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Community Nutrition, Physical Activity and Health Promotion: Current Perspectives in Public Health Nutrition

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (30 September 2019) | Viewed by 127163

Special Issue Editors


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Guest Editor
Department of Physiology, Faculty of Medicine, University of the Basque Country (UPV/EHU), 48940 Leioa, Vizcaya, Spain
Interests: community nutrition; nutrition education; food habits; diet; lifestyle related behavior; diet intake; obesity; chronic disease prevention; community-based interventions
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Spanish Society of Community Nutrition, Royal Academy of Medicine of the Basque Country, 48008 Bilbao, Spain
Interests: public health nutrition; obesity; food habits; food-based dietary guidelines; human nutrition and health; diet and health; lifestyle interventions
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Currently, most societies face the challenge of the growing burden of chronic diseases in aging populations. Moreover, several regions bear the dual burden of over and malnutrition. In this context, nutrition and physical activity are central to all strategies and policies for prevention and support for the management of these problems, both at the individual and community level; considering multiple approaches, scopes and levels of action; involving the main actors, key sectors and stakeholders; looking for participation strategies at the local and community level.

We often live in plural, multicultural societies, in which many people migrate to other places moved by armed conflicts, persecution, disasters and catastrophes, socio-economic or occupational purposes or for any other reason. The reality is that these people undergo food transitions that can pose added risks.

This Special Issue focuses on research on community interventions related to food habits, dietary intake and physical activity. Topics of interest include, but are not limited to, evaluation of effectiveness of community-based interventions (any setting), research on environmental determinants (food availability, access to food and beverages, physical environment, sociocultural, economic, educational factors, family environment, age groups, ethnic groups). In addition, environmental strategies, food policies, educational policies, social policies, consumer literacy, citizen participation, qualitative evaluation, research on dietary habits and food transitions (challenges in the analysis of food consumption: methods, approaches, food composition, etc.) as well as investigations related to sustainability of interventions. Quantitative research (observational or intervention studies) and qualitative research fit well within the scope of this Special Issue.

Dr. Carmen Pérez-Rodrigo
Dr. Javier Aranceta-Bartrina
Guest Editors

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • community-based interventions
  • community participation
  • food policy
  • food habits
  • dietary intake
  • social influences
  • environmental influences
  • physical activity
  • consumer literacy

Published Papers (20 papers)

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Research

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14 pages, 3173 KiB  
Article
Temporal Trends and Recent Correlates in Sedentary Behaviors among Chinese Adults from 2002 to 2010–2012
by Caicui Ding, Ganyu Feng, Fan Yuan, Weiyan Gong, Yecheng Yao, Yanning Ma, Yan Zhang and Ailing Liu
Int. J. Environ. Res. Public Health 2020, 17(1), 158; https://doi.org/10.3390/ijerph17010158 - 24 Dec 2019
Cited by 19 | Viewed by 2635
Abstract
Evidence suggests that more time spent in sedentary behaviors (SB) increases health risk independent of physical activities. Trends in SB among adults have not been fully described in China, and the sociodemographic correlates of SB have not been systematically evaluated either. This study [...] Read more.
Evidence suggests that more time spent in sedentary behaviors (SB) increases health risk independent of physical activities. Trends in SB among adults have not been fully described in China, and the sociodemographic correlates of SB have not been systematically evaluated either. This study examined the temporal trends of SB among 184,257 adults (2002: n = 52,697, 2010–2012: n = 131,560) using data from the China National Nutrition and Health Survey in 2002 and 2010–2012, and analyzed the recent correlates of SB in Chinese adults. Overall, an increase (+0.29 h/d) was seen in total SB across the survey years, and there was a slight increase (+0.14 h/d) in leisure time SB and a decrease (−0.39 h/d) in occupational SB. From 2002 to 2012, the proportion of Chinese adults whose total SB time over 4 h/d increased from 35.4% to 43.0%, and the proportion of leisure SB time over 3 h/d increased from 42.0% to 48.0%, and the proportion of occupational SB time over 4 h/d decreased from 63.4% to 53.0%. Male, urban areas, employed, unmarried, and with higher educational and family economic level were all positively associated with high sedentary time (HST) in 2010–2012. These trends and correlates are important for health policy in China and other countries that are facing similar challenges. Full article
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13 pages, 308 KiB  
Article
Being Conscious of Water Intake Positively Associated with Sufficient Non-Alcohol Drink Intake Regardless of Seasons and Reasons in Healthy Japanese; the KOBE Study: A Cross Sectional Study
by Tomofumi Nishikawa, Naomi Miyamatsu, Aya Higashiyama, Yoshimi Kubota, Yoko Nishida, Takumi Hirata, Daisuke Sugiyama, Kazuyo Kuwabara, Sachimi Kubo, Yoshihiro Miyamoto and Tomonori Okamura
Int. J. Environ. Res. Public Health 2019, 16(21), 4151; https://doi.org/10.3390/ijerph16214151 - 28 Oct 2019
Cited by 2 | Viewed by 2852
Abstract
The present study sought to clarify if being conscious of water intake (CWI) is associated with sufficient non-alcohol drink (NAD) intake. We used data of healthy participants without diabetes, aged 40–74 years, in the Kobe Orthopedic and Biomedical Epidemiologic (KOBE) study. The association [...] Read more.
