The Interplay of Sports and Nutrition in Neurological Health and Recovery

This comprehensive review explores the dynamic relationship between sports, nutrition, and neurological health. Focusing on recent clinical advancements, it examines how physical activity and dietary practices influence the prevention, treatment, and rehabilitation of various neurological conditions. The review highlights the role of neuroimaging in understanding these interactions, discusses emerging technologies in neurotherapeutic interventions, and evaluates the efficacy of sports and nutritional strategies in enhancing neurological recovery. This synthesis of current knowledge aims to provide a deeper understanding of how lifestyle factors can be integrated into clinical practices to improve neurological outcomes.

Impacts of the SARS-CoV-2 pandemic on the dietary practices of university students in Germany

Purpose

The dietary practices (DPs) of university students are influenced by many external factors. Therefore, we investigate how the DPs of students in Germany changed during the SARS-CoV-2 pandemic, what the main motivations were for those changes, and what effect the closure of university catering had on the DPs of students.

Methods

A total of 560 students from two universities in Lübeck (Germany) were surveyed online during a pilot phase. The final online questionnaire was subsequently administered at 10 other German universities (399 respondents). The questionnaire surveyed sociodemographic factors, dietary habits, food consumption frequencies, and the relevance of university catering before and during the SARS-CoV-2 pandemic.

Results

Regarding changes in DPs, similarities to previous studies were found, especially positive eating behaviors and an increasing interest in health- and nutrition-related sustainability. Students prepared meals freshly more often during the pandemic; consumed legumes, plant-based meats and dairy alternatives more often; and reduced their consumption of meat and milk compared to before the pandemic. The consumption frequency of sweets also decreased. It was observed that students consider eating communal in the university canteen to be highly relevant for their social interactions, which was only possible to a limited extent during the pandemic.

Conclusion

In Germany, the DPs of university students as well as criteria regarding health and sustainability changed during the first 2 years of the SARS-CoV-2 pandemic. The social aspect of DPs became evident due to closed university catering. Still, changes in dietary patterns and eating habits were positively related to health and revealed some differences in the cross section of the population.

Stunting and Underweight among Adolescent Girls of Indigenous Communities in Telangana, India: A Cross-Sectional Study

India's indigenous groups remain vulnerable to malnutrition, despite economic progress, reflecting the reliance on traditional agriculture and the problems of poverty and inadequate education and sanitation. This mixed-methods study analyzed the incidence, causes and determinants of chronic malnutrition, measured through stunting, thinness and underweight among adolescent indigenous girls in Telangana. Using 2017 data on 695 girls aged 11-18 years from 2542 households, the analysis showed that 13% had normal nutritional status, while 87% were stunted, underweight or thin. Early adolescents (11-14 years) had higher underweight prevalence (24.4%), while late adolescents (15-18 years) showed greater stunting (30%). Regressions identified key influencing factors. Higher education levels of heads of households and the girls themselves alongside household toilet access significantly improved nutritional status and reduced stunting and underweight. The sociocultural emphasis on starchy staple-based diets and early marriage also impacted outcomes. Tackling this crisis requires mainstreaming nutrition across development agendas via comprehensive policies, education, communication and community participation. Further research can guide context-specific solutions. But, evidence-based investments in indigenous education, livelihoods, sanitation and women's empowerment are the first steps. Nutrition-sensitive development is indispensable for indigenous groups to fully participate in and benefit from India's progress.

Advances in Understanding the Interplay between Dietary Practices, Body Composition, and Sports Performance in Athletes

The dietary practices of athletes play a crucial role in shaping their body composition, influencing sports performance, training adaptations, and overall health. However, despite the widely acknowledged significance of dietary intake in athletic success, there exists a gap in our understanding of the intricate relationships between nutrition, body composition, and performance. Furthermore, emerging evidence suggests that many athletes fail to adopt optimal nutritional practices, which can impede their potential achievements. In response, this Special Issue seeks to gather research papers that delve into athletes' dietary practices and their potential impacts on body composition and sports performance. Additionally, studies focusing on interventions aimed at optimizing dietary habits are encouraged. This paper outlines the key aspects and points that will be developed in the ensuing articles of this Special Issue.

Determinants of body weight changes during Ramadan fasting in India amid COVID-19: A cross-sectional study

Ramadan intermittent fasting (RIF) presents unique challenges and opportunities for public health and clinical practice, especially in populations with a high prevalence of non-communicable diseases. This study aims to investigate the impact of RIF on weight change among Indian Muslims and explore the associated demographic, dietary, and behavioral factors. A cross-sectional survey was conducted with a sample of Indian Muslim adults who observed RIF. Participants were asked to report their demographic information, family and personal health history, and dietary and lifestyle behaviors before and during Ramadan month. The primary outcome was body weight change, with secondary outcomes including changes in dietary patterns, physical activity, and other health-related lifestyle behaviors. The study found that during Ramadan, nearly half of the participants (48.5%) self-reported a retained initial weight, while a significant fraction (30.9%) self-reported a modest weight reduction between 0.5 to 2.5 kg at the end of Ramadan. Additionally, self-reported eating practices demonstrated moderately altered by about half (48.4%) of the study participants, with 32.2% reporting minor changes and 8.2% indicating substantial changes. An urban residence was associated with a higher likelihood of weight gain, where urban residents showed 3 times the odds of increased weight compared to rural inhabitants. Employment status emerged as a significant determinant for weight fluctuation, influencing both weight gain and loss. During Ramadan, there was a significant rise in snacking frequency, increasing from 21.7% to 32.6% in comparison with pre-Ramadan. The consumption of large quantities of food more frequently grew from 14.9% to 36%, and the incidence of eating despite not being hungry went up from 17.4% to 33.2%. The study demonstrates that RIF is associated with variable changes in body weight among adult Indian Muslims, influenced by urbanization, employment status, and dietary changes. The findings suggest that clinicians should provide tailored advice about body weight regulation during Ramadan and consider integrating community-based health initiatives within religious settings to improve health outcomes.

Knowledge, Attitude, and Practice Toward Dietary Salt Intake Among Medical Students at King Abdulaziz University

Background Since the beginning of the century, dietary patterns have been changing rapidly due to evolving lifestyles, restaurants that cater to dietary restrictions, etc. As a result, populations started consuming a large amount of salt in their diets. Years of research have found that high salt intake is strongly related to many serious health problems like hypertension and cardiovascular diseases. This study's objective is to evaluate knowledge, attitudes, and practices regarding dietary salt intake among medical students at King Abdulaziz University (KAU) in Jeddah, Saudi Arabia, and to identify barriers and concerns related to optimum dietary sodium intake. Method A cross-sectional study done at KAU among 310 students using an online questionnaire included items to assess their knowledge, attitudes, and practices related to dietary salt intake. There were 24 questions to assess knowledge, six questions to assess attitude, and eight questions to assess practice. Results The mean age of the participants was 21.52 ± 1.94 years; 180 of the 57.5% were female. A score of "1" was given to the right answer for knowledge, positive attitude, and correct practice. The mean knowledge, attitudes, and practices scores were 16.99 ± 3.8, 3.03 ± 1.46, and 2.13 ± 1.34, respectively. The percentage of poor, fair, and good knowledge levels regarding dietary salt intake among studied students was 72:23%, 210:67.1%, and 31:9.9%. While the prevalence of negative, fair, and positive attitudes was 111:35.5%, 141:45%, and 161:9.5%. As for practice level, none of the students had good practice, while 263:84% and 50:16% had poor and fair practice, respectively. Conclusion In conclusion, the majority of students were aware that a high-salt diet can result in serious health issues. They were also uncertain of whether their salt intake was extremely high or not, which is consistent with the fact that they were ignorant of the daily salt intake guidelines. The findings in our study can stand as a reference point for salt-related knowledge, attitude, and practice (KAP) studies to help further future research in Saudi Arabia and other countries. Multi-sector coordination between the food suppliers, health agencies, and government is necessary to increase public awareness, decrease the salt content of food, and lower individual salt consumption in Saudi Arabia.

