Food insecurity (FI) in the higher education setting is a pressing social justice and public health nutrition issue. Persistent FI rates among students suggest that the current programmes and institutional policies are inadequate. Engaging the community in co-design practices can enhance research and decision-making, leading to more targeted advocacy and solutions. This review describes and evaluates evidence of co-design approaches and identifies strategies for addressing FI in higher education settings.

A review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Literature was searched in three electronic databases (Scopus, Ovid MEDLINE and Web of Science) and two search engines (Google and Google Scholar).

Only studies based in higher education settings were included.

Higher education students.

The search identified 814 studies, of which twenty-eight met the inclusion criteria. Studies involving co-design and participatory research frameworks had higher participation, leading to increased student awareness of FI, student leadership and the development of campaigns and collaborative organisational structures. A content analysis approach identified seven categories for strategies targeting student FI: (1) policy and institutional support; (2) strategic partnerships (3) advocacy and awareness; (4) initiatives for student engagement; (5) student skills and knowledge development; (6) programme development and (7) campus food environment.

Co-designed research methodologies are important for addressing student FI, enhancing advocacy and understanding stakeholder needs. Future studies should prioritise collaborative approaches when exploring solutions to FI and similar social justice issues affecting students.

To explore the information available in school food purchase data and ascertain the potential to assess pupils’ dietary intakes. The proportion of purchased food and drink items that were linked to (i) an Intake24 food group and (ii) a nutrient code from the UK National Diet and Nutrition Survey (NDNS) Databank was calculated.

Pupil-level food purchase data covering the whole school day were obtained. Each item purchased was linked to an Intake24 food group and an NDNS Nutrient Databank code. Depending on the level of detail provided, items may have been assigned both a food group and a nutrient code, a food group only or neither for items, which did not contain enough information about the type of food or drink purchased.

Five secondary schools in northeast England.

Secondary school pupils aged 11–16 years.

The data captured 119 125 purchases made by 3466 pupils. 92 % of item descriptions were assigned a food group, and this equated to 82 % of total purchases. 70 % were assigned an NDNS Databank nutrient code, which accounted for 60 % of total purchases. 8 % of items had insufficient information and did not have a food group or a nutrient code assigned.

The methodological challenges of collecting dietary data from pupils in the secondary school setting are significant. Purchase data offers an alternative, objective approach to collecting information on school food choices across the school day and for a large sample of pupils. With further development, the potential to use purchase data to assess intakes could be achieved.

Fish is high in nutrients that provide a range of health benefits, but people in Great Britain only consume around half the amount that is recommended. This study analysed the demand for fish for consumption at home across different household groups in Great Britain.

Using a Rotterdam demand model, price and income elasticities were estimated for eleven fish groups across seven household groups. To investigate changes in fish demand, we decomposed growth in fish demand into income, relative price and change in taste and seasonality.

The data used for our analysis were drawn from the Kantar Worldpanel dataset for Great Britain for the period from 2013 to 2021.

12 492 households in Great Britain.

Families with children consistently allocated a lower share of their grocery spending on fish and preferred to purchase ready-to-use and convenient fish products, compared with households without children. Purchases of chilled fresh/smoked oily fish, canned oily fish and frozen processed fish led spending across demographic groups, whilst purchases of canned oily fish showed minimal growth. The demand for most fish products across household groups was price inelastic, indicating that the percentage change in the quantity of fish demanded increased or fell by less than the percentage change in price.

Income and taste were identified as significant determinants of demand changes across all household groups, while price only played a prominent role in demand changes for certain fish groups. Thus, increasing fish consumption, especially in lower-income groups, who do not usually consume much fish, may require a different intervention than simply making fish more affordable.

Underweight, wasting and stunting are crucial malnutrition indicators responsible for morbidities among children. Data regarding coexisting forms of malnutrition (CFM) are scarce. We aimed to investigate the prevalence and associated factors of CFM across two survey years among under-5 Bangladeshi children.

Cross-sectional study.

Data were acquired from two rounds of Multiple Indicator Cluster Survey (MICS), Bangladesh conducted in 2012–13 and 2019. Subjects: The analysis included 43 946 (2012–13: 20 885; 2019: 23 061) under-5 children.

