We present prevalence estimates and secular trends of stunting, wasting, underweight, and anaemia among children under 5 years of age and low birth weight (LBW) over the period 1985–2019 in West Africa (WA).

Analysis of Demographic and Health Survey (DHS) and World Bank data. DerSimonian–Laird random effect model with the Knapp–Hartung adjustment to the standard error was used to derive overall prevalence estimates. We used fixed effect ordinary least square regression models with cluster robust standard error to conduct time trends analyses.

West Africa.

Children aged 0 to 59 months.

Three distinct periods (1986–1990, 1993–1996 and 1997–2000) of sharp increases in prevalence of all outcomes was observed. After the year 2000, prevalence of all outcomes except LBW started to decline with some fluctuations. LBW prevalence showed a steady increase after 2000. We observed a decline in prevalence of stunting (β = –0·20 %; 95 % CI –0·43 %, 0·03 %), log-wasting (β = –0·02 %; 95 % CI –0·02 %, –0·01 %), log-underweight (β = –0·02 %; 95 % CI –0·03 %, –0·01 %) anaemia (β = –0·44; 95 % CI –0·55 %, –0·34 %), and an increase in LBW (β = 0·06 %; 95 % CI –0·10 %, 0·22 %) in WA over the period. Pooled prevalence of stunting, wasting, underweight, anaemia and LBW in WA for the period 1985–2019 was 26·1 %, 16·4 %, 22·7 %, 76·2 % and 11·3 %, respectively.

Child undernutrition prevalence varied greatly between countries and the year cohorts. We observed marginal reductions in prevalence of all outcomes except anaemia where the reductions were quite striking and LBW where an increase was noted. There is the need for more rigorous and sustained targeted interventions in WA.

Changes in the item order of the US Household Food Security Survey Module (USHFSSM) were performed throughout time. This study aimed to compare the psychometric properties of the general and specific factors of the 2000 and 2012 versions of the USHFSSM to measure the construct of food insecurity in two Portuguese samples of households with children.

Cross-sectional.

Portugal.

An adaptation of the 2000 version was applied to 839 adults (from households with children aged 7–17 years) from the National Food, Nutrition and Physical Activity Survey 2015–2016, while the 2012 version was used among 2855 families from the Generation XXI birth cohort.

The 2000 version showed to have a stronger ωh than the 2012 version (0·89 v. 0·78 for the general factor), as well as eigenvalues higher than 1 for the general factor (eigenvalues equal to 9·54, 0·97 and 0·80, for the general factor, specific factor 1 and specific factor 2, respectively), while the 2012 version had also the contribution of specific factors to explain food insecurity (eigenvalues equal to 9·40, 2·40 and 1·20, for general factor and specific factors 1 and 2, respectively). Good internal consistency (ωt = 0·99, for both versions) was obtained.

In conclusion, the 2000 and 2012 versions of the USHFSSM showed good psychometric properties; however, the 2000 version has stronger general factor, while the 2012 version also has the contribution of specific factors.

The current study aimed to assess trends, associated factors and the changes in these factors for exclusive breast-feeding (EBF) over the past two decades in Lao People’s Democratic Republic (Lao PDR).

The current study used a quasi-longitudinal design. Descriptive analyses were done with correction for complex survey design. Inferential analyses were done for survey years separately using multiple logistic regression. Finally, pooled logistic regression analysis was done using interaction terms to quantify the difference in association per year.

The current study used data from all provinces of Lao PDR collected in the years 2000, 2006, 2011/2012 and 2017.

Children aged six months or younger from Lao PDR.

EBF practice was estimated at 19·03 %, 26·87 %, 40·67 % and 44·89 % in the four survey years, respectively. Factors significantly associated with EBF included: region of residence, ethnicity, wealth index and age of child. Region and ethnicity saw significant changes in association, and the South developing positively over time as well as in the Lao-Thai ethnic group. Having had any antenatal visits was not associated with EBF practice, nor did this change over time.

Our study shows how EBF trends, and factors associated with EBF, changed over time. We applied an easily replicable methodology to assess similar public health phenomena. We argue that such analysis is particularly relevant for transitioning countries. In such rapidly evolving settings, it is crucial to take into account changing underlying factors when assessing and developing public health policy.