Awareness of Nutrition Facts Labeling and Its Relation to Oral Health Practices and Caries Experience Among Adult Patients

AIM

To investigate the relationship between the usage of nutrition facts labels (NFL) and oral and dietary practices and the decayed, missing, and filled teeth (DMFT) score.

METHODS

A self-administered questionnaire was distributed to a convenient sample of 150 adult dental patients attending the King Abdulaziz University Dental Hospital in Jeddah, Saudi Arabia. Electronic dental records were accessed to record each patient's DMFT score.

RESULTS

Only 38% (N=57) of the participants read the NFL on their food. A statistically significant association was found between patients' DMFT scores and the NFL reading. Participants who said they read NFLs had lower mean DMFT scores than those who said they did not (8.4 vs. 10.5).

CONCLUSIONS

The results of this study demonstrate that there is low usage of NFL among participants. A significant association was noted between the reading of the NFL and caries experience as measured using the DMFT index.

Breast Cancer Risk, Coffee Consumption, and Postdiagnosis Survival

This short review summarizes two studies that explore the association between coffee consumption, breast cancer, and mortality. The researchers found possible protective effects of coffee consumption and no association between coffee and increased risk of breast cancer. Nurses can help women who consume coffee to understand the current research regarding the relationship between coffee consumption, breast cancer risk, and mortality. Nurses can recommend referral to registered dietitians for comprehensive counseling on diet and cancer. Nurses can collaborate with interdisciplinary teams to help facilitate research regarding the association between coffee and breast cancer.

Food Knowledge, Habits, Practices, and Addiction Among Adolescents: A Cross-Sectional Investigation

BACKGROUND

Changing lifestyles and food habits have an impact on both nutrient requirements and intake among adolescents. The aim of this study is to assess the level of knowledge, habits, practices, and the presence of food addiction among adolescents residing in Damanhur City.

METHODS

A descriptive correlational study design is employed to collect data from 363 adolescents selected conveniently from two youth centers in Damanhur, Egypt. Four tools are used: a demographic questionnaire, the Adolescent Food Habits Checklist (AFHC), the General Nutritional Knowledge Assessment Questionnaire (GNKQ), and the Yale Food Addiction Scale version 2.0 (YFAS 2.0).

RESULTS

The age of the participating adolescents ranges from 10 to 19 years. More than half of the participants (51.8%) reported choosing low-fat foods. Additionally, around one-third of the adolescents (34.7%) meet the diagnostic criteria for food addiction. However, there is no statistically significant association found between food addiction and adolescents' eating habits and practices.

CONCLUSION AND RECOMMENDATIONS

Most of the studied adolescents exhibit unhealthy eating practices. Food addiction is identified as a significant health concern among this population. Therefore, it is highly recommended to provide nutritional education for adolescents and their families and implement school-based strategies to promote healthy eating habits.

Senses and repercussions of student assistance on the eating practices of students from a Brazilian public university during the COVID-19 pandemic

Student assistance (SA), regulated through the National Student Assistance Program (PNAES), seeks to meet the basic social needs of university students and is inserted in the field of public policies for higher education in federal institutions in Brazil. The program allocates financial resources in order to provide scholarships, housing, food, transport, physical and mental health, and accessibility for disabled students. The present study aims to identify the senses attributed by students of a federal public university to AE and the relationship between SA and their eating practices during the COVID-19 pandemic. A qualitative approach was used. Online questionnaire and focus groups were employed for data collection. The study public consisted of undergraduate students. Descriptive statistics and content analysis were used, opting for thematic analysis, with the support of the MAXQDA software. The core meanings were organized into two categories: (i) food during pandemic and (ii) role of student assistance. A total of 55 responses were obtained, and three focus groups were carried out. About 45% reported that the pecuniary aid offered by the university was the family's only source of income during the pandemic and 65% used it to buy food. More than half described worsening in food quality, related to food prices. Although no specific evaluation instrument was used, it is plausible to admit that the students experienced a situation of food insecurity, given the uncertainty in regular access to food, the compromised quality of food, and the strategies mobilized to guarantee a minimum amount of food for all members of the family. Among the reported strategies were changing the location and mode of acquisition (receiving donations, buying in groups or in wholesalers) and choosing cheaper genres. Although students consider SA essential for access and maintenance at the university, a sense assigned to SA was the role of "help." In general, students did not link SA to social rights, as part of public educational policy and as a mechanism for food and nutrition security. SA actions developed during the pandemic were essential for keeping students at the university, also functioning, albeit unintentionally, as a food and nutritional security mechanism.

Dietary Perspectives and Practices during Pregnancy in Rural Amhara Region of Ethiopia: An Exploratory Qualitative Study

Background

Nutrition during pregnancy has lifelong impacts on the mother and fetus. In Ethiopia, nearly a third of pregnant women experience undernutrition. When designing nutrition interventions during pregnancy, it is important to understand existing dietary perspectives and practices in local communities.

Objectives

To explore the processes that shape dietary perspectives and practices during pregnancy in rural West Gojjam and South Gondar Zones of the Amhara region in Ethiopia.

Methods

From October to November 2018, we conducted 40 in-depth interviews with pregnant women (n = 16), family members (n = 12), and healthcare providers (n = 12) using a semistructured interview guide. Interviews were conducted in Amharic, transcribed in Amharic, and translated into English. We used a thematic analysis approach to organize data per the predefined topic areas and identify emerging themes, as well as barriers and enablers to healthy nutrition during pregnancy.

Results

Pregnant women and their family members recognized the benefits of a diversified diet to promote the health of the mother and the fetus. However, participants reported low dietary diversity because of limited access to nutritious foods and particular perspectives on food restrictions during pregnancy. The common practice of religious fasting also limited pregnant women's dietary intake. Women reported restricting their food intake in later pregnancy because of loss of appetite, as well as concerns about having a large infant, which might complicate delivery. Intake of locally made alcoholic drinks (Tella) was reported among pregnant women because participants thought it had low levels of alcohol that would not harm the fetus.

Conclusions

Although participants understood the importance of a healthy and diverse diet in pregnancy, we identified several barriers and perspectives regarding nutrition during pregnancy. Low income and lack of access to diverse foods, particularly in certain seasons, religious fasting, intentional food restrictions to limit the size of the infant, and alcohol use were commonly reported. Locally appropriate counseling and interventions should be developed, with an emphasis on increasing access to and consumption of diverse foods. Curr Dev Nutr 2023;x:xx.