The present study sought to clarify if being conscious of water intake (CWI) is associated with sufficient non-alcohol drink (NAD) intake. We used data of healthy participants without diabetes, aged 40–74 years, in the Kobe Orthopedic and Biomedical Epidemiologic (KOBE) study. The association between being CWI and NAD intake was evaluated by multivariate linear regression analyses after adjusting for age, sex, surveyed months (seasons), alcohol drinking, health-awareness life habits, socioeconomic factors, serum osmolarity, estimated daily salt intake, and reasons for NAD intake. Among 988 (698 women and 290 men) participants eligible for the present analyses, 644 participants (65.2%) were CWI and 344 participants (34.8%) were not CWI (non-CWI). The most popular reason for being CWI was to avoid heat stroke in summer and to prevent ischemic cerebral stroke in winter. The CWI group took more NAD, especially decaffeinated beverages, than the non-CWI group (1846.7 ± 675.1 mL/day vs. 1478.0 ± 636.3 ml/day, p < 0.001). There was a significant association between being CWI and NAD intake in multivariate linear regression analyses ever after adjusting for the relevant variables (β = 318.1, p < 0.001). These findings demonstrated CWI, regardless of the reasons and the seasons, was associated with high NAD intake in Japanese healthy population. Full article
11 pages, 331 KiB  
Article
Assessment of Nutritional Intakes in Individuals with Obesity under Medical Supervision. A Cross-Sectional Study
by Costela Lăcrimioara Șerban, Alexandra Sima, Corina Marcela Hogea, Adela Chiriță-Emandi, Iulia Teodora Perva, Adrian Vlad, Alin Albai, Georgiana Nicolae, Salomeia Putnoky, Romulus Timar, Mihai Dinu Niculescu and Maria Puiu
Int. J. Environ. Res. Public Health 2019, 16(17), 3036; https://doi.org/10.3390/ijerph16173036 - 22 Aug 2019
Cited by 7 | Viewed by 5576
Abstract
People with obesity in Romania are often under medical supervision, which is aimed to decrease body weight and treat accompanying metabolic disorders and cardiovascular implications. However, there is limited information regarding the implementation of dietary recommendations in adults with obesity. We aimed to [...] Read more.
People with obesity in Romania are often under medical supervision, which is aimed to decrease body weight and treat accompanying metabolic disorders and cardiovascular implications. However, there is limited information regarding the implementation of dietary recommendations in adults with obesity. We aimed to evaluate the prevalence of reaching the recommended intakes of macro- and micro-nutrients in adults with obesity under medical supervision. Individuals with obesity, recruited in the context of a study with a larger scope (NutriGen ClinicalTrials.gov NCT02837367), who were under medical supervision underwent four 24 h recalls in order to assess daily food intakes. Macro- and micro-nutrient intakes were computed, and the prevalence of reaching recommended dietary allowances (RDAs) for each nutrient was calculated. The majority of subjects did not meet the recommended intakes for most nutrients. Energy from fat exceeded the threshold of 35% recommended intake, even in the lowest quartile of energy intake. The micronutrients with less than 5% of individuals reaching the RDAs were vitamin D, vitamin E, fluoride, and omega-3 fatty acids for both males and females, and choline, magnesium, and potassium in females. The burden of inadequate nutrition in individuals with obesity should be acknowledged and properly addressed within efforts to reduce obesity rates and associated disorders. Full article
12 pages, 329 KiB  
Article
Bone Health and Its Relationship with Impact Loading and the Continuity of Physical Activity throughout School Periods
by Gotzone Hervás, Fatima Ruiz-Litago, Jon Irazusta, Amaia Irazusta, Begoña Sanz, Javier Gil-Goikouria, Ana Belen Fraile-Bermudez, Carmen Pérez-Rodrigo and Idoia Zarrazquin
Int. J. Environ. Res. Public Health 2019, 16(16), 2834; https://doi.org/10.3390/ijerph16162834 - 8 Aug 2019
Cited by 10 | Viewed by 3481
Abstract
Bone is influenced by physical activity (PA) throughout life, but childhood and adolescence provide a key opportunity to maximize peak bone mass. Thus, it is important to identify the relationship between PA practiced in childhood and young adulthood to design a promotion plan [...] Read more.
Bone is influenced by physical activity (PA) throughout life, but childhood and adolescence provide a key opportunity to maximize peak bone mass. Thus, it is important to identify the relationship between PA practiced in childhood and young adulthood to design a promotion plan for bone health. The purpose of this study was to analyze the relationship between different impact-loading PAs (and their continuity throughout school periods from childhood to young adulthood) and bone stiffness index (SI). In this cross-sectional study, which was conducted on 145 university students aged 18–21 years, bone measurements were measured by quantitative ultrasonometry (QUS), and PA information was recalled using a self-administered questionnaire. Associations between the SI and the impact of PA performed during secondary school (p = 0.027), high school (p = 0.002), and university (p = 0.016) periods were observed. The continuity of PA over a longer period of time was related to a higher SI (p = 0.007). Those who practiced PA throughout all school periods had a higher SI than those who practiced during primary school only (p = 0.038) or through primary and secondary schools (p = 0.009). These results suggest that impact-loading PA practiced during different school periods is related to higher values of the SI. Therefore, continuous PA from an early age may be an important contributing factor to achieving and maintaining adequate bone health. Full article
10 pages, 458 KiB  
Article
Accuracy of Predictive Resting-Metabolic-Rate Equations in Chinese Mainland Adults
by Jingjing Xue, Shuo Li, Yong Zhang and Ping Hong
Int. J. Environ. Res. Public Health 2019, 16(15), 2747; https://doi.org/10.3390/ijerph16152747 - 1 Aug 2019
Cited by 11 | Viewed by 4011
Abstract
Accurate measurement of the resting metabolic rate (RMR) is necessary when we make energy requirements and nutrition suggestions in clinical. However, indirect calorimetry is not always available. The objectives of this study were to make a comparison between RMR measured by indirect calorimetry [...] Read more.