Binomial proportion test, slope index of inequality and multinomial logistic regression models were used for analysis. The prevalence of CFM was 27·45 % and 18·56 % in 2012–13 and 2019, respectively. A significant decrease in the prevalence of CFM was seen across the surveys (P-value < 0·001). Children from urban residence ((2012–13:aOR = 0·70, 95 % CI: 0·64, 0·77); (2019:aOR = 0·71, 95 % CI: 0·65, 0·78), higher maternal education ((2012–13:aOR = 0·28, 95 % CI: 0·24, 0·32); (2019:aOR = 0·28, 95 % CI: 0·24, 0·32), larger size at birth ((2012–13:aOR = 0·62, 95 % CI: 0·52, 0·73); (2019:aOR: 0·60, 95 % CI: 0·50, 0·73) and richest wealth quintile ((2012–13:aOR = 0·25, 95 % CI: 0·22, 0·28); (2019:aOR: 0·30, 95 % CI: 0·27, 0·34)) had lower odds of suffering from CFM compared with their counterparts. Children from poorer quintiles were more influenced by CFM than richer quintiles (Coef.:–0·175, 95 % CI: –0·192, –0·157, P-value < 0·001). Higher percentage of CFM was observed among rich families in 2019 compared with 2012–13 (24·50 % and 20·15 %, respectively; P-value < 0·001)

The findings of this study should help the researchers and policymakers to understand CFM more clearly and plan prospective studies to explore CFM outcomes. Targeted interventional approaches are needed among parents of rural communities to control the burden of CFM.

American diets are increasingly based on ultra-processed foods (UPF). Current research, particularly on socio-economic differentials, is lacking. This study aimed to provide an updated examination of US household purchases of UPF and how this differs by race–ethnicity, household income and household education.

The NielsenIQ Consumer Panel 2020 was utilised for analysis. Each food and beverage product purchased by US households was assigned a level of processing under the Nova level of processing classification system. The volume of UPF purchased overall and by food group was determined for each Nova processing group and examined by race–ethnicity, education and income. Results were stratified by race–ethnicity within each income group. A P value < 0·0001 was considered significant.

This study analysed data from the Nielsen IQ Consumer Panel 2020 which recorded household food purchases in the USA.

The Nielsen IQ Homescan Consumer Panel is a nationally representative longitudinal survey of around 35 000 and 60 000 US households.

Of 33 054 687 products purchased by 59 939 US households in 2020, 48 % of foods and 38 % of beverages were considered UPF. Categories with the highest proportion of purchases deriving from UPF included carbonated soft drinks (90 %), mixed dishes and soups (81 %) and sweets and snacks (71 %). Slightly higher but statistically significant proportions of UPF purchases occurred in the lowest income and education groups and among non-Hispanic whites.

It is concerning that household purchases of UPF in the USA are high. Policies that reduce consumption of UPF may help reduce diet-related health inequalities.

We evaluated the impact of an established nutrition education intervention, ‘PhunkyFoods’ on food literacy, cooking skills and fruit and vegetable intake in primary school aged children.

A pre-registered cluster randomised controlled trial was used; the intervention group received the ‘PhunkyFoods’ programme and the wait-list control group received the usual school curriculum. Primary outcomes measured were differences in food literacy and cooking skills scores between the intervention and control arms after 12 months adjusted for baseline values.

The trial was undertaken in twenty-six primary schools in North Yorkshire, UK.

631 children aged 6–9 years participated (intervention n 307, control n 324) through assemblies, classroom activities and after-school clubs.

There were no significant effects of the intervention compared with control on food literacy, cooking skills, vegetable intake or fruit intake. Adjusting for baseline, the Food Literacy Total Score was 1·13 points lower in the intervention group than the control (95 % CI –2·87, 0·62, P = 0·2). The Cooking Skills Total Score was 0·86 lower in the intervention group compared with the control (95 % CI = –5·17, 3·45, P = 0·69). Girls scored 2·8 points higher than boys in cooking skills across the sample (95 % CI = 0·88, 4·82, P < 0·01).

The intervention did not result in improved food literacy or cooking skills, though sex effects on these outcomes were observed. More practical food preparation hours are needed in primary schools to improve the likelihood of an effect on outcomes.