Different methods of dietary intake assessment are frequently used to assess a population’s diet. In this study, we aimed to compare the adherence to Swiss food-based dietary guidelines as depicted in two Swiss population-based surveys using different methods of dietary assessment.

Two population-based, cross-sectional surveys were compared. In the Swiss Health Survey (SHS), diet was assessed via a short set of questions on specific food groups, while in menuCH by two non-consecutive 24-h dietary recall interviews.

To compare the diet depicted in these surveys, we used the Swiss food-based dietary guidelines on vegetable, fruit, dairy product, meat and meat product, fish and alcohol. The weighted proportion of responders meeting these guidelines was calculated for both surveys and was compared overall and by selected characteristics.

Residents of Switzerland, selected from a stratified random sample of the non-institutionalised residents, who agreed to participate in the respective survey. To ensure comparability between the surveys, the age of the study populations was restricted to 18–75 years.

In menuCH, approximately 2 % of responders met ≥4 of the selected Swiss food-based dietary guidelines. In the SHS, using a cruder dietary assessment, the corresponding percentage was 20 %. In both surveys, more women and never smokers were meeting ≥4 food-based dietary guidelines compared to men and current or former smokers, respectively.

Our study comparing the diet in two population-based, representative surveys detected large variations in guideline adherence depending on the dietary assessment method used.

Evaluating the association of water intake and hydration status with nephrolithiasis risk at the population level.

It is a cross-sectional study in which daily total plain water intake and total fluid intake were estimated together with blood osmolality, urine creatinine, urine osmolality, urine flow rate (UFR), free water clearance (FWC) and urine/blood osmolality ratio (Uosm:Bosm). The associations of fluid intake and hydration markers with nephrolithiasis were evaluated using multivariable logistic regression.

General US population.

A total of 8195 adults aged 20 years or older from the National Health and Nutritional Examination Survey 2009–2012 cycles.

The population medians (interquartile ranges, IQR) for daily total plain water intake and total fluid intake were 807 (336–1481) and 2761 (2107–3577) ml/d, respectively. The adjusted OR (95 % CI) of nephrolithiasis for each IQR increase in total plain water intake and total fluid intake were 0·92 (95 % CI 0·79, 1·06) and 0·84 (95 % CI 0·72, 0·97), respectively. The corresponding OR of nephrolithiasis for UFR, blood osmolality, Uosm:Bosm and urine creatinine were 0·87 (95 % CI 0·76, 0·99), 1·18 (95 % CI 1·06, 1·32), 1·38 (95 % CI 1·17, 1·63) and 1·27 (95 % CI 1·11, 1·45), respectively. A linear protective relationship of fluid intake, UFR and FWC with nephrolithiasis risk was observed. Similarly, positive dose–response associations of nephrolithiasis risk with markers of insufficient hydration were identified. Encouraging a daily water intake of >2500 ml/d and maintaining a urine output of 2 l/d was associated with a lower prevalence of nephrolithiasis.

This study verified the beneficial role of general water intake recommendations in nephrolithiasis prevention in the general US population.

Childhood obesity is considered one of the most important public health problems around the world. Chile is currently one of the Latin American countries with a high prevalence of childhood obesity. Given that parents’ food parenting practices shape their children’s lifelong eating habits, addressing those practices is key to curbing later problems of obesity. However, studies of the influences on Chilean parents’ food parenting practices are scarce. Hence, this study explores factors that influence food parenting practices of preschool-aged children in Chile.

Qualitative research, using interviews with the photo-elicitation technique.

Metropolitan Region, Chile

Twenty-five parents from families recruited from public childcare centres.

Through a thematic analysis with an inductive approach, we identified five themes that influence food parenting practices: (1) parents’ previous experiences and how they determine their current goals and beliefs; (2) responses to the child’s characteristics; (3) the influences of other family members, especially grandparents; (4) parents’ nutritional knowledge; and (5) living contexts, especially limited budgets and lack of time.

The study reveals multilevel influences, which converge at the family level, on food parenting practices. A family-centrerd approach that addresses the mentioned influences is necessary to improve the management of the childhood obesity problem in Chile.

To explore motivations, self-regulation barriers and strategies in a multi-ethnic Southeast Asian population with overweight and obesity.

Qualitative design using semi-structured face-to-face and videoconferencing interviews. Data were analysed using thematic framework analysis and constant comparison method.