Nutrition knowledge and influence on diet in the carer-client relationship in residential care settings for people with intellectual disabilities

People with intellectual disabilities generally have poorer health outcomes compared with those who do not, including outcomes related to nutrition-related non-communicable diseases. Carers support people with intellectual disabilities in many aspects including habitual shopping and preparation of food, but their own nutrition knowledge and the influence this may have on dietary intakes of clients is unknown. We explored the nutrition knowledge of carers of people with intellectual disabilities in residential care settings, their dietary habits and their influence on clients' food shopping and preparation and therefore the diet consumed by their clients. Ninety-seven carers belonging to a large independent care sector organisation specialising in the care of people with an intellectual disability completed a validated general nutrition knowledge and behaviour questionnaire. Seventeen carers from the residential care settings were interviewed to contextualise practice. Knowledge about key dietary recommendations scored highly. Carers who had more work experience were found to have higher scores in 'making everyday food choices' (p = 0.034). Daily consumption of fruit and vegetables (at least one portion per day) was observed (for fruit by 46% of the carers and for vegetables by 60% of the carers), whilst most carers reported avoiding consuming full-fat dairy products, sugary foods and fried foods. The concept of a healthy diet; typical dietary habits of clients; role in food acquisition; and training in nutrition emerged as themes from the interviews. Carers discussed various topics including the importance of a balanced diet, cooking fresh foods and control of food portion sizes for clients relative to the care philosophy of a client-centred approach, which encapsulates client autonomy. Gaps in knowledge around specific nutrients, making healthy choices and cooking skills remain. Carers have an influence on clients' dietary choices; they are able to provide healthy meals and share good dietary habits with clients. Further training in nutrition is recommended for impact on clients' health.

Mobile Phone-Based Nutrition Education Targeting Pregnant and Nursing Mothers in Sri Lanka

INTRODUCTION

A woman's nutrition during pregnancy and nursing affects the mother and the growing child. Similarly, the first two years of a child's life are critical to their growth and development and are facilitated by optimum nutrition. Women's nutrition-related knowledge, attitudes, and practices influence household food and nutrition security. Mobile health (mHealth) is a potentially effective health intervention in pandemic situations when physical gatherings are restricted.

OBJECTIVES

To examine the effectiveness of a mobile phone-based nutrition education intervention targeting pregnant and nursing mothers in six Sri Lankan divisional secretariat areas.

METHOD

This intervention was evaluated using a before and after within-subjects design. The intervention included 19 messages over four weeks sent via mobile phone, covering nutrition themes such as pregnancy care, infant and young child-feeding, diet, family care for mother and child, and cash management. The intervention was evaluated based on a quantitative survey using a structured interviewer-administered questionnaire and qualitative interviews using a semi-structured questionnaire. The study population was pregnant and nursing mothers. The objective of the qualitative interviews was to identify how respondents used messages and how satisfied they were with the project. The outcome measures were awareness/knowledge, attitudes, social norms, self-efficacy, behaviour intentions, and practices of pregnant and nursing mothers. Trained enumerators collected data using a mobile phone.

RESULTS

A total of 996 pregnant and nursing mothers participated in the pre-assessment survey, of which 720 completed the post-assessment. Most were nursing mothers (84.2% pre- and 78.9% post-assessment). Participants provided positive feedback on the intervention. Knowledge/awareness (t = -18.70, p < 0.01) and attitudes (t = -2.00, p < 0.05) increased when exposed to the intervention. Favourable improvements in the practices were also observed. Mothers' practices related to breastfeeding and 24-h dietary diversity showed a statistically significant improvement. However, social norms and behaviour intentions did not significantly improve. The qualitative component also revealed favourable responses.

CONCLUSION AND RECOMMENDATIONS

The mobile intervention improved participants' knowledge, awareness, attitude, and practices, but not social norms or behaviour intentions. This approach is recommended to be used on a larger scale in community settings. In addition, mobile technology could drive intervention in pandemic-related situations.

Effect of Mid-Adolescent Dietary Practices on Eating Behaviors and Attitudes in Adulthood

This paper aimed to clarify the association of mid-adolescent dietary practices and experiences with adult eating behavior and attitudes using individual data from the "Survey of Attitudes toward Shokuiku (food and nutrition education), 2019" put forth by the Ministry of Agriculture, Forestry and Fisheries of Japan. We applied conditional mixed-process models to estimate the parameters simultaneously, and used them to predict current eating consciousness, current eating behaviors in a balanced diet, dietary behavior, and attitudes toward preventing or improving lifestyle-related diseases as dependent variables. As a result, compared to those who did not have good dietary practices and experiences in mid-adolescence, participants who had good dietary practices and experiences in the same period displayed greater interest in practicing a healthier diet. These participants frequently consumed a combination of staple foods, main dishes, and side dishes, and were more concerned about preventing or improving lifestyle-related diseases. In conclusion, mid-adolescent dietary practices and experiences had a lasting influence on adult eating behaviors and attitudes in Japanese participants.

Dietary Practices as a Potential Predictor for Dental Erosion among Patients Having Gastroesophageal Reflux Disease: An Analytical Cross-sectional Study

Aim

The aim of this study was to assess how dietary practices impact gastroesophageal reflux disease (GERD) patients in Haryana state, India, from the perspective of either preventing or promoting dental erosion.

Objectives

The primary objective of this study was to find a correlation between the presence of dental erosion and dietary practices among patients with GERD.The secondary objective of this study was to assess the correlation between GERD patients' dietary practices and dental erosion severity.

Materials and Methods

Three hundred and thirty study participants, who've been 18 years of age or older with the diagnosis of GERD for at least six months or more were included. Evaluation of dental erosion was performed with basic erosive wear examination (BEWE) index. On age, gender, medical history, medication history, and dietary habits, a pretested structured questionnaire was used. Statistical analysis software SPSS (Statistical Package for the Social Sciences) variant 20.0 was used to conduct the statistical analysis. Analytic statistics and descriptive statistics were used in the data analysis.

Results

Dental erosion was present in 84.8% of the study participants. The majority of study participants, 122 (37%), had no risk of dental erosion. The occurrence of dental erosion was shown to be substantially adversely associated to the intake of acidic meals and soft drinks in the present investigation (odds ratio [OR] = 0.5, P < 0.05). There has not been any proven link between the severity of dental erosion and the frequency of consuming acidic meals, fruit juice, and soft drinks. Milk consumption frequency and dental erosion severity were observed to be considerably inversely associated (r = -0.1, P = 0.001).

Conclusion

Patients with GERD frequently experienced dental erosion. One probable risk factor for the development of erosive dental lesions can be considered GERD. Most of the patients had dental erosion with a low degree of severity. When dental erosion occurs, the mineral quantity that dissolves from enamel is influenced by several factors, including the buffering action of the acids, pH, and duration of exposure. Whereas if the food and drinks contain adequate amounts of fluoride, calcium, and phosphate, the dissolution can be prevented. The intake of fruit juice, acidic foods, as well as soft drinks was not consumed to be a risk factor in the current study for directly causing or for promoting the severity of dental erosion since they were consumed less frequently. A higher frequency of milk ingestion was found to reduce the severity of dental erosion. Regular milk consumption could be regarded as an alternative dietary practice to stop dental erosion. As dental erosion is a complex condition, it's essential to have an early diagnosis and implement the proper preventive measures. It is vital to inform people about dental erosion and how it is interrelated to GERD and dietary practices.