The use of online food delivery (OFD) platforms is on the rise, and currently, there are no public health policies that regulate what and how food is sold on these platforms. Research quantifying and describing the marketing strategies on OFD platforms is limited. Our study aimed to test the consumers’ acceptability of using two screen capture methods to record their food purchasing behaviour on OFD platforms and describe consumers’ exposure to, and engagement with, marketing strategies on OFD platforms in real time.

Semi-structured online interviews on the consumer acceptability of using the screen capture methods were analysed using thematic analysis. Screen recordings of OFD orders were analysed using content analysis, guided by the marketing mix framework (i.e. product, placement, price and promotion).

Victoria, Australia

Twenty adults using the OFD service at least once a month were recruited.

The mean age of the sample was 28 years. 75 % were females, over 80 % had completed higher education and 20 % lived with children < 18 years of age. Over half used OFD service two to five times per week. Participants expressed that both smartphone’s in-built screen recording function and third-party screen recording application are easy-to-use and time-efficient with high levels of user satisfaction. A range of marketing strategies were observed on the OFD platform. These included the presence of, and strategic placement of selected food products, price discounts and promotion strategies. Participants appeared to engage with marketing strategies through multiple clicks to reduce the total cost of their OFD order.

Our study demonstrates that screen recording is an acceptable method for capturing and assessing consumers’ real-time exposure to, and engagement with, a range of marketing strategies on the OFD platform. Studies with larger samples are needed to substantiate our findings.

This research provides the first population-based investigation of intimate partner violence (IPV) and women’s dietary intake of iron and Vitamin A-rich foods using representative data from eight low- and middle-income countries.

Using multivariable logistic regression, we estimated the relationship between various forms of past year IPV (physical, emotional and sexual) and consumption of Vitamin A and iron-rich foods.

We conducted secondary data analysis of cross-sectional demographic and health surveys from Cambodia (2021, n 5640), Nepal (2022, n 4179), Sierra Leone (2019, n 3812), Nigeria (2018, n 8313), Tajikistan (2017, n 4800), Cote D’Ivoire (2021, n 3656), Kenya (2022, n 10 758) and the Philippines (2022, n 12 278).

Women of reproductive age (15–49 years) comprised the analytical sample.

Results revealed distinct relationship patterns between various IPV forms and women’s dietary consumption of micronutrient-rich foods. The most consistent relationships being that past year (i) sexual IPV (adjusted OR (aOR): 0·72, 95 % CI: 0·53, 0·98), (ii) physical IPV (aOR: 0·86, 95 % CI: 0·73, 1·01) and (iii) emotional IPV (aOR: 0·81, 95 % CI: 0·70, 0·94) significantly reduced the odds of consuming iron-rich foods in the pooled analyses. Due to between-country heterogeneity concerning the relationship between IPV and Vitamin A, pooled estimates for dietary vitamin A consumption were non-significant. However, in the Philippines, IPV was associated with reduced dietary Vitamin A intake.

IPV is associated with altered dietary intake patterns and between-country differences could be due to different food environments. Mechanisms explaining our findings may involve consequences of IPV that impact diet and dietary practices: depression, control of resources and physical trauma.

Understanding country-level nutrition intake is crucial to global nutritional policies that aim to reduce disparities and relevant disease burdens. Still, there are limited numbers of studies using clustering techniques to analyse the recent Global Dietary Database (GDD). This study aims to extend an existing multivariate time series (MTS) clustering algorithm to allow for greater customisability and provide the first cluster analysis of the GDD to explore temporal trends in country-level nutrition profiles (1990–2018).

Trends in sugar-sweetened beverage intake and nutritional deficiency were explored using the newly developed programme ‘MTSclust’. Time series clustering algorithms are different from simple clustering approaches in their ability to appreciate temporal elements.

Nutritional and demographical data from 176 countries were analysed from the GDD.

Population representative samples of the 176 in the GDD.

In a three-class test specific to the domain, the MTSclust programme achieved a mean accuracy of 71·5 % (adjusted Rand Index [ARI] = 0·381) while the mean accuracy of a popular algorithm, DTWclust, was 58 % (ARI = 0·224). The clustering of nutritional deficiency and sugar-sweetened beverage intake identified several common trends among countries and found that these did not change by demographics. MTS clustering demonstrated a global convergence towards a Western diet.