Accurate measurement of the resting metabolic rate (RMR) is necessary when we make energy requirements and nutrition suggestions in clinical. However, indirect calorimetry is not always available. The objectives of this study were to make a comparison between RMR measured by indirect calorimetry and RMR predicted by different kinds of equations, and to develop new predictive equations for Chinese mainland adults. In this study, 315 Chinese mainland adults from different provinces all over China were recruited. Subjects underwent half a day of testing, which consisted of anthropometric assessment and RMR measurement. Measured and predicted RMR were compared; new optimal equations for Chinese mainland adults were developed and tested by splitting the subjects into a development and validation group. The measured RMR was in the range of 831–2776 kcal/day (mean 1651 ± 339 kcal/day). Our findings indicated that, except for the Harris–Benedict and Schofield equations, three Chinese equations and two fat-free mass (FFM) modeling equations all significantly underestimated RMR compared to the measured value (all p < 0.01). There were no significant differences between predicted and measured RMR using the new equations for females and males. Of the pre-existing equations, Schofield’s is the most suitable for Chinese mainland adults. However, the two new equations developed in this study seem to be more effective for predicting the RMR of Chinese mainland adults, and need to be validated by a larger independent sample with different physiological and anthropometric characteristics. Full article
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9 pages, 277 KiB  
Communication
Doctors Rule: An Analysis of Health Ministers’ Diaries in Australia
by Katherine Cullerton, Tom White and Amanda Lee
Int. J. Environ. Res. Public Health 2019, 16(13), 2440; https://doi.org/10.3390/ijerph16132440 - 9 Jul 2019
Cited by 5 | Viewed by 3909
Abstract
Limited progress in nutrition policy action is often blamed on the close relationships the food industry has with health policy decision-makers. This analysis sought to examine this belief through the analysis of health ministers’ diaries. Entries were downloaded from health ministers’ diaries from [...] Read more.
Limited progress in nutrition policy action is often blamed on the close relationships the food industry has with health policy decision-makers. This analysis sought to examine this belief through the analysis of health ministers’ diaries. Entries were downloaded from health ministers’ diaries from two states in Australia from January 2013 to June 2018. Entries were coded according to which interest group met with the minister or whether general parliamentary business was undertaken. Coding was also undertaken for any meeting topics related to nutrition policy. Analysis of health ministers’ diaries found that the food industry has limited documented interaction with the two state health ministers in Australia. Instead, medical associations, private hospitals and health services, and sporting associations (rugby league associations) had the most interactions with health ministers. Poor representation was seen on nutrition issues, and there was an apparent lack of nutrition advocates interacting with the health ministers. There are opportunities for nutrition advocates to increase their level of interaction with state health ministers. This could include building alliances with medical associations, as they are in a powerful position, to advocate directly to health ministers. Health ministers’ diaries can provide valuable insights into who is meeting officially with ministers. However, there are also limitations with the dataset. Full article
16 pages, 2630 KiB  
Article
The Impact of a Community-Based Food Education Program on Nutrition-Related Knowledge in Middle-Aged and Older Patients with Type 2 Diabetes: Results of a Pilot Randomized Controlled Trial
by Carlos Vasconcelos, António Almeida, Maria Cabral, Elisabete Ramos and Romeu Mendes
Int. J. Environ. Res. Public Health 2019, 16(13), 2403; https://doi.org/10.3390/ijerph16132403 - 6 Jul 2019
Cited by 5 | Viewed by 4918
Abstract
The purpose of this study was to evaluate the impact of a community-based food education program on nutrition-related knowledge in middle-aged and older patients with type 2 diabetes (T2D). Participants (n = 36; 65.9 ± 6.0 years old) were recruited in primary [...] Read more.
The purpose of this study was to evaluate the impact of a community-based food education program on nutrition-related knowledge in middle-aged and older patients with type 2 diabetes (T2D). Participants (n = 36; 65.9 ± 6.0 years old) were recruited in primary health care to a 9-month community-based lifestyle intervention program for patients with T2D and randomly assigned to an exercise program (control group; n = 16) or an exercise program plus a food education program (experimental group; n = 20). Nutrition-related knowledge was assessed through a modified version of the General Nutrition Knowledge Questionnaire. The increase in total nutrition-related knowledge score and sources of nutrients area score was significantly higher in the experimental group compared to the control group. No significant changes in nutrition-related knowledge were found between groups in dietary recommendations and diet-disease relationship areas, although improvements were observed. This community-based food education program, with the use of easy to implement strategies (short-duration lectures and dual-task problem solving activities during exercise), had a positive and encouraging impact on nutrition-related knowledge in middle-aged and older patients with T2D. Full article
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13 pages, 1313 KiB  
Article
Effects of Dehydration and Rehydration on Cognitive Performance and Mood among Male College Students in Cangzhou, China: A Self-Controlled Trial
by Na Zhang, Song M. Du, Jian F. Zhang and Guan S. Ma
Int. J. Environ. Res. Public Health 2019, 16(11), 1891; https://doi.org/10.3390/ijerph16111891 - 29 May 2019
Cited by 42 | Viewed by 18514
Abstract
Water accounts for 75% of brain mass. Associations may exist between hydration and cognitive performance. The objective of this study was to investigate the effects of dehydration and rehydration on cognitive performance and mood. In this self-control trial, 12 men were recruited from [...] Read more.
