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Arimond M, Wiesmann D, Grummer‐Strawn LM, Ferguson EL. Food pattern modeling to inform global guidance on complementary feeding of infants. Matern Child Nutr 2024; 20:e13590. [PMID: 38124469 PMCID: PMC10981476 DOI: 10.1111/mcn.13590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/02/2023] [Accepted: 10/26/2023] [Indexed: 12/23/2023]
Abstract
Nutrient needs are difficult to meet during infancy due to high nutrient requirements and the small quantities of food consumed. Guidelines to support food choice decisions are critical to promoting optimal infant health, growth and development and food pattern modeling can be used to inform guideline development. We employed the Optifood modeling system to determine if unfortified complementary foods could meet 13 nutrient targets for breastfed infants (6-11 months), and to describe food patterns that met, or came as close as possible to meeting targets. We also examined the impacts of eliminating food groups, increasing starchy staple foods or adding sentinel unhealthy foods. We collated a global food list from dietary studies in 37 countries and used this list to develop nutrient values for a set of 35 food subgroups. We analyzed infant dietary intakes from studies in eight countries to inform maximum quantities and frequencies of consumption for these subgroups in weekly food patterns. We found that unfortified foods could meet targets for most infants for 12 nutrients, but not for iron. For the smallest and youngest infants, with the lowest energy intakes, there were additional deficits for minerals. Best-case food patterns that met targets or came as close as possible to meeting targets included ample amounts of diverse vegetables, diverse plant- and animal-source protein foods, small amounts of whole grain foods and dairy and no refined grains or added fats or sugar. There were nutrient deficits if animal-source foods or vegetables were eliminated or if unhealthy foods were included.
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Affiliation(s)
| | | | | | - Elaine L. Ferguson
- Department of Population Health, Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineLondonUnited Kingdom
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Varghese B, Panicker R, Mukhopadhyay D, Backholer K, Sethi V, de Wagt A, Murira Z, Bhatia N, Arora M. Estimating the potential impact of a health tax on the demand for unhealthy food and beverages and on tax revenue in India. Health Policy Plan 2024; 39:299-306. [PMID: 38102765 DOI: 10.1093/heapol/czad117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 11/01/2023] [Accepted: 12/11/2023] [Indexed: 12/17/2023] Open
Abstract
Foods high in fat, sugar or salt are important contributors to the rising burden of non-communicable diseases globally and in India. Health taxes (HTs) have been used by over 70 countries as an effective tool for reducing consumption of sugar sweetened beverages (SSBs). However, the potential impacts of HTs on consumption and on revenues have not been estimated in India. This paper aims to estimate the potential impact of health taxes on the demand for sugar, SSBs and foods high in fat, sugar or salt (HFSS) in India while exploring its impact on tax revenues. PE of sugar was estimated using Private Final Consumption Expenditure and Consumer Price Index data while price elasticities for SSBs and HFSS were obtained from literature. The reduction in demand was estimated for an additional 10-30% HT added to the current goods and services tax, for varying levels of price elasticities. The results show that for manufacturers of sweets and confectionaries who buy sugar in bulk and assuming a higher price elasticity of -0.70, 20% additional HT (total tax 48%) would result in 13-18% decrease in the demand for sugar used for confectionaries and sweets. For SSBs, HT of 10-30% would result in 7-30% decline in the demand of SSBs. For HFSS food products, 10-30% HT would result in 5-24% decline in the demand for HFSS products. These additional taxes would increase tax revenues for the government by 12-200% across different scenarios. Taxing unhealthy foods is likely to reduce demand, while increasing government revenues for reinvestment back into public health programmes and policies that may reduce obesity and the incidence of non-communicable diseases in India.
