To explore the impact of online food shopping in France on the selection of products purchased and its potential impact on shoppers’ dietary balance.

A qualitative study involving in-depth semi-structured individual interviews. The interviews were recorded, transcribed verbatim and analysed through a reflexive thematic analysis approach.

France

Thirty-four male and female respondents aged between 21 and 61 years old, residing in various regions of France, including urban, suburban and rural areas, with diverse profiles in terms of gender, age, location and number of children under 18.

Five key themes were identified as influencing decision-making with regard to the products purchased, namely ‘less choice, especially for fresh produce’, ‘sense of security in buying the same products’, ‘convenience of online shopping through time-saving and product recommendation lists’, ‘avoiding unplanned purchases’ and ‘less fresh produce purchased, sometimes replaced by more processed items’. In turn, all of these factors potentially have an impact on the diet of online shoppers.

With grocery e-commerce penetration expected to double in the next 5 years, the study underscores the consequences of online shopping on consumers’ dietary balance. The findings have practical implications for online food retailers, inciting them to develop solutions that would encourage e-grocery shoppers to buy more fresh produce and sample a more varied diet. Additionally, they highlight the importance of monitoring the influence of technology on the consumer buying process, particularly with regard to food.

Weight misperception has been reported as a common problem in high-income countries, but there is a paucity of high-quality empirical evidence in low- and middle-income countries, especially among children and adolescents. This study estimates the prevalence of weight misperception and investigates changes over time among children and adolescents in China, as well as identifies factors that may affect this weight misperception.

The China Health and Nutrition Survey, which is a repeated, representative cross-sectional study employing multistage random cluster processes.

A Chinese national survey across fifteen provinces and municipal cities.

Data from children and adolescents aged 6–16 years from six consecutive waves between 2000 and 2015 were included.

The final sample totalled 7110 children and adolescents. The overall prevalence of weight misperception was largely stable between 2000 and 2015 (range: 34·1–37·3 %). Sex and age groups were associated with weight misperception, with boys and younger participants more likely to misperceive their weight status. In addition, dieting and being physically active or inactive were associated with increased rates of weight misperception.

Weight misperception is common among youth in China and is unequally shared with several subpopulations at increased risk. Researchers and health promoters are called to recognise weight misperception when addressing overweight and obesity countermeasures, and more tailored public health initiatives are warranted to more effectively reach those with weight misperceptions.

This study investigates and measures whether the association of childhood stunting with household socio-economic position (SEP) differs in Sri Lanka compared with other South Asian countries.

Secondary analysis of data of children from the latest available Demographic and Health Surveys data (survey years, 2016–2018). The exposures (SEP) were maternal education and wealth. The outcome was stunting. Binary logistic regression models incorporated SEP, country and SEP-by-country interaction terms.

A nationally representative sample of children from Bangladesh, India, Nepal, Pakistan and Sri Lanka.

Mothers/caregivers of children under 36 months (133 491).

The prevalence of stunting in Sri Lanka of 19 % was much lower than that observed for all the other low- to low–middle income South Asian countries (37 % in Bangladesh, 36 % in India, 31 % in Nepal and 30 % in Pakistan). The association of SEP with odds of stunting was similar in Sri Lanka compared with other South Asian countries. The only exception was weaker associations of wealth with stunting in Sri Lanka compared with Bangladesh. For example, in Sri Lanka, the poorest group had 2·75 (2·06, 3·67) times higher odds of stunting compared with the richest group, but in Bangladesh, this estimate was 4·20 (3·24, 5·44); the difference between these two estimates being 0·65 (0·44, 0·96) on the OR scale.

The lower prevalence of stunting in Sri Lanka is unlikely to be due to less inequality. It is more likely that the lower prevalence of stunting in Sri Lanka is related to there being fewer mothers belonging to the lowest SEP groups.

The aim of this study was to assess the association between fish intake, n-3 PUFA, n-6 PUFA and risk of disabling dementia.

Prospective cohort.

Municipalities within the Japan Public Health Centre-based Prospective Study.

43 651 participants: (20 002 men and 23 649 women).

