To assess the effectiveness of the ‘Weet wat je eet’ (‘Know what you eat’) school-based nutrition education programme on behavioural determinants and behaviour among students aged 12–15 years. A quasi-experimental study design was used, collecting data at baseline and after implementing the programme in both an intervention and control group (in total 611 students) across the Netherlands. Students from eighteen Dutch secondary education schools completed two consecutive questionnaires, assessing knowledge, self-efficacy, attitude, subjective norm, intention, and behaviours related to healthy, safe, and sustainable nutrition. Multilevel regression analyses were conducted corrected for gender, grade, education level, and school location. The intervention group showed a significant higher increase in self-efficacy, attitude, intention to drink water (all three P < 0.01), and a significant higher decrease in the consumption of sugary drinks, snacks, and meat (all P < 0.05) than the control group. Both the groups scored significantly higher on knowledge during the post-test (both P < 0.05), although the intervention group not significantly higher than the control group (P = 0.14). No significant effects were observed for subjective norm, intention, and fruit, vegetable, and whole grain bread consumption. The results of this study showed positive effects of the ‘Weet wat je eet’ school-based nutrition education programme on self-efficacy and attitude towards healthy, safe and sustainable nutrition, intention to drink more water, and various healthy eating behaviours among secondary school students. Further research is necessary to assess the long-term sustainability of these results.

Although dietary factors have been examined as potential risk factors for liver cancer, the evidence is still inconclusive. Using a diet-wide association analysis, our research evaluated the associations of 126 foods and nutrients on the risk of liver cancer in a Chinese population. We obtained the diet consumption of 72,680 women in the Shanghai Women’s Health Study using baseline dietary questionnaires. The association between each food and nutrient and liver cancer risk was quantified by Cox regression model. A false discovery rate of 0.05 was used to determine the foods and nutrients which need to be verified. Totally 256 incident liver cancer cases were identified in 1,267,391 person-years during the follow-up duration. At the statistical significance level (P ≤ 0.05), higher intakes of cooked wheaten foods, pear, grape and copper were inversely associated with liver cancer risk, while spinach, leafy vegetables, eggplant and carrots showed the positive associations. After considering multiple comparisons, no dietary variable was associated with liver cancer risk. Similar findings were seen in the stratification, secondary and sensitivity analyses. Our findings observed no significant association between dietary factors and liver cancer risk after considering multiple comparisons in Chinese women. More evidence is needed to explore the associations between diet and female liver cancer occurrence.

Renal sinus fat (RSF) crucially influences metabolic regulation, inflammation, and vascular function. We investigated the association between RSF accumulation, metabolic disorders, and nutritional status in obese individuals with hypertension. A cross-sectional study involved 51 obese hypertensive patients from Salamat Specialized Community Clinic (February–September 2022). Basic and clinical information were collected through interviews. Data included anthropometrics, blood pressure, number of antihypertensive medications, body composition (bioelectrical impedance analysis), dietary intake (semi-quantitative 147-item food frequency questionnaire), and blood samples. Renal sinus fat was measured via ultrasonography. Statistical analyses included Pearson correlation, binary logistic regression, and linear regression. RSF positively correlated with abdominal visceral adipose tissue (VAT) area (P = 0.016), systolic blood pressure (SBP) (P = 0.004), and diastolic blood pressure (DBP) (P = 0.005). A strong trend toward a positive association was observed between antihypertensive medications and RSF (P = 0.062). In linear regression, RSF was independently associated with abdominal VAT area, SBP, and DBP after adjusting for confounders. After considering other risk factors, RSF volume relates to prescribed antihypertensive medications, hypertension, and central fat accumulation in obese hypertensive subjects. These findings suggest the need for further investigations into whether RSF promotes metabolic disorders.

