Search Results (227)

Background/Objectives: The EAT-Lancet Commission proposed a healthy and sustainable ‘planetary health diet’ (PHD) based on the nutritional needs of adults, but recommended for all population groups over the age of two years. This study investigated the extent to which UK adolescent diets meet these recommendations, and the association between meeting recommendations and nutritional intake. Methods: Dietary intake data collected from students aged 11–15 years between 2019 and 2022 as part of the Food provision, cUlture and Environment in secondary schooLs (FUEL) study was used. Specifically, 24 h intakes of food groups and key nutrients were summarised for each participant, and micronutrient intake was expressed as a percentage of the reference nutrient intake (RNI). The proportion of participants meeting each PHD recommendation was calculated. A PHD index score was developed to measure the overall adherence to recommendations. Multilevel linear regression models were fitted to explore the association between the PHD score and intake of each nutrient. Results: No participants fully met the recommendations. The mean PHD score was 14.2 (3.3) out of 39. Adherence was low for the emphasised foods, and lowest for nuts (1.3%) and unsaturated oils (0.2%). Higher PHD index scores were associated with lower intakes of all micronutrients, with the largest association for vitamin B12 [regression coefficient: −12.9% (95% CI: −16.3, −9.4) of RNI] and the smallest for vitamin D [regression coefficient: −0.4 (95% CI: −0.7, −0.2) of RNI]. Conclusions: Substantial dietary changes are needed for this population group to meet the PHD guidelines. Further research should focus on why these recommendations may lead to the inadequate intake of some nutrients in this age group. We propose that the PHD guidance needs to be reviewed and potentially adapted for this specific population, with consideration of the typical dietary behaviours of this age group. Full article

Background/Objectives: Overweight children and childhood obesity are growing public health concerns influenced by early-life nutrition and lifestyle. Irregular eating patterns, sedentary behaviour, and maladaptive eating behaviours significantly contribute to excess weight gain in children. This cross-sectional study comprehensively assessed physical activity, sleep, anthropometric parameters, and eating behaviours in preschool children in Split, Croatia, examining associations between eating behaviours and nutritional status indicators. Methods: A total of 429 children aged 4 to 7 years were recruited from kindergartens in Split-Dalmatia County. Parents completed a lifestyle questionnaire and the Children’s Eating Behaviour Questionnaire (CEBQ). Anthropometric measurements (weight, height, middle upper arm circumference, waist circumference) were recorded and BMI-for-age z-scores calculated. Physical activity and sleep patterns were assessed based on parental reports. Results: A total of 66% of the children had a healthy body weight, 12.6% were underweight, and 21.4% were overweight or obese. Significant sex differences were found in the CEBQ subscale “Slowness in Eating” (p = 0.04). Overweight or obese children showed a higher food responsiveness, while underweight/normal-weight children had greater emotional undereating and slowness in eating. No significant sex differences were observed regarding physical activity. Girls exhibited significantly more frequent daytime napping than boys. Conclusions: This study shows a significant prevalence of overweight and obese preschool children in Split, Croatia. The results underline the importance of promoting healthy eating behaviours and physical activity from an early age. This is the first study applying CEBQ in the Croatian population and suggests that the interventions should target diet quality and unfavourable eating behaviours to prevent future health risks. Full article

There is growing evidence that public hospitals in high-income countries—in particular, Anglo-Saxon neoliberal countries (USA, UK, Canada, New Zealand, and Australia)—have been engaging with food retailers to attract private capital and maximise their incomes in a drive to reduce costs. Added to which, public hospital food can have a substantial influence on the health of children and young people. However, there is still relatively little research on food for young people in healthcare settings. This is concerning, as an appropriate food intake is vital not only for the prevention of and recovery from diseases, but also for the physical growth and psychological development of young people. This critical narrative review examined the available evidence on hospital food provision, practices, and environments, as well as children’s experiences of hospitalization in high-income countries, drawing on both peer-reviewed articles and the grey literature. Our analytical lens for this review was the Commercial Determinants of Health (CDOH), a framework that necessitates a critical examination of commercial influences on individual, institutional, and policy practices relevant to health. Our findings illustrate the mechanisms through which the CDOH act as a barrier to healthy food and eating for children in hospitals in high-income countries. Firstly, hospital food environments can be characterised as obesogenic. Secondly, there is a lack of culturally inclusive and appropriate foods on offer in healthcare settings and an abundance of processed and convenience foods. Lastly, individualised eating is fostered in healthcare settings at the expense of commensal eating behaviours that tend to be associated with healthier eating. Public hospitals are increasingly facing commercial pressures. It is extremely important to resist these pressures and to protect patients, especially children and adolescents, from the marketing and selling of foods that have been proven to be addictive and harmful. Full article