Exposure intake of fish, n-3 and n-6 PUFA was evaluated in 1995–1997. We defined disabling dementia cases as participants who were certified to receive disability care under the long-term-care insurance programme (2006–2016) in participating municipalities with a grade of activities of daily living related to dementia ≥ IIa on the dementia rating scale (range 0–IV and M). Cox proportional hazard models were applied to obtain hazard ratios (HR) and 95 % CI according to quartiles of exposures of interest. In the main analysis, we adjusted for age and area, smoking, BMI, alcohol and metabolic equivalent tasks. During 410 350 person-years of follow-up with an average follow-up of 9·4 years, 5278 cases of disabling dementia were diagnosed. Fish intake and most PUFA were not associated with the risk of disabling dementia in men. In women, n-6 PUFA showed a significant decreasing trend in risk the highest HR (95 % CI) compared with the lowest was 0·90 (0·81, 0·99) (P for trend = 0·024) and alpha-linolenic acid (ALA) was 0·91 (0·82, 1·00) (P for trend = 0·043).

Our findings suggest no association with fish in general and only n-6 PUFA and ALA may be associated with a decreased risk of disabling dementia especially in women.

To understand healthcare staff perspectives of their hospital food environment and the impact of these perceptions on their food choice, health and well-being.

A narrative systematic review.

Publications were eligible for inclusion if participants were hospital-based staff, and all job roles were eligible, including both clinical and non-clinical staff. Both public and private hospitals in the UK, the USA or Australia were included.

Clinical and non-clinical staff employed in hospitals.

A systematic search was carried out across four databases: OVID Medline, CINAHL, PsycInfo and Scopus. Grey literature screening was completed via Google and Google Scholar. Eleven studies were included and were predominantly from the UK. Setting sizes varied or were unknown, and participant numbers varied (n 16 to n 1158) or were unknown. Most participants were nurses. Methods included reports, surveys, focus groups and interviews. The main themes identified were accessibility to food, diversity of food choices, free foods used to boost staff morale and job role influencing engagement with the food environment. Staff reported issues around canteen opening hours, limited healthy food options and free food on wards, causing extra calories to be consumed. Irregular breaks and staffing shortages affected hospital staff’s ability to engage with the wider food environment, resulting in reliance on convenience foods and snacks.

The current hospital food environment does not facilitate healthy dietary practices and is perceived by staff as a barrier to healthy eating. The hospital food environment requires adaptation to reflect a 24-hour workplace.

To examine the potential indirect effect of meal frequency on mortality via obesity indices.

Prospective cohort study

Korean Genome and Epidemiology Study.

This cohort study involved 148 438 South Korean adults aged 40 years and older.

Meal frequency at the baseline survey was assessed using a validated FFQ. Outcomes included all-cause mortality, cancer mortality and CVD mortality. Cox proportional hazards regression models were employed to examine the relationship between meal frequency and the risk of mortality. Mediation analyses were performed with changes in obesity indices (BMI and weight circumference (WC)) as mediators. In comparison to the three-time group, the once-per-day and four-times-per-day groups had a higher risk for all-cause mortality. The irregular frequency group had a higher risk for CVD mortality. Both once-per-day and four-times-per-day groups exhibited higher risks for cancer mortality. The effect of meal frequency on all-cause mortality was partially mediated by WC. For specific-cause mortality, similar mediation effects were found.

The data suggests that three meals per day have a lower mortality and longer life expectancy compared with other meal frequencies. Increased waist circumference partially mediates this effect. These findings support the implementation of a strategy that addresses meal frequency and weight reduction together.

To investigate whether the introduction of healthy vending machines on a university campus could increase the proportion of healthy food and beverage purchases.

Four new healthy vending machines offering a wider range of healthier food and beverages were installed alongside existing machines. These new machines used traffic light colours to indicate nutritional value. A year after their installation, a traffic light text guide and colourful wrap were added to the new machines. χ2 tests were used to assess significant differences in the sales of green (healthy), amber or red (unhealthy) items from healthy and existing vending machines across the 3 years (2021–2023).

The study was conducted on a university campus where the new healthy vending machines were installed.

Participants of this study were the consumers who purchased items from the vending machines on the university campus.

The results indicated a shift towards healthier purchases following the introduction of the healthy vending machines. The addition of the traffic light text guide and colourful wrap further reduced unhealthy purchases, although this change was small. Sales from the existing vending machines did not meaningfully decrease, and any reductions were more than replaced by sales from the new healthy vending machines.

