Search Results (1,350)

Background/Objectives: Policy implementers play a crucial role in the effective delivery of policies aiming at promoting a healthy lifestyle in the most vulnerable populations. This study aimed to explore (a) policy implementers’ knowledge and perceptions of the policy framework promoting physical activity and healthy nutrition among children in need in Greece, and (b) self-perceived barriers and facilitators of the framework implementation. The term children in need refers to children who are at risk of poverty and/or social exclusion. Methods: A qualitative study design was employed consisting of semi-structured interviews with 25 policy implementers, who represented four delivery systems (health, social protection, food, and education sectors) from three geographical regions in Greece. Interviews were completed between November and December 2023. Thematic analysis was conducted using inductive and deductive approaches to identify key themes, following data management in the N-VIVO 14 software. Results: Commonly mentioned policies that study participants were involved in included school- and/or community-level-based behavioral interventions. Participants perceived policy implementation efforts that often relied on individual initiatives as inconsistent. Most participants argued that existing policies were not tailored to the needs of children in need. Major self-perceived barriers included limited personnel training, limited facilities and infrastructure, and lack of incentives or opportunities to encourage active participation. Major self-perceived facilitators included personnel motivation, integration of nutrition and physical education into school curricula, and provision of free school meals, which was associated with regular school attendance of children from the Roma communities. Conclusions: Individual, sociocultural, and structural issues are shown to persist across different delivery systems indicating the complexity of tackling obesogenic environments, especially among children in need. This is the first study in Greece to provide evidence on self-perceived barriers and facilitators and could inform ongoing national and European efforts to address obesogenic environments in children in need. Full article

Background: Findings from the NutriNet-Santé studies have been used to drive public health policy in France, the European Union, and globally. The fact that NutriNet-Santé studies are not generalizable is a matter of concern. Objectives: We aimed to compare the characteristics and diet quality of consumers and non-consumers of low-calorie sweeteners (LCS) within the National Health and Nutrition Examination Survey (NHANES) sample to published within-cohort findings from NutriNet Santé. Methods: Dietary intake data for the US from two 24 h dietary recalls in 4 cycles of the NHANES 2011-18 study (n = 17,252) were used to identify LCS consumers and non-consumers. Results: LCS consumers in NHANES were more likely to be overweight, were of higher education and incomes, and had lower intakes of added sugar and higher HEI 2020 diet quality scores compared to LCS non-consumers. Based on published reports, higher LCS consumers in NutriNet Santé were normal weight, did not differ in education, did not consume less added sugar, and had lower quality diets overall. Whereas LCS consumers in NHANES were less likely to be current smokers, higher LCS consumers in NutriNet Santé were more likely to be current smokers. Based on published estimates, mean aspartame intake in NutriNet Santé was only 3 mg/day (0.045 mg/kg/day) for lower consumers and 47 mg/day (0.71 mg/kg/day) for higher consumers. Conclusions: Minimal LCS exposure and likely floor effects can be sources of statistical biases in studies of diet and health. NutriNet Santé is a large volunteer cohort of thin, educated, weight conscious French women who diet and smoke. Extreme caution is warranted when findings from atypical and non-representative samples are used to support policies in global public health. Full article

