Global Vegetable Intake and Supply Compared to Recommendations: A Systematic Review

Is Hunger the Best Sauce for Unfamiliar Foods? A Study Investigating the Effect of Hunger on Young Children's Food Intake of a Familiar and Unfamiliar Fruit

Sufficient fruit and vegetable intake is crucial for healthy development, yet many children fail to meet the recommended levels, partly due to food rejection. This study aimed to identify an effective, easy-to-implement strategy to increase fruit intake in children by examining the impact of hunger on the consumption of a familiar and unfamiliar fruit. Additionally, it explored the moderating role of picky eating within this relationship. A total of 177 children aged 4-6 were assigned to a hungry condition (food-deprived for 3-4 h) or a non-hungry condition (food-deprived for less than 30 min). The children were then asked to taste either a familiar fruit (apple) or an unfamiliar fruit (lychee), with up to 9 pieces available for tasting. It was hypothesized that children in the hungry condition would consume more fruit compared to those in the non-hungry condition, and that intake would be higher for the familiar fruit than the unfamiliar fruit. Additionally, the effect of hunger on intake was expected to be moderated by picky eating, with a weaker effect in children who were more picky eaters. Results from a 2x2 ANOVA showed hunger significantly increased fruit consumption, regardless of familiarity, and the familiar fruit was consumed more than the unfamiliar fruit. No interaction between hunger and fruit familiarity was found, and picky eating did not moderate the relationship between hunger, familiarity, and intake. These findings suggest that mild hunger can be an effective strategy to increase children's fruit intake, and offering fruits when children are hungry may promote healthier eating.

Cancers attributable to diet in Italy

Cancer burden can be reduced by controlling modifiable risk factors, including diet. We provided an evidence-based assessment of cancer cases and deaths attributable to diet in Italy in 2020. We considered dietary factor-cancer type pairs for which the World Cancer Research Fund/American Institute for Cancer Research - Continuous Update Project reported either 'convincing' or 'probable' evidence of causal association. Relative risks were retrieved from recent meta-analyses and dietary intakes (around 2005) from a national food consumption survey. Sex-specific population attributable fractions (PAFs) were computed by comparing the distribution of dietary intakes in the Italian population against counterfactual scenarios based on dietary recommendations. Using data from national cancer and mortality registries in 2020, we estimated the number of attributable cancer cases and deaths, assuming ~15-year lag period. Unhealthy diet accounted for 6.3% (95% CI: 2.5%-9.9%) of all cancer cases in men and 4.5% (95% CI: 1.7%-7.4%) in women. PAFs of colorectal cancer were 10.5% and 7.0% for any intake of processed meat, 3.3% and 2.0% for high red meat, 4.8% and 4.3% for low dairy products, and 7.9% and 9.0% for low fiber intakes in men and women, respectively. PAFs for low intake of non-starchy vegetables and fruit ranged from 0.8% to 16.5% in men and 0.6%-17.8% in women for cancers of the aerodigestive tract. The estimated cancer burden associated with unfavorable dietary habits in Italy is considerable, but appears lower than for other high-income countries, reflecting the typically Mediterranean diet.

Production risk and technical efficiency of dry-season vegetable farmers in the Upper East Region of Ghana

The Ghanaian population is aware of the increasing health challenges in our health facilities and the need to consume more vegetables to improve their health status. This, coupled with population growth and changing consumer patterns has led to an increasing demand for vegetable products in Ghana. Smallholder farmers in the country have thus intensified the production of vegetables during the dry season to meet consumers' demand and to generate income. However, their outputs have been lower than the country's potential, so the research was conducted to identify the causes and determinants of the low yields. A total of 322 dry-season vegetable farmers in seven (7) districts in twenty-four (24) communities were selected from the Upper East Region of Ghana using a purposive random sampling technique. The Kumbhakar model was employed to compute the production risk, technical inefficiency and determinants of vegetable production in the region. The study reveals that the input variables: labour, seed, fertilizer, agrochemical and irrigation costs positively are related to the output value of vegetables with an increasing return to scale. In addition, labour, seed and agrochemical costs show a significant production risk-decreasing effect while the risk of vegetable production is reduced with fertilizer and irrigation costs. The study further depicts that extension visits, experience, water pumps and gravity-fed irrigation systems positively affect the technical efficiency of dry-season vegetable production. Again, given the current state of technology and resources available to the farmers, enhancing the vegetable outputs could be achieved by reducing the technical inefficiencies by 27% while considering the effects of production risk. The study concludes that the farmers can improve the output of the vegetable farms for higher income by adopting the best vegetable production practices such as efficient water-saving irrigation technologies and fertilizer usage while adopting the knowledge from the extension training to improve their technical efficiency.

Rooted in routine: Fostering higher order vegetable-shopping habits using a randomised simple planning intervention

A healthy diet is a protective factor against a host of negative health outcomes. To maintain such a diet necessitates the consumption of at least 240 g of vegetables per day. However, most of the population fails to meet this threshold. Utilising a randomised controlled trial, the present study tested the effectiveness of a one-off higher order habit intervention aimed at shopping for a variety of vegetables and the mechanisms that may support such habit development. Specifically, participants (N = 198; 54.5% female; 20 to 74 years of age) were allocated to the intervention or control group to explore (1) how effective an action- and coping-planning intervention is at targeting the formation of vegetable-shopping higher order habits and (2) whether healthy-eater identity, intrinsic motivation and self-efficacy were mechanisms of action. Follow-up measures of habit, the mechanisms of action and behaviour were taken post-intervention, weekly for 4 weeks and at 3- and 6-month follow-ups. The intervention led to stronger higher order habit formation after 6 months and that it was particularly effective for those with low baseline higher order habits for vegetable shopping. These findings demonstrate that a simple, one-off, intervention can lead to long-lasting change in higher order habits within the nutrition domain.

Zero vegetable or fruit consumption and its associated factors among children aged 6 to 23 months in Kenya: a multilevel analysis of a large population-based survey

Poor consumption of fruits and vegetables is associated with an increased risk of non-communicable diseases, micronutrient deficiency, and undernutrition. Fruit and vegetable consumption is generally low worldwide, particularly in rural regions of many low- and middle-income countries. This study aimed to determine the prevalence and determinants of zero vegetable or fruit consumption among children aged 6 to 23 months in Kenya using the most recent Kenya Demographic and Health Survey. A cross-sectional study was employed using data from the most recent nationally representative KDHS 2022. A weighted sample of 2,965 children aged between 6 to 23 months who were living with their mother was included in the study. Data extracted from the KDHS 2022 data sets were cleaned, recoded, and analyzed using STATA/SE version 14.0 statistical software. Multilevel logistic regression was used to determine the factors associated with the dependent variable. Finally, variables with a p-value less than 0.05 were declared statistically significant. The proportion of zero vegetable or fruit consumption among children aged 6 to 23 months in Kenya was 45.50% (95% CI: 43.71%-47.30%). Factors like maternal education [AOR = 0.59; 95% CI (0.37, 0.93)], maternal occupation [AOR = 0.60; 95% CI (0.47, 0.76)], media exposure [AOR = 0.59; 95% CI (0.43, 0.80)], wealth index [AOR = 0.68; 95% CI (0.49, 0.95)], place of delivery [AOR = 0.69; 95% CI (0.51, 0.94)], number of ANC visits [AOR = 1.30; 95% CI (1.05, 1.62)], child's age [AOR = 0.30; 95% CI (0.21, 0.41)], community media exposure [AOR = 0.30; 95% CI (0.21, 0.41)], community literacy [AOR = 0.29; 95% CI (0.20, 0.43)], and community poverty [AOR = 1.46; 95% CI (1.04, 2.05)] were significantly associated with zero vegetable or fruit consumption.

CONCLUSION

The proportion of zero vegetable or fruit consumption among children aged 6 to 23 months in Kenya was high. Zero vegetable or fruit consumption was significantly associated with maternal education, maternal occupation, media exposure, wealth index, place of delivery, number of ANC visits, child's age, community media exposure, community literacy, and community poverty. Giving attention to jobless, media-non-exposed mothers, poor wealth status, who gave birth at home, who had no formal education, attended < 4 ANC visits, and children aged 6 to 8 months is recommended.

WHAT IS KNOWN

• Dietary recommendations for fruit and vegetable consumption were not met by many children in low and middle-income countries.

WHAT IS NEW

• The proportion of zero vegetable or fruit consumption among children aged 6 to 23 months in Kenya was high.

Impact of Cooking Techniques on the Dietary Fiber Profile in Selected Cruciferous Vegetables

Cruciferous vegetables of the plant order Brassicales are an attractive dietary component and a valuable source of fiber. However, the nutritional-physiological properties are different when comparing soluble and insoluble fibers. Another significant impact is the transformation of fibers by different influencing factors during food preparation. Cruciferous vegetables, especially, are dominantly processed to soften the matrix. As a result, during cooking, the polysaccharides are dissolved, swelled, or degraded to a certain extent, influencing the composition and the nutritional-physiological properties. The aim of the present study was to analyze the impact of different cooking procedures on changes in the dietary fiber content profile of three different plants: white cauliflower (Brassica oleracea L. var. botrytis), broccoli (B. oleracea L. var. italica), and Brussels sprouts (B. oleracea L. var. gemmifera). The sample material was subjected to direct ("in the water") and steam cooking. The dietary fiber content and the content of its fractions were determined using an enzymatic analysis method. The results of the research show that the cooking process had a significant influence on the content of dietary fiber fractions in cruciferous vegetables. The concentration of insoluble dietary fiber decreased, whereas the content of soluble dietary fiber increased. When considering the average influence of each process, both steam cooking and direct cooking had a similar impact on changes in the concentrations of dietary fiber fractions. It can therefore be concluded that, when considering dietary fiber content, both processes can be equally well chosen as a thermal treatment for cruciferous vegetables.

