Sodium intake attributed to fast food is increasing globally. This research aims to develop maximum sodium reduction targets for New Zealand (NZ) fast foods and compare them with the current sodium content of products. Sodium content and serving size data were sourced from an existing database of major NZ fast-food chains. Target development followed a step-by-step process, informed by international targets and serving sizes, and previous methods for packaged supermarket foods. Sodium reduction targets were set per 100 g and serving, using a 40% reduction in the mean sodium content or the value met by 35–45% of products. Thirty-four per cent (1797/5246) of products in the database had sodium data available for target development. Sodium reduction targets were developed for 17 fast-food categories. Per 100 g targets ranged from 158 mg for ‘Other salads’ to 665 mg for ‘Mayonnaise and dressings’. Per serving targets ranged from 118 mg for ‘Sauce’ to 1270 mg for ‘Burgers with cured meat’. The largest difference between the current mean sodium content and corresponding target was for ‘Other salads’ and ‘Grilled Chicken’ (both –40% per 100g) and ‘Fries and potato products’ (–45% per serving), and the smallest, ‘Pizza with cured meat toppings’ (–3% per 100 g) and ‘Pies, tarts, sausage rolls and quiches’ (–4% per serving). The results indicate the display of nutrition information should be mandated and there is considerable room for sodium reduction in NZ fast foods. The methods described provide a model for other countries to develop country-specific, fast-food sodium reduction targets.

Previous investigations on protein associations with diet quality and obesity still have inconclusive findings, possibly due to how protein intake was expressed. This study aimed to compare how different ways of expressing total protein intake may influence its relationships with diet quality and obesity. Usual protein intake was estimated from the 2011–12 Australian National Nutrition and Physical Activity Survey (n = 7637 adults, ≥19 years), expressed in grams (g/d), percent energy (%EI), and grams per actual kilogram body weight (g/kgBW/d). Diet quality was assessed using the 2013 Dietary Guidelines Index, and obesity measures included Body Mass Index (BMI) and waist circumference (WC). Sex-stratified multiple linear and logistic regressions were performed and adjusted for potential confounders. Total protein (g/d) was directly associated with diet quality (males, β = 0.15 (95% CI 0.12, 0.19); females, β = 0.25 (0.22, 0.29)), and this association was consistent across units. Protein intake (g/d) was directly associated with BMI (males, β = 0.07% (0.04%, 0.11%); females, β = 0.09% (0.04%, 0.15%)), and WC (males, β = 0.04 (0.01, 0.06); females, β = 0.05 (0.00, 0.09)). While in males, protein as %EI was associated with higher WC, no association was found in females. Adults with higher protein intake (g/d) had higher odds of overweight/obesity (males, OR = 1.01 (1.00, 1.01); females, OR = 1.01 (1.00, 1.01)), and central overweight/obesity (females, OR = 1.01 (1.00, 1.01)), but no significant association with females odds of overweight/obesity when protein was expressed in %EI. In conclusion, protein intake was positively associated with diet quality and obesity, yet these associations were stronger for women. The effect sizes also varied by measurement unit due to the different scales of those units.

The aim of this study is to assess nutritional status and associated factors among infants and young children aged 6–23 months in Yeka sub-city, Ethiopia, 2021. An institution-based cross-sectional study was conducted in selected health centres found in the Yeka sub-city from May 2021 to July 2021. In total, 396 systematically selected infants and young children aged 6–23 months attended the selected health centres were included in the study. Data were collected by using a structured questionnaire and anthropometric measurements. A multinomial logistic regression model was used.

The overall magnitude of undernutrition and overnutrition among infants and young children were 24.7% and 5.5%, respectively. Dietary diversity score (DDS) ((adjusted odd ratio (AOR) = 5.65; 95% CI = 2.301, 10.87; P value = 0.003), minimum meal frequency (MMF) (AOR = 5.435; 95% CI = 2.097, 11.09; P value = 0.0052), and diarrhoea (AOR = 2.52; 95% CI = 1.007, 6.310; P value = 0.002) were statistically significantly associated factors for nutritional status among infants and young children. Malnutrition (undernutrition and overnutrition) is a public health problem among infants and young children in Yeka sub-city, Ethiopia. DDS, MMF, and diarrhoeal disease were associated with higher odds of undernutrition.