Background: Street food vending provides vital employment and nutrition in low- and middle-income countries (LMICs), but poor health and safety compliance pose significant public health and business risks. Despite growing policy recognition, the link between hygiene practices and vendor performance remains underexplored. Objective: This integrative review examines the influence of health and safety practices on the business performance of informal street food vendors, with a particular focus on both global and South African contexts. Methods: A total of 76 studies published between 2015 and 2025 were retrieved between June 2024 and May 2025 and analyzed using an integrative review methodology. Sources were identified through five major academic databases and grey literature repositories. Thematic synthesis followed PRISMA logic and was guided by the Health Belief Model (HBM) and Balanced Scorecard (BSC) frameworks. Results: There was a marked increase in publications post-2019, peaking in 2023. Sub-Saharan Africa accounted for the majority of studies, with South Africa (28%) and Ghana (14%) most represented. Among the 76 included studies, the most common designs were quantitative (38%), followed by qualitative (20%), case studies (14%), and mixed-methods (11%), reflecting a predominantly empirical and field-based evidence base. Thematic analysis showed that 26% of studies focused on food safety knowledge and practices, 14% focused on infrastructure gaps, and 13% focused on policy and regulatory challenges. Of the 76 studies included, 73% reported a positive relationship between hygiene compliance and improved business performance (such as customer trust, revenue, and operational resilience), based on vote-counting across qualitatively synthesized results and business outcomes. The review identifies a conceptual synergy between the HBM’s cues to action and the BSC’s customer dimension, highlighting how hygiene compliance simultaneously influences vendor behaviour and consumer trust. Conceptual saturation was observed in themes related to hygiene protocols, consumer trust indicators, and regulatory barriers. Conclusions: Health and safety practices function not only as compliance imperatives but also as strategic assets in the informal food economy. However, widespread adoption is impeded by structural barriers including limited infrastructure, education gaps, and uneven regulatory enforcement. The findings call for context-sensitive policy interventions and public health models that align with vendor realities and support sustainable, safe, and competitive informal food systems. Full article

Wellington, New Zealand, is highly vulnerable to disaster-induced food security crises due to its geography and geological characteristics, which can disrupt transportation and isolate the city following disasters. Urban agriculture (UA) has been proposed as a potential alternative food source for post-disaster scenarios. This study examined the potential of urban agriculture for enhancing post-disaster food security by calculating vegetable self-sufficiency rates. Specifically, it evaluated the capacity of current Wellington’s community gardens to meet post-disaster vegetable demand in terms of both weight and nutrient content. Data collection employed mixed methods with questionnaires, on-site observations and mapping, and collecting high-resolution aerial imagery. Garden yields were estimated using self-reported data supported by literature benchmarks, while cultivated areas were quantified through on-site mapping and aerial imagery analysis. Six post-disaster food demand scenarios were used based on different target populations to develop an understanding of the range of potential produce yields. Weight-based results show that community gardens currently supply only 0.42% of the vegetable demand for residents living within a five-minute walk. This rate increased to 2.07% when specifically targeting only vulnerable populations, and up to 10.41% when focusing on gardeners’ own households. However, at the city-wide level, the current capacity of community gardens to provide enough produce to feed people remained limited. Nutrient-based self-sufficiency was lower than weight-based results; however, nutrient intake is particularly critical for vulnerable populations after disasters, underscoring the greater challenge of ensuring adequate nutrition through current urban food production. Beyond self-sufficiency, this study also addressed the role of UA in promoting food diversity and acceptability, as well as its social and psychological benefits based on the questionnaires and on-site observations. The findings indicate that community gardens contribute meaningfully to post-disaster food security for gardeners and nearby residents, particularly for vulnerable groups with elevated nutritional needs. Despite the current limited capacity of community gardens to provide enough produce to feed residents, findings suggest that Wellington could enhance post-disaster food self-reliance by diversifying UA types and optimizing land-use to increase food production during and after a disaster. Realizing this potential will require strategic interventions, including supportive policies, a conducive social environment, and diversification—such as the including private yards—all aimed at improving food access, availability, and nutritional quality during crises. The primary limitation of this study is the lack of comprehensive data on urban agriculture in Wellington and the wider New Zealand context. Addressing this data gap should be a key focus for future research to enable more robust assessments and evidence-based planning. Full article