Prevalence and determinants of unhealthy feeding practices among young children aged 6-23 months in five sub-Saharan African countries

INTRODUCTION

Despite the World Health Organization's advice against unhealthy feeding, many low- and middle-income countries, including sub-Saharan Africa (SSA) countries, are experiencing a nutritional transition to high in sugar, unhealthy fats, salts, and processed carbohydrates for younger children. However, there is a scarcity of recently updated multicounty information on unhealthy feeding practices and determinants in SSA countries. Therefore, this study aimed to assess the pooled prevalence of unhealthy feeding practices and determinants among children aged 6-23 months in five SSA countries.

METHOD

A cross-sectional study design was employed with the most recent demographic and health survey secondary data (DHS) from five SSA countries. This secondary data was accessed from the DHS portal through an online request. The DHS is the global data collection initiative that provides detailed and high-quality data on population demographics, health, and nutrition in low- and middle-income countries. We used a weighted sample of 14,064 children aged 6-23 months. A multilevel mixed-effect binary logistic regression model was fitted to identify significant factors associated with unhealthy feeding practices. The level of statistical significance was declared with p-value < 0.05.

RESULT

This study found that overall, 62.4% (95% CI: 61.62-63.17) of children aged 6-23 months in five SSA countries had unhealthy feeding practices. Rural residents, lower-middle-income SSA countries, and children aged above 12 months had lower odds of unhealthy feeding practices. On the other hand, richer households and women who had not had an optimal antenatal care visit had higher odds of unhealthy feeding practices.

CONCLUSION

According to this study, nearly two out of three young children in five SSA countries had unhealthy feeding practices. Both individual and community-level factors are significantly associated with unhealthy feeding practices. As a result, responsible bodies shall make all efforts to reduce unhealthy feeding practices among young children in SSA countries.

Substituting Potatoes with Other Food Groups and Type 2 Diabetes Risk: Findings from the Diet, Cancer, and Health Study

BACKGROUND

Although potatoes are considered a dietary staple in some cultures, evidence suggests that their impact on type 2 diabetes (T2D) risk is nuanced, with preparation methods and dietary patterns playing crucial roles. Investigating the substitution effects of replacing potatoes with other foods is required to inform dietary recommendations for lowering T2D risk.

OBJECTIVE

The objective of this was to investigate associations between the substitution of potatoes (excluding fries/chips) with other food groups (vegetables, whole grains, refined grains, red meat, processed meat, poultry, fish, and dairy) and the risk of T2D.

METHODS

The diet of participants from the prospective Danish Diet, Cancer, and Health study (DCH) was measured at baseline (1993-1997) by a food frequency questionnaire. Participants were followed up for incident T2D from baseline until 2012. Associations between the substitution of potatoes (total, boiled, and mashed) with other food groups and incident T2D was assessed by multivariable Cox proportional hazards model.

RESULTS

In 54,793 DCH study participants, during a median follow-up of 16.3 y, 7693 incident T2D cases were recorded. A 26% lower risk of T2D was observed when 50 g/d of potatoes were substituted with the same amount of whole grains [hazard ratio and 95% confidence interval (CI): 0.74 (0.70, 0.79)]. Similarly, a lower risk of T2D was observed upon substituting 25 g/d of potatoes with an equivalent amount of green leafy [HR (95% CI): 0.79 (0.74, 0.83)], cruciferous [HR (95% CI): 0.87 (0.83, 0.92)], and yellow/orange/red vegetables [HR (95% CI): 0.97 (0.96, 0.99)]. Conversely, a higher risk of T2D was observed when potatoes were substituted with poultry [HR (95% CI): 1.08 (1.02, 1.15)], red meat [HR (95% CI): 1.06 (1.02, 1.10)], and processed meat [HR (95% CI): 1.17 (1.11, 1.23)]. Replacing boiled potatoes with red meat or poultry was associated with a higher risk of T2D compared with replacing mashed potatoes.

CONCLUSIONS

Substituting potatoes with whole grains and most types of vegetables was associated with a lower risk of T2D, whereas substituting potatoes with poultry, red meat, and processed meat was associated with a higher risk.

Urinary Metabolite Profiles of Participants with Overweight and Obesity Prescribed a Weight Loss High Fruit and Vegetable Diet: A Single Arm Intervention Study

BACKGROUND/OBJECTIVES

Thus far, no studies have examined the relationship between fruit and vegetable (F and V) intake, urinary metabolite quantities, and weight change. Therefore, the aim of the current study was to explore changes in urinary metabolomic profiles during and after a 10-week weight loss intervention where participants were prescribed a high F and V diet (7 servings daily).

METHODS

Adults with overweight and obesity (n = 34) received medical nutrition therapy counselling to increase their F and V intakes to national targets (7 servings a day). Data collection included weight, dietary intake, and urine samples at baseline at week 2 and week 10. Urinary metabolite profiles were quantified using 1H NMR spectroscopy. Machine learning statistical approaches were employed to identify novel urine-based metabolite biomarkers associated with high F and V diet patterns at weeks 2 and 10. Metabolic changes appearing in urine in response to diet were quantified using Metabolite Set Enrichment Analysis (MSEA).

RESULTS

Energy intake was significantly lower (p = 0.02) at week 10 compared with baseline. Total F and V intake was significantly higher at week 2 and week 10 (p < 0.05). In total, 123 urinary metabolites were quantified. At week 10, 21 metabolites showed significant changes relative to baseline. Of these, 11 metabolites also significantly changed at week 2. These overlapping metabolites were acetic acid, dimethylamine, choline, fumaric acid, glutamic acid, L-tyrosine, histidine, succinic acid, uracil, histamine, and 2-hydroxyglutarate. Ridge Classifier and Linear Discriminant Analysis provided best prediction accuracy values of 0.96 when metabolite level of baseline was compared to week 10.

CONCLUSIONS

Urinary metabolites quantified represent potential candidate biomarkers of high F and V intake, associated with a reduction in energy intake. Further studies are needed to validate these findings in larger population studies.

Consumer Preferences, Sensory Evaluation, and Color Analysis of Beetroot and Tomato Juices: Implications for Product Development and Marketing in Health-Promoting Beverages

BACKGROUND/OBJECTIVES

This study explores the significance of beetroot and tomato juices, two prominent health-promoting foods known for their rich nutrient content and bioactive compounds. The growing consumer awareness of the link between diet and well-being emphasizes the need for food producers to align their products with health-conscious preferences. The aim of this research was to assess the composition, color, and sensory attributes-specifically color, taste, and odor-of various commercially available beetroot and tomato juices and to evaluate their acceptability among consumers.

METHODS

A total of 50 dietitians (41 women and 9 men) participated in sensory evaluations and spectrophotometric color analysis using the CIELAB system, which measures lightness (L*), red-green tones (a*), and blue-yellow tones (b*). This dual approach allowed for a comprehensive understanding of how color characteristics correspond to sensory ratings.

RESULTS

Results revealed significant differences in color and sensory attributes among the juices, with darker hues and higher red-tone values generally preferred by consumers. Juices with lower lightness (L*) and dominant blue or red tones (negative b*, higher a*) were consistently rated higher, suggesting that color plays a pivotal role in initial product acceptance. However, no single juice excelled across all sensory categories, indicating varied consumer preference.

CONCLUSIONS

The findings underscore the influence of color on consumer perception and its potential for guiding product development. For producers of functional beverages, optimizing visual appeal through precise control of color parameters could enhance marketability while balancing sensory attributes such as taste and aroma. These insights support the development of products that satisfy both nutritional goals and consumer expectations.

Factors associated with zero vegetable and fruit consumption among Tanzanian children

BACKGROUND

Proper nutrition during early childhood is essential for healthy growth and development, yet many children, particularly in low and middle-income countries, fail to meet recommended intake levels of fruits and vegetables. This study aims to assess the factors associated with zero vegetable and fruit (ZVF) consumption among children aged 6-23 months in Tanzania, using data from the 2022 Tanzania Demographic and Health Survey (DHS).

METHODS

A weighted sample of 4582 children aged between 6 and 23 months were included in the study. Data cleaning, coding, and analysis were performed using STATA version 17 software. To address the hierarchical nature of the DHS data and the binary outcome variable, a multilevel mixed-effect binary logistic regression model was used. The deviance value served as a guide for determining the best-fitting model. In the subsequent multivariable multilevel binary logistic regression analysis, adjusted odds ratios were computed alongside their respective 95% confidence intervals to evaluate the strength of association, with statistical significance set at a p-value below 0.05.

RESULT

The overall proportion of ZVF consumption among children aged 6-23 months in Tanzania was 48.34% (95% CI: 46.87, 49.81). Current breastfeeding status, maternal educational status, household wealth index, sex of the household head, and community poverty level were associated with higher odds of ZVF consumption. Meanwhile, child age, maternal employment status, father's educational status, and media exposure were associated with lower odds of ZVF consumption.

CONCLUSION

Child age, current breastfeeding status, maternal educational status, maternal employment status, father's educational status, household wealth index, sex of household, media exposure, and community poverty level were significantly associated with ZVF consumption. Efforts should focus on educating mothers about the early introduction of fruits and vegetables in children's diets, alongside supporting breastfeeding. Tailored economic empowerment initiatives are needed in impoverished communities to improve access to nutritious foods.

Health Claims, Product Features and Instructions for Use on the Labels of Potassium-enriched Salt Products: A Content Analysis

Background

Potassium-enriched salt is a proven dietary intervention for reducing risk of stroke, cardiovascular disease, and premature mortality when used instead of regular table salt. Potassium-enriched salt products are available globally, but the on-pack health claims, product features, and instructions for use are diverse.

Objectives

The objective of this study was to summarize the label features of potassium-enriched salt products available worldwide.

Methods

A content analysis was conducted on the labels of potassium-enriched salt products available for sale in May 2023. Potassium-enriched salt products were identified through a systematic search of literature, major online shopping websites, and Google using similar keywords such as "salt substitute" or "low sodium salt." Information on product labels was coded relating to health claims, product features, and instructions for use, and were quantitatively summarized.