The study concluded that by providing healthier options and guiding consumers towards these options, the vending machine programme offers a promising pathway towards promoting healthier food and beverage choices from vending machines on university campuses.

Public health approaches for addressing diet-related health in the USA include nutrition incentive (NI) and produce prescription (PPR) projects. These projects, funded through the US Department of Agriculture Gus Schumacher Nutrition Incentive Program (GusNIP), aim to support the intake of fruits and vegetables through healthy food incentives. Measuring the GusNIP impact is vital to assessing the ability of incentives to improve public health nutrition outcomes across populations. Shared measures used across GusNIP projects assess fruit and vegetable intake, food security and demographics, among other variables, through a participant survey. This study explored challenges and opportunities to evaluation across populations within a national public health oriented program, GusNIP.

This qualitative study used a sociodemographic survey, semi-structured interviews and focus groups. Descriptive statistics were used to summarise survey data, and applied thematic analysis was used to identify patterns in interview and focus group data.

Data collection occurred in the USA virtually using Qualtrics and Zoom from fall 2021 to fall 2022.

Eighteen GusNIP PPR and NI data collectors, twenty-four external evaluators and eleven GusNIP National Training, Technical Assistance, Evaluation, and Information Center staff participated.

Opportunities to improve evaluation among GusNIP’s participants include tailoring surveys to specific subpopulations, translations, culturally appropriate food examples, avoiding stigmatising language, using mixed methods and intentional strategies to enhance representation.

To increase applicability of data collection in public health programs, evaluation tools must reflect the experiences across populations. This study provides insights that can guide future NI, PPR and public health evaluations, helping to more effectively measure and understand outcomes of all communities.

The study examined the impact of the Diabetes Prevention and Management programme on dietary tracking, changes in dietary behaviour, glycosylated Hb (HbA1c) and weight loss over 6 months among rural adults with type 2 diabetes and prediabetes. The programme was a health coach (HC)-led, community-based lifestyle intervention.

The study used an explanatory sequential quantitative and qualitative design to gain insight on participant’s dietary behaviour and macronutrient consumption as well as experience with food tracking. Five of the twenty-two educational sessions focussed on dietary education. Participants were taught strategies for healthy eating and dietary modification. Trained HC delivered the sessions and provided weekly feedback to food journals.

Obese adults with type 2 diabetes or prediabetes (n 94) participated in the programme and 56 (66 %) completed dietary tracking (optional) for 6 months. Twenty-two participated in three focus groups.

Fifty-nine percent consistently completed food journals. At 6 months, average diet self-efficacy and dietary intake improved, and average weight loss was 4·58 (sd 9·14) lbs. Factors associated with weight loss included attendance, consistent dietary tracking, higher HbA1c, diabetes status and energy intake (adjusted R2 = 43·5 %; F = 0·003). Focus group participants reported that the programme improved eating habits. The consistency of dietary tracking was cumbersome yet beneficial for making better choices and was key to being honest.

Participants who consistently tracked their diet improved dietary self-efficacy and intake over 6 months. This model has the potential to be reproduced in other rural regions of the United States.

To examine associations of Dietary Inflammatory Index (DII) scores with disability and subjective health, which is prognostic of disability, in a large, systematically sampled population of older adults living in non-urban areas in Japan.

Cross-sectional. The Tokyo Metropolitan Institute of Gerontology Index of Competence was used to assess disability. Both overall disability and disabilities in components of everyday competence (instrumental activities of daily living (IADL), intellectual activities and social participation) were examined. Participants who reported an inability to perform one or more activities were categorised as disabled. Subjective health was assessed based on the response to the following question: ‘In general, how do you feel about your own health?’

Six non-urban municipalities in Japan that differ in terms of regional characteristics.

Adults aged 65–74 years (n 7930).

DII scores were positively associated with the odds of overall disability (OR (95 % CI)) = 1·23 (1·19, 1·28)); disabilities in IADL (OR (95 % CI) = 1·10 (1·05, 1·15)); intellectual activities (OR (95 % CI) = 1·28 (1·23, 1·33)); social participation (OR (95 % CI) = 1·17 (1·13, 1·22)) and poor subjective health (OR (95 %CI) = 1·09 (1·05, 1·14)).

Our results imply the importance of reducing dietary inflammation to prevent both disability and a decline in subjective health, a predictor of disability.