Diet indices are quantitative assessments of the quality of population intake. Understanding diet quality is crucial to support health and well-being; however, knowledge of diet quality across racial groups is limited. To examine diet quality of acial groups ‘White’, ‘Black’, ‘Asian’, and ‘Other’ in the United Kingdom (U.K.) and United States (U.S.), U.K. and U.S. national survey data were used to calculate Alternative Healthy Eating Index (AHEI-2010), Diet Quality Index-International (DQI-I), and EAT-Lancet scores. ANCOVA tests compared median total quality scores across racial groups adjusting for covariates. Kruskal–Wallis tests examined differences in individual component scores. Spearman correlations identified association of diet quality scores across indices. Highest diet quality scores were reported for U.K. and U.S. Asian groups. Most noticeable differences were apparent between U.S. Asian and White/Black groups (62% Asians within highest tertile of AHEI-2010 score vs. 29% Whites; P < 0.001). All racial groups demonstrated poor diet quality in terms of sustainability; EAT-Lancet scores were <40% of maximum total score for U.S. White, Black, and Other groups. AHEI-2010 diet quality scores were moderately associated with EAT-Lancet scores, evident across all groups (r = 0.53–0.65; P < 0.001). There is a need for all groups to increase intake of wholegrains, especially Black groups (mean Wholegrain score for U.S. Black group within DQI-I was 0.60 (maximum score of 5)) as demonstrated within AHEI-2010, DQI-I, and EAT-Lancet component scores. Additionally, increased intake of vegetables and legumes and decreased intake of processed and red meat would improve the adequacy, healthiness, and sustainability of U.K. and U.S. racial diets.

Weight loss results in obligatory reductions in energy expenditure (EE) due to loss of metabolically active fat-free mass (FFM). This is accompanied by adaptive reductions (i.e. adaptive thermogenesis) designed to restore energy balance while in an energy crisis. While the ‘3500-kcal rule’ is used to advise weight loss in clinical practice, the assumption that EE remains constant during energy restriction results in a large overestimation of weight loss. Thus, this work proposes a novel method of weight-loss prediction to more accurately account for the dynamic trajectory of EE. A mathematical model of weight loss was developed using ordinary differential equations relying on simple self-reported inputs of weight and energy intake to predict weight loss over a specified time. The model subdivides total daily EE into resting EE, physical activity EE, and diet-induced thermogenesis, modelling obligatory and adaptive changes in each compartment independently. The proposed model was tested and refined using commercial weight-loss data from participants enrolled on a very low-energy total-diet replacement programme (LighterLife UK, Essex). Mathematical modelling predicted post-intervention weight loss within 0.75% (1.07 kg) of that observed in females with overweight or obesity. Short-term weight loss was consistently underestimated, likely due to considerable FFM reductions reported on the onset of weight loss. The best model agreement was observed from 6 to 9 weeks where the predicted end-weight was within 0.35 kg of that observed. The proposed mathematical model simulated rapid weight loss with reasonable accuracy. Incorporated terms for energy partitioning and adaptive thermogenesis allow us to easily account for dynamic changes in EE, supporting the potential use of such a model in clinical practice.

The aim of this study was to explore and identify why young adults aged between 18 and 30 years in the UK and France do or do not consume dairy products. Several studies have associated dairy products with a healthy diet, and the production of soft dairy, i.e. milk, yoghurt, and soft cheese, as more environmentally friendly than some other animal-based products. Yet recent reports highlight that dairy intake is lower than recommended for health, especially among young adults. Using a qualitative methodology, forty-five participants aged 18–30 years (UK: n = 22; France: n = 23) were asked about their reasons for (non)consumption of a wide range of dairy products. Audio-recorded focus groups and individual interviews were conducted in English in the UK and in French in France, transcribed and coded. A thematic analysis found four themes and sixteen sub-themes (theme product-related: sub-themes sensory, non-sensory, composition; theme individual-related: sub-themes mode of consumption, preferences, personal reasons, knowledge, attitudes and concerns, needs or cravings; theme cultural aspects: sub-themes product categorization, social norms, use; theme market offering: sub-themes alternative, packaging, value for money, availability) to influence participants’ dairy (non)consumption in both countries. A seventeenth sub-theme (theme cultural aspects: sub-theme structure of the meal) was found to influence dairy consumption only in France. Further studies are needed to investigate these themes within larger samples, but these findings contribute to understanding dairy (non)consumption in young adults in the UK and France and may aid the development of strategies to improve young adults’ diets.