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Affiliation(s)
- Beena Varghese
- Indian Institute of Public Health, Public Health Foundation of India, Rajendra Nagar Mandal, Kismatpur, Hyderabad, Telangana 500030, India
| | - Rajashree Panicker
- Total Alliance Health Partners International, Dubai Healthcare City, Dubai 66566, UAE
| | - Dripto Mukhopadhyay
- Ascension Centre for Research and Analytics (ACRA), 5/1, Sector 5, Rajendra Nagar, Sahibabad, Ghaziabad, UP 201005, India
| | - Kathryn Backholer
- A/P Deakin University, Geelong, Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Burwood, Victoria 3125, Australia
| | - Vani Sethi
- UNICEF Regional Office for South Asia, Kathmandu 5815, Nepal
| | | | - Zivai Murira
- UNICEF Regional Office for South Asia, Kathmandu 5815, Nepal
| | - Neena Bhatia
- Ministry of Health and Family Welfare, Government of India, New Delhi 110011, India
| | - Monika Arora
- Public Health Foundation of India, Gurgaon, Haryana 122102, India
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Kruger HS, Makore P, van Zyl T, Faber M, Ware LJ, Monyeki MA, Kruger R. Validation of a short food group questionnaire to determine intakes from healthy and unhealthy food groups in 5-9-year-old South African children. J Hum Nutr Diet 2024; 37:234-245. [PMID: 37798954 PMCID: PMC10953415 DOI: 10.1111/jhn.13249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 09/22/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Reliable dietary data for children are necessary to investigate associations with health outcomes. The present study aimed to develop and validate a questionnaire to determine the frequency of intakes of specific healthy and unhealthy food groups in young children. METHODS Participants were 5-9-year-old South African children (n = 920) from 10 urban schools. Their parents completed a demographic questionnaire and the food intake questionnaire with food pictures. Based on the literature, four healthy food groups (fruits, vegetables, milk, meat/fish/poultry/eggs) and six unhealthy food groups (hot and cold sugar-sweetened beverages, candy, salty snacks, cakes and fast foods) were included, with five different frequency responses. Six experienced nutritionists assessed the face validity and content validity. After pilot testing, construct validity and homogeneity were determined in the participants. Convergent validity was determined using urinary sodium and potassium concentrations as biological intake markers. RESULTS Nutritionists confirmed face and content validity. Caregivers confirmed understanding of the questionnaire. Three factors explained 50.2% of the variance, with most unhealthy food groups as factor 1, fruits and vegetables as factor 2, and animal source protein and milk groups clustered with sugar-sweetened beverages as factor 3. The frequency of milk group, fruits and vegetables intake correlated negatively, whereas the frequency of salty snacks and fast foods intakes correlated positively with the urinary sodium:potassium ratio. CONCLUSIONS The healthy and unhealthy food group questionnaire has advantages of low respondent burden, as well as acceptable content and convergent validity in South African children. The questionnaire may be used to investigate associations between food intakes and health outcomes.
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Affiliation(s)
- H Salome Kruger
- Centre of Excellence for NutritionNorth‐West UniversityPotchefstroomSouth Africa
- Medical Research Council Research Unit for Hypertension and Cardiovascular DiseaseNorth‐West UniversityPotchefstroomSouth Africa
| | - Persuade Makore
- Centre of Excellence for NutritionNorth‐West UniversityPotchefstroomSouth Africa
| | - Tertia van Zyl
- Centre of Excellence for NutritionNorth‐West UniversityPotchefstroomSouth Africa
- Medical Research Council Research Unit for Hypertension and Cardiovascular DiseaseNorth‐West UniversityPotchefstroomSouth Africa
| | - Mieke Faber
- Centre of Excellence for NutritionNorth‐West UniversityPotchefstroomSouth Africa
- Non‐Communicable Diseases Research UnitSouth African Medical Research CouncilCape TownSouth Africa
| | - Lisa J. Ware
- SA MRC‐Wits Developmental Pathways for Health Research UnitUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Makama A. Monyeki
- Physical Activity, Sport and Recreation Research Focus AreaNorth‐West UniversityPotchefstroomSouth Africa
| | - Ruan Kruger
- Medical Research Council Research Unit for Hypertension and Cardiovascular DiseaseNorth‐West UniversityPotchefstroomSouth Africa
- Centre of Excellence: Hypertension in Africa Research TeamNorth‐West UniversityPotchefstroomSouth Africa
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Moraes JMM, Sproesser G, Alvarenga MDS. Food healthiness judgements among Brazilian and German lay adults. NUTR BULL 2023; 48:482-499. [PMID: 37712882 DOI: 10.1111/nbu.12638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/24/2023] [Accepted: 08/29/2023] [Indexed: 09/16/2023]
Abstract
This study investigated which foods are most saliently judged as healthy and unhealthy in Brazil and Germany and the reasons for these judgements. Dietary guidelines in the two countries differ in that those in Brazil are based on a food processing classification rather than nutrient profiling, whereas dietary guidelines in Germany do not include the processing level of food. In an online study with 355 lay adults (Brazil n = 205, Germany n = 150), we explored which foods are listed as healthy and unhealthy using a free-listing method. The main reasons for these healthiness judgements were then identified with a one or two-word phrase and compared between countries. Saliency analysis was conducted to identify the 15 most salient healthy and unhealthy foods in each country. Principles of content analysis were used to assess the reasons why these 15 items were listed as most salient by the participants. Results showed that both Brazilians and Germans listed mostly natural or minimally processed food (e.g. fruits, vegetables, grains, fish and milk) as healthy, whereas types of convenience and fast food, sweets and other ultra-processed foods (e.g. chocolate, soda, French fries, pizza and hamburger) were the most salient unhealthy items listed in both countries. Differences in culturally relevant items listed in each country are discussed. Further, in both countries, despite differences in their dietary guidelines, food healthiness judgements for the most salient items listed relied heavily on the nutritional content of food, reinforced the 'good/healthy' and 'bad/unhealthy' dichotomy, and were centred on benefits or harms to the body (e.g. prevention or cause of diseases and weight control). The similarity of food healthiness judgements between the two countries, together with their agreement with conventional health claims and dietary guidelines, suggest that lay Brazilian and German adults are knowledgeable about the general concepts of 'healthy' and 'unhealthy' food. Finally, these findings suggest that rather than just providing more nutritional information, policymakers and health professionals need to take into account the multiple psychosocial and environmental determinants of eating in these countries.