Background/Objectives: To inform person-centred clinical practice, it is important to know what features may predict or moderate treatment outcomes. Thus, we investigated pre-treatment clinical features and mid-therapy reduction in loss of control over eating (MTLOCE), including impacts on treatment outcomes of a new manualised psychotherapy, a healthy approach to weight management and food in eating disorders (HAPIFED). HAPIFED was developed as an integrated psychological and behavioural treatment for individuals with bulimia nervosa or binge eating disorder, which are co-morbid with a high body mass index (BMI). Methods: In total, 50 participants were randomised to HAPIFED and 48 were randomised to the control cognitive behaviour therapy-enhanced group. Assessments included mental health-related quality of life (MHRQoL), eating disorder symptom severity, binge-eating frequency, BMI, and loss of control over eating (LOCE) at baseline, mid-treatment, end-treatment, and 6 and 12 months end of follow-up (EndFU). These were measured with the SF-12, the EDE-Q, and the LOCES, respectively. Linear and negative binomial mixed models were used. Missing data were imputed multiple times, assuming intention of treatment for the analysis. Results: Pre-treatment eating disorder symptom severity, MHRQoL, and BMI positively predicted eating disorder symptom severity, MHRQoL, and BMI up to 6 and 12 months end of follow-up. Mid-treatment LOCE MTLOCE predicted improved MHRQoL (coefficient = 0.387, 95% CI 0.0824–0.6921, p = 0.004), reduced binge-eating frequency (IRR = 0.5637, 95% CI 0.3539–0.8977, p = 0.0191), and eating disorder symptom severity (coefficient= −0.65, 95% CI −1.0792–−0.2217, p = 0.0139). Neither purging nor illness duration were a significant predictor of any of the outcomes. The effect of HAPIFED was not moderated by baseline weight/BMI but was moderated negatively by MTLOCE for binge-eating frequency (coefficient = −0.636, SE = 0.28, p < 0.05, IRR = 0.529) and eating disorder symptom severity (coefficient = −0.268, SE = 0.13, p < 0.05, Cohen’s d = −0.102). Conclusions: Greater control over eating improved MHRQoL and decreased the frequency of binge-eating episodes and eating disorder symptom severity. These positive effects were moderated by being in the HAPIFED group, supporting previous findings of benefits to people’s mental health through participation in the HAPIFED trial. Full article

Background: Social media platforms increasingly influence dietary behaviours, with cooking videos emerging as a key tool for promoting healthy eating. However, limited research has examined how such digital content affects adults in established adulthood. Objective: This study investigates the relationships among cooking behaviour, engagement with healthy cooking videos on Instagram, and healthy eating behaviours among Taiwanese adults aged 30 to 45. Methods: A cross-sectional online survey collected valid responses from 488 participants (effective response rate = 81.3%) who regularly cook and engage with food-related content on Instagram. Structural equation modelling (SEM) was used to test hypothesised relationships. Results: Cooking behaviour was positively associated with engagement in healthy cooking multimedia (β = 0.262, p < 0.01). Engagement significantly predicted healthy eating behaviours (β = 0.399, p < 0.001) and mediated the effect of cooking behaviour on dietary outcomes (indirect effect = 0.105, 95% CI [0.044, 0.204]). Cooking behaviour alone was not directly associated with healthy eating behaviours (β = 0.009, n.s.). Conclusions: Engagement with healthy cooking videos enhances healthy eating practices among adults in established adulthood. These findings highlight Instagram’s potential as a digital health promotion tool and support the integration of culinary media into public nutrition strategies. Full article