Specialist weight management clinic.

Twenty-two participants were purposively sampled from 13 April to 30 April 2021. Median age and BMI of the participants were 37·5 (interquartile range (IQR) = 13·3) and 39·2 kg/m2 (IQR = 6·1), respectively. And 31·8 % were men, majority had a high intention to adopt healthy eating behaviours (median = 6·5; IQR = 4·8–6·3) and 59 % of the participants had a medium level of self-regulation.

Six themes and fifteen subthemes were derived. Participants were motivated to lose weight by the sense of responsibility as the family’s pillar of support and to feel ‘normal’ again. We coupled self-regulation barriers with corresponding strategies to come up with four broad themes: habitual overconsumption – mindful self-discipline; proximity and convenience of food available – mental tenacity; momentary lack of motivation and sense of control – motivational boosters; and overeating triggers – removing triggers. We highlighted six unique overeating triggers namely: trigger activities (e.g. using social media); eating with family, friends and colleagues; provision of food by someone; emotions (e.g. feeling bored at home, sad and stressed); physiological condition (e.g. premenstrual syndrome); and the time of the day.

Future weight management interventions should consider encompassing participant-led weight loss planning, motivation boosters and self-regulation skills to cope with momentary overeating triggers.

We wanted to identify factors related to dietary behavioural change among impoverished pregnant women in the face of nutrition education and counselling, describing what creates an enabling environment and barriers for dietary change.

We used qualitative data from a cluster-randomised maternal education trial and conducted a thematic analysis using a social ecological framework to describe the factors that influenced dietary adherence.

Mangochi district in rural Malawi.

We interviewed ten pregnant women and conducted four sets of focus group discussions with twenty-two significant family members (husbands and mothers-in-law) and twelve counsellors.

The participants’ experiences showed that the main barriers of adherence to the intervention were taste, affordability and poverty. The use of powders and one-pot dishes, inclusion of both women and significant family members and a harmonisation with local food practices enabled adherence to the intervention. We found it crucial to focus the dietary education and counselling intervention on locally available ingredients and food processing methods.

Use of contextualised food-based solutions to combat maternal malnutrition was observed to be relatively cheap and sustainable. However, there is need for more research on local foods used as nutrition supplements. We suggest that investments need to be directed not only to nutrition education and counselling but also to the enabling factors that enhance adherence. The original cluster-randomised controlled trial was registered with Clinical trials.gov ID: NCT03136393.

To systematically review evidence from systematic reviews of interventions to improve dietary behaviours and reduce food wastage in secondary school pupils.

CINAHL, Cochrane Reviews, EMBASE, MEDLINE, PsychINFO and Web of Science were searched for systematic reviews of school-based dietary interventions from 2000 to 2020 published in a peer-reviewed journal in English. Articles were reviewed independently by two authors. AMSTAR-2 was used for quality assessment.

Secondary school dietary interventions.

Adolescents (aged 11–18).

In total, thirteen systematic reviews of dietary interventions in secondary schools met the inclusion criteria. A number of key characteristics of interventions that contributed to improvements in food choices in secondary school pupils were identified. These included the combination of education and environmental restructuring, incorporation of computer-based feedback, media or messaging, peer and/or parent involvement, an increase in the availability of healthy foods and the use of behavioural theory as a basis to the intervention. Intervention components that contributed specifically to a reduction in sugar-sweetened beverage intake or an increase in fruit and vegetable consumption, which are particularly relevant to adolescents, could not be determined. Similarly, evidence for interventions that improve nutritional knowledge and attitudes was limited.

This systematic review of systematic reviews has identified a number of components of dietary interventions that can be explored to improve dietary behaviours in secondary school environments and, if demonstrated to be effective, be considered for inclusion in policies and strategies to improve the school food environment and promote dietary change.

To explore the factors influencing Taiwanese adolescents’ consumption of sugar-sweetened beverages (SSB) and sugary snacks from a socio-ecological perspective.

This study adopted a qualitative design by using face-to-face, in-depth interviews guided by a semistructured questionnaire.

Eight junior high schools in New Taipei City and Changhua County, Taiwan, September to November 2018.

Fifty-nine participants aged 12–14 years participated in this study.

