Editor’s Choice Articles

Schools constitute strategic settings for shaping eating behaviors among youth. Given the profound environmental, health, and social challenges associated with current food systems, there is an urgent need to explore dietary patterns that simultaneously support human well-being, ecological sustainability, and ethical principles. This comprehensive review provides a contemporary overview of the role of plant-based diets as an instrumental pathway to a healthier and more sustainable future by examining (i) environmental and social impacts of current food systems; (ii) the effects of plant-based diets on health; (iii) determinants of plant-based diet implementation in schools, including barriers and facilitators to their adoption; and (iv) the development of future-oriented dietary guidelines. Transitioning to plant-based diets, combined with sustainable agricultural practices, can reduce resource use and promote ecological sustainability. Promoting plant-based diets can also encourage the development of a more responsible and equitable social culture. Plant-based diets consistently provide metabolic, cardiovascular, and anti-inflammatory benefits across diverse populations, contributing to healthy weight and glycemic regulation. Well-planned plant-based diets may also improve cognitive function and promote psychological well-being. The integration of plant-based diets in schools is limited by barriers such as children’s food preferences, habitual eating patterns, peer influence, time and resource constraints, limited knowledge, cultural attachment to meat, and low family involvement. Conversely, facilitators including experiential learning, nutrition education, teacher and family engagement, social norms, ethical or environmental motivations, and institutional support promote acceptance and implementation. Ongoing research is required to refine dietary recommendations, assess long-term health outcomes, and ensure nutritional adequacy across pediatric populations. Continued evaluation of school-based interventions and policy frameworks will be essential to optimize the integration of plant-based diets and to monitor their health, ethical, and environmental impacts. Full article

Child and adolescent health plays a critical role in shaping future public health and intergenerational outcomes. In China, rising rates of myopia, obesity, mental health issues, and other common conditions highlight the need for continuous monitoring. Since 2016, the Chinese National Surveillance on Students’ Common Diseases and Risk Factors (CNSSCDRF) has provided comprehensive, nationwide data on student health. By 2022, the system had expanded to nearly all counties, tracking key indicators such as vision problems, overweight/obesity, dental caries, and health-risk behaviors across multiple administrative levels. This review outlines the surveillance methodology, including sampling, data collection, and analysis. Findings have directly informed school health policies and technical guidelines, supporting national goals such as those in the Healthy China 2030 Plan. Full article

Background: Previous studies reported screen time in association with unhealthy dietary behaviors, such as excessive intake of sugar-sweetened beverages leading to dental caries. Thus, we aimed to explore the association between screen time on mobile devices and dental caries experience in adolescents, as well as whether sugar-sweetened beverages would mediate the association. Methods: We analyzed 24,374 junior and senior high school students of age 12 to 17 years from the 2021 “Surveillance for common diseases and health risk factors among students” Project in Jiangsu Province of China. Dental caries experience was determined by the designated dentists. Screen time and consumption of sugar-sweetened beverages were self-reported and treated as a priori risk. We employed an instrumental variable (IV) approach for the current cross-sectional setting. We used the lasso technique to shortlist covariates from a range of confounding factors. Binary logistic regression or ordered logistic regression was performed where appropriate to explore the associations of screen time on mobile devices with dental caries and sugar-sweetened beverages. Results: The prevalence rate of dental caries was 38.4% in the study population. In comparison with <2 h/d screen time on mobile devices, extended screen time (≥2 h/d) was associated with higher dental caries risk (coefficient: 1.27, 95%; confidence interval: 0.80–1.75). Mediation analysis suggested that sugar-sweetened beverage intake might be an independent risk factor for dental caries, instead of the mediator between screen time on mobile devices and dental caries. None of the interaction terms under investigation was statistically significant. Conclusions: Exposure to mobile device screens and sugar-sweetened beverages was associated with dental caries in adolescents. These findings highlighted the importance of increasing awareness of potential risks owing to mobile device usage and sugar-sweetened beverages and the necessity to develop appropriate intervention strategies for school-aged adolescents. Full article

Background: Puberty is a life milestone that marks the transition from childhood to adulthood. An ambispective Chongqing Pubertal Timing (CQPT) cohort was started in 2014 to understand pubertal timing and identify environmental risk factors. Methods: A total of 1429 children and adolescents were recruited and have been followed up once every 6 months for 8 years in a district of Chongqing, China. Data were collected via questionnaires for social and family environment, health conditions, gestational and maternal information, and in-person physical examinations by trained medical school graduate students in follow-ups. Environmental exposures of polycyclic aromatic hydrocarbons (PAHs), neonicotinoids, and heavy metals in urine samples were measured at different time points. Results: The mean ages at pubertal onset were 10.20 for thelarche, 11.62 for pubic hair development, and 11.84 for menarche in girls, and 11.16 for genital development, 11.66 for testicular enlargement, and 12.71 for first spermatorrhea in boys. Four OH-PAHs were associated with delayed timing of menarche, thelarche, pubic hair, and axillary hair development in girls, and thiacloprid was found to potentially impact genital stages in boys and axillary hair development in girls. Conclusions: We built a cohort to provide evidence of regional pubertal timing of boys and girls and the significant environmental factors. Further health outcomes, especially mental health and women’s health and its long-term health implications, will be followed. Full article

This study explores the feasibility of large language models (LLMs) like ChatGPT and Bard as virtual participants in health-related research interviews. The goal is to assess whether these models can function as a “collective knowledge platform” by processing extensive datasets. Framed as a “proof of concept”, the research involved 20 interviews with both ChatGPT and Bard, portraying personas based on parents of adolescents. The interviews focused on physician–patient–parent confidentiality issues across fictional cases covering alcohol intoxication, STDs, ultrasound without parental knowledge, and mental health. Conducted in Dutch, the interviews underwent independent coding and comparison with human responses. The analysis identified four primary themes—privacy, trust, responsibility, and etiology—from both AI models and human-based interviews. While the main concepts aligned, nuanced differences in emphasis and interpretation were observed. Bard exhibited less interpersonal variation compared to ChatGPT and human respondents. Notably, AI personas prioritized privacy and age more than human parents. Recognizing disparities between AI and human interviews, researchers must adapt methodologies and refine AI models for improved accuracy and consistency. This research initiates discussions on the evolving role of generative AI in research, opening avenues for further exploration. Full article