Results

A total of 117 potential potassium-enriched salt products were identified, with 83 included in the final analysis after excluding products containing no sodium (n = 15), no potassium (n = 5), or that were duplicates (n = 14). There were 23 (28%) products with on-pack claims for health benefits and 36 (43%) with health warnings. Twenty-five (30%) of product labels included descriptions of other product features such as taste and potassium content, and 36 (43%) had instructions for use.

Conclusions

There was large variability in the label features of potassium-enriched salt products identified in this study. Most product labels made no health-related statements, but among those that did, warnings occurred more frequently than statements of health benefits. The diversity in labeling may cause confusion among consumers, and standardized, evidence-based labeling should be developed.

Loneliness and low fruit and vegetable consumption among adults in Japan

Background

Loneliness is the distressing feeling that arises when a person's network of social relations is perceived as being inadequate in some way. Research has linked loneliness to a number of detrimental health outcomes. There is also some evidence that lonely individuals are more likely to engage in poorer health behaviors. However, as yet, there has been comparatively little attention paid to the relation between loneliness and dietary behavior. In particular, there has been little focus on the association between loneliness and fruit and vegetable intake.

Objective

The aim of this cross-sectional study was to examine the association between loneliness and low fruit and vegetable consumption in the Japanese general population.

Methods

Data were analyzed from 3,410 Japanese adults collected in an online survey in early 2023. Information was obtained on past-week fruit and vegetable consumption with a single-item measure, while loneliness was assessed with the Three-Item Loneliness Scale. Information was also collected on sociodemographic characteristics, physical health status, health-risk behaviors and depressive symptoms. Logistic regression was used to assess associations.

Results

One in twenty (5.3%) adults reported low fruit and vegetable consumption. In a fully adjusted analysis loneliness was associated with higher odds for low fruit and vegetable consumption (OR: 1.14, 95%CI: 1.04-1.26). In sex- and age-stratified analyses loneliness was significantly associated with low fruit and vegetable consumption in both women and middle-aged adults, although confidence intervals overlapped for this association across all of the sex and age groups in the fully adjusted analyses.

Conclusions

Loneliness is associated with low fruit and vegetable consumption among adults in Japan. As loneliness and inadequate fruit and vegetable intake have both been linked to poorer health outcomes, the results of this study underscore the potential importance and public health benefits of reducing loneliness in Japan.

Understanding consumer beliefs and choices related to food safety: a qualitative study in urban Ethiopia

OBJECTIVE

Provide an in-depth examination of consumers' food safety beliefs and practices to draw implications for interventions to improve nutrition and food safety in Ethiopia.

DESIGN

Adapted Focused Ethnographic Study approach using in-person semi-structured interviews and free-listing exercises, in two iterative phases.

SETTING

A traditional food market in Hawassa, a mid-sized city.

PARTICIPANTS

Forty-six market shoppers, selected randomly in line with quotas for age and gender.

RESULTS

Consumers did not clearly differentiate between quality and safety, seeing them through connected concepts such as 'freshness'. While most respondents had some understanding of the causes of unsafe food, they did not generally worry about becoming ill themselves and felt food safety risks were easily mitigated through in-home behaviours. Thus, food safety practices were not a main motivator of market or vendor choice. There was no evidence that food safety concerns led consumers to prefer packaged, processed food or to avoid consuming fresh foods.

CONCLUSIONS

The study offers novel depth and detail on a topic of strong policy relevance. While building on an encouraging base of understanding of food safety, there remains considerable scope for increasing knowledge, particularly with regard to the need to procure safe food as opposed to expecting household-level practices to mitigate all safety risks. Motivating customers to give food safety factors more consideration when making food purchasing decisions, such as by leveraging emotion-based communication from trusted messengers to elevate the issue's salience in their minds, may contribute to improvements in food safety in low-income countries such as Ethiopia.

Boosting Health Benefits in Vegetables: A Novel Ultraviolet B (UVB) Device for Rapid At-Home Enhancement of Phytochemicals and Bioactivity

The consumption of vegetables is essential for reducing the risk of noncommunicable diseases, yet global intake falls short of recommended levels. Enhancing the nutraceutical content of vegetables through postharvest abiotic stress, such as ultraviolet B (UVB) radiation, offers a promising solution to increase health benefits. This study developed a user-friendly, at-home UVB device designed to increase the phytochemical content in common vegetables like carrots, lettuce, and broccoli. The device applies UVB radiation (305-315 nm) to fresh-cut vegetables, optimizing exposure time and intensity to maximize nutraceutical enrichment. The results demonstrated that UVB exposure increased the phenolic content by 44% in carrots, 58% in broccoli, and 10% in lettuce, with chlorogenic acid levels rising by 367% in lettuce, 547% in broccoli, and 43% in carrots after 48 h of storage. UVB treatment also enhanced antioxidant activity by up to 41% in broccoli and anti-inflammatory potential by 22% in carrots. In terms of gene expression, UVB treatment upregulated UCP-1 expression by 555% in carrots, enhanced thermogenesis, and increased SIRT-1 and ATGL expression by over 200%, promoting lipid metabolism. This process provides a convenient and efficient method for consumers to boost the health benefits of their vegetables. The study concludes that UVB-induced abiotic stress is an effective strategy to improve vegetable nutritional quality, offering a novel approach to increasing bioactive compound intake and aiding in the prevention of diet-related diseases.

A review of conditions influencing fate of Shiga toxin-producing Escherichia coli O157:H7 in leafy greens

The accuracy of predictive microbial models used in quantitative microbial risk assessment (QMRA) relies on the relevancy of conditions influencing growth or inactivation. The continued use of log-linear models in studies remains widespread, despite evidence that they fail to accurately account for biphasic kinetics or include parameters to account for the effect of environmental conditions within the model equation. Although many experimental studies detail conditions of interest, studies that do not do so lead to uncertainty in QMRA modeling because the applicability of the predictive microbial models to the conditions in the risk scenarios is questionable or must be extrapolated. The current study systematically reviewed 65 articles that provided quantitative data and documented the conditions influencing the inactivation or growth of Shiga toxin-producing Escherichia coli (STEC) O157:H7 in leafy greens. The conditions were identified and categorized as environmental, biological, chemical, and/or processing. Our study found that temperature (n = 37 studies) and sanitizing and washing procedures (n = 12 studies) were the most studied conditions in the farm-to-table continuum of leafy greens. In addition, relative humidity was also established to affect growth and inactivation in more than one stage in the continuum. This study proposes the evaluation of the interactive effects of multiple conditions in processing and storage stages from controlled experiments as they relate to the fate of STEC O157:H7 in leafy greens for future quantitative analysis.

Exploring reasons for high levels of food insecurity and low fruit and vegetable consumption among university students post-COVID-19

High rates of food insecurity and low consumption of fruit and vegetables among university students have been observed prior to the COVID-19 pandemic and intensified during the pandemic. This study aimed to investigate food insecurity among university students and its associations with sociodemographic factors, fruit and vegetable consumption behaviours, and preferred campus programs to address these issues. A convenience sample of 237 Australian university students completed a cross-sectional online survey from October to December 2022. Food insecurity was assessed using the 10-item US Adult Food Security Module, applying the Canadian classification scheme. Sociodemographic variables, fruit and vegetable consumption behaviours, and perceptions of fruit and vegetable access and their affordability were included in the survey. Students were also asked to select the most suitable program(s) and provide reasons for their choice using open-ended questions. Approximately half of respondents (46.4%) were identified as food insecure. The proportion of students meeting the recommended intake of vegetables as specified in the Australian Dietary Guidelines was very low (5.1%) compared with fruit (46.2%). Low fruit consumption was significantly associated with food insecurity (OR = 1.81; 95%CI 1.03, 3.18, p = 0.038). Factors such as the perceived lower accessibility and higher price of fruit and vegetables were significantly associated with higher odds of food insecurity. In terms of potential programs, a free fruit and vegetable campaign was the most popular program, with affordability and physical access being the most frequently cited reasons. These findings suggest that food insecurity is associated with low fruit and vegetable consumption in university students. Therefore, transforming campus food environments and developing food policies at the university level must be considered to address food and nutrition security in university students.

Single-Person Households: Insights from a Household Survey of Fruit and Vegetable Purchases

Despite the efforts made to promote consumption, some countries are not increasing their fruit and vegetable intake, while household structures are undergoing relevant changes. Fruit and vegetable consumption is necessary but not sufficient for a healthy diet. Previous research has linked adequate fruit and vegetable consumption to a lower risk of cardiovascular diseases, type 2 diabetes, and some mental health conditions. Furthermore, millions of deaths are reported annually worldwide due to diets low in fruit and vegetables, highlighting their critical public health importance. This study aims to separately analyze the purchases of fruit and vegetables in single-person households. We used three waves of the Family Budget Survey, Encuesta de Presupuestos Familiares, in Chile, which is nationally representative of urban areas and includes over 10,000 households in each wave. We employed descriptive statistics to examine the characteristics of the head of household and the food shopper as well as the structure, composition, and overall characteristics of households. Additionally, we performed separate analyses for fruit and vegetable purchases, using these variables to determine the marginal effect on the probability of purchasing fruit or vegetables through probit models. Results show that, from 2011-2012 to 2021-2022, the share of households not purchasing fruit and vegetables increased from 5.0% to 8.4% and that, in single-person households, it rose from 11.2% to 19.1%. Male-headed, single-person households with low education and income were more likely not to purchase fruit, and these households also have decreasing vegetable purchases. Additionally, household income significantly impacts fruit purchases but does not significantly affect vegetable purchases. Our findings highlight the importance of considering single-person households as a target population segment for future public policies to promote fruit and vegetable consumption.