The Role of Diets and Dietitians for Para-Athletes: A Pilot Study Based on Interviews

Efforts to provide nutrition support to para-athletes have not been established to date, and are far behind those established for athletes without disabilities. In the present study, we attempted to clarify the actual situation regarding dietary challenges of para-athletes. The aim of this study was to obtain clues to effective intervention methods that encourage the practice of sports nutrition. Six active elite para-athletes (30–70 years, four males) and a female physical therapist without physical disability participated in semi-structured interviews. All para-athletes had lower-limb disabilities and participated in the international wheelchair sports competitions (tennis, softball, and table tennis, with 2–26 years of player history). The interview items were on the ideal diet for improving competitive performance, evaluation of their typical diets, and the role of the dietitian as support. Responses obtained from participants were analyzed using quantitative content analysis by language analysis software. There are differences in the ideal diet based on the characteristics of the sport, but most participants believed that a nutritionally well-balanced diet with abundant vegetables was ideal for improving competitive performance. Para-athletes who use a wheelchair daily pay attention to their total calorie intake, because gaining weight is a critical issue for operating their wheelchairs and transferring themselves to and from their wheelchairs. Despite their world-class competition levels, none of them received routine dietary advice from dietitians. Some para-athletes did not even feel the need to engage with dietitians. Even for these para-athletes at a high level of competition, the “ideal diet” they considered was not always the optimal diet for improving their competitive performance. In addition, there are various barriers to practicing their optimal diet due to disability characteristics. Dietitians need to understand these barriers, their concerns and conflicts, and how to help them plan the optimal diet to improve their performance and maintain overall health.

Dietary Practices during Pregnancy in a Marshallese Community: A Mixed Methods Analysis

Dietary practices during pregnancy play a pivotal role in the health of women and their children and set the foundation for long-term health. Marshallese women have disproportionally higher rates of maternal and infant health disparities, yet little is known about the dietary practices during their pregnancy. The purpose of this study was to identify dietary practices during pregnancy among Marshallese women. From March 2019 to March 2020, a purposive sample of 33 pregnant Marshallese participants participated in a mixed methods study. Two primary themes emerged: (1) traditional beliefs about a healthy diet during pregnancy; and (2) dietary change during pregnancy. Within the first theme, four subthemes emerged: (1) should eat; (2) should not eat; (3) challenges to traditional diet; and (4) spiritual dietary customs during pregnancy. Within the second theme, three subthemes emerged: (1) a healthy diet for my baby; (2) autonomy and diet; and (3) sugar-sweetened beverages. The transition in discourse from traditional customs of dietary practices to an individualistic discourse highlights that acculturation is a complex process that should be included in maternal health education and interventions. Findings from this study provide insight into potential considerations for future interventions aiming to improve maternal and child health outcomes among Marshallese.

Eating Perception, Nutrition Knowledge and Body Image among Para-Athletes: Practical Challenges in Nutritional Support

Limited information exists on dietary practices in para-athletes. The aim of this study was to clarify the actual situation of para-athletes' dietary practice and to sort out the factors (i.e., eating perception, nutrition knowledge, and body image), that may hinder their dietary practices, and explored the practical challenges in nutritional support and improving nutrition knowledge for para-athletes. Thirty-two Japanese para-athletes (22 men) and 45 collegiate student athletes without disabilities (27 men) participated in the online survey. The questionnaire included demographic characteristics, eating perception, dietary practices, and nutrition knowledge. The Japanese version of the body appreciation scale was used to determine their body image. Para-athletes who answered that they knew their ideal amount and way of eating showed significantly higher body image scores (r = 0.604, p < 0.001). However, mean score for nutrition knowledge of para-athletes were significantly lower than collegiate student athletes (19.4 ± 6.8 vs. 24.2 ± 6.1 points, p = 0.001). Both groups did not identify a dietitian as the source of nutrition information or receiving their nutrition advice. The results indicate para-athletes have unique eating perceptions and inadequate nutrition knowledge. Future interventions are needed to examine nutritional supports and education in relation to the role of dietitians.

Assessment of Sport Nutrition Knowledge, Dietary Practices, and Sources of Nutrition Information in NCAA Division III Collegiate Athletes

Nutrition knowledge is a critical component of meeting sport nutrition guidelines. The present study aimed to evaluate the sport nutrition knowledge of National Collegiate Athletic Association (NCAA) Division III (DIII) athletes using a validated questionnaire, and to assess the dietary practices and sources of nutrition information in this population. A total of 331 student-athletes (n = 149 males, n = 181 females, n = 1 no sex indicated) completed the questionnaire. The mean score for total sport nutrition knowledge was 6.49 ± 8.9 (range −49 to 49) with a mean percent (%) correct score of 36.9 ± 19.1%. Athletes who had a previous college-level nutrition course (n = 62) had significantly higher (p < 0.05) total sport nutrition, carbohydrate, and hydration knowledge compared to those who did not (n = 268). Individual sport athletes (n = 90) scored significantly higher (p < 0.05) on hydration and micronutrients knowledge than team sport athletes (n = 237), while females scored higher than males for hydration knowledge (p < 0.05). The majority of athletes reported sensible dietary habits, such as not frequently skipping meals and eating carbohydrate and protein foods peri-workout. Athletes also reported their primary sources of nutrition information, the top three sources being social media, coaches, and athletic trainers, despite most frequently rating registered dietitians/nutritionists as “extremely knowledgeable”. Despite low sport nutrition knowledge, NCAA DIII collegiate athletes practiced seemingly prudent dietary habits but lacked exposure to high-quality sources of nutrition information.

Effect of nutritional education intervention to reduce anaemia during pregnancy in Dodoma City, Tanzania: protocol for a cluster randomized controlled trial

The objective of this study is to assess the effectiveness of community-based nutritional intervention in reducing the burden of anaemia during pregnancy. Study design will be a cluster-randomized controlled trial. Study setting will be peri-urban wards of Dodoma City. The study will have two arms (the interventional and the control arms). A total of 400 pregnant women at second trimester will be recruited. The study will consist of four phases in four months for both the interventional and the control arms namely: baseline, first and second follow-up and end-line surveys. During each phase, participants from both arms will be measured for haemoglobin concentration and assessed for gestational age, dietary practices and knowledge about anaemia. Furthermore, all participants will receive iron and folic acid supplements, sulphadoxinepyrimethamine and mebendazole tablets throughout the entire period of the study. Nutritional education will be provided to the interventional arm only during each phase. Main outcomes of the study will be changes in haemoglobin concentration, nutritional knowledge and dietary practices at each phase after the baseline survey in the interventional compared to the control arm. Descriptive statistics will be used to describe the participants. Independent and paired t-tests will be performed to make comparisons between and within groups. P-values less than 0.05 will be considered statistically significant.

Trial registration PACTR Registry, PACTR202007617885299. Registered on 28 May 2020.

Customization of Diet May Promote Exercise and Improve Mental Wellbeing in Mature Adults: The Role of Exercise as a Mediator

Diet, dietary practices and exercise are modifiable risk factors for individuals living with mental distress. However, these relationships are intricate and multilayered in such a way that individual factors may influence mental health differently when combined within a pattern. Additionally, two important factors that need to be considered are gender and level of brain maturity. Therefore, it is essential to assess these modifiable risk factors based on gender and age group. The purpose of the study was to explore the combined and individual relationships between food groups, dietary practices and exercise to appreciate their association with mental distress in mature men and women. Adults 30 years and older were invited to complete the food–mood questionnaire. The anonymous questionnaire link was circulated on several social media platforms. A multi-analyses approach was used. A combination of data mining techniques, namely, a mediation regression analysis, the K-means clustering and principal component analysis as well as Spearman’s rank–order correlation were used to explore these research questions. The results suggest that women’s mental health has a higher association with dietary factors than men. Mental distress and exercise frequency were associated with different dietary and lifestyle patterns, which support the concept of customizing diet and lifestyle factors to improve mental wellbeing.

High prevalence of overall overweight/obesity and abdominal obesity amongst adolescents: An emerging nutritional problem in rural high schools in Limpopo Province, South Africa

BACKGROUND

As the gap in nutritional profiles between urban and rural rapidly reduces because of nutrition transition, rural adolescents are likely to engage in urban lifestyle behaviours.