Background/Objectives: The global population is undergoing a significant demographic shift characterised by an increasing proportion of older individuals. Healthy aging has become a priority for personal well-being and sustainable healthcare systems, with nutrition playing a pivotal role. However, the rise in non-communicable diseases (NCDs), malnutrition, and a shift in eating behaviour underscore the need for tailored, effective nutrition communication strategies. This research is intended to provide the basic data needed to support the development of tailored nutritional communication strategies and practices. Methods: To investigate these aspects, a cross-national survey about nutrition and nutrition communication was conducted within the framework of the Innovative Training Network SmartAge, focusing on older adults aged 60 years and above in Germany, Switzerland, Spain, and France (each 25%; N = 1000 persons). This paper specifically focuses on the development, methodology, and discussion of the survey and aims to investigate the characteristics of the sample in relation to their dietary patterns and food choices within the European context. Results: The analysis identified significant associations between various plant- and animal-based food items and the variables gender, age group, and country. Spanish participants showed a dietary pattern towards the Mediterranean Diet, while German participants showed tendencies towards the Western Diet. Furthermore, the findings revealed that protein-rich foods such as meat, fish, nuts and seeds, legumes, and (whole) grains were infrequently consumed, particularly among German and Swiss participants. Conclusions: This study highlights the need to promote adequate protein intake among older adults, emphasising diverse sources like legumes, nuts and seeds, (whole) grains, and lean meats to support healthy aging. For the development of future nutrition communication strategies, the influence of the specific social, cultural, and traditional factors needs to be considered. Full article

Background/Objectives. Traditional dietary patterns are being abandoned in Mediterranean countries, especially among younger generations. This study aimed to investigate the potential lifestyle determinants that can increase adherence to the Mediterranean diet in children and adolescents. Methods. This study is a cross-sectional analysis of data from five Mediterranean countries (Italy, Spain, Portugal, Egypt, and Lebanon) within the context of the EU-funded project DELICIOUS (UnDErstanding consumer food choices & promotion of healthy and sustainable Mediterranean Diet and LIfestyle in Children and adolescents through behavIOUral change actionS). This study comprised information on 2011 children and adolescents aged 6–17 years old collected during 2023. The main background characteristics of both children and parents, including age, sex, education, and family situation, were collected. Children’s eating (i.e., breakfast, place of eating, etc.) and lifestyle habits (i.e., physical activity level, sleep, and screen time) were also investigated. The level of adherence to the Mediterranean diet was assessed using the KIDMED index. Logistic regression analyses were performed to test for likelihood of higher adherence to the Mediterranean diet. Results. Major determinants of higher adherence to the Mediterranean diet were younger age, higher physical activity level, adequate sleep duration, and, among dietary habits, having breakfast and eating with family members and at school. Parents’ younger age and higher education were also determinants of higher adherence. Multivariate adjusted analyses showed that an overall healthier lifestyle and parents’ education were the factors independently associated with higher adherence to the Mediterranean diet. Conclusions. Higher adherence to the Mediterranean diet in children and adolescents living in the Mediterranean area is part of an overall healthy lifestyle possibly depending on parents’ cultural background. Full article

Background: Young women spend 50 min daily on social media (SM); thus, SM platforms are promising for health interventions. This study tested the feasibility and preliminary efficacy of the co-designed SM intervention the Daily Health Coach (DHC). The DHC is a 3-month healthy lifestyles intervention programme, targeting eating, physical activity, and social wellbeing behaviours in women aged 18–24, via the dissemination of health and nutrition content on social media platform Instagram. Methods: The programme was tested using an assessor-blinded, two-arm pilot randomised controlled trial with 46 participants over 12 weeks. Engagement was assessed via SM metrics; acceptability via post-programme questionnaires; and feasibility included retention, randomisation, recruitment, and data collection. Secondary outcomes—dietary quality, physical activity, social influence, disordered eating behaviours, body image, and digital health literacy—were assessed using validated surveys. Analyses included t-tests, chi-squared tests, and linear mixed models. The treatment effects were estimated by testing mean score differences from baseline to 3 months for intention-to-treat populations. Results: The DHC scored 83.6% for programme satisfaction. Over time, a significant decrease in body image disturbance was observed (p = 0.013). A significant group-by-time interaction for digital health literacy (p = 0.002) indicated increased ability to discern evidence-based nutrition information (p = 0.006). The waitlist control group showed increased social influence compared to the intervention group (p = 0.034). No other significant changes were observed. Conclusion: The DHC is a feasible and acceptable method for disseminating nutrition information. Larger studies are needed to determine efficacy. Full article