'Whatever we have is what we eat': How marginalised urban populations in the Philippines and Thailand experienced their food environments, food security and diets through COVID-19

This qualitative cross-country comparative study investigated the lived experience of marginalised urban populations (unemployed, daily wage earners/street vendors, and internal/external migrants) in Manila (Philippines) and Bangkok (Thailand) on food environments, food security and diets during COVID-19. Semi-structured interviews were conducted with individuals (n = 59) in April-May 2022. Thematic analysis revealed loss of income and strict mobility restrictions (Philippines) as key drivers of dietary changes and hunger. Common narratives included financial hardship, loss of personal agency, and daily survival. Coping strategies included drawing on social networks, cash and food aid, and 'scheming' around restrictions. Contextualised crisis policy planning should explicitly consider the lived experience of marginalised populations for future shocks.

Associations between Vegetable Nitrate Intake and Cardiovascular Disease Risk and Mortality: A Systematic Review

Consumption of nitrate-rich vegetables increases nitric oxide bioavailability, lowers blood pressure, and improves endothelial function. These effects could also translate into reduced cardiovascular disease (CVD) risk and mortality. This systematic review aimed to investigate the associations between habitual vegetable nitrate intake and CVD incidence and mortality. A secondary aim was to identify factors that moderate the relationship between vegetable nitrate intake and CVD incidence/mortality. Seven databases (PubMed, MEDLINE, Embase, Scopus, Web of Science, CINAHL, and APA PsycINFO) were searched from inception to 13 February 2023. Observational studies quantifying vegetable nitrate intake in participants aged 18+ years through self-reported dietary exposure and assessing incidence or mortality from CVD overall, or individual CVD subtypes, were eligible. Five studies including a total of 63,155 participants were included. There was an inverse association between vegetable nitrate intake and most reported CVD outcomes. Reported risk reductions tended to plateau at moderate intake, suggesting a possible ceiling effect. The risk of bias across all studies was low. The results of this systematic review suggest a potential role for vegetable nitrate in reducing CVD risk and mortality. Further randomised controlled trials are now required to corroborate these findings.

Trends in Fruit and Vegetable Intake Among the Labor Force Population - China, 2010-2018

Introduction

This research investigates trends pertaining to the prevalence of low fruit and vegetable consumption among the labor force population in China. The study considered data derived from four nationally representative cross-sectional surveys.

Methods

The data under review for this study was derived from the China Chronic Disease and Risk Factor Surveillance (CCDRFS) carried out in 2010, 2013, 2015, and 2018, correspondingly. We utilized a food frequency questionnaire to evaluate the quantity and frequency of fruit and vegetable consumption. The estimated prevalence of low fruit and vegetable consumption was calculated for each survey, while considering factors such as sex, age, location, and socioeconomic status (SES). Participants' SES was ascertained via latent class analysis, serving to identify distinct classes based on criteria such as education, occupation, and household income per capita. Logistic regression was deployed to determine the statistical significance of trends.

Results

From 2010 to 2018, there was a notable increase in the average daily consumption of vegetables and fruits among the working population, rising from 418.6 g/day to 491.8 g/day (P<0.01 for trend). During the same period, the prevalence of low fruit and vegetable intake declined from 51.1% to 43.5% [P<0.001 for trend; -1.6% average annual percent change (AAPC)]. This downward trend was prevalent across genders, however, certain subgroups of adults (e.g., those living in rural areas or those of low SES) saw stable consumption levels throughout this period (P>0.05 for trend).

Conclusion

Over the past nine years, there has been a notable decline in the prevalence of low fruit and vegetable consumption among the labor force population in China. Moreover, the comparatively deficient intake of fruits and vegetables evident among individuals of lower SES warrants further attention.

School health promotion and fruit and vegetable consumption in secondary schools: a repeated cross-sectional multilevel study

BACKGROUND

Worldwide, recommendations for fruit and vegetable consumption are not met, which can cause chronic diseases. Especially adolescence is an important phase for the development of health behaviours. Therefore, in the Netherlands, the Healthy School program was established to aid schools in promoting healthy lifestyles among their students. We examined to what extent the variation between secondary schools regarding students' fruit and vegetable consumption could be explained by differences between schools regarding Healthy School certification, general school characteristics, and the school population. Additionally, we examined whether Healthy School certification was related to the outcomes, and whether the association differed for subgroups.

METHODS

We performed a repeated cross-sectional multilevel study. We used data from multiple school years from the national Youth Health Monitor on secondary schools (grades 2 and 4, age ranged from approximately 12 to 18 years) of seven Public Health Services, and added data with regard to Healthy School certification, general school characteristics and school population characteristics. We included two outcomes: the number of days a student consumed fruit and vegetables per week. In total, we analysed data on 168,127 students from 256 secondary schools in the Netherlands.

RESULTS

Results indicated that 2.87% of the variation in fruit consumption and 5.57% of the variation in vegetable consumption could be attributed to differences at the school-level. Characteristics related to high parental educational attainment, household income, and educational track of the students explained most of the variance between schools. Additionally, we found a small favourable association between Healthy School certification and the number of days secondary school students consumed fruit and vegetables.

CONCLUSIONS

School population characteristics explained more variation between schools than Healthy School certification and general school characteristics, especially indicators of parental socioeconomic status. Nevertheless, Healthy School certification seemed to be slightly related to fruit and vegetable consumption, and might contribute to healthier dietary intake. We found small differences for some subgroups, but future research should focus on the impact in different school contexts, since we were restricted in the characteristics that could be included in this study.

Clusters in Infant Environmental Factors Influence School-Age Children's Vegetable Preferences in Japan

It remains unclear how the various environmental factors are combined in practice to influence vegetable preferences in school-aged children. This study aimed to clarify the environmental factors during infancy and their association with vegetable preference in school-aged children. To find clusters of early childhood environmental factors, we conducted a factor analysis on 58 items related to early childhood environmental factors and a k-means cluster analysis using the factors obtained. The association of the extracted factors and clusters with vegetable preferences was assessed by multiple regression analysis. Twelve factors relating to vegetable eating, cooking and harvesting experience, and parental attitudes were extracted by factor analysis. Three clusters, "low awareness of experiences", "high awareness" and "low positive encouragement", were then extracted. In the multiple regression analysis, all 12 factors were found to be associated with vegetable preferences. Furthermore, it was found that the "high awareness" group had a significantly higher score for vegetable preference than the "low awareness of experiences" group (β = 0.56, 95% CI: 0.37-0.74). Thus, the study found that environmental factors during infancy, in isolation and combination, influenced vegetable preferences in school-aged children. Assessing the combination of various environmental factors during infancy may contribute to a better understanding of future vegetable preferences.

From Information Seeking and Scanning to the Practice of Healthy Habits: A Longitudinal Test of the Integrative Model of Behavioral Prediction in the Context of Fruit and Vegetable Consumption

Fruit and vegetable intake is essential for health, but global adherence to recommended levels remains insufficient. Health information exposure positively influences consumption, yet the underlying mechanisms are not fully understood. This study aims to explore the relationships between information seeking and scanning, attitudes, norms, perceived behavioral control (PBC), intentions, and fruit and vegetable intake, following the main tenets of the Integrative Model of Behavioral Prediction (IM). Data were collected through face-to-face surveys in Santiago, Chile, with a representative sample of individuals aged 25 and older in two waves. Findings revealed that intentions in Wave 1 predicted fruit and vegetable consumption in Wave 2, with positive associations between attitudes, norms, PBC, and intentions. Information seeking was positively associated with attitudes, norms, and PBC, and it had indirect effects on fruit and vegetable consumption through attitudes, norms, PBC, and intentions. Information scanning did not show significant indirect effects on fruit and vegetable consumption, even though the path between scanning and attitudes was significant. The study provides support for the IM and highlights the importance of information seeking in promoting fruit and vegetable consumption through its influence on attitudes, norms, and PBC. The findings have practical implications for health campaigns, educational programs, healthcare interactions, and public policies targeting healthier dietary habits.

Analysing food groups and nutrient intake in adults who met and did not meet the daily recommended vegetable intake of 350 g: the 2016 National Health and Nutrition Survey in Japan

This study aimed to compare the differences in the intake of food groups and nutrients between Japanese adults who consumed the recommended daily vegetable intake (350 g/day) and those who did not. Dietary information was obtained from one-day dietary records collected from the 2016 National Health and Nutrition Survey, which was conducted in 46 prefectures in Japan. The participants aged ≥20 years (n = 21,606; 53.8% women) were classified into the < and ≥350 g/day groups. Inter-group differences for 17 food groups and 27 nutrients were assessed as percentages of consumers (food groups only) and energy-adjusted intake (units/MJ/d or % of total energy intake). Overall, 29% of participants consumed ≥350 g/day of vegetables. The ≥350 g/day group had a higher percentage of consumers and energy-adjusted intakes for all vegetable subgroups than the <350 g/day group. For other food groups, the ≥350 g/day group had higher percentages of consumers for all food groups, except for cereals, eggs, and condiments and seasonings, which showed no significant differences. However, the ≥350 g/day group had a significantly higher energy-adjusted intake for potatoes and other tubers, mushrooms, meats, and condiments and seasonings but a significantly lower value for cereals, eggs, savoury snacks and confectionaries, and beverages. The ≥350 g/day group had a significantly higher intake of almost all (25/27) nutrients, including sodium, than the <350 g/day group. Participants with vegetable intake ≥350 g/day might have a more favourable intake of food groups and nutrients; however, watching for salt intake is necessary when promoting vegetable intake.