AIM

The study determined the prevalence of overweight/obesity amongst adolescents in rural high schools and the association with selected factors.

SETTING

Fetakgomo Municipality in rural Limpopo Province, South Africa.

METHODS

A cross-sectional study was conducted amongst 378 adolescents selected through multistage sampling from high schools. Data collected were socio-demography, nutritional knowledge, dietary practices and anthropometry. The International Obesity Task Force age and sex-specific body mass index (BMI) cut-off values were used to determine overweight/obesity, whilst adult BMI cut-off values were used for those ≥ 18 years. Waist-to-height ratio (WHtR) greater than 0.5 indicated abdominal obesity, as well as waist circumference (WC) and waist-to-hip ratio (WHR) above the cut-off values.

RESULTS

The proportion of overweight/obesity amongst adolescents was 35%, whilst 25% had abdominal obesity by WHR and 21% by WHtR. Multivariate logistic regression showed that being a girl (AOR = 2.9, 95% CI: 1.74-4.85), older adolescent (AOR = 3.1, 95% CI: 1.57-6.29) and living in a household with employed adults (AOR = 2.3, 95% CI: 1.19-4.51) were associated with increased odds of being overweight/obese. Eating breakfast was associated with reduced odds of being overweight/obese (AOR = 0.6, 95% CI: 0.34-0.97).

CONCLUSION

Overweight/obesity and abdominal obesity amongst adolescents were more prevalent than underweight. The Integrated School Health Programme should have clear guidelines on food items served and sold at schools.

The Effect of Health Education on Dietary Knowledge and Practices of Pregnant Women in Jordan: A Quasi-Experimental Study

Background

Evidence reported inadequate dietary practices among pregnant women and recommended educating pregnant women about their diet to improve pregnancy outcomes. However, studies examining the effect of health education about dietary practices during pregnancy are lacking in Jordan.

Objective

To examine the effect of health education on the levels of dietary knowledge and practices among pregnant women in Jordan.

Methods

A quasi-experimental design (pretest-posttest control group) was used. A consecutive sample of 195 pregnant women was recruited from four public health centers in Jordan; two health centers formed the intervention group (n=95) and two formed the control group (n=100). A structured questionnaire was used to assess dietary knowledge and practices before and after the intervention. The intervention group received health education for one month, while the control group received routine antenatal care. Data were collected from September to November 2019.

Results

After health education, the intervention group recorded significantly higher dietary knowledge score (mean= 19.30, SD= 0.88) compared to the control group score (mean= 14.36, SD= 2.11), p < 0.001. In addition, the intervention group reported significantly higher dietary practices score (mean= 8.70, SD= 1.16) compared to the control group score (mean= 7.02, SD= 1.66), p < 0.001. In particular, the intervention group recorded a significant increase in dietary knowledge score from the pretest (mean= 14.60, SD= 2.53) to posttest (mean= 19.30, SD= 0.88), as well as practices score from the pretest (mean= 6.69, SD= 1.97) to posttest (mean= 8.70, SD= 1.16), p < 0.001.

Conclusion

Providing health education concerning dietary knowledge and practices in the care of pregnant women may improve their knowledge and practices. Nurses and midwives in primary care centers have an essential role in assessing this knowledge and providing health education for pregnant women.

Dietary Habits Associated with Anemia in Pregnant Women Attending Antenatal Care Services

Anemia is a major cause of morbidity and mortality of pregnant women and increases the risks of fetal and neonatal morbidity and mortality. Approximately 50% of all anemia is estimated to be caused by low dietary intake of iron, poor absorption of dietary iron, or blood loss. The objective of the present study was to determine the prevalence of and assess the dietary habits associated with anemia in pregnant women receiving antenatal care (ANC) in Unguja Island, Tanzania. A cross-sectional study was conducted to select 338 pregnant women at Kivunge, Mwembeladu, and Mnazimmoja hospitals from March to June 2018. Hemoglobin concentration was measured using a HemoCue photometer on capillary blood. Sociodemographic data and dietary habits were collected using a structured questionnaire. Multivariate logistic regression analysis was carried out to determine the predictors of anemia in pregnant women. The overall prevalence of anemia was 80.8%. Of these 68.64% had mild anemia, 11.24% had moderate anemia, and 0.89% had severe anemia. Anemia was significantly associated with inadequate dietary diversity [adjusted OR (AOR): 1.16; 95% CI: 0.57, 2.36; P < 0.05], drinking tea or coffee with a meal (AOR: 0.06; 95% CI: 0.03, 0.13; P < 0.001), consuming <3 meals/d (AOR: 2.92; 95% CI: 1.60, 5.84; P < 0.001), higher education level (AOR: 3.4; 95% CI: 1.6, 7.2; P < 0.0001), birth interval <2 y (AOR: 3.6; 95% CI: 1.1, 11.9; P < 0.05), and multigravida status (AOR: 1.2; 95% CI: 0.3, 4.4; P < 0.0001). The prevalence of anemia in this study demonstrates a severe public health problem among pregnant women. Inadequate dietary diversity coupled with inadequate daily meal intake and consumption of tea or coffee were the dietary habits predicting anemia in pregnant women. Other predictors of anemia were higher education level, multigravida status, and birth interval <2 y. Nutrition policy interventions are needed to complement ANC services by providing important information on healthy eating habits during pregnancy.

El Sancocho, la Bandera y la Familia: The Social Life of Food and its Implications for Dominican Immigrant Health and Well-Being

In order to better understand factors that influence the health and well-being of Dominican immigrants, we explored the ways in which immigration influences cultural practices, health behavior, and health. Dominican immigrants (n = 42) took part in five reflective and unstructured group discussions and (n = 5) participated in an intergenerational photovoice group. The loss of the familial and social context in which Dominican dietary practices traditionally take place was a salient theme. For participants, eating became a rushed, perfunctory activity involving fewer people and less socializing. Dietary practices in the Dominican Republic are set in the context of familial norms and social processes, which provide support as well as opportunities for socializing and the transmission of cultural practices across generations. In the United States, broader sociopolitical forces are guided by individualism and do not support the development or maintenance of these factors for Dominicans. Policies that promote work-life balance may have important implications for dietary practices in new immigrant communities.

Sociocultural Influences on Dietary Practices and Physical Activity Behaviors of Rural Adolescents-A Qualitative Exploration

In the aftermath of nutrition transition and ever-increasing sedentarism, adolescents globally are exposed to negative health consequences. Diverse sociocultural influences play a critical role in their adoption of unhealthy dietary practices and suboptimal physical activity behaviors. Context-specific understandings of how these sociocultural influences shape adolescents’ dietary and physical activity patterns in a rural, resource-limited setting remained elusive. Aiming to address the gap, this qualitative study explored adolescents’ and mothers’ perception of broader sociocultural aspects that sculpt the food choices, eating habits and physical activity behaviors of adolescents in Matlab, Bangladesh. Six digitally-recorded focus group discussions were transcribed verbatim, translated into English and analyzed thematically. Marked taste-driven dietary preference of adolescents and its prioritization within family by the mothers, popularity of street foods, better understanding of the importance of food hygiene and safety contrasting with narrow perception of balance and diversity in diet, peer influence along with deficient school and community food environment, internalization and rigidity of gender norms were found to be exerting major influence. The findings highlighted key targets for community-based nutrition interventions and endorsed thorough consideration of socio-cultural factors in formulating strategies to promote healthful eating and physical activity behaviors among the adolescents.

