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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Public Health".

Deadline for manuscript submissions: closed (15 February 2026) | Viewed by 10202

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Dr. Valentina De Cosmi

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Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy
Interests: nutrition; public health; health-promoting schools; food portion sizes; pediatric nutrition; fatty acids; non-communicable diseases

Special Issue Information

Dear Colleagues,

Schools, communities and families play a vital role in shaping children’s lifelong healthy habits, and the environment where children grow up influences their future choices, including decisions related to health and nutrition. Schools are a key setting where children not only acquire knowledge but also develop habits that can last a lifetime. Through structured programs, such as nutrition education, physical activity initiatives and the promotion of healthy meals, schools can teach the importance of balanced diets and active lifestyles. Communities also have a deep impact on children’s health by providing the external support systems children need to thrive. Access to community resources, such as local farmers’ markets, recreational facilities and health education campaigns, encourage healthier food choices and active living. Community leaders, organizations and policies can collectively address issues like food insecurity and create safe spaces for children to engage in physical activities, further reinforcing healthy habits. Families form the core setting where children learn their first behaviors and preferences. Parents and caregivers influence dietary choices through the foods they prepare, the mealtime routines they establish and the behaviors they model. Together, schools, communities and families create a network of influence that shapes children’s choices. This Special Issue aims to bring together research that examines how these interconnected spheres influence health outcomes, with a focus on their impact and potential for fostering positive change.

Dr. Valentina De Cosmi
Guest Editors

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Keywords

public health
health-promoting schools
prevention
community-based approach
food preferences
food choices
health literacy
physical activity
public food procurement

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Published Papers (8 papers)

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Research

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17 pages, 561 KB

Open AccessArticle

Building Food Literacy in Adolescence: A Pilot Study of the Teens CAN Curriculum

by Emily Sklar, Tonya Xie, Gretchen L. George, Rebecca Crosby, Marcela D. Radtke, Sheri Zidenberg-Cherr and Rachel E. Scherr

Nutrients 2026, 18(9), 1434; https://doi.org/10.3390/nu18091434 - 30 Apr 2026

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Abstract

Background/Objectives: There is a limited body of research on evidence-based food literacy education for adolescents. The inquiry-based curriculum, Teens CAN: Comprehensive Food Literacy in Cooking, Agriculture, and Nutrition, was designed to improve food literacy among adolescents ages 14–18 years. This study aimed to assess the Teens CAN curriculum by examining changes in food literacy outcomes among high school–aged adolescents and explore the effectiveness of undergraduate facilitators in implementing the curriculum with fidelity. Methods: This quasi-experimental pilot study was conducted among high school students comprising intervention (n =14) and comparison groups (n = 16). All Teens CAN lessons were delivered by trained undergraduate facilitators, and lesson fidelity was measured by a trained observer. Baseline and follow-up survey measures assessed various components of food literacy, including adolescent nutrition knowledge, diet quality, and intrinsic motivation to prepare healthy food (cooking self-efficacy). Between-group differences were examined using t-tests, and ANCOVA regression models assessed associations between changes in baseline to follow-up nutrition knowledge, diet quality, and cooking self-efficacy, adjusting for baseline values. Results: The adolescents in the intervention group had a significant increase in nutrition knowledge scores compared to the comparison group (4.6 ± 2.3 vs. 1.1 ± 3.7, respectively; p = 0.01). High fidelity (≥80%) was achieved across lessons and lesson components. In ANCOVA regression analyses, participation in the intervention was positively associated with nutrition knowledge (β = 3.3, 95% CI [0.87–5.80]; p = 0.01), providing evidence for future investigation. Conclusions: The findings from this pilot study suggest that Teens CAN has the potential to positively influence food literacy and related behaviors among adolescents, therefore warranting further investigation in a larger population. Full article

(This article belongs to the Special Issue Community, School and Family-Based Nutritional Research)