Water accounts for 75% of brain mass. Associations may exist between hydration and cognitive performance. The objective of this study was to investigate the effects of dehydration and rehydration on cognitive performance and mood. In this self-control trial, 12 men were recruited from a medical college in Cangzhou, China. After 12 h of overnight fasting, the participants took baseline tests at 8:00 AM on day 2. First morning urine and blood osmolality were analyzed to determine hydration state. Height, weight, and blood pressure were measured following standardized procedures. A visual analog scale for the subjective sensation of thirst was applied, and a profile of mood states questionnaire was applied. Tests were conducted for cognitive performance, including a test of digit span forward and backward, digit-symbol substitutions, dose-work, and stroop effects. Participants were required not to drink water for 36 h but were given three meals on day 3. On day 4, the same indexes were tested as a baseline test. At 8:30 AM, participants drank 1500 mL of purified water over 15 min. After a 1 h interval, the same measurements were performed. Compared with baseline test results, during the dehydration test, participants had lower scores of vigor (11.9 vs. 8.8, %, p = 0.007) and esteem-related affect (8.2 vs. 5.7, %, p = 0.006), lower total scores of digit span (14.3 vs. 13.3, %, p = 0.004), and higher error rates for dose-work (0.01 vs. 0.16, %, p = 0.005). Compared with the dehydration test scores, rehydration test scores showed that fatigue (4.3 vs. 2.1, %, p = 0.005) and total mood disturbance (TMD) (99.0 vs. 90.2, %, p = 0.008) improved, and scores of forward, backward, and total digit span increased (7.7 vs. 8.6, p = 0.014; 5.7 vs. 1.2, p = 0.019; 13.3 vs. 15.4, p = 0.001). Increases were also noted in correct number of digit symbol substitutions, reading speed, and mental work ability (70.8 vs. 75.4, p < 0.001; 339.3 vs. 486.4, n/min, p < 0.001; 356.1 vs. 450.2, p < 0.001), and reaction time decreased (30.2 vs. 28.7, s, p = 0.002). As a conclusion, dehydration had negative effects on vigor, esteem-related affect, short-term memory, and attention. Rehydration after water supplementation alleviated fatigue and improved TMD, short-term memory, attention, and reaction. Full article
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12 pages, 450 KiB  
Article
Association between Breakfast Frequency and Atherosclerotic Cardiovascular Disease Risk: A Cross-Sectional Study of KNHANES Data, 2014–2016
by Hyeon Ji Lee, Jieun Jang, Sang Ah Lee, Dong-Woo Choi and Eun-Cheol Park
Int. J. Environ. Res. Public Health 2019, 16(10), 1853; https://doi.org/10.3390/ijerph16101853 - 25 May 2019
Cited by 6 | Viewed by 4139
Abstract
The burden of cardiovascular disease (CVD) is increasing worldwide and one related lifestyle choice is breakfast consumption. This study examined the association between breakfast frequency and the 10-year risk of atherosclerotic CVD (ASCVD). The 10-year risk of ASCVD was defined as the risk [...] Read more.
The burden of cardiovascular disease (CVD) is increasing worldwide and one related lifestyle choice is breakfast consumption. This study examined the association between breakfast frequency and the 10-year risk of atherosclerotic CVD (ASCVD). The 10-year risk of ASCVD was defined as the risk of the first event of nonfatal myocardial infarction, coronary heart disease death, and nonfatal or fatal stroke within 10 years. Data from the Korean National Health and Nutrition Examination Survey, 2014–2016 were analyzed, and 7212 participants aged 40–79 years with no history of CVD were included. ASCVD risk was calculated according to the pooled cohort ASCVD equation, and participants with a score >7.5% were considered at high risk of ASCVD. The association between breakfast frequency and high ASCVD risk was confirmed by logistic regression analysis. Participants who never ate breakfast were more likely to be in the high-risk group compared to participants who ate breakfast >5 times per week (OR (adjusted odds ratio) = 1.46; 95% CI (confidence interval) = 1.12–1.89), and the risk was especially higher in female participants and those with a family history of CVD. Our study confirms that breakfast consumption even once per week may prevent CVD. Full article
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18 pages, 795 KiB  
Article
Evaluation of the Computer-Based Intervention Program Stayingfit Brazil to Promote Healthy Eating Habits: The Results from a School Cluster-Randomized Controlled Trial
by Karine Brito Beck da Silva, Naiá Ortelan, Sheila Giardini Murta, Isabel Sartori, Ricardo David Couto, Rosemeire Leovigildo Fiaccone, Maurício Lima Barreto, Megan Jones Bell, Craig Barr Taylor and Rita de Cássia Ribeiro-Silva
Int. J. Environ. Res. Public Health 2019, 16(10), 1674; https://doi.org/10.3390/ijerph16101674 - 14 May 2019
Cited by 13 | Viewed by 5135
Abstract
Interventions via the Internet are promising regarding the promotion of healthy habits among youth. The objective of this study was to evaluate the effect of an adapted version of StayingFit to promote healthy eating habits and the measurement adequacy of anthropometric markers among [...] Read more.