Ruminal microbes catabolise feed carbohydrates mainly into SCFA, methane (CH4), and carbon dioxide (CO2), with predictable relationships between fermentation end products and net microbial increase. We used a closed in vitro batch culture system, incubating grass and maize silages, and measured total gas production at 8 and 24 h, as well as the truly degraded substrate, the net production of SCFA, CH4, and microbial biomass at 24 h, and investigated the impact of silage type and inoculum microbial mass on fermentation direction. Net microbial yield was negatively correlated with total gas at 8 h (P < 0•001), but not at 24 h (P = 0•052), and negatively correlated with CH4 production (P < 0•001). Higher initial inoculum microbial mass was related to a lower net microbial yield (P < 0•001) but a higher CH4 production (P < 0•001). A significant difference between grass silage and maize silage was detected within the context of these relationships (P < 0•050). The metabolic hydrogen (2H) recovery was 102.8 ± 12.3 % for grass silages and 118.8 ± 13.3% for maize silages. Overall, grass silages favoured more substrate conversion to microbial biomass and less to fermentation end products than maize silage. Lower inoculum microbial mass facilitated more microbial growth and, because of the 2H sink by microbial synthesis, decreased CH4 production.

Dietary surveys are critical in evaluating dietary trends prevailing across the entire population. The aim of this study is to present the results of the latest research into the intakes of energy, macronutrients, and micronutrients amongst the adult population in Lithuania from 2019 through 2020. A cross-sectional study was conducted and dietary data was collected using a 24-h dietary recall method from a total of 2555 Lithuanian adults. Medians, 25th and 75th percentiles were calculated. The diet of Lithuanian adults was found insufficient as the energy intake from fats exceeded the recommended norms, while the energy intake from carbohydrates was below the lower range. The intakes of dietary fibre and most vitamins and minerals were insufficient. Men, compared to women, had a statistically higher total energy intake and energy intake from fats, and a higher intake of dietary fibre. Younger adults, compared to older ones, had statistically lower intakes of energy from fats, including saturated fats, and lower intakes of sodium chloride. Respondents with primary education, compared to those who had attained a higher degree of education, had a statistically lower intake of total energy and dietary fibre. Study showed that intakes of majority of nutrients in the diet of the adult Lithuanian population are not in compliance with the recommended daily intakes. Continuous nationally representative studies into food consumption and nutrient intake of the adult Lithuanian population must be carried out to assess the changes in the population’s diet and the effectiveness of policies aimed at promoting healthy diets.

Globally, each year 1.3 million neonates acquire human immunodeficiency virus during pregnancy, labour, and breastfeeding time. Replacing breastfeeding with recommended safe infant feeding practices significantly reduces the risk of transmission, nearly eliminating it. This study aimed to assess Human immunodeficiency virus exposed child feeding among 314 mothers with infants under 24 months old. Participants were selected using a systematic random sampling technique, and data were collected through a semi-structured questionnaire. Bivariable and multivariable logistic regression analyses employed to identify determinants for safe infant feeding. During interviews, the mean age of women was 32.35 years (standard deviation±4.5), and infants were 10.8(±3.951) months. The overall safe infant feeding was 67.2% (95% CI: 61.7, 72.9), with a mean knowledge score. By the study’s end, 9 infants (2.89%) were confirmed to be infected with virus based on dried blood sample test. Maternal promoting factors for safe infant practice included infant age 25–35 years (adjusted odd ratio (aOR) =2.9) completing high school education (adjusted odd ratio = 9.2), having a good knowledge score for infant feeding (adjusted odd ratio = 8.2), and urban residency (adjusted odd ratio = 2.2). On the other hand, being married made it 83% less likely for safe infant feeding practices (adjusted odd ratio = 0.17) compared to those never in a union. Two in three mothers practiced safe infant feeding for their HIV-exposed infants, with a mean knowledge score of 70.3%. Therefore, healthcare providers give accurate information and counselling services to make informed decisions about infant safe feeding.

Vitamin D and cholesterol share the same intestinal transporters. Thus, it was hypothesized that dietary cholesterol adversely affects vitamin D uptake. The current studies investigated the influence of cholesterol on the availability of oral vitamin D. First, 42 wild-type mice received a diet with 25 µg/kg labelled vitamin D3 (vitamin D3-d3), supplemented with either 0% (control), 0.2%, 0.4%, 0.6%, 0.8%, 1.0% or 2.0% cholesterol for four weeks to investigate vitamin D uptake. In a second study, 10 wild-type mice received diets containing 0% (control) or 1% cholesterol over four weeks to determine cholesterol-induced changes in bile acids. Finally, we investigated the impact of cholesterol versus bile acids on vitamin D uptake in Caco-2 cells. Surprisingly, dietary cholesterol intake was associated with 40% higher serum levels of vitamin D3-d3 and 2.3-fold higher vitamin D3-d3 concentrations in the liver compared to controls. The second study showed that cholesterol intake resulted in higher concentrations of faecal bile acids (control: 3.55 ± 1.71 mg/g dry matter; 1% dietary cholesterol: 8.95 ± 3.69 mg/g dry matter; P < 0.05) and changes in the bile acid profile with lower contents of muricholic acids (P < 0.1) and higher contents of taurodeoxycholic acid (P < 0.01) compared to controls. In-vitro analyses revealed that taurocholic acid (P < 0.001) but not cholesterol increased the cellular uptake of vitamin D by Caco-2 cells. To conclude, dietary cholesterol seems to improve the bioavailability of oral vitamin D by stimulating the release of bile acids and increasing the hydrophobicity of bile.