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Affiliation(s)
- Jessica Maria Muniz Moraes
- Postgraduate Program in Nutrition in Public Health, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Gudrun Sproesser
- Institute of Psychology, Johannes Kepler University Linz, Linz, Austria
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Marle Dos Santos Alvarenga
- Postgraduate Program in Nutrition in Public Health, School of Public Health, University of São Paulo, São Paulo, Brazil
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Damigou E, Kouvari M, Chrysohoou C, Barkas F, Kravvariti E, Dalmyras D, Koutsogianni AD, Tsioufis C, Pitsavos C, Liberopoulos E, Sfikakis PP, Panagiotakos D. Diet Quality and Consumption of Healthy and Unhealthy Foods Measured via the Global Diet Quality Score in Relation to Cardiometabolic Outcomes in Apparently Healthy Adults from the Mediterranean Region: The ATTICA Epidemiological Cohort Study (2002-2022). Nutrients 2023; 15:4428. [PMID: 37892503 PMCID: PMC10610374 DOI: 10.3390/nu15204428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/16/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
The Global Diet Quality Score (GDQS) is a novel food-based score that assesses both nutrient adequacy and chronic disease risk, by evaluating healthy (GDQS+) and unhealthy foods (GDQS-). The aim of this study was to evaluate the association among GDQS, GDQS+, and GDQS- against the 20-year risk of cardiometabolic outcomes in a Mediterranean population. The sample was n = 2169 initially free of cardiovascular disease (CVD) participants of the ATTICA study (2002-2022) that participated in the 20-year follow-up. The incidence of CVD, hypertension, hypercholesterolemia, and type 2 diabetes mellitus (T2DM) was defined according to WHO-ICD-10 criteria. The GDQS was computed based on previously published instructions. In multivariate analyses, a higher diet quality, per 1/49 of the GDQS, was associated with an 8% [95% Confidence Interval-CI: 6-9%] and 2% [95% CI: 1-3%] lower CVD and T2DM risk, respectively. A higher consumption of healthy foods, per 1/32 of GDQS+, was associated with a 9% [95% CI: 7-11%] and 2% [95% CI: 1-3%] lower CVD and T2DM risk, respectively. Contrarily, a lower consumption of unhealthy foods (GDQS-) was not associated with cardiometabolic events in the adjusted models (all p value< 0.05). In clinical practice or future public health actions to ameliorate dietary habits and prevent CVD and T2DM, more attention should be focused on healthy foods that should be included in our diets.