Interventions via the Internet are promising regarding the promotion of healthy habits among youth. The objective of this study was to evaluate the effect of an adapted version of StayingFit to promote healthy eating habits and the measurement adequacy of anthropometric markers among adolescents. A web school-based 12-month cluster-randomized controlled trial examining 7th to 9th grade students was conducted in twelve schools in Salvador, Bahia, Brazil. The schools’ students were randomly distributed into the intervention and control groups. The intervention group participated in StayingFit, an online program designed to encourage and guide healthy eating habits and control body weight. Data on food consumption, anthropometry, physical activity level, and sedentary behavior were collected from all of the students at the beginning of and after the 12-month study. Demographic and socioeconomic data were collected at baseline. The baseline data indicated high rates of overweight (14.4% overweight and 8.5% obese), insufficiently active (87.6%), and sedentary (63.7%). Furthermore, few adolescents regularly consumed fruits (18.8%) and vegetables/legumes (16.4%). Generalized estimating equations (GEEs) were used to evaluate the effect of the intervention. At the end of the follow-up period, students in the intervention group had a 43% increased chance of regularly consuming beans (OR = 1.43, 95% CIs = 1.10–1.86) and a 35% decreased chance of regularly consuming soft drinks (OR = 0.65, 95% CIs = 0.50–0.84). No differences were found between the groups studied with regard to the anthropometric parameters. Despite these modest results, the implementation of a web intervention can be beneficial and help promote positive changes in adolescent eating habits. Full article
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16 pages, 359 KiB  
Article
Identifying Participants Who Would Benefit the Most from an Adult Food-literacy Program
by Andrea Begley, Ellen Paynter, Lucy M. Butcher, Vanessa Bobongie and Satvinder S. Dhaliwal
Int. J. Environ. Res. Public Health 2019, 16(7), 1272; https://doi.org/10.3390/ijerph16071272 - 9 Apr 2019
Cited by 19 | Viewed by 4114
Abstract
Food literacy programs aim to improve behaviours required to achieve a quality diet. The objectives of this study were to assess the demographic, food literacy related and dietary behaviour of participants enrolling in Food Sensations® for Adults, a free four-week food literacy [...] Read more.
Food literacy programs aim to improve behaviours required to achieve a quality diet. The objectives of this study were to assess the demographic, food literacy related and dietary behaviour of participants enrolling in Food Sensations® for Adults, a free four-week food literacy program and identify the subgroup of participants who benefit most. Cross-sectional pre-program questionnaire data (n = 1626) from participants enrolling in the program was used to stratify into low, middle and high food-literacy tertiles. Factor scores from a reliability analysis of food literacy behaviours were then used to produce a composite score). Participants were 80.2% female, 56% aged 26 to 45 years and 73.3% from low to middle socio-economic areas. Demographic characteristics were not a significant predictor of the lowest composite food-literacy group. Those with the lowest composite food-literacy tertile score were more likely to have lower self-rated cooking skills, a negative attitude to the cost of healthy foods, lower intakes of fruits and vegetables and a higher frequency of consuming takeaway food and sugary drinks. Food literacy programs must focus on recruiting those who have low self-rated cooking skills, who consider healthy foods expensive and have poor dietary intakes and will most likely to benefit from such programs. Full article
13 pages, 337 KiB  
Article
Are Adolescent Body Image Concerns Associated with Health-Compromising Physical Activity Behaviours?
by Rasa Jankauskiene, Migle Baceviciene, Simona Pajaujiene and Dana Badau
Int. J. Environ. Res. Public Health 2019, 16(7), 1225; https://doi.org/10.3390/ijerph16071225 - 5 Apr 2019
Cited by 13 | Viewed by 7261
Abstract
The present study aimed to assess the-prevalence of health-compromising eating and physical activity behaviours, and to test their associations with physical activity, internalisation of sociocultural attitudes towards appearance, and body image in a sample of adolescents of both genders. A total sample of [...] Read more.