India has one of the highest burdens of childhood undernutrition in the world. The two principal dimensions of childhood undernutrition, namely stunting and underweight can be significantly associated in a particular population, a fact that is rarely explored in the extant literature. In this study, we apply a copula geoadditive modelling framework on nationally representative data of 104,021 children obtained from the National Family Health Survey 5 to assess the spatial distribution and critical drivers of the dual burden of childhood stunting and underweight in India while accounting for this correlation. Prevalence of stunting, underweight and their co-occurrence among under 5 children were 35.37%, 28.63% and 19.45% respectively with significant positive association between the two (Pearsonian Chi square = 19346, P-value = 0). Some of the factors which were significantly associated with stunting and underweight were child gender (Adjusted Odds Ratio (AOR) = 1.13 (1.12) for stunting (underweight)), birthweight (AOR = 1.46 (1.64) for stunting (underweight)), type of delivery (AOR = 1.12 (1.19) for stunting (underweight)), prenatal checkup (AOR = 0.94 (0.96) for stunting (underweight)) and maternal short-stature (AOR = 2.19 (1.85) for stunting (underweight)). There was significant spatial heterogeneity in the dual burden of stunting and underweight with highest prevalence being observed in eastern and western states while northern and southern states having relatively lower prevalence. Overall, the results are indicative of the inadequacy of a “one-size-fits-all” strategy and underscore the necessity of an interventional framework that addresses the nutritional deficiency of the most susceptible regions and population subgroups of the country.

Maternal diet may modulate human milk microbiota, but the effects of nutritional supplements are unknown. We examined the associations of prenatal diet and supplement use with milk microbiota composition. Mothers reported prenatal diet intake and supplement use using self-administered food frequency and standardised questionnaires, respectively. The milk microbiota was profiled using 16S rRNA gene sequencing. Associations of prenatal diet quality, dietary patterns, and supplement use with milk microbiota diversity and taxonomic structure were examined using Wilcoxon signed-rank tests and multivariable models adjusting for relevant confounders. A subset of 645 mothers participating in the CHILD Cohort Study (originally known as the Canadian Healthy Infant Longitudinal Development Study) provided one milk sample between 2 and 6 months postpartum and used prenatal multivitamin supplements ≥4 times a week. After adjusting for confounders, vitamin C supplement use was positively associated with milk bacterial Shannon diversity (β = 0.18, 95% CI = 0.05, 0.31) and Veillonella and Granulicatella relative abundance (β = 0.54; 95% CI = 0.05, 1.03 and β = 0.44; 95% CI = 0.04, 0.84, respectively), and negatively associated with Finegoldia relative abundance (β = –0.31; 95% CI = –0.63, –0.01). Fish oil supplement use was positively associated with Streptococcus relative abundance (β = 0.26; 95% CI = 0.03, 0.50). Prenatal diet quality and dietary patterns were not associated with milk microbiota composition. Prenatal vitamin C and fish oil supplement use were associated with differences in the milk microbiota composition. Future studies are needed to confirm our findings and elucidate mechanisms linking maternal supplement use to milk microbiota and child health.

Genotype-based dietary and physical activity advice can be delivered to young adults before unhealthy lifestyle behaviours or metabolic and physiological conditions have developed. The aim of the present study was to investigate the factors that influence the intention to adopt genotype-based personalised advice on diet and physical activity in young adults who perceive themselves to be a healthy weight versus those who perceive themselves to be overweight or obese. An online survey of 396 young adults (18–25 years) evaluated background factors (participant characteristics (including perception of body weight), psychological factors, belief composites) and constructs of the Theory of Planned Behaviour (TPB) related to the adoption of genotype-based personalised advice. The association between background factors and TPB constructs was assessed using multiple linear regression. The constructs of TPB predicted intention to adopt genotype-based personalised nutrition (P < 0.001, adj. R2 = 0.54; attitude: B = 0.24, subjective norm: B = 0.25, PBC: B = 0.45). Background factors including belief composites, health locus of control, gender, physical activity, and food choice motives of ‘health’, ‘price’, ‘familiarity’, ‘weight control’, and ‘convenience’ significantly added to models of TPB constructs related to the intention to adopt personalised advice (P < 0.05). The influence of background factors varied between TPB constructs and differed based on participants perception of their body weight. The study provides support for the use of the TPB in understanding the intention of young adults to adopt gene-based advice for dietary and physical activity behaviour. In addition to perceived body weight, the background factors identified should help to inform and modify the delivery of advice in behaviour change interventions that seek to use genotype-based personalised advice in young adult populations.

