44. [PMID: 26475773 DOI: 10.1177/1757913915609945] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
AIMS The purpose of this study was to assess weight status, dietary habits, physical activity, dietary beliefs, and nutrition knowledge among a sample of students from Central Michigan University. METHODS A cross-sectional survey was conducted among a sample of undergraduate students in Fall 2011 and Spring 2012 at Central Michigan University. Participating students completed an online questionnaire that included questions related to their eating habits, physical activity and lifestyle, dietary beliefs, and nutritional knowledge. Weight, height, and waist circumference were measured. Percentage body fat and visceral fat score were determined using a Tanita body composition analyser (SC-331S). RESULTS Outcomes of this study indicated that 78% of female students were within the healthy weight range compared to 52% of male students. Visceral body fat and waist circumference scores were higher in males than in females. Most students showed 'satisfactory' dietary habits. Almost half of the students reported drinking two glasses of milk and consuming two cups of fruits and vegetables daily. Physical activity and lifestyle score indicated that most of the students were not physically active. Only 7% of students reported having a very active lifestyle, and 4% had quite good nutritional knowledge. CONCLUSION The majority of students, particularly females, were within the healthy body weight range. Students' dietary habits were satisfactory. However, physical activity, students' knowledge of healthy and unhealthy diet habits, and nutritional knowledge needed improvement. Developing gender-specific programmes for promoting healthy lifestyle behaviours among students is recommended.
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Affiliation(s)
- Najat Yahia
- Associate Professor of Nutrition and Dietetics, Department of Human Environmental Studies, Central Michigan University, Mt. Pleasant, USA
| | - Daniel Wang
- Associate Professor of Mathematics, Department of Human Environmental Studies, Central Michigan University, Mt. Pleasant, MI, USA
| | - Melyssa Rapley
- Department of Human Environmental Studies, Central Michigan University, Mt. Pleasant, MI, USA
| | - Rajarshi Dey
- Director of Statistical Consulting Center, Central Michigan University, Mt. Pleasant, MI, USA
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Fruit and Vegetable Intake: Benefits and Progress of Nutrition Education Interventions- Narrative Review Article. IRANIAN JOURNAL OF PUBLIC HEALTH 2015; 44:1309-21. [PMID: 26576343 PMCID: PMC4644575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Sufficient intake of fruits and vegetables has been associated with a reduced risk of chronic diseases and body weight management but the exact mechanism is unknown. The World Health Organisation and Food and Agriculture of the United Nation reports recommend adults to consume at least five servings of fruits and vegetables per day excluding starchy vegetables. This review focuses on the importance of fruits and vegetables as well as the benefits and progress of nutrition education in improving intake. METHODS For this narrative review, more than 100 relevant scientific articles were considered from various databases (e.g Science Direct, Pub Med and Google Scholar) using the keywords Fruit and vegetable, Nutrition education, Body weight, Obesity, Benefits and challenges. RESULTS Existing data suggests that despite the protective effects of fruits and vegetables, their intakes are still inadequate in many countries, especially developing ones. Consequently enhancing strategies to promote fruit and vegetable intake are essential for health promotion among population. A number of reviews confirm that a well planned and behaviour focused nutrition education intervention can significantly improve behaviour and health indicators. CONCLUSION Despite challenges in nutrition education intervention programs, they are considered as a good investment in terms of cost benefit ratio. Rapid improvement in trends of nutrition education can be seen in many countries and majority of interventions has been successful in increasing fruits and vegetables intake. It is recommended that health professionals use multiple interventions to deliver information in several smaller doses over time to ensure improved outcomes.
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