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Affiliation(s)
- Evangelia Damigou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17676 Athens, Greece
| | - Matina Kouvari
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17676 Athens, Greece
| | - Christina Chrysohoou
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 15772 Athens, Greece
| | - Fotios Barkas
- Department of Internal Medicine, Medical School, University of Ioannina, 45500 Ioannina, Greece
| | - Evrydiki Kravvariti
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 15772 Athens, Greece
| | - Dimitrios Dalmyras
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17676 Athens, Greece
| | - Amalia D. Koutsogianni
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 15772 Athens, Greece
| | - Costas Tsioufis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 15772 Athens, Greece
| | - Christos Pitsavos
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 15772 Athens, Greece
| | - Evangelos Liberopoulos
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 15772 Athens, Greece
| | - Petros P. Sfikakis
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 15772 Athens, Greece
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17676 Athens, Greece
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Boxer B, Trübswasser U, Lesi V, Naika A, Dahal P, Sagan S, Joshi K, Irache A, Singh P, Nand D, Kama A, Deo A, Goudet S. Rapid review of factors influencing dietary behaviors in Fiji. Front Nutr 2023; 10:1164855. [PMID: 37621737 PMCID: PMC10445140 DOI: 10.3389/fnut.2023.1164855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 07/20/2023] [Indexed: 08/26/2023] Open
Abstract
Introduction In Fiji, multiple burdens of malnutrition including undernutrition, overweight/obesity, and micronutrient deficiencies coexist at the individual, household, and population levels. The diets of children, adolescents, and adults are generally unhealthy. The objective of this review was to understand how the dietary behaviors of children, adolescents, and women in Fiji are influenced by individual, social, and food environment factors. Methods This rapid review was conducted to synthesize existing evidence, identify research gaps in the evidence base, and make recommendations for future research. The Cochrane Rapid Reviews Methods and the updated guideline for reporting systematic reviews were used. The search strategy for this rapid review was based on the Population Context Outcome [P(E)CO] framework, including search terms for population (children, adolescents, and adults), context (Fiji), and outcome (dietary behaviors). Searches were conducted in PubMed, Scopus, PsycINFO, and Google Scholar. Results The 22 studies included in this review identified different factors influencing dietary behaviors in Fiji. Individual preferences for processed and imported foods, especially of younger generations, and social dynamics, especially gender norms and social pressure, to serve meat and overeat appeared to be prominent in driving dietary habits. The ongoing nutrition transition has led to increasing availability and affordability of ultra-processed and fast foods, especially in urban areas. Concerns about food safety and contamination and climate change and its effect on local food production also appear to influence dietary choices. Discussion This review identified different dynamics influencing dietary behaviors, but also research gaps especially with regard to the food environment, calling for an integrated approach to address these factors more systemically.
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Affiliation(s)
| | | | - Viola Lesi
- Nutrition Research, Dikoda, London, United Kingdom
| | - Asaeli Naika
- Nutrition Research, Dikoda, London, United Kingdom
| | | | | | | | - Ana Irache
- Nutrition Research, Dikoda, London, United Kingdom
| | - Pragya Singh
- School of Public Health and Primary Care, College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji
| | - Devina Nand
- Ministry of Health and Medical Services, Suva, Fiji
| | - Ateca Kama
- Ministry of Health and Medical Services, Suva, Fiji
| | - Alvina Deo
- National Food and Nutrition Centre, Suva, Fiji
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Amevinya GS, Vandevijvere S, Kelly B, Afagbedzi SK, Aryeetey R, Adjei AP, Quarpong W, Tandoh A, Nanema S, Agyemang C, Zotor F, Laar ME, Mensah K, Laryea D, Asiki G, Holdsworth M, Laar A. Advertising of unhealthy foods and beverages around primary and junior high schools in Ghana's most urbanized and populous region. Front Public Health 2022; 10:917456. [PMID: 36211683 PMCID: PMC9539976 DOI: 10.3389/fpubh.2022.917456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 08/22/2022] [Indexed: 01/22/2023] Open
Abstract
Introduction The advertising of energy-dense, nutrient-poor foods and beverages is a common feature in obesogenic food environments. Such advertising, within and around settings where children live, learn, and play, negatively affects their food acquisition and consumption. We examined the extent and nature of food and beverage advertising around primary and junior high schools in Ghana's most populous and urbanized region, Greater Accra. Materials and methods Outdoor advertisements for foods and beverages within a 250 m road network distance of 200 randomly sampled schools were geocoded. For each food and beverage advertisement, information was collected on the setting, type, size, and number of product types featured in the advertisement. Promotional techniques (promotional characters and premium offers) used in advertisements were documented. Advertised foods and beverages were classified using the INFORMAS and NOVA food classification systems. Results A total of 5,887 advertisements were identified around the schools surveyed, 42% of which were for foods and beverages. Advertisements were most prevalent at food outlets (78% of all food advertisements), but also along roads and on non-food structures. Overall, 70% of food advertisements featured non-core/unhealthy products, while 12 and 14% had core/healthy and miscellaneous (including soup cubes, seasonings, and tea) products. About 4% of food advertisements had only a product/brand name or logo displayed. One out of two of the foods and beverages advertised were ultra-processed foods, 30% processed, 3% processed culinary ingredients, and 17% unprocessed or minimally processed foods. Sugar-sweetened beverages were the most advertised food product type (32%). Promotional characters were found on 14% of all food advertisements (most-69% were cartoons or manufacturer's characters), while 8% of all food advertisements had premium offers (including price discounts and gift/collectables). Conclusions There is an abundance of unhealthy food advertisements around primary and junior high schools in the Greater Accra Region. Policy actions such as restricting the promotion of unhealthy foods in children's settings are needed to protect pupils from such advertising practices.