Dietary Practices and Meal Patterns among Overweight and Obese School Children in Malaysia: Baseline Data from a School-Based Intervention Study

This study aimed to determine dietary practices and meal patterns among Malaysian overweight and obese school children at baseline. This study was part of a school-based obesity intervention study, My Body is Fit and Fabulous at School (MyBFF@school). It involved 1045 primary and 1041 secondary overweight and obese school children from a randomly selected 23 out of 1196 primary and 15 out of 416 secondary government schools in central Peninsular Malaysia. The results showed a significantly higher of adequate intake (4-8 servings/day) of cereals and grains among primary (54.7%) than secondary school children (48.2%). About 28.2% of primary and 32.6% of secondary school children had consumed adequate fruit (2 servings/day), while a very low percentage of both primary (5.0%) and secondary (3.6%) school children consumed adequate vegetables (3 servings/day). As for the meal patterns, school children in both primary and secondary were not taking breakfast regularly (mean±SD for primary: 3.16 ± 2.61 days/week vs secondary: 2.97 ± 2.52 days/week). There was also a significantly higher mean frequency of primary school children brought plain water to school than the secondary school children. In conclusion, urgent actions to address improper dietary practices and meal patterns of overweight and obese school children in Malaysia are warranted.

Dietary Patterns, Exercise, and the Metabolic Syndrome Among Young People in Urban Pakistan (Lahore)

Background: Increasing urbanization, mechanization, and rural-to-urban migration has led to deranged sleeping patterns, surplus energy intake, and sedentary lifestyles in South Asian young people. This shift poses an insidious health risk for the development of metabolic syndrome (MetS). Early detection is needed because in the South Asian population, this syndrome carries an increased risk of comorbidities compared to people without the syndrome. This study was designed to elucidate the prevalence of MetS and its risk factors in young people in urban areas of Pakistan. Methods: A cross-sectional study was conducted in four undergraduate institutions in Lahore, Pakistan. Five hundred and nine young people participated, and each provided their informed consent for the collection of data on their demographic, physical, and biochemical characteristics along with information on their dietary, sleep, and physical activity habits. Results: Most participants reported consuming greater-than-recommended amounts of protein and smaller-than-recommended amounts of vegetables and fruits. The International Diabetes Federation criteria for MetS were fulfilled by 6.1% of the students. Hypertension (67.7%) and hypo-HDL-emia (64.5%) were the most common risk factors. More than 50% of the respondents slept fewer hours per day than recommended, and 33% had a sedentary lifestyle. Men, participants with a family history of metabolic illness and those with low physical activity levels had higher odds of a positive result on screening for MetS. Conclusions: The early detection of MetS and early identification of probable risk factors may make beneficial contributions to both public health and clinical interventions directed at high-risk individuals. Establishing and using cutoff values for modified waist circumference and specific body mass index in Asian populations may aid in early detection.

The Dietary Intake and Practices of Adolescent Girls in Low- and Middle-Income Countries: A Systematic Review

In many low- and middle-income countries (LMICs) the double burden of malnutrition is high among adolescent girls, leading to poor health outcomes for the adolescent herself and sustained intergenerational effects. This underpins the importance of adequate dietary intake during this period of rapid biological development. The aim of this systematic review was to summarize the current dietary intake and practices among adolescent girls (10–19 years) in LMICs. We searched relevant databases and grey literature using MeSH terms and keywords. After applying specified inclusion and exclusion criteria, 227 articles were selected for data extraction, synthesis, and quality assessment. Of the included studies, 59% were conducted in urban populations, 78% in school settings, and dietary measures and indicators were inconsistent. Mean energy intake was lower in rural settings (1621 ± 312 kcal/day) compared to urban settings (1906 ± 507 kcal/day). Self-reported daily consumption of nutritious foods was low; on average, 16% of girls consumed dairy, 46% consumed meats, 44% consumed fruits, and 37% consumed vegetables. In contrast, energy-dense and nutrient-poor foods, like sweet snacks, salty snacks, fast foods, and sugar-sweetened beverages, were consumed four to six times per week by an average of 63%, 78%, 23%, and 49% of adolescent girls, respectively. 40% of adolescent girls reported skipping breakfast. Along with highlighting the poor dietary habits of adolescent girls in LMIC, this review emphasizes the need for consistently measured and standardized indicators, and dietary intake data that are nationally representative.

Undernutrition in children & critical windows of opportunity in Indian context

It is intriguing to note that majority of the wasting among the under 5 yr in India is present at birth. The National Family Health Survey 4 (NFHS-4) data analysis shows 31.9 per cent wasting at birth, which is decreasing to 17.7 per cent in the under five children; clearly suggesting that any reduction in wasting should come from improvement in foetal growth. In addition, children with both severe wasting and severe stunting, in whom the risk of mortality increases many folds, are <1 per cent in almost all the States; and these are the children in whom special care is required under the community-based management of severe acute malnutrition. This article presents an overview of nutrition status in children, their antecedents, and the critical phases; especially, nutrition status before pregnancy that plays a crucial role in all the nutrition status indicators of children. More attention on the critical phases is crucial to maximize the benefits from national programmes.

The Influence of Oral Health Knowledge on Parental Practices among the Saudi Parents of Children Aged 2-6 Years in Riyadh City, Saudi Arabia

AIMS AND OBJECTIVES

The parent's oral health knowledge has a great influence on their children, so the aim of the study was to estimate the parental knowledge about oral health care and its influence in maintaining the diet and hygiene practices on their children and also to access how the demographic variables will influence them in taking their child to dental visits.

MATERIALS AND METHODS

The self-administered pretested questionnaire was distributed among Saudi parents whose children are in the age group of 2-6 years vising primary health care centers (PHCCs) in Riyadh city. The PHCCs were divided into five zones (Central, East, West, South, and North). 240-250 samples were randomly selected from each zone to reach the prescribed sample size of 1200. The survey will be composed of self-administered pretested questionnaires seeking for age, gender, educational level, and their financial status followed by 26 questions related to parent knowledge about oral health (14), dietary (5), and hygiene (7) practices what they implement on their child. The data collected were analyzed using SPSS software SPSS 25.0 (SPSS, Inc., Chicago, IL, USA).

RESULTS

Demographic information showed that the average age of the parents who participated in the study is 32.2 years. The mothers were 942 (75.7%) and fathers were 303 (24.3%) among the participants. The mean knowledge score among the mothers (34.85) is slightly greater than fathers (34.76). Similar results with dietary and hygiene practices were not statistically significant (>0.05). The parents having more than one child have better knowledge, of which the parents with more than three children have better scores, which is statistically significant. 69.3% of the parents prefer taking to a dentist only when they have a problem. Moreover, these findings found to be statistically significant (P < 0.05).

CONCLUSION

Parents should get access to oral health knowledge to put in practice on their children so as to influence them in gaining better oral health.

Dietary practices of children and adolescents with Down syndrome

The aim of this study was to assess dietary intake, breastfeeding history, weight at birth and current weight in children and adolescents with Down syndrome (DS). Therefore, a cross-sectional, controlled study with 19 DS participants and 19 controls without DS matched by gender and age was performed. Except for vitamin D, a lower or the same frequency of insufficient intake in other micronutrients was noted in participants compared with controls. The DS group had a reduced exclusive breastfeeding duration and increased carbohydrate and caloric intake. The consumption of micronutrients in both groups reinforced the current trend of excessive sodium consumption and insufficient intake of calcium, some B complex vitamins and water by children and adolescents.