19 pages, 2221 KB

Open AccessArticle

Beverage Intake Patterns in a National Sample of Polish Adolescents: PLACE-19 Study

by Dominika Głąbska, Dominika Skolmowska and Dominika Guzek

Nutrients 2026, 18(9), 1384; https://doi.org/10.3390/nu18091384 - 28 Apr 2026

Viewed by 206

Abstract

Background/Objectives: Insufficient hydration and high consumption of sugar-sweetened beverages (SSBs) is a significant public health challenge among adolescents. The aim of the presented study was to assess the beverage intake, in terms of quantity and choices, in a national-based population of Polish adolescents within the PLACE-19 Study. Methods: Within the PLACE-19 Study, the population of n = 1027 secondary school adolescents (age 15–20 years) was recruited based on a quota sampling of Polish secondary schools and n = 984 individuals (n = 674 female, n = 310 male) were included in the analysis. The study assessed beverages intake using the National Youth Physical Activity and Nutrition Study (NYPANS) survey questionnaire and data were gathered using the Computer-Assisted Web Interview (CAWI) technique. The beverages were assessed in the following groups: water, milk beverages, 100% fruit juices, coffee/tea, regular carbonated soft drinks (CSDs), diet CSDs, other sugar-sweetened beverages (SSBs); additionally, total SSBs were summarized. The total beverage intake was compared with 80% of the Adequate Intake (AI) level. Results: The highest intake was observed for water (250 mL per day), and tea beverages (178.1 mL per day). However, in combining SSBs, the total daily intake for this group was 394.4 mL per day. The highest share of the daily intake of beverages was attributed to water intake (23.81%), and tea beverages (11.45%), followed by 100% fruit juices (7.14%), fruit drinks (6.67%), and milk (6.45%); however, the intake of total combined SSBs was even higher than for water (32.47%). Male individuals were characterized by a higher share of milk beverages, regular CSDs, diet CSDs, and other SSBs than female ones, while female individuals were characterized by a higher share of water, and coffee/tea in their total daily beverage intake than male ones (p < 0.001). Younger individuals were characterized by a higher share of other SSBs in their total daily beverage intake than older ones (p = 0.034). For the vast majority of the studied group, the inadequate intake of beverages was observed, as over 70% of the studied sub-groups did not meet the AI value. Conclusions: The inadequate beverage intake in a population of adolescents may be a problem, especially considering high intake of SSBs, and relatively low intake of water. Especially in male and younger individuals, due to a higher intake of SSBs, than for female and older individuals, education is necessary to promote adequate intake and choices of beverages. Further research is needed in the area of beverage consumption to understand the determinants of beverage consumption and develop opportunities to improve it. Full article

(This article belongs to the Special Issue Community, School and Family-Based Nutritional Research)

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15 pages, 305 KB

Open AccessArticle

“What I Do Not Eat”: Feeding Difficulties in Middle Childhood—An Italian Pilot Study

by Paolo Brambilla, Laura Antolini, Marco Giussani, Carlo Agostoni, Paolo Becherucci, Emanuela Malorgio and Cristiana Berti

Nutrients 2026, 18(1), 129; https://doi.org/10.3390/nu18010129 - 31 Dec 2025

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Abstract

Background/Objectives: Feeding difficulties in childhood can persist over time, affecting health and family dynamics. Timely identification is crucial to prevent atypical eating behaviors and nutrition-related consequences. However, data on childhood feeding difficulties remain limited. This study provides the first pilot characterization of eating behaviors among Italian children aged 5–11 years in order to characterize feeding difficulties, identify protective or detrimental factors, and assess relationships with anthropometric indices or blood pressure. Methods: In 2023, a 1-year cross-sectional pilot study was launched by the Società Italiana delle Cure Primarie Pediatriche involving child–parent dyads. Family pediatricians collected anthropometric data and blood pressure, after which parents completed an online questionnaire purposely developed for this study. The questionnaire generated a feeding difficulty score (0–10) where higher values reflected greater risk of atypical eating behaviors. Scores were categorized as follows: low risk (0–1), intermediate risk (2–6), and high risk (7–10). Results: A total of 742 questionnaires were collected. Overall, 19.8% of the children were categorized as high risk (7–10) for atypical behavior, 43.8% as intermediate risk (2–6), and 36.4% as low risk (0–1). Children with two omnivorous parents showed significantly lower odds of feeding difficulty scores at or above any threshold (OR 0.46, 95% CI 0.30–0.71; p < 0.0001). Borderline associations were observed for a breastfeeding duration of at least 9 months (OR 0.79, 95% CI 0.61–1.02; p = 0.075) and baby-led weaning (OR 0.72, 95% CI 0.52–1.00; p = 0.053). High-risk children had a significantly lower BMI percentile with respect to the other groups. Conclusions: A significant proportion of Italian children aged 5–11 years exhibited moderate to severe risk of atypical behaviors. Parental eating appears to play a key role in shaping children’s eating behaviors in middle childhood, underscoring the pivotal role of pediatricians in guiding families. Further research and targeted strategies are needed to prevent childhood feeding difficulties. Full article