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Affiliation(s)
- Gideon Senyo Amevinya
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | | | - Bridget Kelly
- Early Start, School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
| | - Seth Kwaku Afagbedzi
- Department of Biostatistics, School of Public Health, University of Ghana, Accra, Ghana
| | - Richmond Aryeetey
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Akosua Pokua Adjei
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Wilhemina Quarpong
- Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA, United States
| | - Akua Tandoh
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Silver Nanema
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Charles Agyemang
- Department of Public and Occupational Health, Amsterdam University Medical Center (UMC), University of Amsterdam, Amsterdam, Netherlands
| | - Francis Zotor
- Department of Family and Community Health, University of Health and Allied Sciences, Ho, Ghana
| | - Matilda E. Laar
- Department Family and Consumer Sciences, School of Agriculture, University of Ghana, Accra, Ghana
| | - Kobby Mensah
- Department of Marketing and Entrepreneurship, University of Ghana Business School, University of Ghana, Accra, Ghana
| | - Dennis Laryea
- Non-communicable Disease Programme, Ghana Health Service, Accra, Ghana
| | - Gershim Asiki
- African Population and Health Research Center, Nairobi, Kenya
| | - Michelle Holdsworth
- UMR MoISA (Montpellier Interdisciplinary Centre on Sustainable Agri-Food Systems), (Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD), Montpellier, France
| | - Amos Laar
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
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Tizazu W, Laillou A, Hirvonen K, Chitekwe S, Baye K. Child feeding practices in rural Ethiopia show increasing consumption of unhealthy foods. Matern Child Nutr 2022:e13401. [PMID: 35852042 DOI: 10.1111/mcn.13401] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 06/15/2023]
Abstract
The quality of complementary feeding can have both short- and long-term health impacts by delaying or promoting child growth and establishing taste preferences and feeding behaviours. We aimed to assess the healthy and unhealthy feeding practices of infants and young children in rural Ethiopia. We conducted two rounds of surveys in December 2017/18 in Habru district, North Wello, rural Ethiopia among caregivers of infants and young children (N = 574). We characterised the consumption of infants and young children using non-quantitative 24 h recall and the World Health Organization infant and young child feeding indicators. Sociodemographic characteristics, anthropometry and haemoglobin concentrations were assessed. Breastfeeding was a norm as 82% and 67% were breastfed in the first and second rounds. Between the two rounds, dietary diversity increased from 5% to 17% (p < 0.05), but more pronounced increases were observed in the consumption of ultra-processed food (UPFs). Up to one-in-five (22%) of the children consumed UFPs. With an average of only three food groups consumed, the consumption of nutrient-dense foods like animal source foods, fruits and vegetables was very low particularly among younger children. UPFs are an additional risk factor that contributes to poor quality diets. Behavioural Change Communication interventions, including those in rural areas, should explicitly discourage the consumption of UPFs. Future studies should aim to quantify the amount of UPFs consumed and evaluate how this is associated with diet adequacy and nutritional outcomes.