Reflexive thematic analysis was used to analyse the data. This study identified four themes to address the multifaceted factors that influence adolescents’ consumption of SSB and sugary snacks. At the intrapersonal level, physiological factors, psychological factors, individual economic factors and taste preferences were mentioned in connection with people’s consumption of SSB and sugary snacks. Positive or negative influences of parents, siblings, peers and teachers on SSB and sugary snack intake were identified at the interpersonal level. The availability of SSB and sugary snacks at home, their availability in vending machines or in school stores in the school environment and participants’ access to convenience stores and hand-shaken drink shops in the broader community influenced SSB and sugary snack consumption. Additionally, food culture and food advertising were identified as influencing societal factors.

Overall, this qualitative study determined not only that the consumption of SSB and sugary snacks is influenced by intrapersonal factors but also that interpersonal, environmental and societal factors affect adolescents’ increased sugar intake. The findings are helpful to broaden the options for designing and developing interventions to decrease SSB and sugary snack consumption by adolescents.

To investigate the seasonal variations of women’s dietary diversity (WDD) (items consumed and food supply) and its linkages with agriculture, market and wild resources.

A cohort of 300 women was followed-up over a year to investigate WDD and food sources (production, purchase or foraging). Monthly qualitative 24 h recalls allowed computing WDD Scores from a standard 10-food groups (FG) classification (WDDS-10). Associations between farm/women’s characteristics and WDDS-10 were investigated using multivariate mixed models including interaction terms factor*months.

Tuy province, Burkina Faso.

300 women of reproductive age.

Both dietary diversity and food sources were seasonal. The mean WDDS-10 was relatively stable from August to January (ranging from 3·1 to 3·5 FG) when farm production predominated. The WDDS-10 gradually increased from February, concomitantly with an increase in food purchases (onions, tomatoes, mangoes) and reached its highest levels (>4 FG) from March to June, when food purchases were still relatively high and when more women consumed foraged fruits (shea plums and wild grapes). Women living on farms owning > 3 plough oxen and different animal species had significantly higher WDDS-10 than others (+0·28 and +0·35 FG, respectively). Women who practiced off-farm activities also had higher WDDS-10 than those who did not (+0·21 FG, P < 0·05). Other factors, for example, the number of foraged edible species, provided advantages in terms of dietary diversity only during certain seasons (October – January, P for interaction < 0·01).

Diversifying women’s diets throughout the year requires complementary interventions aimed at diversifying production, promoting foraging and increasing income-generating activities to enable food purchasing.

To examine the relationship between a posteriori dietary patterns in early childhood and alcohol consumption in adolescence.

Data were obtained from the Avon Longitudinal Study of Parents and Children (ALSPAC) prospective cohort study. Dietary information was obtained using FFQ at the age of 3 and 7 years. The association between dietary patterns, derived using principal components analysis and the Alcohol Use Disorders Identification Test (AUDIT) scores (to assess harmful intake) and frequency of alcohol consumption at the age of 17 years were examined. Secondary analysis considered sugar intake as a percentage of total energy intake.

Women who gave birth between 1 April 1991 and 31 December 1992 in the Avon area in southwest England were eligible for the ALSPAC cohort study.

Totally, 14 541 pregnancies were enrolled in ALSPAC during its initial recruitment phase. For this analysis, complete data were available for between 3148 and 3520 participants.

Adherence to the ‘healthy’ dietary pattern at both 3 and 7 years of age was positively associated with consuming more than one alcoholic drink per week at 17 years of age, whilst adherence to the ‘traditional’ dietary pattern at both ages was protective of harmful alcohol intake at 17 years of age. Sugar intake was not associated with either alcohol outcome after adjustment for ethnicity, maternal level of education, parental social class and maternal AUDIT score.

For the population studied, changes to diet in early childhood are unlikely to have an impact on harmful alcohol use in adolescence given the lack of consistency across the results.

To investigate the association between ultra-processed food (UPF) consumption and internalising symptoms (IS) among adolescents.

It is a cross-sectional study. Paper-pencil survey was completed in classroom with information on UPF consumption, IS and selected covariates. IS were assessed with the Internalizing Symptoms sub-scale from the Social Behaviour Questionnaire (IS-SBQ). UPF was evaluated with a FFQ extracted from the Brazilian National School Health Survey. Crude and adjusted association between UPF and IS was investigated with structural equation models.

São Paulo, SP, Brazil.