Objective: This study aimed to assess and comparatively analyse two menus from a Young Offenders Institution (YOI). One menu from 2019, and one from 2022, with the objective of identifying any improvements in meeting dietary guidelines. Design: Cross-sectional and comparative analysis. Setting: United Kingdom, a YOI in Northern England. Participants: YOI Menus. Results: Analysis of 30 dietary components identified that 25 exceeded the dietary guidelines (P < 0.05) for the 2022 menu, with five failing to meet the guidelines (P < 0.05). When compared to the 2019 menu, the 2022 menu showed improvements in saturated fat, sodium, and vitamin D. Despite the improvement, vitamin D levels remained below dietary guidelines (P < 0.01). Salt and energy content were reduced in the 2022 menu (P < 0.05); however, they were still above the dietary guidelines (P < 0.01). Free sugars were significantly above dietary guidelines for both menus, with no significant change between the 2019 and 2022 menu (P = 0.12). Conclusion: The 2022 menu has demonstrated progress in alignment with meeting dietary guidelines, particularly in reducing calories, fat, saturated fat, salt, sodium, and chloride, as well as increasing vitamin D. Despite improvements, calories, free sugars, salt, saturated fat, sodium, and chloride are still exceeding dietary guidelines, posing as potential health risks.

The 2019 coronavirus (COVID-19) pandemic and strict quarantine increased the likelihood of mental symptoms and abnormal eating behaviours. This study aimed to assess the magnitude of emotional eating (EE) among nurses working in Lebanese hospitals and its association with mental health. A cross-sectional study was conducted among nurses aged between 18 and 50 years working in Lebanese hospitals during the COVID-19 outbreak and the economic crisis. A total of 303 nurses consented to participate. The mean EE score was 28.56 (±8.11). The results of this study revealed that 53.8% of the nurses reported depression, 58.1% suffered from anxiety and 95.1% experienced either moderate or severe stress. The study concluded that females (β = 8.112, P = 0.004), non-smokers (β = –4.732, P = 0.01) and depressed nurses (β = 0.596, P = 0.046) had a higher tendency towards EE. Additionally, it was found that EE was associated with weight gain (β = 6.048, P = 0.03) and increased consumption of fried foods (β = 5.223, P = 0.001). Females experienced more stress (β = 2.244, P = 0.003) and anxiety (β = 1.526, P = 0.021) than their male counterparts. With regard to mental health, depression was associated with weight gain (β = 2.402, P = 0.003) and with lower consumption of healthy foods such as nuts (β = –1.706, P = 0.009) and dishes prepared with sofrito sauce (β = –1.378, P = 0.012). These results can help the health authorities to design preparedness plans to ensure proper mental and physical well-being of nurses during any unforeseen emergencies.

In the current study we evaluated an afterschool nutrition education programme, called Vetri Cooking Lab (VCL), for promoting healthy and diverse eating habits among at-risk children in the Greater Philadelphia area. To understand potential programme impacts, we conducted a longitudinal analysis of survey data collected before and after participation in VCL. Main study included cooking confidence, cooking knowledge, changes in dietary consumption behaviours, and changes in vegetable preferences. Participants included students in grades 3–11 enrolled in VCL during the 2018–19 school year at VCL sites (n = 60) throughout Philadelphia, PA, and Camden, NJ. Eligible participants completed surveys both before and after participating in the programme. We found that students’ confidence and knowledge increased (P < 0.001) after the cooking intervention. Knowledge and confidence were positively associated (r = 0.55; P < 0.001). Confidence was correlated with consumption behaviour changes (r = 0.18; P = 0.022). Confidence was positively associated with consumption changes in both our adjusted (OR = 1.81; P < 0.001) and unadjusted models (aOR = 1.88; P = 0.013). Compared to Black students, White students were more likely to report consumption changes (aOR = 5.83; P = 0.013). Hispanic/Latino participants and participants who spoke Spanish had nearly three times higher odds of consumption behaviour changes (Hispanic/Latino OR = 2.55; P = 0.007; Spanish OR = 3.04; P = 0.005). Student age and gender were not associated with behaviour changes. Our research demonstrates that programmes integrating practical cooking skills education along with nutrition, food, and cooking education can improve confidence and knowledge about healthy food choices amongst children driving an overall improvement in children’s eating habits.