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Affiliation(s)
- Woinshet Tizazu
- Center for Food Science and Nutrition, Addis Ababa University, Addis Ababa, Ethiopia
| | - Arnaud Laillou
- Nutrition Section, UNICEF Ethiopia, Addis Ababa, Ethiopia
| | - Kalle Hirvonen
- Development Strategy and Governance Division, International Food Policy Research Institute, Washington, District of Columbia, USA
- The United Nations University, World Institute for Development Economics Research, Helsinki, Finland
| | | | - Kaleab Baye
- Center for Food Science and Nutrition, Addis Ababa University, Addis Ababa, Ethiopia
- Research Center for Inclusive Development in Africa, Addis Ababa, Ethiopia
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Keeling E, Lynn SA, Koh YM, Scott JA, Kendall A, Gatherer M, Page A, Cagampang FR, Lotery AJ, Ratnayaka JA. A High Fat "Western-style" Diet Induces AMD-Like Features in Wildtype Mice. Mol Nutr Food Res 2022; 66:e2100823. [PMID: 35306732 PMCID: PMC9287010 DOI: 10.1002/mnfr.202100823] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 03/01/2022] [Indexed: 12/20/2022]
Abstract
Scope The intake of a “Western‐style” diet rich in fats is linked with developing retinopathies including age‐related macular degeneration (AMD). Wildtype mice are given a high fat diet (HFD) to determine how unhealthy foods can bring about retinal degeneration. Methods and results Following weaning, female C57BL/6 mice are maintained on standard chow (7% kcal fat, n = 29) or a HFD (45% kcal fat, n = 27) for 12 months. Animals were sacrificed following electroretinography (ERG) and their eyes analyzed by histology, confocal immunofluorescence, and transmission electron microscopy. HFD mice become obese, but showed normal retinal function compared to chow‐fed controls. However, diminished β3tubulin labeling of retinal cross‐sections indicated fewer/damaged neuronal processes in the inner plexiform layer. AMD‐linked proteins clusterin and TIMP3 accumulated in the retinal pigment epithelium (RPE) and Bruch's membrane (BrM). Neutral lipids also deposited in the outer retinae of HFD mice. Ultrastructural analysis revealed disorganized photoreceptor outer segments, collapsed/misaligned RPE microvilli, vacuoles, convoluted basolateral RPE infolds and BrM changes. Basal laminar‐like deposits were also present alongside abnormal choroidal endothelial cells. Conclusions We show that prolonged exposure to an unhealthy “Western‐style” diet alone can recapitulate early‐intermediate AMD‐like features in wildtype mice, highlighting the importance of diet and nutrition in the etiology of sight‐loss.
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Affiliation(s)
- Eloise Keeling
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, MP806, Tremona Road, Southampton, SO16 6YD, UK
| | - Savannah A Lynn
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, MP806, Tremona Road, Southampton, SO16 6YD, UK
| | - Yen Min Koh
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, MP806, Tremona Road, Southampton, SO16 6YD, UK
| | - Jenny A Scott
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, MP806, Tremona Road, Southampton, SO16 6YD, UK
| | - Aaron Kendall
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, MP806, Tremona Road, Southampton, SO16 6YD, UK
| | - Maureen Gatherer
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, MP806, Tremona Road, Southampton, SO16 6YD, UK
| | - Anton Page
- Biomedical Imaging Unit, University of Southampton, MP12, Tremona Road, Southampton, SO16 6YD, UK
| | - Felino R Cagampang
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
| | - Andrew J Lotery
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, MP806, Tremona Road, Southampton, SO16 6YD, UK.,Eye Unit, University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK
| | - J Arjuna Ratnayaka
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, MP806, Tremona Road, Southampton, SO16 6YD, UK
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Pinheiro AC, Quintiliano-Scarpelli D, Flores JA, Álvarez C, Suárez-Reyes M, Palacios JL, Quevedo TP, de Oliveira MRM. Food Availability in Different Food Environments Surrounding Schools in a Vulnerable Urban Area of Santiago, Chile: Exploring Socioeconomic Determinants. Foods 2022; 11:foods11070901. [PMID: 35406988 PMCID: PMC8997463 DOI: 10.3390/foods11070901] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/16/2022] [Accepted: 03/18/2022] [Indexed: 12/13/2022] Open
Abstract
The analysis of the food environment is used to identify areas with gaps in the availability of healthy foods and can be used as a public policy assessment tool. In recent decades, Chile has implemented several strategies and regulations to improve food environments, with encouraging results. Little is known about the scope of these measures in socially vulnerable environments. This study is part of a project that seeks to build an integrated intervention model for healthy school environments in a vulnerable area of Santiago, Chile. The objective of this study was to evaluate the availability of healthy and unhealthy foods around schools and the relationship between it and socioeconomic determinants of the school community in the Chilean context. A cross-sectional study to measure the food environment of informal markets (street food), formal markets (stores), and institutions (schools) was conducted in and around 12 schools (100 m surrounding schools) in a vulnerable urban area of Santiago, Chile. A lack of healthy foods was observed, which was related to some socio-economic determinants and the multidimensional poverty was the most relevant. The diagnosis of food environments around schools can represent an important target for governments to implement policies focused at improving the availability of healthy foods.