Background/Objectives: Numerous risk factors of cardiac diseases are influenced by health behaviours. An individual’s health behaviours, somatic symptoms and even cardiac outcomes can be influenced by their personality. The aim of this study was to analyse the influence of personality traits on the knowledge and health behaviour of cardiac patients. Methods: The study was conducted at the Independent Public Voivodship Hospital in Szczecin on 180 patients in the invasive cardiology wards and the intensive cardiac care unit between July and September 2019. A self-developed questionnaire and the NEO-Five-Factor Inventory-3 (NEO-FFI) and Health Behaviour Inventory (HBI) standardised tools were used. Results: Respondents mostly linked the occurrence of cardiovascular disease with smoking (87.22%) and hypertension (85.56%). A large majority of the respondents (68.44%) knew the correct recommended values for blood pressure. This was also the case for total cholesterol—only 20.56% of the patients did not know the correct levels. Respondents experienced more difficulty in adhering to preventive measures—only 27.22% followed a low-fat diet and only half controlled their weight. The overall HBI scale score was 5.93 sten, which indicates an average score. The most intense personality trait among the respondents was extraversion (5.79), while the least intense was agreeableness (4.12). Neuroticism was found to be negatively correlated (p < 0.05) with healthy eating habits and a positive mental attitude. Extroverts, on the other hand, are more likely to take preventive action. Older and non-working individuals are more likely to exhibit health-promoting behaviours in all HBI categories (p < 0.05). Conclusions: The personality traits that have the greatest impact on health behaviour are extraversion, agreeableness and conscientiousness. Health practises also depend on gender, age and work activity. Further research on more diverse groups is needed. Full article

There is a raising of concerns about the need to change environmental behaviours through economic and social activities. Education plays a significant role in this process, with schools enhancing the necessary behaviour adoption by youngsters and their community. Thus, the present study examines the relationship between different variables, such as sustainability (green public procurement, healthy food activity) and education (course, impact, interactive teaching methods/technology). We developed a survey regarding education for sustainable development (ESD), with five sections considering the referred variables. We applied it to 385 Romanian educators and teachers from kindergarten and primary school. An SEM model was formed to evaluate the relationship between the associated variables. The results showed that an organisation or school with a long-term plan incorporating green public procurement will positively stimulate initiatives that help the next generation adopt good eating habits. Moreover, this eco-sustainable approach affects the creation of interactive teaching methods and the courses and classes. Consequently, the changes in interactive methods will positively affect the overall impact. Nevertheless, the relationship between courses and impact was not significant. This means management decisions regarding green strategies can lead to a broader change in a school setting, fostering the ESD. Full article

Background/Objectives: Problematic eating behaviours may affect food consumption and, therefore, body weight. However, these associations have not been well understood, especially among adolescents. The aim of the study was to evaluate the associations of restrained eating and disinhibited eating with diet quality and body weight status among adolescents. Methods: A cross-sectional study was conducted among 1450 primary school students aged 11–13 years (52% girls). Dietary data were collected using the food frequency questionnaire (SF-FFQ4PolishChildren^®). Two diet quality scores were evaluated: (i) the pro-Healthy Diet Index (pHDI), which included vegetables, fruit, dairy products, and fish, and (ii) the non-Healthy Diet Index (nHDI), which included fast food, sweets, sweetened beverages, and energy drinks. Based on the Three-Factor Eating Questionnaire, two eating styles were identified: restrained eating (RE) and disinhibited eating (DE). Body weight status was evaluated using the body mass index (BMI) z-score and the waist-to-height ratio (WHtR). Spearman’s correlation coefficient and logistic regression analysis were used to assess the association between eating styles, diet quality, and body weight status. Results: Restrained eating was negatively correlated with nHDI (r = −0.178, p < 0.001) and positively correlated with the BMI z-score (r = 0.253, p < 0.001) and WHtR (r = 0.197, p < 0.001). Disinhibited eating was positively correlated with nHDI (r = 0.232, p < 0.001). Among adolescents with different RE and DE levels, significant differences in the mean nHDI, BMI z-score, and WHtR were found. Compared to adolescents with ‘low RE & DE’, those with ‘low RE & higher DE’ were more likely to fall in the upper than bottom tertile of nHDI (odds ratio (OR) =1.90, 95% CI: 1.29–2.81). Adolescents with ‘higher RE & low DE’ were less likely to be underweight (OR = 0.17, 95% CI: 0.06–0.49) and more likely to be overweight (OR = 2.02, 95% CI: 1.41–2.91) and to have abdominal obesity (OR = 1.79, 95% CI: 1.13–2.82). Conclusions: The findings suggest that both eating styles may be predictors of diet quality among adolescents. Body weight status was related to restrained eating, which seems to characterise mainly adolescents with overweight or obesity. Full article