Maternal malnutrition is pervasive throughout the world, notably in sub-Saharan Africa, including Ethiopia. This study examined the effect of community-based iron-folic acid supplementation (IFAS) nutrition education on IFAS knowledge and attitude among pregnant women in urban settings in South Ethiopia. A community-based quasi-experimental study was conducted among 198 randomly selected pregnant women attending antenatal care (ANC) (99 intervention and 99 control). We used a multistage sampling technique followed by systematic sampling to select the pregnant women. Pregnant women who participated in the intervention arm received six nutrition education sessions and counselling using a health belief model (HBM), while the control group received only routine ANC services. Baseline and endline data were collected during the ANC and compared. The data was analysed using statistical package for social sciences. Analyses of the effect of the intervention were done using difference-in-difference and generalised estimation equation to allow correlation of repeated observations over time. The results indicated a significant effect of intervention on maternal knowledge towards IFAS; with intervention, group levels increased by 35 percentage points (P < 0.001). The odds of being knowledgeable at the endpoint in the intervention group were 2.6 times higher than baseline (OR = 2.67, 95% CI 1.88–3.80). There was a significant (P = 0.001) change in proportion with a favourable attitude towards IFAS between the two time points. The community-based nutrition education intervention approach has significantly improved maternal knowledge and a favourable attitude towards IFAS among pregnant women. The HBM is effective in improving knowledge and attitude among pregnant women.

The aim of this study was to explore the associations between diet quality, socio-demographic measures, smoking, and weight status in a large, cross-sectional cohort of adults living in Yorkshire and Humber, UK. Data from 43, 023 participants aged over 16 years in the Yorkshire Health Survey, 2nd wave (2013–2015) were collected on diet quality, socio-demographic measures, smoking, and weight status. Diet quality was assessed using a brief, validated tool. Associations between these variables were assessed using multiple regression methods. Split-sample cross-validation was utilised to establish model portability. Observed patterns in the sample showed that the greatest substantive differences in diet quality were between females and males (3.94 points; P < 0.001) and non-smokers vs smokers (4.24 points; P < 0.001), with higher diet quality scores observed in females and non-smokers. Deprivation, employment status, age, and weight status categories were also associated with diet quality. Greater diet quality scores were observed in those with lower levels of deprivation, those engaged in sedentary occupations, older people, and those in a healthy weight category. Cross-validation procedures revealed that the model exhibited good transferability properties. Inequalities in patterns of diet quality in the cohort were consistent with those indicated by the findings of other observational studies. The findings indicate population subgroups that are at higher risk of dietary-related ill health due to poor quality diet and provide evidence for the design of targeted national policy and interventions to prevent dietary-related ill health in these groups. The findings support further research exploring inequalities in diet quality in the population.

The neutropenic diet (ND) is often recommended to people with cancer to reduce infection risk despite recommendations of clinical guidelines advising against its use. While recent literature suggests the ND does not reduce infection risk, other outcomes related to health, nutrition, and lifestyle are unknown. The aim of this review is to systematically scope the literature on the ND in people with cancer for all outcomes related to clinical health, nutrition, and lifestyle. Scientific databases were systematically searched. Eligible studies were in English, people with any cancer type, consuming an ND, any age group, date, or setting. Eligible study types were randomised control trials, observational studies, systematic reviews, and meta-analyses. Twenty-one studies met the inclusion criteria. Outcomes of interest found were infection rates, fever, mortality, antibiotic use, gastrointestinal side effects, comorbidities, biochemistry, hospitalisation, nutritional status, quality of life (QoL), well-being, and financial costs. Most research has focused on infection and mortality rates with few assessing hospitalisation rates, nutritional status, financial costs, and QoL. Most included studies found no significant differences between ND and comparator diet for mortality, antibiotics use, comorbidities, and QoL; however, several studies reported the ND significantly increased the risk of infection. Gaps in the literature included effect of ND on QoL in an adult population, microbiome, lifestyle changes, and financial burden. Further research is needed regarding how the ND affects the microbiome and QoL of its consumers, but in the interim, it is important for hospitals providing an ND to their patients to liberalise the ND wherever possible.