Background/Objectives: Dietary patterns have changed over time, characterising a process of nutritional transition that reflects socioeconomic and demographic inequalities among different populations. This study assessed changes in dietary consumption patterns and the associated social determinants, comparing two time periods in a sample of individuals from a state in the Northeast Region of Brazil. Methods: Data from the 2008–2009 and 2017–2018 Household Budget Survey for the state of Paraíba were analysed, totalling 951 and 1456 individuals, respectively. Foods were categorised according to the NOVA classification and compared based on sociodemographic and economic variables. To determine the factors that most strongly explain the contribution of each NOVA food group to the diet, beta regression analysis was conducted. Results: Differences were observed between the two periods regarding the dietary contribution of the NOVA food groups, with a decrease in consumption of unprocessed foods and an increase in ultra-processed foods. Living in urban areas, being an adolescent, and having an income above the minimum wage were associated with reduced intake of unprocessed foods in both periods. Additionally, being an adolescent and having more than eight years of schooling were associated with higher consumption of ultra-processed foods. Conclusions: The population under study showed changes in food consumption, reflecting a transition process that is occurring unevenly across socioeconomic and demographic groups, thereby reinforcing social inequalities. These findings can guide priorities in food and nutrition policies, highlighting the need for intervention studies to evaluate the effectiveness of such actions. Full article

Background: Current food systems contribute significantly to poor public health and environmental degradation. With increasing rates of chronic disease and undernutrition globally and in the United States of America (U.S.), transforming food systems toward sustainability is a critical public health priority. Objectives: This narrative review aimed to summarize U.S. policies from the past decade relevant to sustainable food systems, focusing on four domains—availability, accessibility, affordability, and desirability—proposed by the 22nd Annual Harvard Nutrition Obesity Symposium. Methods: Systematic searches were conducted using MEDLINE (PubMed), Scopus, U.S. Congress websites, and Google searches. Studies and policies published between 2013 and 2023 that addressed at least one of the four domains were included. Policies were reviewed according to their alignment with the policy lifecycle framework, encompassing formulation through implementation. Results: A review of the final 632 articles explained that, despite growing interest in sustainable food systems, there is a lack of comprehensive U.S. policies that address the four domains in an integrated manner. Most initiatives were limited in scope, often school-based, and not explicitly sustainability-focused. Food availability and accessibility policies exist but remain fragmented, while affordability and desirability domains are severely underrepresented. Few laws or bills have been enacted or evaluated for population-level or environmental outcomes. Conclusions: Transforming U.S. food systems requires more robust evidence-based policy development and evaluation. There is an urgent need for integrated multisectoral policy frameworks to ensure health, equity, and sustainability across all food system domains. Full article

It is crucial to clarify the grassland carrying capacity (CC) and the balance between grass and livestock under different scenarios for ecological protection and sustainable development in the Three River Headwaters Region (TRHR). This study focused on the TRHR and used livestock data, MODIS Net Primary Productivity (NPP) data, and artificial supplementary feeding data to analyze grassland CC and explore changes in the grass–livestock balance across various scenarios. The results showed that the theoretical CC of edible forage under complete grazing conditions was much lower than that of crude protein under nutritional carrying conditions. Furthermore, without increasing the grazing intensity of natural grasslands, artificial supplementary feeding reduced overstocking areas by 21%. These results suggest that supplementary feeding effectively addresses the imbalance between forage supply and demand, serving as a key measure for achieving sustainable grassland livestock husbandry. Despite the effective mitigation of grassland degradation in the TRHR due to strict grass–livestock balance policies and ecological restoration projects, the actual livestock CC exceeded the theoretical capacity, leading to overgrazing in some areas. To achieve desired objectives, more effective grassland management strategies must be implemented in the future to minimize spatiotemporal conflicts between grasses and livestock and ensure the health and stability of grassland ecosystems. Full article