A total of 2680 students, Mage = 14·85; (95 % CI 14·81, 14·88).

UPF consumption was associated with higher scores in IS in the crude (β = 0·14; P < 0·001) and adjusted (β = 0·12; P < 0·001) models. The higher the consumption of UPF, the higher is the IS score. The following variables were associated with a lower risk of UPF consumption: male sex, public school and having more meals with parents. The change in the magnitude of the standardised score was almost negligible, but the model was significantly improved with the inclusion of covariates.

Our results provide evidence about the positive association between UPF consumption and IS among adolescents. The association, despite its low magnitude, remained significant after adjusting for potential confounders. These results are relevant considering the increase in UPF consumption worldwide and in low- and middle-income countries. Also, our study emphasises the importance of a healthy diet with a reduction in UPF consumption among adolescents.

To investigate the association between serum vitamin D (25-hydroxy-cholecalciferol) (25(OH)D) concentrations and cognitive impairment in older adults living in Southern Brazil.

Cross-sectional analysis using data from the second follow-up wave of the populational-based EpiFloripa Aging Cohort Study was collected in 2013–2014.

Cognitive impairment was evaluated using the Mini-Mental State Examination (MMSE). Blood samples were collected to measure serum vitamin D concentrations using a chemiluminescent microparticle immunoassay. Vitamin D concentrations were distributed in quartiles (Q1: 4·0–20·7 ng/ml; Q2: 20·8–26·6 ng/ml; Q3: 26·7–32·0 ng/ml and Q4: 32·1–60·1 ng/ml), and its association with cognitive impairment was tested by crude and adjusted logistic regression (sociodemographic, behavioural and health aspects) using Q4 as a reference group.

200 men and 371 women aged 60 years or older participated in this study.

The prevalence of probable cognitive impairment was 21·7 %. Those without cognitive impairment had a higher mean of vitamin D serum concentrations (26·8 v. 24·6, P = 0·014). In the crude analysis, only individuals in Q2 of vitamin D presented an increased risk for probable cognitive impairment compared with Q4 (highest quartile) (OR 2·65, 95 % CI 1·46, 4·81), remaining significant in the adjusted analysis (OR 6·04, 95 % CI 2·78, 13·13). While Q1 (lowest quartile) was not associated in the crude analysis, but when adjusted, an increased risk of cognitive impairment was observed.

The lowest quartile of vitamin D was directly associated with probable cognitive impairment in older adults in Southern Brazil. More studies are needed to investigate whether maintaining adequate serum levels may represent a significant factor in preventing age-related neurological disorders as well as to verify the need for new cutoff points for this age group.

To assess the relationship between the sense of coherence (SOC), eating behaviour and nutritional status.

It is a systematic review.

The following databases were searched: MEDLINE/PubMed, Science Direct/Elsevier, LILACS/Bireme, SciELO and Google Scholar, using the indexed terms ‘salutogenesis’, ‘sense of coherence’, ‘nutritional status’, ‘nutrition’, ‘eating behavior’ and ‘healthy eating’. The indexed terms were used in Portuguese and English according to the database searched. The data were extracted in a standardised way and the quality of the studies was assessed using the Newcastle–Ottawa Scale.

Observational studies were included, with no limitations on the date of publication or language.

After reading the titles and abstracts of 1855 articles, 107 full texts were retrieved, of which 27 were included. Of these, twenty-five were cross-sectional and two were longitudinal. The average score for Newcastle–Ottawa studies was 6 and most studies were rated as moderate and low quality. The cumulative sample size of all included studies was 28 981 adults and the elderly, aged between 18 and 81 years. The studies were carried out in fifteen different countries. Fifteen articles assessed eating behaviour/habit and twelve assessed nutritional status. Studies have shown that SOC has a positive relationship with an appropriate eating behaviour/habit. On the other hand, the relationship between SOC and nutritional status was controversial among studies. The heterogeneity of the data resulting from the use of different methods of evaluation of the outcomes of interest (nutritional status and eating behaviour) made it impossible to perform a meta-analysis.

SOC was positively associated with adequate eating behaviour. However, it was not possible to establish a relationship between SOC and nutritional status.

To examine dietary patterns changes from preconception to during pregnancy and their associations with socio-demographic and lifestyle factors.