The present study aimed to assess the-prevalence of health-compromising eating and physical activity behaviours, and to test their associations with physical activity, internalisation of sociocultural attitudes towards appearance, and body image in a sample of adolescents of both genders. A total sample of 736 adolescents (437 or 59.4% were girls) participated in the study. The participants ranged in age from 16 to 19 years (x = 17.2, SD = 0.6). The sample completed a questionnaire measuring body mass index, the risk of eating disorders, body image, internalisation of sociocultural ideals of appearance, health-compromising eating behaviours (HCEB), and health-compromising weight control related to physical activity behaviours (HCPAB). Logistic regressions were used to assess the associations between the study variables and predictors of HCEB and HCPAB. The results of the study showed a relatively high prevalence of HCEB with a significantly higher prevalence in girls and participants with a higher BMI. The study also demonstrated that the prevalence of adolescent HCPAB was higher than HCEB. The internalisation of sociocultural attitudes towards appearance and body image concerns were higher in the HCEB and HCPAB groups. Female gender (OR = 1.88; 95% PI = 1.10–3.18), HCPAB (OR = 1.19; 95% PI = 1.10–1.28), a preoccupation with being overweight (OR = 3.43; 95% PI = 2.52–4.66), and body weight evaluation as too high (OR = 2.40; 95% PI = 1.57–3.68) were significant predictors of HCEB. More frequent physical activity (OR = 3.02; 95% PI = 1.76–5.17), HCEB (OR = 1.22; 95% PI = 1.11–1.32), and perceived pressures to conform to popular beauty ideals (OR = 1.51; 95% PI = 1.12–2.03) predicted higher HCPAB. HCPAB is an important variable associated with adolescents’ body image, physical activity, and weight control. The results of the present study are important for health promotion and education programs addressing adolescents’ healthy lifestyle, weight control, and body image concerns. Full article
13 pages, 621 KiB  
Article
Associations of Genetic Variations in ABCA1 and Lifestyle Factors with Coronary Artery Disease in a Southern Chinese Population with Dyslipidemia: A Nested Case-Control Study
by Tian-Yu Zhao, Song Lei, Liu Huang, Yi-Nan Wang, Xiao-Ni Wang, Ping-Pu Zhou, Xiao-Jun Xu, Long Zhang, Liang-Wen Xu and Lei Yang
Int. J. Environ. Res. Public Health 2019, 16(5), 786; https://doi.org/10.3390/ijerph16050786 - 4 Mar 2019
Cited by 4 | Viewed by 2801
Abstract
Coronary artery disease has become a major health concern over the past several decades. We aimed to explore the association of single nucleotide polymorphisms (SNPs) in the ATP-binding cassette subfamily A member 1 (ABCA1) and lifestyle factors with coronary artery disease [...] Read more.
Coronary artery disease has become a major health concern over the past several decades. We aimed to explore the association of single nucleotide polymorphisms (SNPs) in the ATP-binding cassette subfamily A member 1 (ABCA1) and lifestyle factors with coronary artery disease (CAD) in dyslipidemia. This nested case-control study included 173 patients with CAD and 500 matched control individuals (1:3, case: control) from a district in southern China. We collected medical reports, lifestyle details, and blood samples of individuals with dyslipidemia and used the polymerase chain reaction-ligase detection reaction method to genotype the SNPs. The CC genotype of the additive and recessive models of rs4149339, together with regular intake of fried foods or dessert, increased the risk of CAD (adjusted odd ratio (OR) = 1.91, p = 0.030; adjusted OR = 1.97, p = 0.017; adjusted OR = 1.80, p = 0.002; adjusted OR = 1.98, p = 0.001). The AT + AA genotype of the dominant model of rs4743763 and moderate/heavy physical activity reduced the risk of CAD (adjusted OR = 0.66, p = 0.030; adjusted OR = 0.44, p = 0.001). The CT + CC genotype of the dominant model of rs2472386 reduced the risk of CAD only in males (adjusted OR = 0.36, p = 0.001). The interaction between rs4149339 and rs4743763 of ABCA1 and haplotype CTT (comprising rs4149339, rs4743763, and rs2472386) appeared to increase the risk of CAD (relative excess risk due to interaction (RERI) = 3.19, p = 0.045; OR = 1.49, p = 0.019). Polymorphisms of rs4149339, rs4743763 and rs2472386 in ABCA1 and three lifestyle factors (physical activity, fried food intake, and dessert intake) were associated with CAD in people with dyslipidemia in southern China. These results provide the theoretical basis for gene screening and the prevention of chronic cardiovascular diseases. Full article
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Review

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23 pages, 5761 KiB  
Review
Socio-Ecological Model of Correlates of Double Burden of Malnutrition in Developing Countries: A Narrative Review
by Trias Mahmudiono, Calista Segalita and Richard R. Rosenkranz
Int. J. Environ. Res. Public Health 2019, 16(19), 3730; https://doi.org/10.3390/ijerph16193730 - 3 Oct 2019
Cited by 42 | Viewed by 15763
Abstract
(1) Background: The double burden of malnutrition (DBM) is a complex problem involving the coexistence of under- and over-nutrition within the same individual, household or population. This review aimed to discuss the correlates of the double burden of malnutrition through the socio-ecological model [...] Read more.