Animal source foods (ASFs) are diverse and heterogeneous, including unprocessed red meat, processed meat, poultry, eggs, seafood, milk, cheese, and yoghurt. It is essential for preventing malnutrition and its consequences among vulnerable populations, including infants, young children, adolescents, women of reproductive age, and pregnant and lactating women. Understanding the intakes of ASF among adolescents and associated factors is critical for establishing priorities to promote its consumption and enhance growth and development during this period. Consequently, the purpose of the current study is to examine the current levels of not consuming ASF among school-aged adolescent girls and the relationship between anaemia and not consuming ASF. A facility-based cross-sectional study design was conducted among 516 school adolescent girls in Silti District, Central Ethiopia, spanning from October 2 to 20, 2023. Data were entered into Epi-data 3.1 and exported to SPSS version 25 for further analysis. Adjusted odds ratios, along with their corresponding 95% confidence intervals, were calculated to examine the association between not consuming ASF and anaemia status after adjusting for age, residence, menstrual status, and morbidity. Statistical significance was defined as a p-value less than 0.05 in the final model. In this study, the prevalence of not consuming any form of ASF was 51.1% (95 CI: 44.6%–53.2%) and the prevalence of anaemia was 29% (95% CI: 25.2, 33.3). Moreover, unlikely consumption of ASF was significantly associated with anaemia (AOR = 3.2, 95% CI:2, 5.1) after adjusting for age, place of residence, experience of morbidity symptoms and menstrual status. The current study found a significant prevalence of adolescent girls in the area not consuming ASF while attending school. Moreover, the prevalence of anaemia was moderate. Unlikely consumption of ASF was significantly associated with anaemia. Hence, enhancing ASF consumption is one of the key actions to fight against anaemia.

Numerous public initiatives aim to influence individual food choices by informing about what is considered ‘healthy’, ‘climate-friendly’, and generally ‘sustainable’ food. However, research suggests that rather than public authorities, social influence is more likely to affect people’s behaviour. Using a randomised controlled trial, this study investigated if and how the two kinds of influences (factual versus social) could affect the real-life, self-reported intake of plant- and animal-based foods. In a four-month randomised controlled trial, a self-selected sample of adults living in Sweden (N = 237) tracked their daily food consumption several times per week using a tailored mobile phone app. Participants were randomised into one of three groups: two treatment groups receiving factual or social information about plant- and animal-based food consumption, or a control group receiving no information. Pre- and post-questionnaires provided additional background information about the participants. Participants’ food habits varied from week to week, and an explorative analysis pointed to a slight decrease in the consumption of animal-based food in the group that received social information. However, the longer-term patterns remained relatively constant in all groups, showing no substantial shift regardless of the kind of cues that the participants received. By investigating the roles of two common types of information about food and dietary change, the results contribute to discussions about how and by whom effective and efficient measures can be implemented to transform food habits. The results suggest there is limited potential for sustained and substantial behavioural changes through both social and factual information campaigns.

Feeding is an interactive process between parents and children and is related to children’s healthy nutrition, growth, and feelings about the child or parent. The effectiveness of the interaction between feeding and behaviour is strongly influenced by how well this reciprocal procedure is stimulated and supported.

The current study aimed to cross-culturally adapt and validate the About Your Child’s Eating (AYCE) questionnaire in its Greek language version for Greek-Cypriot parents and caregivers of children aged six months to 16 years with or without feeding and swallowing problems.

One hundred Greek-Cypriot parents/caregivers of children with feeding and swallowing difficulties and 100 Greek-Cypriot parents/caregivers of children without feeding and swallowing difficulties participated in this study. This study was conducted at mainstream schools and private speech-language therapy clinics in Cyprus. According to WHO, the AYCE questionnaire was translated and culturally tailored for Greek speakers.

The analysis revealed a statistically significant difference between the AYCE total mean scores of parents in the Typical Development of Feeding Behaviors group (c-TDFB) (M = 44.03, SD = 11.18) and parents in the Atypical Development of Feeding Behaviors group (c-ADFB) (M = 63.56, SD: 16.22) (P < 0.001), with c-ADFB scoring significantly higher. The overall evaluation of the scale yielded a Cronbach’s α coefficient of 0.916.

The validity of the AYCE questionnaire in Cyprus was also assessed. The findings demonstrate that the AYCE can be a beneficial tool for determining critical facets of the feeding parent–child interaction for preschool- and school-aged Greek-Cypriot children in Cyprus.