To simulate the impact of a price subsidy (price reduction) on purchases of healthy foods with suboptimal consumption.

We used data from the 2018 Mexican National Household Income and Expenditure Survey, a cross-sectional study. We estimated own- and cross-price elasticities of the demand for food groups using a Linear Approximation of an Almost Ideal Demand System. Using the estimated elasticities, we derived changes in purchases associated with a 10, 20 and 30 % price reduction in healthy food groups with suboptimal consumption. We also estimated price reductions for these food groups that would meet the recommendations of the Healthy Reference Diet (EAT-HRD) proposed by the EAT-Lancet commission.

Mexico (country).

A nationally representative sample of mexican households.

Price reductions were associated with increases in the quantity purchased, ranging from 9·4 to 28·3 % for vegetables, 7·9 to 23·8 % for fruits, 0·8 to 2·5 % for legumes and 6·0 to 18·0 % for fish. Higher reductions in prices would be needed to achieve the EAT-Lancet Commission’s recommendations for food groups with suboptimal consumption in Mexico: a 39·7 % reduction in prices for fruits, 20·0 % for vegetables and 118·7 % for legumes.

Our study shows that reductions in prices can lead to increases in purchases of healthier food options. More research is needed to assess the most cost-effective strategy to deliver subsidies using either conditional cash transfers, vouchers or food baskets provided to families or direct subsidies to producers.

Australian children fall short of national dietary guidelines with only 63 % consuming adequate fruit and 10 % enough vegetables. Before school care operates as part of Out of School Hours Care (OSHC) services and provides opportunities to address poor dietary habits in children. The aim of this study was to describe the food and beverages provided in before school care and to explore how service-level factors influence food provision.

A cross-sectional study was conducted in OSHC services. Services had their before school care visited twice between March and June 2021. Direct observation was used to capture food and beverage provision and child and staff behaviour during breakfast. Interviews with staff collected information on service characteristics. Foods were categorised using the Australian Dietary Guidelines, and frequencies were calculated. Fisher’s exact test was used to compare food provision with service characteristics.

The before school care of OSHC services in New South Wales, Australia.

Twenty-five OSHC services.

Fruit was provided on 22 % (n 11) of days and vegetables on 12 % (n 6). Services with nutrition policies containing specific language on food provision (i.e. measurable) were more likely to provide fruit compared with those with policies using non-specific language (P= 0·027). Services that reported receiving training in healthy eating provided more vegetables than those who had not received training (P= 0·037).

Before school care can be supported to improve food provision through staff professional development and advocating to regulatory bodies for increased specificity requirements in the nutrition policies of service providers.

We determined whether dietary species richness (DSR) (i) can be robustly measured using 4-day food intake data, (ii) is dependent on socio-demographic characteristics and (iii) is associated with diet quality.

The National Diet and Nutrition Survey (NDNS) nutrient databank 2018–2019 was expanded to include FoodEx2 food classifications, ingredients, the number and identity of unique species, Nutrient Rich Food 8·3 (NRF 8·3) Index scores and greenhouse gas emissions. Four-day food intake data and socio-demographic variables were used to calculate diet quality and DSR on the food and diet level.

The United Kingdom (UK).

Participants from NDNS 9–11 (2016–2019).

Composite dishes had the highest DSR (median 8 (Q1 = 4, Q3 = 12)), followed by seasoning, sauces and condiments (median 7, (Q1 = 4, Q3 = 10)) and, grains and grain-based products (median 5, (Q1 = 2, Q3 = 7)). Median DSR over 4 days was 49 (Q1 = 43, Q3 = 56; range 14–92), with the first 2 days achieving 80 % of DSR measured over 4 days. DSR was significantly higher in those who were younger, those with a higher household income or those with a lower level of deprivation (all P < 0·001). Higher DSR was associated with a small but significant improvement in nutritional quality (P < 0·001). Also, adherence to dietary guidelines such as fibre, fruits and vegetables and fish was associated with significantly higher DSR (all P < 0·001).

We successfully established DSR based on 4-day food intake data. We also identified opportunities to improve DSR by increasing the consumption of fruits, vegetables, fibre and fish.

To use the validated Online Quality Assessment Tool (OQAT) to assess the quality of online nutrition information.

The social networking platform was formerly known as Twitter (now X).