(1) Background: The double burden of malnutrition (DBM) is a complex problem involving the coexistence of under- and over-nutrition within the same individual, household or population. This review aimed to discuss the correlates of the double burden of malnutrition through the socio-ecological model (SEM); (2) Methods: The PubMed database was systematically searched for peer-reviewed articles related to the double burden of malnutrition. Information on correlates of the double burden of malnutrition was extracted for analysis and discussion in alignment with the levels of the socio-ecological model.; (3) Results and Discussion: The correlates of the double burden of malnutrition identified from previous literature were: Race/genetics; maternal short stature; breastfeeding status; low maternal education; family size; household food security; household dietary diversity; and rural and urban settings. In the absence of evidence linking factors in a certain level of the SEM and the double burden of malnutrition, we employed correlates of overweight status and obesity to complete this narrative. Potential intervention strategies were proposed in alignment with the targets and settings identified, based on the socio-ecological approach; (4) Conclusions: The double burden of malnutrition is a public health phenomenon associated with a variety of socio-ecological determinants. An integrated approach is needed to address the root causes of malnutrition in all its forms, and at all life stages. Full article
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22 pages, 3480 KiB  
Review
Overview of Meta-Analyses: The Impact of Dietary Lifestyle on Stroke Risk
by Emma Altobelli, Paolo Matteo Angeletti, Leonardo Rapacchietta and Reimondo Petrocelli
Int. J. Environ. Res. Public Health 2019, 16(19), 3582; https://doi.org/10.3390/ijerph16193582 - 25 Sep 2019
Cited by 6 | Viewed by 2951
Abstract
A stroke is one of the most prevalent cardiovascular diseases worldwide, both in high-income countries and in medium and low-medium income countries. The World Health Organization’s (WHO) report on non-communicable diseases (NCDs) indicates that the highest behavioral risk in NCDs is attributable to [...] Read more.
A stroke is one of the most prevalent cardiovascular diseases worldwide, both in high-income countries and in medium and low-medium income countries. The World Health Organization’s (WHO) report on non-communicable diseases (NCDs) indicates that the highest behavioral risk in NCDs is attributable to incorrect nutrition. The objective of our work is to present an overview of meta-analyses that have investigated the impact of different foods and/or drinks in relationship with the risk of stroke events (ischemic/hemorrhagic). The papers to be included in the overview were found in MEDLINE, EMBASE, Scopus, Clinicaltrials.gov, Web of Science, and Cochrane Library and were selected according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) flow chart. Quality assessment were made according to the AMSTAR 2 scale. This overview shows that all primary studies came from countries with high income levels. This evidence shows that many countries are not represented. Therefore, different lifestyles, ethnic groups, potentially harmful or virtuous eating habits are not reported. It is important to underline how the choose of foods may help reduce the risk of cardiovascular diseases and stroke in particular. Full article
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31 pages, 841 KiB  
Review
Practical Guidance for Interventions in Adults with Metabolic Syndrome: Diet and Exercise vs. Changes in Body Composition
by Enrique Albert Pérez, Marina Poveda González, Rosa María Martínez-Espinosa, Mariola D Molina Vila and Manuel Reig García-Galbis
Int. J. Environ. Res. Public Health 2019, 16(18), 3481; https://doi.org/10.3390/ijerph16183481 - 18 Sep 2019
Cited by 22 | Viewed by 5456
Abstract
(1) Objective: to establish practical guidance for the design of future clinical trials in MS (metabolic syndrome) patients aged 18 and older, based on a systematic review of randomized clinical trials connecting diet, physical exercise and changes in body composition. (2) Method: this [...] Read more.
(1) Objective: to establish practical guidance for the design of future clinical trials in MS (metabolic syndrome) patients aged 18 and older, based on a systematic review of randomized clinical trials connecting diet, physical exercise and changes in body composition. (2) Method: this systematic review of randomized clinical trials (RCT) is based on the guidelines recommended by PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses). Criteria of selection: ≥18 years of age; patients diagnosed with MS; intervention programs including diet, physical exercise and/or modifications in the style of life as treatment, as well as the magnitude of changes in body composition (BC); randomized clinical trial published between 2004 and 2018. (3) Results: the multidisciplinary interventions describe major changes in BC, and the recurring pattern in these clinical trials is an energy reduction and control in the percentage of intake of macronutrients along with the performance of regularly structured exercise; the most analyzed parameter was waist circumference (88.9% of the trials), followed by body weight (85.2%), BMI (77.8%) and body fat (55.6%). (4) Conclusions: The analysis of the information here reported sheds light for the design of future clinical trials in adults with MS. The best anthropometric parameters and units of measurement to monitor the interventions are related to dietary and physical exercise interventions. A list of practical advice that is easy to implement in daily practice in consultation is here proposed in order to guarantee the best results in changes of body composition. Full article
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21 pages, 726 KiB  
Review
Measuring Rural Food Environments for Local Action in Australia: A Systematic Critical Synthesis Review
by Penelope Love, Jillian Whelan, Colin Bell and Jane McCracken
Int. J. Environ. Res. Public Health 2019, 16(13), 2416; https://doi.org/10.3390/ijerph16132416 - 7 Jul 2019
Cited by 11 | Viewed by 4925
Abstract
Poor diet is a significant contributor to obesity and chronic disease. With all being more prevalent in rural than urban Australia, modifying the food environment is a potential intervention point to improve the health of rural populations. This review examined the applicability of [...] Read more.