The objective of this study was to explore barriers and facilitators to utilising a range of food assistance resources as reported by parents living with or at risk for food insecurity (FI), as well as parents’ recommendations for improving utilisation of these resources. Qualitative data from semi-structured interviews about parents’ perspectives on interventions to address FI were analysed using a hybrid deductive/inductive thematic approach. Parents were drawn from the larger Family Matters longitudinal cohort study (N = 1,307), which was recruited from primary care clinics in Minnesota. Forty racially and ethnically diverse parents (Mage = 38.5 years; 97.5% mothers; 85% parents of colour) were recruited by food security level, with ten parents representing each level (i.e. high, marginal, low, very low). Six overarching qualitative themes were identified, which indicated the importance of (1) comfort level seeking assistance; (2) routine screening to assess need; (3) advertising, referrals, and outreach; (4) adequacy of policies and programmes to address need; (5) resource proximity and delivery; and (6) acceptability of foods/benefits provided. With some exceptions, these themes were generally represented from more than one angle (i.e. as barriers, facilitators, recommendations) and raised as relevant across different types of assistance (e.g. federal food assistance programmes, food pantries) and different settings (e.g. schools, healthcare). This study identified key factors influencing food assistance utilisation across multiple dimensions of access. These factors—which range from psychosocial to logistical in nature—should be considered in efforts to expand the reach of food assistance programmes and, in turn, improve food security among families.

Spontaneous abortion (SA) is considered one of the most prevalent adverse outcomes of pregnancy. SA may occur due to genetic susceptibility and various maternal factors such as nutritional status. The aim of this study was to assess how dietary carotenoids and the FTO gene are related to SA. This case–control study included 192 women with a history of SA as the case group and 347 healthy women without history of SA as the control group. To evaluate carotenoid intake, a valid 168-item food frequency questionnaire (FFQ) was used. The FTO gene was genotyped for the presence of the rs9939609 polymorphism using the tetra-primer amplification refractory mutation system-polymerase chain (ARMS-PCR). The results indicated a significant negative association between dietary intake of β-cryptoxanthin and SA in carriers of the TT genotype of the FTO rs9939609 polymorphism after adjustment for age, BMI, physical activity, smoking, alcohol drinking, and calorie intake (β = −0.28, P = 0.02). No association was found between SA with dietary intake of beta-carotene, alpha-carotene, lutein, and lycopene among carriers of different FTO genotypes. The FTO genotype may have an effect on the association between SA and carotenoid intake. Dietary intake of β-cryptoxanthin may act as a protective factor against SA only in carriers of the TT genotype of the FTO rs9939609 polymorphism.

Combating the double burden of malnutrition (DBM) in adolescents is a critical public health challenge in low-income countries like Ethiopia. However, past efforts have lacked focus and exhibited diverse governance strategies. Therefore, this study assesses the effect of selected double-duty interventions (DDIs) on DBM among adolescents in Central Ethiopia. The DBM status (thinness, normal, overweight/obesity) was determined using WHO AnthroPlus software. A two-arm parallel cluster randomised controlled trial was used among 708 adolescents (356 for the intervention group [IG] and 352 for the control group [CG]) from 13 October 2022 to 30 June 2023. The intervention’s effect was analysed through difference-in-difference (DID) analysis and a multivariable multinomial generalised estimating equation (GEE) model with significance set at P < 0.05. The overall DBM prevalence decreased by nearly 7% (4.7% for thinness, 2.2% for overweight/obesity) in the DID analysis. After adjusting for possible confounders, the GEE model indicated that adolescents in the IG were 34% less likely to have higher DBM than those in the CG (AOR = 0.66, 95% CI [0.46, 0.94]). Additionally, the probability of DBM decreased by 59% at the end line compared to baseline measurements (AOR = 0.41, 95% CI [0.03, 0.92]). Adolescents in the category of time and IG interaction were 44% less likely to have increased DBM (AOR = 0.56, 95% [CI 0.02, 0.38]). Thus, this study underscores the effectiveness of selected DDIs in addressing DBM among adolescents using a health belief model. These results advocate for the integration of DDI strategies into existing nutrition guidelines, programmes, and policies.