Health Risk Assessment of Lead, Cadmium, and Arsenic in Leafy Vegetables in Tehran, Iran: the Concentration Data Study

Absorption of heavy and toxic metals causes their accumulation in the edible parts of vegetables. Pollutants such as heavy metals have directly affected the health of society and contributed to emerging diseases in recent years. The current study aimed to detect heavy metals (Pb, Cd, As) in highly consumed leafy vegetables provided from the Tehran market. Four types of vegetables, including dill, parsley, cress, and coriander were selected and 64 samples were randomly collected from fruit and vegetable markets in different regions of Tehran in August and September 2022. Then, samples were analyzed by the ICP-OES system, and health risk assessment was conducted using non-carcinogenic and carcinogenic approach. The range of Pb concentration was 54-314, < LOQ-289, < LOQ-230, and < LOQ-183 μg/kg for dill, cress, parsley, and coriander, respectively. The high mean concentrations of Pb belong to the dill (161.43 ± 77.3 μg/kg) and cress (154.75 ± 72.9 μg/kg). In some samples of dill (37.5% of samples), cress (18.75% of samples), and parsley (12.5% of samples), the Pb content was above the national allowable limit (200 μg/kg). The range of Cd concentration was < LOQ-42, < LOQ-41, < LOQ-30, and < LOQ-38 μg/kg for dill, cress, parsley, and coriander, respectively. In none of the samples, the concentration of Cd was higher than the Iranian national limit (50 μg/kg). The As occurrence was observed in all cress samples with a mean of 165.19 ± 64.83 μg/kg. The range of As concentration was < LOQ-71, < LOQ-256, 58-273, and < LOQ-75 μg/kg for parsley, dill, cress, and coriander, respectively. The THQ and HI values were higher than 1, and either ILCR value was higher than 10-4 for all tested heavy metals, it can be concluded that higher levels of heavy metals than the standard limits in some samples may raise the warning alarm and should come to the attention of the authorities.

Factors associated with frequency of fruit and vegetable consumption among selected sub-Saharan African populations: evidence from the Cardiovascular H3Africa Innovation Resource Project

BACKGROUND

Frequent fruit and vegetable consumption is considered a promising dietary behaviour that protects health. However, most existing studies about the factors associated with this phenomenon among Africans are based on single-country reports, apart from one meta-regression combining smaller studies. This study harmonized large datasets and assessed factors associated with the frequency of fruit and vegetable consumption in this population.

METHODS

Individual-level data on sociodemographics, lifestyle and diet from 20 443 participants across five African countries (Burkina Faso, Ghana, Kenya, South Africa and Nigeria), from the Stroke Investigative Research and Educational Network (SIREN) and Africa Wits-INDEPTH partnership for Genomic Research (AWI-Gen) studies, were harmonized. Total frequency of fruit and vegetable consumption (in portions/week) was classified as 'low' (≤6), 'moderate' (7-14) and 'high' (≥15). Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) of factors associated with the total frequency of fruit and vegetable consumption (using 'low' consumption as the reference) were estimated using multinomial regression models.

RESULTS

Mean age of participants was 54.3 ± 11.8 years, 10 641 (52.1%) were female, and the median (interquartile range) frequency of total fruit and vegetable consumption was 10.0 (4.0, 21.0) portions/week. Participants with a family history of cardiovascular disease [moderate (aOR, 0.92; 95% CI, 0.85, 1.00) and high (aOR, 0.85; 95% CI, 0.78, 0.92)], current smokers [moderate (aOR, 0.83; 95% CI, 0.74, 0.94) and high (aOR, 0.78; 95% CI, 0.69, 0.88)], current alcohol users [moderate (aOR, 0.92; 95% CI, 0.85, 1.00) and high (aOR, 0.82; 95% CI, 0.76, 0.89)] and physically inactive participants [moderate (aOR, 0.85; 95% CI, 0.75, 0.96) and high (aOR, 0.80; 95% CI, 0.70, 0.90)] were less likely to consume fruits and vegetables frequently.

CONCLUSION

Africans with lifestyle risk factors for cardiovascular disease were less likely to consume fruit and vegetables frequently.

Relationship between home garden ownership and the consumption of fruits and vegetables

OBJECTIVE

This study assessed the extent to which access to home gardens associate with the frequency of fruit and vegetable (FV) consumption.

SETTING

The study was carried out in fifty rural communities in Northern Ghana where food insecurity and malnutrition including micronutrient deficiencies are prevalent.

DESIGN

A community-based comparative analytical cross-sectional study.

PARTICIPANTS

A sample of 847 randomly selected rural households.

RESULTS

The proportion of households that consumed FV at least 3 d in a week was 45 %. Members in households who owned a home garden were 1·5 times more likely to consume FV at least 3 d in a week (adjusted OR (AOR) = 1·46 (95 % CI 1·06-2·0)), compared with their counterparts who had no home gardens. Furthermore, households in which mothers had a positive attitude towards FV consumption were 1·6 times more likely to consume FV (AOR = 1·63 (95 % CI 1·17-2·27)) compared with mothers who were less positive.

CONCLUSIONS

Our results suggest that food and nutrition policy measures that promote home gardens can improve consumption of diversified diets including FV among vulnerable rural households in Northern Ghana. Additionally, households with lower income may benefit from nutrition behaviour change communication campaigns directed towards increasing a positive attitude to FV intake.

Myocardial infarct size is reduced by nitrite and nitrate administration: a systematic review and meta-analysis of animal studies

Ischemic heart disease (IHD) is the leading cause of mortality worldwide and can be complicated by myocardial infarction (MI), leading to cardiac failure. Inorganic nitrite and nitrate, which release nitric oxide (NO), can protect the heart against myocardial injury. This animal systematic review and meta-analysis aims to assess whether the administration of nitrite/nitrate decreases myocardial infarct size. We systematically searched PubMed, Scopus, and Web of Science databases until October 2023; 15 eligible animal studies (35 study arms for in-vivo and 10 for in-vitro studies) published between 1989 and 2023 were included. In-vivo studies were conducted on rats, mice, cats, and dogs, and in-vitro studies on rats and mice with an overall exposure of 0.03 to 12713 mg/kg to nitrate/nitrite administrated before, after, or during ischemia mainly by intravenous single bolus or by oral over 270 days. All in-vitro studies used nitrite/nitrate before ischemia, with the concentration ranging between 0.34 to 201 μM. MI was induced by occlusion of the left anterior diagonal or left circumflex arteries in in-vitro studies and by isoproterenol in in-vivo studies. Infarct size was measured by direct staining of the sliced heart sections. In in-vivo studies, nitrite (overall effect size (ES)=-17.0 %, 95 % confidence interval (CI)=-21.3, -12.8, P<0.001) and nitrate (overall ES= -9.6 %, 95 % CI=-15.7, -3.4, P=0.002) reduced myocardial infarct size. In in-vitro studies, nitrite (overall ES=-15.8 %, 95 % CI=-25.5, -6.2, P=0.001) reduced the infarct size. Sensitivity analysis showed that the overall effect of nitrite on myocardial infarct size was unaffected by doses or health conditions in in-vivo and in-vitro studies. In conclusion, our meta-analysis showed that nitrite/nitrate administration can effectively reduce myocardial infarct size. However, these results should be approached with caution because of the limitations of animal studies and the existing high heterogeneity.

Nutrition fact label (NFL) use is related to meeting the requirements for vitamins and minerals not listed on NFLs: Data from the Korea National Health and Nutritional Examination Survey VIII (2019-2021) for the prepandemic and pandemic periods

The credibility and wide usability of nutrition fact labels (NFLs) have increased due to the pandemic, which may lead to healthier nutritional choices. This cross-sectional study aimed to evaluate the association between NFL use and meeting the estimated average requirements (EARs) for vitamins and minerals not listed on NFLs during the prepandemic (2019, n = 6606) and pandemic periods (2020 and 2021, n = 12085) using KNHANES data. Household surveys, health behavior interviews, and health checkup examinations were conducted for all participants. Subjects were included in the unAware+noUse, Aware+noUse, and Aware+Use groups according to NFL usage, and nutritional intake was analyzed by the 24-hour recall method. Complex-sample multiple logistic regression analysis was used to determine the odds ratios (ORs) and 95% confidence intervals (CIs) for meeting the EARs according to NFL usage in the crude and adjusted (including metabolic conditions) models. The primary finding was that awareness and NFL use were associated with adequate intake above the EARs for vitamin A, vitamin B2, niacin, folate, Ca, Fe, and P; this association was more evident during the pandemic. After adjusting for covariates, during the pandemic, the ORs of meeting the EARs in the Aware+noUse group and Aware+Use group were 1.25 (CI 1.06-1.47) and 1.36 (CI 1.05-1.75) for vitamin A, 1.26 (CI 1.06-1.50) and 1.54 (CI 1.19-2.00) for vitamin B2, 1.32 (CI 1.13-1.56) and 1.46 (CI 1.15-1.85) for folate, and 1.46 (CI 1.06-2.00) and 1.73 (1.09-2.75) for P, respectively. Additionally, the ORs for niacin (1.21, 1.02-1.43) and Fe (1.29, 1.08-1.54) were significant in the Aware+noUse group, and that for Ca (1.39, 1.08-1.78) was significant in the Aware+Use group (all p <0.05). In conclusion, NFL awareness and use are associated with meeting the EARs for vitamins and minerals not listed on NFLs. For future recurring health crises, effective NFL use is necessary for healthy dietary practices.

Green Onion (Allium fistulosum): An Aromatic Vegetable Crop Esteemed for Food, Nutritional and Therapeutic Significance

In recent years, there has been a shift towards a greater demand for more nutritious and healthier foods, emphasizing the role of diets in human well-being. Edible Alliums, including common onions, garlic, chives and green onions, are staples in diverse cuisines worldwide and are valued specifically for their culinary versatility, distinct flavors and nutritional and medicinal properties. Green onions are widely cultivated and traded as a spicy vegetable. The mild, onion-like flavor makes the crop a pleasant addition to various dishes, serving as a staple ingredient in many world cuisines, particularly in Eastern Asian countries such as China, Japan and the Republic of Korea. The green pseudostems, leaves and non-developed bulbs of green onions are utilized in salads, stir-fries, garnishes and a myriad of culinary preparations. Additionally, green onions have a rich historical background in traditional medicine and diets, capturing the attention of chefs and the general public. The status of the crop as an important food, its culinary diversity and its nutraceutical and therapeutic value make it a subject of great interest in research. Therefore, the present review has examined the distribution, culinary, nutritional and therapeutic significance of green onions, highlighting the health benefits derived from the consumption of diets with this aromatic vegetable crop as a constituent.