While global nutrition trends are associated with geography, demographic variables such as sex and age are less influential to the trends of certain nutrition intake. The literature could be further supplemented by applying outcome-guided methods to explore how these trends link to disease burdens.

Despite strong evidence linking exposure to food and beverage marketing with poor diet quality and negative health impacts in children, the effect of brand marketing (i.e. marketing featuring branded content, but no food products) is uncertain. This study evaluated the impact of brand marketing v. product-based advertising on children’s food preferences and behavioural intentions.

An online survey was administered to participants randomised to one of four ad conditions; familiar product (i.e. from popular Canadian brands); familiar brand (i.e. no food product, Canadian brand); unfamiliar product (i.e. foreign products); and unfamiliar brand ad (i.e. foreign brand). Participants viewed three ads displaying features of that condition and answered three 5-point Likert-scale questions related to the study outcomes: food preference, purchase intent and pester power. The average of all outcomes determined the total impact. An ANOVA with Bonferroni post hoc tests evaluated differences in impact between conditions.

Canada participants: n 1341 Canadian children (9–12 years)

Familiar product ads had a higher total impact on children (mean score 3·57) compared with familiar brand ads (2·88), unfamiliar brand ads (3·24) or unfamiliar product ads (3·09; P < 0·001 for all pairwise comparisons). Total impact was lower for familiar brand ads than for unfamiliar brand ads or unfamiliar product ads (P < 0·001 for all pairwise comparisons). The impact of an unfamiliar brand and product did not differ (P = 0·53).

Results suggest that familiar product ads seem to have a stronger impact on children’s food preferences and behavioural intentions than familiar brand ads, unfamiliar brand ads and unfamiliar product ads.

There have been unsafe levels of unpaired fructose in the high fructose corn syrup (HFCS) in US beverages, and research/case study evidence shows that their intake is associated with greater asthma prevalence/risk/incidence, a debilitating disease, likely due to fructose malabsorption, gut fructosylation and gut dysbiosis mechanisms. The ‘unexplained’ asthma epidemic has disproportionately affected children and Black individuals, groups with higher fructose malabsorption prevalence than others, and research to assess disproportionately higher asthma risk/incidence among Black individuals in association with HFCS-sweetened beverage intake is lacking.

Demographic, lifestyle and dietary data collected at enrollment (1985–86), and incident asthma through exam 5 (1995–96), were used in Cox proportional hazards models to assess HFCS intake associations (hazard ratios) with asthma risk/incidence.

CARDIA study participants from Birmingham, AL, Chicago, IL, Minneapolis, MN and Oakland, CA.

1998 Black and 2104 White young adults.

HFCS-sweetened beverage intake > once/week was significantly associated with higher asthma risk relative to ≤ once/week (P-trend = 0·04), among Black participants only; risk was 2·8 times higher among 2–4 times/week consumers (HR = 2·8, 95 % CI 1·1, 7·3, P = 0·04) and 3·5 times higher when consumed multiple times/d, independent of sucrose intake/obesity/dietary quality/smoking/in-home smoke-exposure (HR = 3·5, 95 % CI 1·3, 9·9, P = 0·02). Intake of orange juice, with nominal unpaired fructose, was not associated with asthma in either group, nor was intake of sucrose, a disaccharide (paired) of fructose/glucose.

Ubiquitous HFCS in the US food supply, with HFCS that contains high/unsafe unpaired fructose, also known as excess-free-fructose, and the fructose/gut/lung/axis are overlooked risk factors in the ‘unexplained’ US asthma epidemic that disproportionately affects Black individuals.

To map out evidence on instruments for evaluating organisational food environments of workplaces and the components and dimensions considered in the identified instruments.

A scoping review that includes studies published as of January 2005, the year of publication of the model developed by Glanz et al. (2005). The databases consulted were PubMed, Embase, Web of Science, PsycINFO, Scopus and Google Scholar until November 2024, without language restrictions. Studies were included if they evaluated the food environment of workplaces such as companies/factories, universities/post-secondary institutions/technical colleges and hospitals/health care units. The conceptual model of Castro and Canella (2022), considering its components and dimensions, was used to synthesise the data.