As the global trend for healthy eating grows, firms are emphasising dairy functional foods (DFFs). This study looks into the relationship between consumer attitudes and readiness to consume DFFs, taking into account how a healthy lifestyle might both motivate and deter people from using them. Hungary was chosen because consumer behaviour towards functional foods is under-researched in comparison to Western Europe. Data were generated using a survey questionnaire from 313 respondents. The results of Partial Least Squares (PLS) analysis revealed that consumer attitudes had a considerable influence on the desire to consume DFFs. Furthermore, the motivators and barriers had a direct influence on willingness through the consumer attitudes that serve as mediators. These findings show the need for targeting consumer attitudes and lifestyle characteristics in order to increase the market acceptance of DFFs. Full article

Background: Nutrition and adequate dietary intake during pregnancy strongly influence the health and well-being of the mother, as well as the physical and cognitive development of the unborn child. While previous studies have documented factors associated with the dietary behaviour of pregnant women in Ethiopia, a comprehensive overview is missing. Objective: The aim of this study was to close this research gap. Methodology: We conducted a mapping review, including 37 studies published between 2000 and 2022 in our analysis. Dietary behaviour refers to all phenomena related to food choice, eating behaviour and dietary intake. We used an innovative approach by integrating a socio-ecological framework with UNICEF’s conceptual framework on maternal and child nutrition, which specifies multidimensional individual, underlying and enabling determinants associated with the nutritional status of women. Importantly, we integrated a focus on care for women and healthy environments. Results: A total of 68 factors were identified as influencing the dietary behaviour of pregnant women, with a focus on the intra- (31/68) and interpersonal (21/68) levels, while factors at the community (11/68) and the institutional levels (5/68) were scarce. Few studies investigated socio-cultural aspects, such as gender roles, decision-making power and workload of women, psychological factors and eating practices related to food taboos. None of the studies explored the influence of resources at the institutional level. Conclusions: This attests that the focus in maternal nutrition is still placed on the individual responsibility of women, instead of addressing the structural conditions that would enable women to access resources such as land, education and nutrition information. Full article

Adherence to dietary recommendations and the implementation of appropriate dietary habits after myocardial infarction (MI) can significantly improve health and reduce mortality from cardiac causes. The aim of this study was to analyse the adherence of patients with a history of MI to a healthy diet, which is one of the primary methods of cardiovascular disease (CVD) prevention. Following a proper diet involves limiting the consumption of saturated fats, salt, alcohol, and simple sugars. It is recommended to follow the Mediterranean diet, which is based on whole grains, fruits, vegetables, and fish. This study involved 120 patients hospitalised in the Invasive Cardiology and Cardiac Intensive Care Unit at the Independent Public Voivodship Hospital in Szczecin from August to December 2019. A self-designed questionnaire and the Questionnaire of Eating Behaviour (QEB) were used. The majority of respondents were hospitalised for a first-time MI (88.33%), and 65% of them reported adherence to the recommendations. The vast majority (78.33%) considered their diet good, with 50.83% of the respondents eating four meals a day and never eating fast food (49.17%). The analysis showed that although the respondents’ diets did not contain many unhealthy foods, they did not consume enough vegetables, fruits, fish, nuts, or fibre, which have a protective effect, lowering the risk of cardiovascular diseases and death. Furthermore, patients with a better education had a higher level of knowledge. Respondents’ knowledge of proper post-MI nutrition was sufficient, and their index of unhealthy diets was low, but they still made dietary mistakes and did not consume enough health-protective foods. These results indicate a need for further education. Full article

Given the high prevalence of overweight and obesity amongst educators, this study investigated the feasibility of the 16-week Health4LIFE weight loss intervention for primary school educators living with overweight/obesity in low-income settings in Cape Town, South Africa. The research comprised two sub-studies, a pilot randomised controlled trial testing the intervention (10 intervention, n = 79 and 10 control schools, n = 58), and an investigation of the perceptions of participating educators and principals. Feasibility outcomes included reach, applicability, acceptability, implementation integrity, and a hypothesis-generating signal of effect on lifestyle factors and weight. The intervention consisted of a wellness day, weight loss manual, and text messages. Results indicated acceptable reach, with positive feedback on intervention components from principals and educators. Implementation was largely successful, though three schools dropped out due to scheduling issues. Barriers included interruption of teaching time and busy school schedules. The intervention group (n = 42) showed favourable shifts in belief patterns, stages of change, and lifestyle behaviours, with a trend towards weight loss. Control group (n = 43) changes were limited to dietary intake. The triangulation of results supported the intervention’s feasibility in terms of primary and secondary outcomes. Recommendations for enhancement include adding in-person follow-up sessions and an app-based element to potentially increase impact on lifestyle indicators and weight loss. Full article