Validation of resonance Raman spectroscopy-measured skin carotenoid status as a biomarker for fruit and vegetable intake in Korean adults

Blood carotenoid concentration measurement is considered the gold standard for fruit and vegetable (F&V) intake estimation; however, this method is invasive and expensive. Recently, skin carotenoid status (SCS) measured by optical sensors has been evaluated as a promising parameter for F&V intake estimation. In this cross-sectional study, we aimed to validate the utility of resonance Raman spectroscopy (RRS)-assessed SCS as a biomarker of F&V intake in Korean adults. We used data from 108 participants aged 20-69 years who completed SCS measurements, blood collection and 3-d dietary recordings. Serum carotenoid concentrations were quantified using HPLC, and dietary carotenoid and F&V intakes were estimated via 3-d dietary records using a carotenoid database for common Korean foods. The correlations of the SCS with serum carotenoid concentrations, dietary carotenoid intake and F&V intake were examined to assess SCS validity. SCS was positively correlated with total serum carotenoid concentration (r = 0·52, 95 % CI = 0·36, 0·64, P < 0·001), serum β-carotene concentration (r = 0·60, 95 % CI = 0·47, 0·71, P < 0·001), total carotenoid intake (r = 0·20, 95 % CI = 0·01, 0·37, P = 0·04), β-carotene intake (r = 0·30, 95 % CI = 0·11, 0·46, P = 0·002) and F&V intake (r = 0·40, 95 % CI = 0·23, 0·55, P < 0·001). These results suggest that SCS can be a valid biomarker of F&V intake in Korean adults.

Meal kit subscription services and opportunities to improve family vegetable consumption

Popular commercial meal kit subscription services (MKSSs) may support families to overcome barriers to cooking and eating at home, and facilitate improved vegetable consumption. The global meal kit market has expanded rapidly creating a gap in our understanding of the health-promoting potential of MKSSs. This paper describes the contemporary MKSS market in Australia and provides a vegetable-specific content analysis of a sample of recipes. A 1-week subscription was purchased for all Australian-based MKSSs (n = 9) and websites were systematically reviewed to document key characteristics and recipe features. Vegetable content of all available recipes within a 1-week period were analysed. Our findings highlight the rapid expansion and evolution of MKSS market offerings over the past decade and their potential to support family vegetable consumption. Across all analysed recipes (n = 179), MKSSs provided a median of 2.5 vegetable serves per person (range 0.7-7.5 serves) and a median of 3 different types of vegetables from 2 vegetable subgroups (i.e. dark green, red and orange, starchy, legumes and all other vegetables). This suggests that MKSSs may support family vegetable consumption if families select recipes with a greater number and variety of vegetables. However, an opportunity remains for MKSSs to improve both vegetable quantity and variety to positively influence population health. Further research is required to describe how families use meal kits promoting a greater understanding of their potential to improve family nutrition.

Don't forget the veggies! Identifying and addressing a lack of vegetable education in physiology

Ninety-five percent of Westerners do not consume the recommended daily vegetable intake, exacerbating the incidence of obesity, malnutrition, and nutritional deficiencies such as fiber. This article reviews the literature from PubMed, ERIC, and Web of Science, as well as Internet sites and government resources, to identify what should be considered important inclusions relating to dietary vegetable (including legumes and pulses) intake content in university physiology subjects. The primary aim is to advance the competency relating to good nutrition knowledge for future health professionals to enable them to guide and counsel patients and clients toward better health. A review of the literature provides scant nutritional content relating to vegetable intake, particularly across physiology subjects and health professional programs in general. A review of country dietary guidelines yielded discrepancies and ambiguity around recommended daily vegetable intake, including what constitutes essential vegetables. Educators responsible for embedding nutritional information in the curriculum would therefore be challenged to find reliable, evidence-based resources. Adding quality curriculum content on the importance of vegetable intake also promotes some of the Sustainable Development Goals (SDGs), including SDG 2 (Zero Hunger), thereby contributing to SDG 3 (Good Health and Well-Being). This article offers recommendations on how to embed content relating to the importance of dietary vegetables for good health and guidance for educators of health professions programs wanting to improve their curriculum content relating to adequate nutrition.NEW & NOTEWORTHY Is nutritional literacy an important concept in physiology? This article identifies a paucity of content and addresses the need for vegetable intake education.

Barriers to consumption of fruits and vegetables and strategies to overcome them in low- and middle-income countries: a narrative review

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.

Availability and price of fruits and vegetables in the surroundings of food and nutrition public establishments

BACKGROUND

Inequalities of access to healthy food reinforce the need to strengthen public policies on Food and Nutritional Security. In this context, Food and Nutrition Public Establishments, which are public spaces for distribution and commercialization of healthy foods, stand out. However, in middle-income countries there is little monitoring of the impacts of public policies on food environments, which are fundamental for strengthening these actions. Thus, the purpose of the study was to evaluate the availability and price of fruits and vegetables in areas with and without Food and Nutrition Public Establishments.

METHODOLOGY

A cross-sectional study carried out in Belo Horizonte, Brazil. Audits were conducted in the retail food environment of a representative sample of Food and Nutrition Public Establishments (n = 10) and corresponding census sectors, without Food and Nutrition Public Establishments (n = 10). Information was collected on the availability and price of the most consumed fruits and vegetables in Belo Horizonte. The food retailers were grouped into fresh food retailers and mixed food retailers. The Chi-Square test was used to compare the availability of fruits and vegetables between areas. The Mann Whitney test was used to compare the prices of fruit and vegetables and the price differences between fresh food retailers and mixed food retailers between areas.

RESULTS

148 food retailers were audited, including 17 Food and Nutrition Public Establishments. In fresh food retailers, the availability of vegetables was higher in areas with Food and Nutrition Public Establishments (p = 0.024). In mixed food retailers there was low availability of fruit and vegetables in both areas (34.0% vs. 26.2%; p>0.05). The price difference between fresh food retailers and mixed food retailers differed significantly between areas (p<0.001). In general, fresh food retailers had lower prices than mixed food retailers only in areas with Food and Nutrition Public Establishments.

CONCLUSIONS

The presence of Food and Nutrition Public Establishments was associated with the availability of vegetables, and with lower prices in fresh food retailers compared with mixed food retailers. Monitoring and understanding the impacts of public policies on the food environment are essential to register trends and provide relevant information to civil society and government authorities.

Exploring Benefits and Barriers of Plant-Based Diets: Health, Environmental Impact, Food Accessibility and Acceptability

Unhealthy dietary patterns are directly linked to the current Global Syndemic consisting of non-communicable diseases, undernutrition and climate change. The dietary shift towards healthier and more sustainable plant-based diets is essential. However, plant-based diets have wide intra differences; varying from vegan diets that totally exclude meat and animal products to traditional ones such as the Mediterranean diet and the new Nordic diet. It is acknowledged that plant-based diets may contribute simultaneously to improving population health as well as to decreasing the environmental impact of food systems. Evidence from cohort and randomized-controlled trials suggests that plant-based dietary patterns have beneficial effects on bodyweight control, cardiovascular health and diabetes prevention and treatment. On the other hand, micronutrient requirements may not be met, if some plant-based diets are not well-planned. Additionally, studies showed that lower consumption of meat and animal products results in lower environmental impacts. Consequently, plant-based diets could be a key factor to increase diet sustainability. This narrative review addresses the advantages of adherence to plant-based diets on human and planetary health considering strains and barriers to achieve this dietary transition, including cultural acceptability and affordability factors. Finally, potential intervention and policy recommendations are proposed, focusing on the update of current national food-based dietary guidelines.

Global food nutrients analysis reveals alarming gaps and daunting challenges

Eliminating both overt and hidden hunger is at the core of the global food and nutrition security agenda. Yet, the collective state of nutrition security at the population level is not known. Here we quantify food-based availability of 11 essential nutrients for 156 countries using a food production-consumption-nutrition model, followed by assessment of the nutrient availability status as a ratio of recommended intake. For the baseline year 2017, global per capita availability was adequate for calorie and protein but in severe deficit for vitamin A and calcium (intake ratios, <0.60, where 1.0 is adequate) and moderate deficit for vitamin B12 (intake ratio, 0.76). At the country level, more than half of the 156 countries were in various degrees of deficit for all nine micronutrients. Disparities across regions or countries were enormous. We explore intervention strategies from an agriculture-food system perspective and discuss the daunting challenges of addressing nutrition security broadly.

Translating and Testing a Digital Game Promoting Vegetable Consumption in Young Children: Usability Study

BACKGROUND

Promoting healthy eating in children is key to preventing chronic diseases, and vegetable consumption is notably lower than recommended in this population. Among the interventions tested, gamification has shown promise in promoting familiarization, increasing knowledge, and potentially increasing vegetable intake.

OBJECTIVE

This pilot study aimed first to translate the digital game "Veggies4myHeart" into French and to assess its influence on young children's preferences and willingness to taste vegetables when combined with repeated tasting and education. We also aimed to investigate the acceptability and applicability of the game in 2 classrooms.

METHODS

During 5 consecutive weekly sessions, children from 2 elementary classes played the digital game consisting of 5 mini games on different vegetables (lettuce, carrot, red cabbage, cucumber, and tomato) in pairs for 10-15 minutes. In addition, they discussed one of the vegetables and tasted the 5 vegetables in each session. Pretest and posttest food preferences and willingness to taste the vegetables were compared. Teachers participated in a semistructured interview.