After a full reading, fifty-four articles were selected. Most were conducted in the United States and Brazil, although there were studies from sixteen countries. A total of thirty-six instruments were identified: nineteen were used in universities, eight in hospitals, and eleven in companies. No instrument included all components and dimensions of the conceptual model; however, three instruments included most of them. The most evaluated component was the internal level of eating spaces, and the most evaluated dimensions were the availability and quality of foods/beverages in eating spaces. Of the thirty-six instruments, twenty-nine reported some measure of validity or reproducibility. The limitation most reported by the studies was the non-generaliation of results because samples are limited.

Evaluations of the organisational food environment of workplaces can be used for monitoring, planning interventions and formulating public policies for such places, thereby enhancing workers’ health.

We investigated vitamin D (VitD) nutritional status in children aged 2–6 years to provide a basis for prevention and intervention strategies for VitD deficiency (VitDD) in Chinese children.

From November 2018 to September 2019, a total of 2192 healthy children aged 2–6 years were enrolled. The serum 25-hydroxyvitamin D (25(OH)D) concentrations were measured by liquid chromatography tandem MS.

Twelve jurisdictions in eight provinces and cities across northern and southern China were selected through stratified cluster sampling.

2192 children aged 2–6 years were enrolled.

(1) A serum 25(OH)D concentration of 23·87 (sd 8·24) ng/ml, a VitDS rate of 65·2 %, an insufficiency rate of 29·6 % and a deficiency rate of 5·2 % were noted. (2) Age (OR = 2·22, 95 % CI 1·86, 2·64) and spring (OR = 1·35, 95 % CI 0·91, 2·01) are risk factors for VitDD and VitDI. The male (OR = 0·68, 95 % CI 0·52, 0·90), the temperature (OR = 0·89, 95 % CI 0·86, 0·93), summer (OR = 0·25, 95 % CI 0·09, 0·68), autumn (OR = 0·26, 95 % CI 0·09, 0·74) the intake of VitD supplements (OR = 0·08, 95 % CI 0·03, 0·28), the intake frequency of dairy products (OR = 0·86, 95 % CI 0·78, 0·96) and egg products (OR = 0·83, 95 % CI 0·74, 0·93) are protective factors for VitDD and VitDI.

VitDD in children aged 2–6 years is still prevalent in China, but the influencing factors of VitD nutrition have changed. Latitude is not the main factor in the 25(OH)D concentrations of children aged 2–6 years; temperature, intake of eggs and dairy products and sampling season have more obvious impacts.

Increased out-of-home consumption may elevate sodium (Na) intake, but self-reported dietary assessments limit evidence. This study explored associations between neighbourhood exposure to fast-food and sit-down restaurants and estimated 24-hour urinary Na excretion.

A cross-sectional analysis from the ORISCAV-LUX 2 study (2016–2017). 24-hour urinary Na was estimated from a morning spot urine sample using the INTERSALT formula. Spatial access to fast-food and sit-down restaurants was derived from GIS data around participants’ addresses within 800-m and 1000-m road network buffers by summing up the inverse of the road network distance between their residential address and all restaurants within the corresponding buffer size. Multi-adjusted linear models were used to assess the association between spatial access to restaurants and estimated 24-hour urinary Na excretion.

Luxembourg

Urban adults age over 18 years (n 464).

Fast-food and sit-down restaurants accounted for 58·5 % of total food outlets. Mean 24-hour urinary Na excretion was 3564 mg/d for men and 2493 mg/d for women. Health-conscious eating habits moderated associations between spatial access to fast-food and sit-down restaurants and Na excretion. For participants who did not attach great importance to having a balanced diet, greater spatial access to restaurants, combining both density and accessibility, was associated with increased urinary Na excretion at 800 m (βhighvslow = 259, 95 % CI: 47, 488) and 1000 m (βhighvslow = 270, 95 % CI: 21, 520).

Neighbourhood exposure to fast-food and sit-down restaurants influences Na intake, especially among individuals with less health-conscious eating habits, potentially exacerbating diet-related health disparities.