(This article belongs to the Special Issue Community, School and Family-Based Nutritional Research)

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23 pages, 1598 KB

Open AccessArticle

Lights and Shadows of a Primary School-Based Nutrition Education Program in Italy: Insights from the LIVELY Project

by Sara Basilico, Maria Vittoria Conti, Ilaria Ardoino, Chiara Breda, Federica Loperfido, Francesca Orsini, Maria Luisa Ojeda Fernandez, Laura Pierini, Stefano Conca Bonizzoni, Elisabetta Modena, Federica Villa, Hellas Cena, Marta Baviera and Carlotta Franchi

Nutrients 2025, 17(17), 2778; https://doi.org/10.3390/nu17172778 - 27 Aug 2025

Cited by 1 | Viewed by 2598

Abstract

Background/Objectives: Childhood obesity represents a pressing global health challenge, demanding coordinated, long-term strategies. Schools and families are pivotal environments for shaping children’s lifestyle behaviors. The LIVELY project aimed to assess overweight/obesity prevalence and associated factors in primary school children, and to implement a multidimensional educational intervention promoting healthy, sustainable lifestyles. Methods: This single-arm study was conducted from October 2023 to October 2024 in a primary school in Milan. The intervention included age and culturally tailored lessons, games, and activities. Anthropometric measures, dietary adherence, and lifestyle habits were assessed before and after the intervention. Satisfaction surveys were administered to children, families, and teachers. Results: The project involved 227 children across 14 classes (mean age 8.9, SD 1.2 years). The prevalence of overweight/obesity was 23.4%. Adherence to the Mediterranean Diet was moderate, limited by low intake of vegetables, nuts, and dairy. Physical activity was low, screen time excessive, and sleep insufficient. No statistically significant improvements in anthropometrics or diet adherence were observed post-intervention, but positive trends emerged for physical activity, sleep, and hydration. Over half of the children passed the nutritional knowledge test. Despite these challenges, high satisfaction levels have been shared by children, parents, and teachers. Conclusions: The limited duration of the intervention and challenges engaging families in a low socio-economic context may have constrained the impact of the program, and caution is advised in generalizing the findings. The LIVELY project highlights the complexity of tackling childhood obesity in multicultural settings and emphasizes the need for longer, continuous, and culturally tailored programs that actively involve families to promote sustainable healthy behaviors. Full article

(This article belongs to the Special Issue Community, School and Family-Based Nutritional Research)

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14 pages, 653 KB

Open AccessArticle

An Evaluation of Food Allergy Management Practices in a Sample of Canadian and American Schools

by April Quill, Michael A. Golding, Lisa M. Bartnikas and Jennifer L. P. Protudjer