RESULTS

A total of 45 children aged 5 to 6 years tested the French version of the digital game. The children's declared food preferences were already high for carrot, cucumber, and tomato, with scores higher than 4 out of a maximum of 5. The scores did not change significantly after the intervention, except for red cabbage (pretest: mean 2.52, SD 1.49; posttest: mean 3.29, SD 1.67; P=.006) and a composite score (pretest: mean 3.76, SD 1.06; posttest: mean 4.05, SD 1.03; P=.001). Before the intervention, 18 (44%), 30 (73%), 16 (39%), 29 (71%), and 26 (63%) children out of 41 were willing to taste lettuce, carrot, red cabbage, cucumber, and tomato, respectively. After the intervention, no significant statistical differences were observed, with 23 (51%), 36 (80%), 24 (53%), 33 (73%), and 29 (64%) children out of 45 willing to taste lettuce, carrot, red cabbage, cucumber, and tomato, respectively. Teachers supported this tool combined with repeated tasting and education and highlighted facilitators and barriers that should be anticipated to improve implementation in schools.

CONCLUSIONS

In this study, we translated an existing digital game applicable and acceptable to both children and teachers. A larger study is warranted to confirm the effectiveness of interventions using the digital game to promote vegetable preference, willingness to taste, and intake.

Latin American and the Caribbean Code Against Cancer 1st edition: Weight, physical activity, diet, breastfeeding, and cancer

In Latin America and the Caribbean a considerable proportion of the population have excess body weight, do not meet the recommendations of physical activity and healthy diet, and have suboptimal rates of breastfeeding. Excess body weight is associated with at least 15 cancer sites, physical activity protects against three cancers, with some evidence suggesting a protective effect for eight more cancer sites, and sedentary behavior probably increases the risk of five cancer sites. Fiber and wholegrains protect against colorectal cancer, high intake of fruits and vegetables could reduce the risk of aerodigestive cancers; processed and red meat increase the risk of colorectal cancer; and very hot beverages are associated with esophageal cancer. Moreover, sugar-sweetened beverages and ultra-processed foods are a convincing cause for excess body weight, increasing cancer risk through this pathway, with some emerging evidence suggesting also direct pathways. Breastfeeding protects against breast cancer, and could protect against ovarian cancer. Taking this evidence into account, the Latin America and the Caribbean Code Against Cancer recommends the general public to maintain a healthy body weight, be physically active and limit sedentary behavior, eat a healthy diet (eat plenty of vegetables, fruits, wholegrains and legumes; avoid sugar-sweetened beverages and processed meat; and limit ultra-processed foods, red meat and very hot beverages), and breastfeed. Moreover, the Latin America and the Caribbean Code Against Cancer also includes a set of public policy recommendations for cancer prevention to inform policy makers and civil society about the need of policies to shape healthy environments and create opportunities to facilitate the adoption of the recommendations directed to the public.

Mechanistic investigation of enhanced bacterial soft rot resistance in lettuce (Lactuca sativa L.) with elemental sulfur nanomaterials

Crop diseases significantly threaten global food security and will worsen with a changing climate. Elemental sulfur nanomaterials (S NMs) were used to suppress bacterial pathogen Pectobacterium carotovorum on lettuce (Lactuca sativa L.). Foliar application with S NMs at 10-100 mg/L statistically decreased the occurrence of bacterial soft rot, where 100 mg/L exhibited the best performance with alleviating disease severity by 94.1 % as relative to infected controls. The disease suppression efficiency of S based materials (100 mg/L) and a conventional pesticide (thiophanate-methyl) followed the order of S NMs ≈ pesticide > S bulk particles (BPs) > sulfate. The disease control efficiency of S NMs was 1.33- and 3.20-fold that of S BPs and sulfate, respectively, and the shoot and root biomass with S NMs was 1.25- and 1.17-fold that of the pesticide treated plants. Mechanistically, S NMs (1) triggered jasmonic acid (JA) and salicylic acid (SA) mediated systematic induced resistance and systemic acquired resistance, thereby upregulating pathogenesis-related gene expression (enhanced by 29.3-259.7 %); (2) enhanced antioxidative enzyme activity and antioxidative gene expression (improved by 67.5-326.6 %), thereby alleviating the oxidative stress; and (3) exhibited direct in vivo antibacterial activity. Metabolomics analysis demonstrated that S NMs also promoted the tricarboxylic acid cycle and increased SA and JA metabolite biosynthesis. Moreover, S NMs application increased nutritive quality of lettuce by 20.8-191.7 %. These findings demonstrate that S NMs have potential to manage crop disease, thereby reducing the environmental burden due to decreasing use of conventional pesticides.

Cost and affordability of a healthy diet for urban populations in Thailand and the Philippines before and during the COVID-19 pandemic

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic severely affected global food security, but analyses of its impact on the cost and affordability of a healthy diet are limited. This study examines the immediate effect of the COVID-19 pandemic on the cost and affordability of a healthy diet among urban households in Bangkok, Thailand and Manila, the Philippines.

METHODS

We used official food price and household income and food expenditure data from the national statistics offices. The cost of recommended diet (CoRD) method was employed to assess the minimum cost of a healthy diet, following the healthy diet recommendations provided in the national food-based dietary guidelines of the specific countries. Regression discontinuity design was estimated to determine the COVID-19 effect on food prices and scenario analysis done to determine the effect of reduced food budgets with and without government relief programs.

RESULTS

The results show that the average cost of the recommended diet was US$ 1.55 per person/day in Bangkok and US$ 3.76 in Manila (2019 prices in purchasing power parities) immediately before the pandemic. This diet is generally affordable for all households in Bangkok, but only for 37% of households (4.98 million people) in Manila, indicating much higher poverty in the latter. The pandemic and associated government measures decreased the cost of the recommended diet with 6.5% in Bangkok (p = 0.001) but not in Manila (p = 0.167). Assuming contractions in people's food budgets of 15-20%, the recommended diet became unaffordable for 0.08-0.12 million people in Bangkok and 6.32-7.73 million people in Manila during the pandemic. Government relief largely compensated for this loss in Bangkok, but relief payments in Manila were not enough to compensate the effect.

CONCLUSION

These results show that the main effect of the COVID-19 pandemic on the affordability of healthy diets was through the effect on reduced incomes of the poor rather than through prices. Government relief measures should target low-income households to give them the means to purchase healthy food items.

Zero fruits/vegetables consumption and associated factors among Children aged 6-23 months in Ethiopia: Mixed effect logistic regression analysis

BACKGROUND

The first two years of life is a vital period for promoting optimal growth, development and health. The lifelong nutritional habit and overall health of children is influenced by their early age feeding practice. Ethiopia is among the top five countries in Sub-Saharan Africa with the highest burden of zero fruits/vegetables consumption. This study aims to access factors associated with zero fruits/vegetables consumption among children aged 6-23 months in Ethiopia.

METHODS

The study analyzed Ethiopian Mini Demographic and Health Survey 2019 dataset with a total weighted sample of 1459 young children aged between 6-23 months and who were living with their mothers. Data cleaning, coding and labeling were done using STATA version 14 software. Multilevel mixed effect logistic regression model was employed to identify associated factors.

RESULTS

Exactly 69.3% of children aged 6-23 months in Ethiopia had zero fruits/vegetables consumption. In the multivariable multilevel binary logistic regression analysis a child from household with middle (AOR = 0.55, 95% CI: 0.35, 0.86) and rich (AOR = 0.37, 95% CI: 0.23, 0.60) wealth index, mothers who aged between 25-34 years old (AOR = 0.44; 95%CI = 0.29-0.69), mothers who were married/living with partner (AOR = 3.21; 95%CI: 1.58-6.52), children of mothers who follow Islamic religion (AOR = 0.34, 95% CI: 0.19, 0.61), mothers who had more than four ANC visits during their most recent pregnancy (AOR = 0.57; 95%CI: 0.39-0.83), children in age group of 12-18 month(AOR = 0.41, 95% CI: 0.28, 0.59), and 19-23 months (AOR = 0.26, 95% CI: 0.17, 0.40), health facility delivery (AOR = 1.52, 95% CI; 1.00-2.30), and small peripheral regions (AOR = 4.40, 95% CI; 1.39-13.97) were found to be significant factors associated with children's zero fruits /vegetables consumption. The Interclass correlation coefficient (ICC) value in the null model was 0.34, which indicates that 34% of the variation in children's zero fruits /vegetables consumption was attributed to the variation between clusters.

CONCLUSION

This study found that zero fruits/vegetables consumption among children aged 6-23 months in Ethiopia is high. Therefore, efforts should be made by stakeholders who are concerned about optimal diet and health of children to improve fruits/vegetables consumption of children particularly those from poor households, young mothers (15-24), and peripheral regions of Ethiopia. This could be done during ANC follow up visits and during nutrition counseling.

How the EAT-Lancet Commission on food in the Anthropocene influenced discourse and research on food systems: a systematic review covering the first 2 years post-publication

In 2019, the EAT-Lancet Commission's report on food in the Anthropocene presented a planetary heath diet to improve health while reducing the environmental effect of food systems globally. We assessed EAT-Lancet's immediate influence on academic research and debate by conducting a systematic review of articles citing the Commission and others published from January, 2019, to April, 2021. The Commission influenced methods, results, or discourse for 192 (7·5%) of 2560 citing articles, stimulating cross-disciplinary research and debate across life sciences (47%), health and medical sciences (42%), and social sciences (11%). Sentiment analysis of 76 critiquing articles indicated that opinions were, on average, more positive than negative. Positive sentiments centred on benefits for informing policy, public health, and raising public awareness. Negative sentiments included insufficient attention to socioeconomic dimensions, feasibility, and environmental effects other than emissions. Empirical articles predominantly evaluated the effects of changed diets or food production on the environment and wellbeing (29%), compared current diets with EAT-Lancet recommendations (12%), or informed future policy and research agendas (20%). Despite limitations in EAT-Lancet's method, scope, and implementation feasibility, the academic community supported these recommendations. A broad suite of research needs was identified focusing on the effects of food processing, socioeconomic and political drivers of diet and health, and optimising consumption or production for environment and health.

Dietary Polyphenol Intake and Risk of Hypertension: An 18-y Nationwide Cohort Study in China

BACKGROUND

Although increasing evidence suggests that polyphenol helps regulate blood pressure (BP), evidence from large-scale and long-term population-based studies is still lacking.