This study used data from the Australian Longitudinal Study on Women’s Health (ALSWH), a population-based prospective cohort study. Women’s dietary patterns were assessed using Healthy Eating Index-2015 (HEI-2015) score and the four patterns were obtained from the factor analysis (Western diets, vegetable and grains, traditional vegetable and fruit patterns). Multi-variable linear regression and repeated measures mixed-effect models were used.

A national representative survey which covers all Australian citizens and permanent residents in Australia.

621 women were included from the ALSWH.

Women’s scores increased on the ‘HEI-2015’, ‘traditional vegetable’ and ‘fruit’ patterns while the ‘vegetable and grains’ decreased from preconception to during pregnancy. Women with higher education were more likely to increase their HEI-2015 score and fruit consumption from preconception to during pregnancy, respectively (β = 2·31, (95 % CI 0·02, 4·60)) and (β = 23·78, (95 % CI 4·58, 42·97)), than those with lower educational status. Single women were more likely to increase the consumption of vegetables and grains compared to married women (β = 76·08, (95 % CI 20·83, 131·32)). Women with higher income had a greater increase in the HEI-2015 score than those with lower income (β = 3·02, (95 % CI 0·21, 5·83)).

The findings indicate that there have been marked dietary changes from preconception to during pregnancy. Changes in healthy dietary patterns were influenced by education, marital status and income.

To examine the associations of trimester-specific maternal prenatal carbohydrate (CHO) intake with offspring adiposity and metabolic health during peripuberty.

Prospective cohort study in which maternal dietary intake was collected via validated FFQ during each trimester. Offspring adiposity and metabolic biomarkers were evaluated at age 8–14 years. We used multivariable linear regression to examine associations between total energy-adjusted maternal CHO intake and offspring BMI z-score, skinfold thickness and metabolic syndrome risk z-score calculated as the average of waist circumference, fasting glucose, fasting C-peptide, TAG:HDL and systolic blood pressure + diastolic blood pressure/2.

Mexico City, Mexico

237 mother–child pairs in the Early Life Exposure in Mexico to Environmental Toxicants cohort.

We found non-linear associations of maternal CHO intake during pregnancy with offspring metabolic health during peripuberty. After adjusting for maternal age, and child age, sex and pubertal status, children whose mothers were in the fourth v. first quartile of total CHO intake during the third trimester had 0·42 (95 % CI –0·01, 0·08) ng/ml lower C-peptide and 0·10 (95 % CI –0·02, 0·22) units lower C-peptide insulin resistance (CP-IR). We found similar magnitude and direction of association with respect to net CHO intake during the first trimester and offspring C-peptide and CP-IR. Maternal CHO intake during pregnancy was not associated with offspring adiposity.

In this study of mother–child pairs in Mexico City, children born to women in the highest quartile of CHO intake during pregnancy had lowest C-peptide and CP-IR during peripuberty. Additional research is warranted to replicate and identify mechanisms.

To assess the association between diet cost and quality by place of residence.

We analysed cross-sectional data of the National Health and Nutrition Survey-2012. Diet cost was estimated by linking dietary data, obtained from a 7-d SFFQ, with municipality food prices, which were derived from a national expenditure survey. Diet quality was assessed using the Healthy Eating Index-2015 (HEI-2015). Association between quintiles of diet cost and HEI-2015 was assessed using linear regression analysis.

Mexico.

2438 adults (18–59 years).

Diet cost was positively associated with diet quality (HEI-2015) in urban but not in rural areas. Compared with quintile (Q1) of cost, the increment in diet quality score was 1·17 (95 % CI –0·06, 4·33) for Q2, 2·14 (95 % CI –0·06, 4·33) for Q3, 4·70 (95 % CI 2·62, 6·79) for Q4 and 6·34 (95 % CI 4·20, 8·49) for Q5 (P-trend < 0·001). Individuals in rural v. urban areas on average have higher quality diets at lower cost with higher intakes of whole grains and beans and lower intakes of Na, added sugars and saturated fats. Living in the South, being indigenous and having low socio-economic status were also associated with higher quality diets.

Diet cost was positively associated with diet quality, but only in urban areas. Further studies are needed to understand the relation between diet cost and quality in rural areas. To improve overall diet quality in Mexico, strategies that aim to reduce the cost of high-quality diets should consider the heterogeneity by place of residence.