Poor diet is a significant contributor to obesity and chronic disease. With all being more prevalent in rural than urban Australia, modifying the food environment is a potential intervention point to improve the health of rural populations. This review examined the applicability of measurement tools used in rural food environment research for rural Australia. Six electronic databases were searched for peer-reviewed literature, published in English between 2006 and 2018, including at least one objective measure of the Community or Consumer Food Environment in a rural or mixed rural/urban context. One-hundred and seventy-seven papers were returned after removal of duplicates, with a final review of 25. Most studies were cross-sectional, with one intervention study of quasi-experimental design. Nine studies employed a conceptual model; there was considerable variability in tools used; and few described psychometric testing. The most common attribute measured was price, followed by available healthy options. The findings of this review do not offer a suite of ‘gold standard’ measurement tools known to be reliable, valid and sensitive to change to assess the community or consumer food environments in rural Australian towns. However, recommendations are proposed to progress this important area of research within a rural context. Full article
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15 pages, 631 KiB  
Review
An Umbrella Review and Narrative Synthesis of the Effectiveness of Interventions Aimed at Decreasing Food Prices to Increase Food Quality
by Chiara Milani, Chiara Lorini, Alberto Baldasseroni, Claudia Dellisanti and Guglielmo Bonaccorsi
Int. J. Environ. Res. Public Health 2019, 16(13), 2346; https://doi.org/10.3390/ijerph16132346 - 2 Jul 2019
Cited by 3 | Viewed by 3393
Abstract
Background: sustainability of population diet is a public health concern: the high price of healthy food is one of the main causes of diet-related health problems. The aim of this study is to synthesize the evidence produced by systematic reviews that evaluated the [...] Read more.
Background: sustainability of population diet is a public health concern: the high price of healthy food is one of the main causes of diet-related health problems. The aim of this study is to synthesize the evidence produced by systematic reviews that evaluated the effectiveness of decreasing healthy food prices to improve accessibility in order to positively modify the dietary pattern. Methods: We carried out a review of systematic reviews that examined the effects of the interventions, by exploring the online databases PubMed, Embase, Web of Science, Cochrane Library and hand-searching the reference lists. Results: after screening by titles and abstracts, we selected 11 systematic reviews that met the inclusion criteria, plus one that was hand-searched. The review generally presented a good quality. Studies concluded that measures aimed at modifying the prices of targeted healthy food were effective in improving population diet by modifying what people buy. Conclusions: the complexity of the outcome—population diet—as well as the poor transferability of data across populations and geographical areas makes it obligatory to provide clear and universal conclusions. Nonetheless, this should not stop policymakers from adapting them and resorting to food fiscal interventions to improve people’s diet and health. Full article
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27 pages, 635 KiB  
Review
Data Collection Instruments for Obesogenic Environments in Adults: A Scoping Review
by Alba Martínez-García, Eva María Trescastro-López, María Eugenia Galiana-Sánchez and Pamela Pereyra-Zamora
Int. J. Environ. Res. Public Health 2019, 16(8), 1414; https://doi.org/10.3390/ijerph16081414 - 19 Apr 2019
Cited by 9 | Viewed by 4850
Abstract
The rise in obesity prevalence has increased research interest in the obesogenic environment and its influence on excess weight. The aim of the present study was to review and map data collection instruments for obesogenic environments in adults in order to provide an [...] Read more.
The rise in obesity prevalence has increased research interest in the obesogenic environment and its influence on excess weight. The aim of the present study was to review and map data collection instruments for obesogenic environments in adults in order to provide an overview of the existing evidence and enable comparisons. Through the scoping review method, different databases and webpages were searched between January 1997 and May 2018. Instruments were included if they targeted adults. The documents were categorised as food environment or built environment. In terms of results, 92 instruments were found: 46 instruments measuring the food environment, 42 measuring the built environment, and 4 that characterised both environments. Numerous diverse instruments have been developed to characterise the obesogenic environment, and some of them have been developed based on existing ones; however, most of them have not been validated and there is very little similarity between them, hindering comparison of the results obtained. In addition, most of them were developed and used in the United States and were written in English. In conclusion, there is a need for a robust instrument, improving or combining existing ones, for use within and across countries, and more sophisticated study designs where the environment is contemplated in an interdisciplinary approach. Full article
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27 pages, 1321 KiB  
Review
Measuring and Understanding Food Insecurity in Australia: A Systematic Review
by Fiona H. McKay, Bronte C. Haines and Matthew Dunn
Int. J. Environ. Res. Public Health 2019, 16(3), 476; https://doi.org/10.3390/ijerph16030476 - 6 Feb 2019
Cited by 63 | Viewed by 18159
Abstract
The number of Australians seeking food aid has increased in recent years; however, the current variability in the measurement of food insecurity means that the prevalence and severity of food insecurity in Australia is likely underreported. This is compounded by infrequent national health [...] Read more.
The number of Australians seeking food aid has increased in recent years; however, the current variability in the measurement of food insecurity means that the prevalence and severity of food insecurity in Australia is likely underreported. This is compounded by infrequent national health surveys that measure food insecurity, resulting in outdated population-level food insecurity data. This review sought to investigate the breadth of food insecurity research conducted in Australia to evaluate how this construct is being measured. A systematic review was conducted to collate the available Australian research. Fifty-seven publications were reviewed. Twenty-two used a single-item measure to examine food security status; 11 used the United States Department of Agriculture (USDA) Household Food Security Survey Module (HFSSM); two used the Radimer/Cornell instrument; one used the Household Food and Nutrition Security Survey (HFNSS); while the remainder used a less rigorous or unidentified method. A wide range in prevalence and severity of food insecurity in the community was reported; food insecurity ranged from 2% to 90%, depending on the measurement tool and population under investigation. Based on the findings of this review, the authors suggest that there needs to be greater consistency in measuring food insecurity, and that work is needed to create a measure of food insecurity tailored for the Australian context. Such a tool will allow researchers to gain a clear understanding of the prevalence of food insecurity in Australia to create better policy and practice responses. Full article
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