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Affiliation(s)
- Anna Christina Pinheiro
- Carrera de Nutrición y Dietética, Facultad de Medicina-Clinica Alemana, Universidad del Desarrollo, Santiago 7610658, Chile
- PhD Program in Nursing, Medical School, São Paulo State University, Botucatu 18618-687, Brazil;
- Correspondence: (A.C.P.); (D.Q.-S.)
| | - Daiana Quintiliano-Scarpelli
- Carrera de Nutrición y Dietética, Facultad de Medicina-Clinica Alemana, Universidad del Desarrollo, Santiago 7610658, Chile
- Correspondence: (A.C.P.); (D.Q.-S.)
| | | | - Claudio Álvarez
- IT Innovation Center for Social Apps, University of Santiago de Chile, Santiago 9170020, Chile;
| | - Mónica Suárez-Reyes
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, University of Santiago de Chile, Santiago 9170020, Chile;
| | - José Luis Palacios
- Center for Studies in Food Science and Technology, University of Santiago de Chile, Santiago 9170020, Chile;
| | - Tito Pizarro Quevedo
- Faculty of Medical Sciences, University of Santiago de Chile, Santiago 9170020, Chile;
| | - Maria Rita Marques de Oliveira
- PhD Program in Nursing, Medical School, São Paulo State University, Botucatu 18618-687, Brazil;
- Institute of Biosciences, São Paulo State University, Botucatu 18618-689, Brazil
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Yang X, Huang Y, Han M, Wen X, Zheng Q, Chen Q, Chen Q. The Differential Effects of Physical Activity Calorie Equivalent Labeling on Consumer Preferences for Healthy and Unhealthy Food Products: Evidence from a Choice Experiment. Int J Environ Res Public Health 2021; 18:ijerph18041860. [PMID: 33672920 PMCID: PMC7918401 DOI: 10.3390/ijerph18041860] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/07/2021] [Accepted: 02/08/2021] [Indexed: 11/24/2022]
Abstract
Background: Since numerical calorie labels have limited effects on less-calorie food ordering, an alternative called physical activity calorie equivalent (PACE) labels, which exhibit calories using visible symbols and the minutes of exercise to burn off the calories, may be more effective in reducing calories ordered. Methods: By using a choice experiment (CE) approach, the aims of this study were to estimate the effects of PACE labels on consumer preferences for healthy and unhealth food. Red date walnuts and potato chips were used as the representatives of healthy and unhealthy foods respectively in this study. Moreover, future time perspective (FTP) is an individual trait variable of consumers, which has been recognized as a significant driver of healthy behaviors. We also included FTP into the interaction with PACE labels. Results: Firstly, the results were opposite between the healthy and unhealthy food groups. Respondents showed significantly more positive attitudes toward red date walnuts (i.e., healthy food) with PACE labels, while they showed significantly more negative preferences for chips (i.e., unhealthy food) with PACE labels. Secondly, people with higher FTP are preferred red date walnuts with PACE labels, while PACE labels on chips could undermine the preferences of respondents with higher FTP. Thirdly, we found that women (vs. men) were less inclined to choose healthy food with standard calorie labels and labels showing the minutes of running to burn off the calories, as well as that the elderly (vs. younger) people in the healthy food group preferred the labels showing the minutes of running to burn off the calories. People with a higher body mass index (BMI) were reluctant to purchase walnuts with the information about the minutes of walking. Conclusions: Results from this study showed that PACE labels have significant effects on consumers’ preferences for food products.
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Affiliation(s)
- Xiaoke Yang
- College of Management, Fujian Agriculture and Forestry University, Fuzhou 350002, China; (X.Y.); (M.H.); (X.W.); (Q.Z.); (Q.C.)
| | - Yuanhao Huang
- School of Business, Renmin University of China, Beijing 100089, China;
| | - Mengzhu Han
- College of Management, Fujian Agriculture and Forestry University, Fuzhou 350002, China; (X.Y.); (M.H.); (X.W.); (Q.Z.); (Q.C.)
| | - Xiaoting Wen
- College of Management, Fujian Agriculture and Forestry University, Fuzhou 350002, China; (X.Y.); (M.H.); (X.W.); (Q.Z.); (Q.C.)
| | - Qiuqin Zheng
- College of Management, Fujian Agriculture and Forestry University, Fuzhou 350002, China; (X.Y.); (M.H.); (X.W.); (Q.Z.); (Q.C.)
| | - Qian Chen
- College of Management, Fujian Agriculture and Forestry University, Fuzhou 350002, China; (X.Y.); (M.H.); (X.W.); (Q.Z.); (Q.C.)
- Correspondence:
| | - Qiuhua Chen
- College of Management, Fujian Agriculture and Forestry University, Fuzhou 350002, China; (X.Y.); (M.H.); (X.W.); (Q.Z.); (Q.C.)