Nutrients 2025, 17(12), 1971; https://doi.org/10.3390/nu17121971 - 10 Jun 2025

Cited by 2 | Viewed by 1345

Abstract

Background: Children, including the estimated 7% with food allergy, spend most of their waking hours in school. Variations in school-based food allergy (FA) practices exist. We aimed to examine differences in FA management practices across schools in Canada and the United States (US). Methods: Parents of children with Immunoglobulin E (IgE)-mediated FA were recruited through social media to complete a survey evaluating the schools’ stock epinephrine, epinephrine storage locations, school type, and location. Data were described, analyzed using logistic and linear regressions, and then reported as odds ratios (ORs) and standardized coefficients (b), respectively, with corresponding 95% confidence intervals (95%CIs) and p < 0.05. This study was approved by the University of Manitoba Health Research Ethics Board. Results: Overall, 177 participants (14% [26/177] Canada, 86% [151/177] US) were included. Children were, on average, 4.92 ± 3.12 years and were commonly but not mutually exclusively allergic to tree nuts (50% Canada; 40% US) and peanuts (33% Canada; 29% US). Compared to US parents, Canadian parents were more likely to report epinephrine self-carriage by their children (OR = 4.58; 95%CI = 1.67–12.59). Parents with children age > 5 years were more likely to report epinephrine self-carriage by their children (OR = 3.70; 95%CI = 1.38–9.93) but less likely to report that their children’s school had an allergen-friendly zone (OR = 0.25; 95%CI = 0.06–0.99). Compared to US parents, Canadian parents were more likely to report their child’s school had anaphylaxis management policies (OR = 8.98; 95%CI = 1.11–72.42). Conclusions: Significant in-school FA management differences exist between countries. These findings stress the need for consistent policies and practices to ensure effective care. Full article

(This article belongs to the Special Issue Community, School and Family-Based Nutritional Research)

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20 pages, 1083 KB

Open AccessArticle

Nurturing Movement: Longitudinal Associations Between Caregiver Type, Adolescent Diet, and Young Adult Physical Activity in a National Cohort

by Rahel Mathews, Danielle K. Nadorff and Riley Cowart

Nutrients 2025, 17(11), 1874; https://doi.org/10.3390/nu17111874 - 30 May 2025

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Abstract

Background: Childhood obesity rates remain high in the United States, with long-term implications for physical and mental health. Emerging research suggests that caregiving arrangements, particularly those involving non-parental caregivers such as grandparents, may influence adolescent health behaviors, including diet and physical activity. This study examined whether caregiver type (parents-only, grandparents-only, or multi-generational households) during adolescence predicted dietary patterns and physical activity trajectories into young adulthood. Methods: Data were drawn from 6260 participants in the National Longitudinal Study of Adolescent to Adult Health (Add Health). Caregiver type was identified at baseline (Wave 1), and dietary intake and physical activity were assessed across four waves from adolescence (~age 15) to early adulthood (~age 29). We employed generalized linear models and linear mixed-effects models with multiply imputed data to examine changes in sedentary behavior, individual exercise, and team sport participation over time, controlling for age, sex, and race. Results: Overall dietary intake at baseline did not significantly differ by caregiver type (Wilks’ Λ = 0.998, p = 0.389); however, an exploratory comparison indicated lower dairy consumption in homes with a grandparent present (t(6258) = 1.995, p = 0.046). Trajectories of individual exercise differed significantly by caregiver type over time (Time × Caregiver interaction: F(6, 10,395.601) = 2.795, p = 0.010), with adolescents in grandparent-only households reporting higher individual exercise at Wave 1. Sedentary behavior trajectories also significantly differed by caregiver group over time (Wave × Caregiver interaction: F(6, 18,951.310) = 23.026, p < 0.001). Baseline nutrition was positively associated with individual exercise trajectories into young adulthood (Time × Nutrition interaction: F(2.961, 13,096.103) = 3.974, p = 0.012). Conclusions: Caregiver structure during adolescence appears to shape long-term physical activity patterns, albeit modestly. These findings highlight the need to consider diverse family configurations—particularly grandparent-led households—when designing public health interventions to promote adolescent nutrition and physical activity. Full article

(This article belongs to the Special Issue Community, School and Family-Based Nutritional Research)

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Review

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17 pages, 641 KB

Open AccessReview

Health and Nutrition Interventions to Prevent Childhood Overweight and Obesity in Mexico and Latin America: A Systematic Review

by Teresa Shamah-Levy, Marti Yareli Del Monte-Vega, Danae Gabriela Valenzuela-Bravo, Carmen Morales-Ruán, Lidia Moreno-Macías, Carlos Galindo-Gómez, Ileana Fajardo-Niquete and Javier Troconis-Cervera