The trial was registered prospectively in ClinicalTrials.gov with registration number NCT05574842.

Polymorphisms in the vitamin D receptor (VDR) gene (BsmI (rs1544410), FokI (rs2228570), ApaI (rs7975232), TaqI (rs731236)) and low vitamin D concentrations have previously been associated with type 1 diabetes (T1D). Vitamin D is thought to mediate the switch from a pro-inflammatory Th1 response to an anti-inflammatory Th2 response which is protective against the development of T1D. These associations are inconsistent across studies and population groups. These associations have not been investigated in the South African black population. Thus, this observational, case-control study aims to address this knowledge gap. South African black participants with T1D (cases; n = 182) and healthy controls (n = 151) were genotyped for the four VDR polymorphisms using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Vitamin D levels were measured using high performance liquid chromatography (HPLC). Vitamin D levels were not significantly different between cases and controls (62.8 ± 20.7 vs. 59.5 ± 17.0 nmol/l, respectively; P = 0.122). Higher vitamin D levels were associated with the TaqI TT (P = 0.045) and FokI TT/TC (P = 0.014) genotypes in multivariate analyses. Furthermore, the TaqI TT genotype was associated with T1D status in multivariate analysis (P = 0.040). The FokI CC genotype increases the transcription of CYP24A1, resulting in vitamin D catabolism and thus decreased vitamin D concentration through the action of 24-hydroxlase. The TaqI TT genotype results in increased vitamin D potentially through calcium metabolism feedback pathways. In addition, the TaqI TT genotype is associated with T1D through a vitamin D-independent mechanism and may be in linkage disequilibrium with a true causative variant.

This study aimed to assess nutritional status and associated factors among adult tuberculosis patients in public health centres in Horro Guduru Wollega Zone, Western Ethiopia, 2021. An institutional-based cross-sectional study was conducted among 334 randomly selected adult TB patients at public health centres from May 7, 2021, to June 21, 2021. Data were collected using structured questionnaires and anthropometric measurements. The nutritional status was measured by using body mass index (BMI). Data was entered into EpiData version 4.6 and exported to SPSS version 25 for analysis. A bivariate and multivariable multinomial logistic regression analysis was done to identify factors associated with nutritional status. The prevalence of under and overnutrition was found to be 48.2% and 8.7%, respectively. Female TB patients (AOR = 3.48, 95% CI: (1.918–6.314)), patients who didn’t receive dietary counselling (AOR = 2.51, 95% CI: (1.335–4.720)), TB patients on the initiation phase of treatment (AOR = 3.76, 95% CI: (2.072–6.852)), and meal frequency less than three times per day (AOR = 3.6, 95% CI: (1.942–6.676)) were significantly associated with under nutrition. The prevalence of undernutrition was high in the study area. Being a female, being in the initiation phase of treatment, lack of dietary counselling, and having meal less than three per day were independently associated with undernutrition. Hence, regular nutritional assessments, dietary counselling, and nutritional support should be encouraged at the facility and community level.

This cross-sectional study examined the barriers and facilitators that influence vegetarian menu choices in a university cafeteria in Geneva, Switzerland. As a first step, an online survey developed by the authors based on the Capability, Opportunity, and Motivation Behaviour (COM-B) model was e-mailed to all university students and staff. In the second step, focus groups (FG) were held to complete the survey responses and identify what needed to be changed to promote the choice of the vegetarian menu in the cafeteria. Data from 304 participants collected through the survey was analysed. The main mentioned barriers were lack of vegetarian options, tastelessness and insufficient satiation. The facilitators that emerged from the survey were the price of the vegetarian menu for students and health and environmental benefits. Thirteen people participated in four FG sessions, which were analysed using thematic analysis. Five themes were identified: spontaneous menu selection, predefined menu selection, influence of opportunity on menu selection, influence of environmental sensitivity on menu selection, and threat to identity in menu selection. The choice of a vegetarian menu in a university cafeteria was mainly influenced by the attractiveness and taste of the plate. Future strategies to reduce food-related greenhouse gas emissions should (a) ensure the quality and attractiveness of the vegetarian menu, especially to appeal to the more resistant, such as men and omnivores, and (b) inform consumers about the guarantee of balanced nutrient intake of the vegetarian menu offered in the cafeteria, and about health and environmental benefits.