Utilising the Twitter search application programming interface (API; v1·1), all tweets that included the word ‘nutrition’, along with associated metadata, were collected on seven randomly selected days in 2021. Tweets were screened, those without a URL were removed and the remainder were grouped on retweet status. Articles (shared via URL) were assessed using the OQAT, and quality levels were assigned (low, satisfactory, high). Mean differences between retweeted and non-retweeted data were assessed by the Mann–Whitney U test. The Cochran–Mantel–Haenszel test was used to compare information quality by source.

In total, 10 573 URL were collected from 18 230 tweets. After screening for relevance, 1005 articles were assessed (9568 were out of scope) sourced from professional blogs (n 354), news outlets (n 213), companies (n 166), personal blogs (n 120), NGO (n 60), magazines (n 55), universities (n 19) and government (n 18). Rasch measures indicated the quality levels: 0–3·48, poor, 3·49–6·3, satisfactory and 6·4–10, high quality. Personal and company-authored blogs were more likely to rank as poor quality. There was a significant difference in the quality of retweeted (n 267, sum of rank, 461·6) and non-retweeted articles (n 738, sum of rank, 518·0), U = 87 475, P= 0·006 but no significant effect of information source on quality.

Lower-quality nutrition articles were more likely to be retweeted. Caution is required when using or sharing articles, particularly from companies and personal blogs, which tend to be lower-quality sources of nutritional information.

To describe the development and validation of the Nova FFQ (NovaFFQ) for Brazilian adults.

The NovaFFQ is a self-administered, semi-quantitative questionnaire. The food list includes the most consumed foods and drinks based on 2017–2018 National Food Intake Survey data. We identified and differentiated foods that could be classified into multiple Nova groups. We assessed reproducibility and criterion validity using the percent energy contribution of each Nova group. Reproducibility was assessed by comparing NovaFFQ estimates on two occasions. Criterion validity was assessed by comparing the first NovaFFQ estimate against the mean of two Nova24h recalls. We estimated the intraclass correlation coefficients (ICC) for both analyses and assessed the agreement of classification into quintiles using the prevalence-and-bias-adjusted kappa coefficients for criterion validity analysis.

Nationwide Brazilian study, the NutriNet-Brasil cohort.

There were 243 participants in the reproducibility analysis and 376 in the criterion validity analysis.

Strong reproducibility was observed, with an ICC of 0·91 for all the Nova groups. Criterion validity showed a moderate ICC, ranging from 0·61 for processed and ultra-processed foods (UPF) to 0·65 for unprocessed and minimally processed foods. Substantial agreement in ranking individuals across quintiles was found, as indicated by the prevalence-and-bias-adjusted kappa (PABAK = 0·74, 0·72, 0·70 and 0·73 for unprocessed and minimally processed foods, culinary ingredients and processed and ultra-processed foods, respectively).

The NovaFFQ is a valid instrument for assessing food consumption by processing level, especially for discriminating individuals according to the magnitude of consumption in all Nova groups.

The objectives of this study were to (1) document factors that promoted or hindered the successful implementation of small quantity lipid-based nutrient supplements (SQ-LNS) for children 6–23 months and pregnant and lactating women (PLW) and (2) gather programme staff perspectives on considerations for expanding SQ-LNS programmes in their context.

We used qualitative methods to interview programme staff (n 23), conduct distribution site observations (n 9) and facilitate focus group discussions with caregivers of children 6–23 months (n 9) and PLW (n 6) with 6–8 participants per group across the three countries.

The study was conducted in SQ-LNS programme sites in Honduras, Niger and Somalia.

We found high acceptability of SQ-LNS among caregivers of children 6–23 months and PLW women. However, caregivers and PLW were dissatisfied with the size of the product in Niger and Somalia and PLW disliked the aftertaste of iron in Honduras. In Somalia, PLW referred to high levels of food insecurity. We also found variation in how the partners designed their SQ-LNS programmes (e.g. enrolment and exit criteria), the level of communication around SQ-LNS and problem-solving to support appropriate use of SQ-LNS. Partners tracked anthropometric measurements in all countries and used the information to assess changes and, in some cases, noted improvements in child anthropometry and vaccination rates.

Programmes need to consider several operational factors during implementation, such as securing household food access in highly food-insecure areas, counselling on the use of SQ-LNS and evidence-based criteria for enrolment, exit and supplementation duration.