Nutrients 2025, 17(24), 3818; https://doi.org/10.3390/nu17243818 - 5 Dec 2025

Cited by 1 | Viewed by 1659

Abstract

Background: Childhood obesity is a pressing global health challenge. Analyzing the efficacy of interventions is crucial to mitigate its impact and inform effective public health policies. This study aimed to conduct a systematic review of interventions (SRI) targeting school-aged children with obesity. Our goal was to identify the key components that contribute to the success of integrated interventions addressing diet/nutrition (D/N), physical activity (PA), and socioemotional skills. Methods: The Cochrane Collaboration methodology and the PRISMA statement were followed. The SRI included the following criteria, established a priori: studies that addressed obesity in school-aged children, including one or more interventions related to physical activity (PA), diet/nutrition (D/N), or socioemotional skills. Following the PICO (Population, Intervention, Comparison, and Outcome) framework, we searched six digital databases using relevant keywords and MeSH terms. The Mixed-Methods Appraisal Tool (MMAT) was used to assess article quality via “function group string” methods. Finally, a thematic synthesis of the SRI findings was conducted. The protocol for this study was registered in PROSPERO (CRD4202454214). Results: Initial screening yielded 127 articles. Following critical appraisal with the MMAT, studies with inadequate methodology, solely descriptive designs, unclear results, or interventions shorter than six months were excluded. Ultimately, 10 studies remained, eight of which included two of the three components of interest (D/N or PA). Conclusions: In this overview, many interventions were presented for the prevention of overweight and obesity in school-age children; however, methodological and standardized limitations still exist that hinder the establishment of effective interventions. Engaging families and teachers as active participants in interventions significantly enhanced effectiveness in both the D/N and PA domains. However, an analysis of current interventions highlights a stark gap in multisectoral and integrated approaches to tackling childhood obesity. This presents a remarkable opportunity for future initiatives to move beyond fragmented efforts and embrace a holistic model that unites families, schools, and communities to promote healthy lifestyles. Full article

(This article belongs to the Special Issue Community, School and Family-Based Nutritional Research)

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Other

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13 pages, 410 KB

Open AccessBrief Report

Validation of the Texas School Physical Activity and Nutrition (SPAN) Dietary Index Against the Healthy Eating Index Among Elementary-Aged Students

by Ethan T. Hunt, Allison N. Marshall, Raja Malkani, Nalini Ranjit, Adriana Pérez, David J. Badillo, Danielle J. Gartner, Ashley Schelfhout, Vijay R. Narayanan, Christopher D. Pfledderer and Deanna M. Hoelscher

Nutrients 2025, 17(12), 1965; https://doi.org/10.3390/nu17121965 - 10 Jun 2025

Viewed by 1365

Abstract

Objective: Assess the accuracy of the Texas School Physical Activity and Nutrition (SPAN) survey’s diet quality index against the 24 h recall-based Healthy Eating Index (HEI-2020). Methods: Fifty-one rising third and fourth graders (mean age 9.5 yrs., SD = 1.03 yrs.) from a summer program completed the SPAN survey and a 24 h dietary recall on the same day. The study compared SPAN HEI scores from survey food frequency items to HEI-2020 scores from recalls using Nutrition Data System for Research (NDS-R) software, evaluating correlations and agreement metrics. Results: SPAN HEI averaged 36.87 (SD = 3.78), while recall-derived HEI was 49.05 (SD = 11.92). The mean difference between indices was 12.18 (SD = 10.83), with an absolute difference of 13.51 (SD = 9.01). Bland–Altman analysis indicated limits of agreement from −9.05 to 33.40. Spearman correlation between SPAN HEI and recall HEI was r = 0.44 (p < 0.01), with an ICC of 0.45 (95% CI = 0.04, 0.68). Conclusions and Implications: After comparing HEI scores from both tools, SPAN HEI and HEI-2020 demonstrated a moderate correlation, indicating that SPAN HEI may serve as a practical and less burdensome alternative for large-scale dietary assessments. While further validation is needed, these findings suggest its potential utility in monitoring diet quality at the population level. Full article

(This article belongs to the Special Issue Community, School and Family-Based Nutritional Research)

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