OBJECTIVES

This study aimed to investigate the association between dietary polyphenol and hypertension risk in the China Health and Nutrition Survey (N = 11,056).

METHODS

Food intake was assessed using 3-d, 24-h dietary recalls and household weighing method; polyphenol intake was calculated by multiplying consumption of each food and its polyphenol content. Hypertension was defined as BP ≥ 140/90 mmHg, physicians' diagnosis, or taking antihypertension medications. HR and 95% CI were estimated using mixed-effects Cox models.

RESULTS

During 91,561 person-years of follow-up, a total of 3866 participants developed hypertension (35%). The lowest multivariable-adjusted HR (95% CI) of hypertension risk occurred in the third quartile intake, which was 0.63 (0.57, 0.70) for total polyphenol, 0.61 (0.55, 0.68) for flavonoid, 0.62 (0.56, 0.69) for phenolic acid, 0.46 (0.42, 0.51) for lignan, and 0.58 (0.52, 0.64) for stilbene, compared with the lowest quartile. The polyphenol-hypertension associations were nonlinear (all Pnonlinearity < 0.001), and different patterns were observed. U-shaped relations with hypertension were observed for total polyphenol, flavonoid, and phenolic acid, whereas L-shaped associations were observed for lignan and stilbene. Moreover, higher fiber intake strengthened the polyphenol-hypertension association, especially for lignan (P-interaction = 0.002) and stilbene (P-interaction = 0.004). Polyphenol-containing food, particularly vegetables and fruits rich in lignan and stilbene, were significantly associated with lower hypertension risk.

CONCLUSIONS

This study demonstrated an inverse and nonlinear association between dietary polyphenol, especially lignan and stilbene, and hypertension risk. The findings provide implications for hypertension prevention.

Total meat (flesh) supply may be a significant risk factor for cardiovascular diseases worldwide

Consumption of red meat instead of white meat has typically been associated with cardiovascular diseases (CVDs). Reflecting actual diet patterns, this study explored the role of total meat (red + white) in predicting CVD incidence. Data from 217 countries were extracted from United Nations agencies for the analyses in five steps. Bivariate correlations were applied to examine the relationship between total meat and CVD incidence globally and regionally. Partial correlation was applied to identify that total meat was an independent predictor of CVD incidence while socioeconomic status, obesity, and urbanization were statistically constant. Stepwise linear regression was conducted for selecting the significant predictor of CVD incidence. SPSS 28 and Microsoft Excel were used for correlation analyses. Globally, total meat correlated to CVD incidence strongly and significantly in bivariate correlation models. This relationship remained significant in partial correlation when socioeconomic status, obesity, and urbanization were statistically kept constant. Stepwise multiple regression identified that, second to socioeconomic status, total meat was a significant predictor of CVD incidence. Total meat correlated to CVD incidence in different country groupings. However, the correlations between total meat and CVD incidence were significantly stronger in developing countries than in developed countries. Worldwide, total meat (flesh) consumption correlated to CVD incidence independently, but significantly stronger in developing countries than in developed countries. This correlation is worth exploring further in longitudinal cohort studies.

Ultra-Processed Food vs. Fruit and Vegetable Consumption before and during the COVID-19 Pandemic among Greek and Swedish Students

BACKGROUND

The COVID-19 pandemic has impacted children's lifestyles, including dietary behaviors. Of particular concern among these behaviors is the heightened prevalence of ultra-processed food (UPF) consumption, which has been linked to the development of obesity and related non-communicable diseases. The present study examines the changes in (1) UPF and (2) vegetable and/or fruit consumption among school-aged children in Greece and Sweden before and during the COVID-19 pandemic.

METHODS

The analyzed dataset consisted of main meal pictures (breakfast, lunch, and dinner) captured by 226 Greek students (94 before the pandemic and 132 during the pandemic) and 421 Swedish students (293 before and 128 during the pandemic), aged 9-18, who voluntarily reported their meals using a mobile application. The meal pictures were collected over four-month periods over two consecutive years; namely, between the 20th of August and the 20th of December in 2019 (before the COVID-19 outbreak) and the same period in 2020 (during the COVID-19 outbreak). The collected pictures were annotated manually by a trained nutritionist. A chi-square test was performed to evaluate the differences in proportions before versus during the pandemic.

RESULTS

In total, 10,770 pictures were collected, including 6474 pictures from before the pandemic and 4296 pictures collected during the pandemic. Out of those, 86 pictures were excluded due to poor image quality, and 10,684 pictures were included in the final analyses (4267 pictures from Greece and 6417 pictures from Sweden). The proportion of UPF significantly decreased during vs. before the pandemic in both populations (50% vs. 46%, p = 0.010 in Greece, and 71% vs. 66%, p < 0.001 in Sweden), while the proportion of vegetables and/or fruits significantly increased in both cases (28% vs. 35%, p < 0.001 in Greece, and 38% vs. 42%, p = 0.019 in Sweden). There was a proportional increase in meal pictures containing UPF among boys in both countries. In Greece, both genders showed an increase in vegetables and/or fruits, whereas, in Sweden, the increase in fruit and/or vegetable consumption was solely observed among boys.

CONCLUSIONS

The proportion of UPF in the Greek and Swedish students' main meals decreased during the COVID-19 pandemic vs. before the pandemic, while the proportion of main meals with vegetables and/or fruits increased.

Agro-Food Waste as an Ingredient in Functional Beverage Processing: Sources, Functionality, Market and Regulation

Waste generated from the agro-food industry represents a concerning environmental, social and economic issue. The Food and Agriculture Organization of the United Nations defines food waste as all food that decreases in quantity or quality to the extent that it is thrown out by food service providers and consumers. The FAO reports that 17% of worldwide food production may be wasted. Food waste may include fresh products, food close to the expiration date discarded by retailers and food products from household kitchens and eating establishments. However, food waste offers different possibilities to extract functional ingredients from different sources, such as dairy, cereals, fruits, vegetables, fibers, oils, dye and bioactive compounds. The optimization of agro-food waste as an ingredient will help in the development and innovation of food products to generate functional food and beverages to prevent and treat several diseases in consumers.

Digital behaviour change interventions to increase vegetable intake in adults: a systematic review

BACKGROUND

Digital interventions may help address low vegetable intake in adults, however there is limited understanding of the features that make them effective. We systematically reviewed digital interventions to increase vegetable intake to 1) describe the effectiveness of the interventions; 2) examine links between effectiveness and use of co-design, personalisation, behavioural theories, and/or a policy framework; and 3) identify other features that contribute to effectiveness.

METHODS

A systematic search strategy was used to identify eligible studies from MEDLINE, Embase, PsycINFO, Scopus, CINAHL, Cochrane Library, INFORMIT, IEEE Xplore and Clinical Trial Registries, published between January 2000 and August 2022. Digital interventions to increase vegetable intake were included, with effective interventions identified based on statistically significant improvement in vegetable intake. To identify policy-action gaps, studies were mapped across the three domains of the NOURISHING framework (i.e., behaviour change communication, food environment, and food system). Risk of bias was assessed using Cochrane tools for randomized, cluster randomized and non-randomized trials.

RESULTS

Of the 1,347 records identified, 30 studies were included. Risk of bias was high or serious in most studies (n = 25/30; 83%). Approximately one quarter of the included interventions (n = 8) were effective at improving vegetable intake. While the features of effective and ineffective interventions were similar, embedding of behaviour change theories (89% vs 61%) and inclusion of stakeholders in the design of the intervention (50% vs 38%) were more common among effective interventions. Only one (ineffective) intervention used true co-design. Although fewer effective interventions included personalisation (67% vs 81%), the degree of personalisation varied considerably between studies. All interventions mapped across the NOURISHING framework behaviour change communication domain, with one ineffective intervention also mapping across the food environment domain.

CONCLUSION

Few digital interventions identified in this review were effective for increasing vegetable intake. Embedding behaviour change theories and involving stakeholders in intervention design may increase the likelihood of success. The under-utilisation of comprehensive co-design methods presents an opportunity to ensure that personalisation approaches better meet the needs of target populations. Moreover, future digital interventions should address both behaviour change and food environment influences on vegetable intake.

Level of Fruit and Vegetable Intake and Its Relationship with Risk for Malnutrition in China’s Adult Labor Force: China Nutrition and Health Surveillance, 2015–2017

The purpose of this study was to analyze the fruit and vegetable intake status and examine both potential risk and protective action factors in the Chinese labor force population, while investigating the association between fruit and vegetable intake and malnutrition in this population. Data were derived from a population-based cross-sectional survey, the China Nutrition and Health Surveillance, 2015–2017. Sociodemographic information, physical measurements, and dietary intake data were collected. A total of 45,459 survey respondents aged 18–64 years old were included in the analysis. Fruit and vegetable consumption data were assessed by a food frequency questionnaire (FFQ), and the average daily intake was calculated. In 2015, the daily intake of fresh fruits, fresh vegetables, and combined fruits and vegetables among the Chinese labor force was 64.3 g, 210.0 g, and 330.0 g (median), respectively. Compared with the Dietary Guidelines for Chinese Residents (2022), 79.9% and 53.0% were at risk of inadequate fruit and vegetable intake, while 55.2% were at risk of inadequate intake of combined fruits and vegetables compared with the WHO recommendation. Multivariate logistic regression analysis showed that female gender, higher educational level, and higher income were protective factors for adequate fruit intake, while increasing age and living in the southern region were protective factors for adequate vegetable intake. The results confirmed that increasing vegetable intake helped urban labor force maintain normal BMI and control overweight. Increased fruit consumption may reduce the risk of underweight, but no clear negative association with overweight and obesity was observed. In conclusion, the consumption of fresh fruits and vegetables by the Chinese labor force was inadequate, especially for fruits. Interventions are needed to promote the daily intake of fruits and vegetables in this population. In addition, further in-depth studies in this area are recommended in populations with different health status.