Since lack of culture-specific foods in dietary assessment methods may bias reported dietary intake, we identified foods and dishes consumed by residents not born in Sweden and describe consequences for reported foods and nutrient intake using a culturally adapted dietary assessment method. Design consisted of cross-sectional data collection using (semi-)qualitative methods of dietary assessment (and national diet survey instrument RiksmatenFlex) with subsequent longitudinal data collection using quantitative methods for method comparison (December 2020–January 2023). Three community-based research groups were recruited that consisted of mothers born in Sweden, Syria/Iraq, and Somalia, with a median age of 34, 37, and 36 years, respectively. Women born in Syria/Iraq and Somalia who had lived in Sweden for approximately 10 years, reported 78 foods to be added to RiksmatenFlex. In a subsequent study phase, 69% of these foods were reported by around 90% of the ethnic minority groups and contributed to 17% of their reported energy intake. However, differences between the three study groups in median self-reported energy intake remained (Sweden 7.19 MJ, Syria/Iraq 5.54 MJ, and Somalia 5.69 MJ). The groups also showed differences in relative energy contribution from fats and carbohydrates, as well as differences in energy intake from food groups such as bread and sweet snacks. We conclude that a dietary assessment instrument containing culture-specific foods could not resolve group differences in reported energy intake, although these foods provided content validity and contributed 17% of energy intake. The dietary habits collected in this study serve to develop new dietary assessment instruments.

The objectives of this experiment were to determine the digestible indispensable amino acid score (DIAAS) for eggs cooked in different forms and in traditional egg-bread or egg-hash brown combinations, and to test the hypothesis that DIAAS in eggs is greater than in breads or potatoes. Nine ileal cannulated gilts (average initial body weight: 51.1 ± 6.0 kg) were allotted to a 9 × 6 Youden square design with nine diets and six 7-day periods. Fried egg, boiled egg, scrambled egg, English muffin, Texas toast, and hash brown were included in the experiment. Six diets each contained one source of protein and three diets were combinations of fried eggs and English muffin, boiled eggs and Texas toast, or scrambled egg and hash brown. A nitrogen-free diet was also used and fed to all pigs in one period. The standardised ileal digestibility (SID) of crude protein (CP) and amino acids (AA) was calculated, and DIAAS was calculated for the individual ingredient and combined meals for children between 6 and 36 months and individuals older than 3 years. For both age groups, all cooked eggs had greater (P < 0.001) DIAAS compared with the other foods, and hash brown had greater (P < 0.001) DIAAS than both breads. All combined meals had DIAAS greater than 75 and there were no differences between measured and predicted DIAAS for the combined meals. In conclusion, eggs have ‘excellent’ protein quality for individuals older than 6 months and can compensate for the lower protein quality in plant-based foods, and DIAAS obtained from individual ingredients are additive in mixed meals.

Perinatal malnutrition is a critical cause of diseases in offspring. Based on the different rates of organ development, we hypothesised that malnutrition at varying early life stages would have a differential impact on cardiovascular disease in middle-aged and older adults. This study sought to assess the long-term impact of exposure to the 1959–1961 Great Chinese Famine (GCF) during early developmental periods on risks of cardiovascular diseases in the late middle-aged offspring. A total 6, 662 individuals, born between 1958 and 1964, were divided into six groups according to the birth date. The generalised line model was used to control age and estimate differences with 95% confidence interval (CI) in blood pressure. Binary logistic regression was applied to evaluate the association between famine exposure and cardiovascular diseases. Compared to the unexposed late middle-aged persons, blood pressure was elevated in the entire gestation exposure group, regardless of postnatal exposure to GCF. Increased blood pressure was also found in the female offspring exposed to GCF during early and middle gestation. The early-childhood exposure was associated with the risk of bradycardia in the offspring. The risks of vertebral artery atherosclerosis were elevated in GCF famine-exposed groups except first trimester exposed group. The chronic influence of GCF in early life periods was specific to the developmental timing window, sexesand organs, suggesting an essential role of interactions among multiple factors and prenatal malnutrition in developmentally “programming” cardiovascular diseases.