Childhood obesity is increasing in many countries, including Kuwait. Currently, adiposity is most commonly assessed from simple anthropometric measurements, e.g. height and weight or combined as body mass index (BMI). This is despite these surrogate measurements being poor indices of adiposity. Bioelectrical impedance analysis (BIA) is a popular method for the assessment of body composition providing a measurement of adiposity as absolute fat mass (FM) or FM expressed as a percentage of body weight (%BF). BIA is, however, an indirect predictive method. This study developed a BIA-based prediction equation for body composition assessment in Kuwaiti children and, additionally, a prediction equation for %BF based on sum of skin-fold (SSF) thickness measurements.

A cross-sectional design was used with primary school recruitment.

School population in Kuwait City; in-clinic assessments.

158 Kuwaiti children aged 7–9 years. Body composition assessed using bioimpedance spectroscopy and skin-folds with prediction equations generate against deuterium dilution measurement of total body water and fat-free mass (FFM) as reference.

The newly developed and cross-validated BIA equation predicted FFM with minimal bias (< 1%) and acceptable 2 sd limits of agreement (±1·6 kg equivalent to ±10%) improving on the predictive performance of comparable published equations. Similarly, SSF predicted %BF with small bias (0·2 %BF) but relatively wide limits of agreement (±7 %BF).

These new equations are suitable for practical use for nutritional assessment in Kuwaiti children, particularly in epidemiological or public health settings although their applicability in other populations requires further research.

We aimed to validate in-body bioelectrical impedance analysis (BIA) measures with dual-energy X-ray absorptiometry (DXA) as reference and describe the body composition (BC) profiling of Tibetan adults.

This cross-sectional study included 855 participants (391 men and 464 women). Correlation and Bland–Altman analyses were performed for method agreement of in-body BIA and DXA. BC were described by obesity and metabolic status.

In-body BIA and DXA have not been employed to characterise the BC of the Tibetan population living in the Qinghai–Tibet Plateau.

A total of 855 Tibetan adults, including 391 men and 464 women, were enrolled in the study.

Concordance correlation coefficient for total fat mass (FM) and total lean mass (LM) between in-body BIA and DXA were 0·91 and 0·89. The bias of in-body BIA for percentages of total FM and total LM was 0·91 % (2·46 %) and –1·74 % (–2·80 %) compared with DXA, respectively. Absolute limits of agreement were wider for total FM in obese men and women and for total LM in overweight men than their counterparts. Gradience in the distribution of total and regional FM content was observed across different BMI categories and its combinations with waist circumference and metabolic status.

In-body BIA and DXA provided overall good agreement at the group level in Tibetan adults, but the agreement was inferior in participants being overweight or obese.

To examine the extent and nature of food and non-alcoholic drink advertising displayed on public transport and infrastructure on school routes.

Audit of outdoor advertisements on government-controlled public transport and associated infrastructure (e.g. tram shelters, bus stops) on busy school routes in Victoria, Australia. Using a strict protocol, trained field workers collected data on the type and content of outdoor advertising during February 2023 (start of school year). Food/drink advertising was classified (unhealthy or healthy) according to the Council of Australian Governments Health Council National interim guide to reduce children’s exposure to unhealthy food and drink promotion (2018).

Government-controlled buses, trams and public transport infrastructure on routes from eleven of the busiest train stations in metropolitan Melbourne and regional Victoria, Australia to fifty public primary and secondary schools. Stations were chosen based on annual patronage, area-based socio-economic area (SEA) and regionality).

156 out of 888 advertisements were for food and non-alcoholic drinks. Of these, almost six in ten (58 %) were deemed unhealthy irrespective of SEA or regionality. Marketing appeals most featured were taste (31 %), convenience (28 %) and emotion (9 %). A significantly higher proportion of unhealthy advertisements were displayed within 500 m of schools v. outside this radius (91 % v. 57 %, P < 0·01).

Given the detrimental impacts of exposure to unhealthy food/drink advertising on children’s diets, the pervasive, powerful presence of such advertising across government public transport assets, particularly around schools, contradicts public health recommendations to protect children from exposure to and influence by this harmful marketing and warrants government action.