"If I Can Afford Steak, Why Worry About Buying Beans": African American Men's Perceptions of Their Food Environment

Due to the high level of food-related chronic diseases for African American men, the purpose of this qualitative study was to induce (n = 83) urban American men’s perspective of their food environment considering different ethnic subgroups, built environment, and the temporal context using a phenomenological method and snowball sampling. Focus group interviews were audio-recorded, transcribed, and entered into ATLAS.ti to aid in establishing themes. African American men perceived that fast-food chains are their food choices and that they do not have any other healthy alternatives near their residential community. Their perspective of their current environment was primarily influenced by their formative years, the availability of current food environments, marketing and advertising of food on television, and the cost of eating healthy as compared to the cost of eating what is convenient to their residence. A central theme of the findings of this study is that the availability and accessibility of restaurants and food options are harmful to health over time. The finding suggests that future interventions should consider and incorporate how people develop and understand their current food practices and environment through the lens of time, not just their adult context.

Factors associated with nutritional status and dietary practices of Bangladeshi adolescents in early pregnancy

Bangladesh has a high prevalence of adolescent pregnancy, but little is known about the nutritional status and dietary practices of Bangladeshi adolescents in early pregnancy or associated factors. We used the baseline data of 1552 pregnant adolescents from a longitudinal, cluster-randomized effectiveness trial conducted in northwest Bangladesh. Forty-four percent of the adolescents were short for their age, 36% had low body mass index, 28% were anemic, 10% had iron deficiency, and 32% had vitamin A deficiency. The mean consumption of animal-source foods was 10.3 times/week. In multivariate analysis, socioeconomic status, education, and food security were generally positively associated with anthropometric indicators and dietary practices but not with iron or vitamin A status. Our findings confirm that there is a high burden of undernutrition among these Bangladeshi adolescents in early pregnancy. Understanding factors related to undernutrition can help to identify adolescent pregnant women at higher risk and provide appropriate counseling and care.

Psychosocial Factors and Dietary Practices in Korean Americans

This study was to identify the role of demographics and social support from family and friends in predicting self-efficacy for a healthy diet and healthy dietary practices. A descriptive, cross-sectional study was conducted with a sample of 112 Korean American adults in the southwestern United States. Most were college educated (85.3%), with mean age of 54.0 (± 10.6), and women (66.4%). The findings indicate that gender and education played a moderating role between family support and self-efficacy for a healthy diet, whereas age and education were moderators between support from family and friends and healthy dietary practices. Diet interventions tailored to demographic subgroups may increase self-efficacy, promote healthy dietary practices, and ultimately contribute to a reduction in the rates of critical health conditions and health costs in the community.

Factors Affecting Dietary Practices in a Mississippi African American Community

This study examined the practices, personal motivation, and barriers of African American communities in Mississippi regarding their dietary practices. We selected the Metro Jackson Area comprised of Hinds, Madison and Rankin Counties because it is a combination of urban and rural communities. The sample consisted of 70 participants from seven sites. A total of seven focus groups responded to six questions to assess practices, personal motivation, and barriers to dietary practices: (1) Where in your community can you access fresh fruits and vegetables? (2) How many meals a day should a person eat? (3) What would you consider to be a healthy breakfast, lunch and dinner? (4) What would you consider to be a healthy snack? (5) What do you consider to be your motivations for eating healthy? (6) What do you consider to be your barriers to eating healthy? Each of the seven focus groups consisted of 6 to 12 participants and provided details of their dietary practices. The focus group interviews were digitally-recorded. The recorded interviews were transcribed. The majority of the participants stated that there is a limited availability of fresh fruits/vegetables in rural areas because of a shortage of grocery stores. When they do find fruits, they are priced very high and are unaffordable. Even though health conditions dictate food frequency and portion size, community members feel that individuals should eat three good balanced meals per day with snacks, and they should adhere to small portion sizes. While the desire to attain overall good health and eliminate associative risks for heart disease (e.g., diabetes, obesity) are personal motivations, the cost of food, transportation, age, and time required for food preparation were seen as barriers to healthy eating. Decisions regarding meal choice and meal frequency can have an impact on long-term health outcomes. Health promotion programs should become an integral part of academic- community collaborative agreements.

Parental perception of child's body mass index and health within primary care

BACKGROUND AND PURPOSE

Overweight and obesity are sensitive issues to address with pediatric patients during any visit. Patients and families may not recognize that their child is overweight or obese and may not be ready to make change. The goals for this study were to collect overall statistics on the clinic in regards to weight status of children presenting for well child visits and to capture parental perception of the child's weight status in relation to child's age.

METHODS

A consecutive sample of parents and caregivers with a child aged 2-18 completed the survey and consented for the study on the day of the survey during a well child visit.

CONCLUSIONS

Parents, regardless of culture and age tended to underestimate the weight of their child. These findings further support the literature in that the younger the child, the more likely it is that the parent underestimates their weight status.

IMPLICATIONS FOR PRACTICE

Interventions should include early education with parents on what a healthy weight is and how it can predict future health. Addressing and recognizing early concerns and assessing parental perception can be important if educational messages are delivered throughout the span of the early years.

Prevention of Non-communicable Diseases by Balanced Nutrition: Population- specific Effective Public Health Approaches in Developing Countries

INTRODUCTION

Currently, the developing countries are afflicted with the dual burden of disease - non-communicable diseases (NCDs) becoming a major public health challenge. It is projected that in near future, NCDs will account for nearly 70% of the mortality in developing world. Caused due to lifestyle related factors, there is an upsurge in the incidence of overweight/obesity, cardiovascular diseases, type 2 diabetes mellitus, cancers, respiratory diseases and mental illnesses. Appropriate dietary practices, increased physical activity, weight management, abstinence from tobacco/substance use and alcohol abuse play an important role in their prevention and management. This narrative review highlights the role of various dietary components - both nutrient and non-nutrient, in the prevention and risk reduction of NCDs.

METHOD

It is a comprehensive overview of various experimental researches, observational studies, clinical trials, epidemiological studies, pooled/meta-analyses and reviews carried out globally, particularly the developing nations. Studies were retrieved by an extensive search of the online PubMed/Medline, SciVerse Scopus databases using individual/combination of several keywords like non-communicable diseases, energy, various nutrients, sugar sweetened beverages, functional foods, tea, coffee, spices/condiments/herbs, animal foods, nuts and oil seeds, physical activity, dietary practices, cancer, cardiovascular diseases, T2DM, respiratory diseases, lifestyle modifications, tobacco, smoking, alcohol and public health approaches. The review also highlights several preventive approaches for curbing NCDs in the developing world with special emphasis on dietary factors.

CONCLUSION

Since the occurrence of NCDs is marked by a cumulative effect of various risk factors, urgent collective actions are needed to avert/prevent the same effectively.

Dietary practices and nutritional status of under-five children in rural and urban communities of Lagos State, Nigeria

Background:

Evidence shows that urban children generally have a better nutritional status than their rural counterparts. However, data establishing whether this difference in prevalence of undernutrition could be ascribed to difference in dietary practices are few.

Objective:

The aim of this study was to compare dietary practices and nutritional status of children in rural and urban communities of Lagos State, Nigeria.

Methods:

This was a comparative-analytical study conducted using the multistage sampling technique to select the study cases. A total of 300 mother–child pairs were studied, including 150 each from rural and urban communities. Data collected include demographics, socioeconomic characteristics, feeding practices and anthropometric measurements of the participants. Food intake data were collected using 24-h dietary recall. Malnutrition in children was determined by calculating the prevalence of low height-for-age (stunting), low weight-for-age (underweight), and low weight-for-height (wasting) using the World Health Organization cutoff points.