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Johnson BJ, Zarnowiecki D, Hendrie GA, Mauch CE, Golley RK. How to reduce parental provision of unhealthy foods to 3- to 8-year-old children in the home environment? A systematic review utilizing the Behaviour Change Wheel framework. Obes Rev 2018; 19:1359-1370. [PMID: 30092606 DOI: 10.1111/obr.12702] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 04/04/2018] [Accepted: 04/11/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND OBJECTIVE The effectiveness of obesity prevention interventions to improve children's diet can be enhanced. Deconstructing past interventions can identify components with potential to change behaviour. This systematic review using the Behaviour Change Wheel aimed to examine the behaviour change content of interventions supporting parents of 3- to 8-year olds to reduce provision of unhealthy foods to children. METHODS Ebscohost, Ovid, Scopus and Web of Science were searched. Eligible studies included controlled interventions with active parent involvement, at least one intervention strategy and outcome measure for unhealthy foods ≥3 months from baseline. Seventeen interventions were included describing 18 intervention arms. RESULTS Interventions frequently targeted parents' reflective motivation (n = 17) and psychological capability (n = 15), through education (n = 15) or enablement (n = 15) intervention functions and service provision (n = 18) policy category. Only 24 of the 93 behaviour change techniques were used with an average of five techniques used per intervention. CONCLUSIONS Existing interventions achieving small reductions in unhealthy food intake are homogenous in approach. There is potential to utilize untapped behaviour change techniques, through comprehensive intervention design and behavioural analysis guided by the Behaviour Change Wheel. Interventions targeting opportunity through persuasion, modelling or environmental restructuring, and using different policy categories are urgently needed to provide an evidence base to inform policy and practice.
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Affiliation(s)
- B J Johnson
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia
| | - D Zarnowiecki
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia.,Early Prevention of Obesity in Childhood Centre for Research Excellence, Sydney, Australia
| | - G A Hendrie
- Health and Biosecurity Flagship, Commonwealth Scientific Industrial Research Organisation Adelaide, Adelaide, Australia
| | - C E Mauch
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia.,Early Prevention of Obesity in Childhood Centre for Research Excellence, Sydney, Australia
| | - R K Golley
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia.,Early Prevention of Obesity in Childhood Centre for Research Excellence, Sydney, Australia
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Ranjit N, Evans AE, Springer AE, Hoelscher DM, Kelder SH. Racial and ethnic differences in the home food environment explain disparities in dietary practices of middle school children in Texas. J Nutr Educ Behav 2015; 47:53-60. [PMID: 25439762 DOI: 10.1016/j.jneb.2014.09.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 09/03/2014] [Accepted: 09/07/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To examine racial and ethnic differences among middle school children in the home food environment (HFE) and the extent to which associations of healthy and unhealthy eating with the HFE differ by race and ethnicity. DESIGN Cross-sectional secondary analyses of baseline data from Coordinated Approach to Child Health Middle School, a school-based intervention targeting obesity and obesogenic behaviors among middle school children in Austin, TX. PARTICIPANTS A total of 2,502 children (mean age, 13.9 years; 58% Hispanic, 28% white, and 14% black). VARIABLES MEASURED Availability and accessibility of healthy foods, and parental support of healthy eating, and family meals. Consumption of both healthy and unhealthy foods was examined. ANALYSIS Differences across racial and ethnic groups in aspects of HFE were estimated using linear regression. Models also examined racial and ethnic differences in consumption of healthy and unhealthy foods. If adjusting for HFE, such differences were accounted for. RESULTS White children had significantly better HFEs than Hispanic and black children with greater availability and accessibility of healthy foods (P < .001). Adjusting for a healthy HFE reduced disparities in consumption of healthy foods but not in consumption of unhealthy foods. CONCLUSIONS AND IMPLICATIONS Improved HFE may increase healthy eating among ethnic minorities but is unlikely to reduce unhealthy eating.
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Affiliation(s)
- Nalini Ranjit
- Michael and Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston School of Public Health, Austin Regional Campus, Austin, TX.
| | - Alexandra E Evans
- Michael and Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston School of Public Health, Austin Regional Campus, Austin, TX
| | - Andrew E Springer
- Michael and Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston School of Public Health, Austin Regional Campus, Austin, TX
| | - Deanna M Hoelscher
- Michael and Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston School of Public Health, Austin Regional Campus, Austin, TX
| | - Steve H Kelder
- Michael and Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston School of Public Health, Austin Regional Campus, Austin, TX
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