Results:

The prevalence of exclusive breastfeeding for 6 months (25.3% vs. 28.7%; P = 0.516), use of formula feeds (48.7% vs. 44%; P = 0.077), and mean age of child at introduction of semisolid foods (7.54 ± 4.0 months vs. 8.51 ± 7.3 months; P = 0.117) were not significantly different between urban and rural communities. The diversity of food choices and frequencies of consumption were similar between urban and rural communities. However, prevalence levels of underweight and stunted children were significantly higher in rural than that of urban communities (19.4% vs. 9.3%, P < 0.001 and 43.3% vs. 12.6%, P < 0.001, respectively).

Conclusions:

Other risk factors besides inappropriate feeding practices need to be considered for higher prevalence of undernutrition among children in rural communities.

Prevalence of screening-detected eating disorders in chinese females and exploratory associations with dietary practices

OBJECTIVE

China is undergoing dramatic Westernization, hence may be able to provide unique insights into the role of sociocultural factors in disease. The purpose of this exploratory study was two-fold: to describe the prevalence of screening-detected eating disorders and disordered eating in China at the first occasion of assessment in the large-scale China Health and Nutrition Survey (CHNS) and to explore the associations between dietary practices and disordered eating. Regarding the first objective, participants are provincially representative and in subsequent waves will be followed longitudinally.

METHOD

CHNS participants were recruited using multistage, cluster random sampling, beginning in 1989. In this study, participants comprised 259 female adolescents (12-17 years) and 979 women (18-35 years) who participated in the CHNS 2009 survey, which is the first CHNS survey to assess disordered eating. Dietary practice-disordered eating associations were investigated with logistic regression adjusting for age, body mass index, and urbanization.

RESULTS

Of the participants, 6.3% (95% CI: 4.8, 8.2) of adults and 7.8% (95% CI: 5.0, 12.0) of adolescents had a screening-detected eating disorder. Dietary practices had non-significant associations with disordered eating at the general population level, except for protein consumption among women. There was evidence that skipping meals and a high-fat diet may confer risk.

DISCUSSION

Screening-detected eating disorders in China are lower in prevalence than in developed countries. Dietary practices had fairly limited associations with disordered eating at the general population level; protein consumption, skipping meals, and a high-fat diet are candidate dietary practice exposures for disordered eating. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.

Feasibility of Increased Navy Bean Powder Consumption for Primary and Secondary Colorectal Cancer Prevention

INTRODUCTION

Emerging evidence supports that increased consumption of dry beans (Phaseolus vulgaris L.) reduces both the incidence and recurrence of adenomatous polyps or precancerous growths. Navy beans have been studied for dietary colorectal cancer (CRC) chemoprevention in animal models. Our main objectives were to assess the feasibility of increased navy bean consumption in adults with and without history of CRC and to achieve intake amounts associated with chemoprevention.

METHODS

Seven meals and six snacks were developed for both the absence and inclusion of cooked navy bean powder (35grams/day). Sixteen healthy adults (7 non-cancer and 9 CRC survivors) completed the placebo-controlled, randomized, single-blinded dietary intervention trial. Participants consumed one study-provided meal and snack daily for 28 days, which accounted for approximately one-third of their total recommended caloric intake (meals = 202-483 kcal and snacks = 194-401 kcal). Participants also recorded three-day dietary food logs each week.

RESULTS

The addition of 35g of cooked navy bean powder (NBP) into foods provided 5-8% daily caloric intake. The compliance to the meal and snack intervention ranged from 89-100%. Non-cancer participants in the NBP group had a significant decrease in total caloric intake after week 4 (p≤0.0001). CRC survivors in the NBP group significantly increased total fiber intake by week 4 (p≤0.0001).

CONCLUSIONS

NBP are feasible to include in meals for increased total fiber intake and for consuming the amount that is associated with CRC chemoprevention outcomes. These findings warrant further evaluation of NBP consumption in clinical nutrition trials for CRC control and prevention.

Binge eating and weight loss behaviors of overweight and obese college students

PURPOSE

To investigate binge eating (BE) and weight-related behaviors in overweight and obese college students.

DATA SOURCES

This was a secondary analysis of data from 487 overweight and obese college-age students from a private university in the northeastern United States.

CONCLUSIONS

BE was reported by 34.9% of students. Only 6.2% of participants reported the use of compensatory behaviors (i.e., self-induced vomiting, laxative, or diuretic use) to prevent weight gain. BE was associated with smoking and exercising to lose weight. Gender differences emerged from the data as women were more likely to report being obese, the use of compensatory behaviors, and to perceive themselves as moderately or extremely overweight.

IMPLICATIONS FOR PRACTICE

BE is a significant problem on college campuses and is associated with the development of obesity and eating disorders. Nurse practitioners (NPs) are in an excellent position to effect change in this population through their frequent contact with young adults in community and school-based venues. NPs are well-prepared to identify at-risk college students and provide them with individualized care, education, and support.

Obesity-related behaviors of Malaysian adolescents: a sample from Kajang district of Selangor state

This study aims to determine the association between obesity-related behaviors (dietary practices, physical activity and body image) and body weight status among adolescents. A total of 382 adolescents (187 males and 195 females) aged 13 to 15 years in Kajang, Selangor participated in this study. Majority of the respondents were Malays (56.0%), followed by Chinese (30.1%) and Indians (13.9%). Dietary practices, physical activity and body image of the adolescents were assessed through the eating behaviors questionnaire, two-day dietary record, two-day physical activity record and multi-dimensional body image scale (MBIS), respectively. Body weight and height were measured by trained researchers. The prevalence of overweight and obesity (19.5%) was about twice the prevalence of underweight (10.5%). About two-thirds of the respondents (72.3%) skipped at least one meal and half of them (56.2%) snacked between meals with a mean energy intake of 1,641 ± 452 kcal/day. More than half of the respondents (56.8%) were practicing sedentary lifestyle with a mean energy expenditure of 1,631 ± 573 kcal per day. Energy intake (r = 0.153, P < 0.05), physical activity (r = 0.463, P < 0.01) and body image (r = 0.424, P < 0.01) were correlated with BMI. However, meal skipping, snacking and energy expenditure per kg body weight were not associated with body weight status. Multiple linear regression analysis showed that body image, physical activity and energy intake contributed significantly in explaining body weight status of the adolescents. In short, overweight and obesity were likely to be associated not only with energy intake and physical activity, but also body image. Hence, promoting healthy eating, active lifestyle and positive body image should be incorporated in future obesity prevention programmes in adolescents.

Combating the epidemic of obesity and cardiovascular disease: perspectives from school-aged children

This study was designed to assess students' perceptions of the obstacles to positive dietary practices and increased physical activity and to solicit the students' recommendations for addressing and possibly reducing the negative practices that are associated with the rise in obesity and the development of cardiovascular diseases. Data for the study were obtained from the administration of the 2005 Project Health High School Survey (PHHSS) which measured the students' perceptions regarding obstacles to eating more nutritious, healthier foods and obstacles to participating in daily physical activity. The reasons for students' lack of interest in practicing more life-healthy behaviors are ranked and recorded. Some of the students indicated that they usually ate what they liked to eat, and the decision about what to eat was made because of the taste of the food without regard for any health consequence or negative health outcomes. Finding ways to reach these students at their young ages is the key to successfully combating the high prevalence of obesity and the development of other chronic diseases in childhood, as well as in adulthood.