Background/Objectives: The effect of diet on maternal and infant genetic levels has been reported in the literature. Diet-associated DNA damage, such as the presence of micronuclei (MN), may be related to an increased risk of developing chronic diseases such as cancer. There is particular concern regarding this damage during pregnancy, as it may affect the newborn (NB). Thus, this review aims to summarize the primary evidence of the impact of diet on the frequency of MN in the mother–infant population. Methods: Five databases (PubMed, Embase, Web of Science, Scopus, and ScienceDirect) were used to search for observational studies. Google Scholar and manual searching were required to perform the “gray literature” search. Results: The search strategy retrieved 1418 records. Of these, 13 were read in full and 5 were included in the review. Most studies were of the cohort type (n = 4) and were carried out in the European region. A total of 875 pregnant women and 238 newborns were evaluated. Despite insufficient evidence to confirm that diet changes the frequency of MN, the included studies found possible effects from the consumption of fried red meat and processed meats and the adequate consumption of vegetables and polyunsaturated fats. Conclusions: Future research is needed in order to understand the effects of diet on genetic stability and to obtain evidence to help plan public policies on food and nutrition or reinforce protective dietary patterns for this and future generations. Full article

Background: Non-communicable diseases (NCDs) are a leading cause of mortality globally, contributing significantly to the burden on healthcare systems. Understanding the spatiotemporal patterns of NCD mortality is crucial for identifying vulnerable populations and regions at high risk. Objectives: Here, we evaluated the spatiotemporal patterns of NCD mortality in the Metropolitan Area of the Valley of Mexico (MAVM) from 2000 to 2019 for five International Classification of Diseases chapters (4, 5, 6, 9, and 10) at two spatial scales: the municipal level and metropolitan region. Methods: Mortality rates were calculated for the total population and stratified by sex and age groups at both spatial scales. In addition, the relative risk (RR) of mortality was estimated to identify vulnerable population groups and regions with a high risk of mortality, using women and the 25–34 age group as reference categories for population-level analysis, and the overall MAVM mortality rate as the reference for municipal-level analysis. Results: Mortality trends showed that circulatory-system diseases (Chapter 9) are emerging as a concerning health issue, with 45 municipalities showing increasing mortality trends, especially among older adults. Respiratory-system diseases (Chapter 10), mental and behavioral disorders (Chapter 5) and nervous-system diseases (Chapter 6) predominantly did not exhibit a consistent general mortality trend. However, upon disaggregating by sex and age groups, specific negative or positive trends emerged at the municipal level for some of these chapters or subgroups. Endocrine, nutritional, and metabolic diseases (Chapter 4) showed a complex pattern, with some age groups presenting increasing mortality trends, and 52 municipalities showing increasing trends overall. The RR showed men and older age groups (≥35 years) exhibiting higher mortality risks. The temporal trend of RR allowed us to identify spatial mortality hotspots mainly in chapters related to circulatory, endocrine, and respiratory diseases, forming four geographical clusters in Mexico City that show persistent high risk of mortality. Conclusions: The spatiotemporal analysis highlights municipalities and vulnerable populations with a consistently elevated mortality risk. These findings emphasize the need for monitoring NCD mortality patterns at both the municipal and metropolitan levels to address disparities and guide the implementation of health policies aimed at reducing mortality risk in vulnerable populations. Full article

Background/Objectives: In many parts of the world, pharmacists hold the primary responsibility for providing safe and effective pharmacotherapy. A key aspect is the availability of appropriate medicines for each individual patient. When industrially manufactured medicines are unsuitable or unavailable, pharmacists can prepare tailor-made medicines. While this principle applies globally, practices vary between countries. In the Netherlands, the preparation of medicines in pharmacies is well-established and integrated into routine healthcare. This narrative review explores the role and significance of extemporaneous compounding, pharmacy preparations and related product care in the Netherlands. Methods: Pharmacists involved in pharmacy preparations across various professional sectors, including community and hospital pharmacies, central compounding facilities, academia, and the professional pharmacists’ organisation, provided detailed and expert insights based on the literature and policy documents while also sharing their critical perspectives. Results: We present arguments supporting the need for pharmacy preparations and examine their position and role in community and hospital pharmacies in the Netherlands. Additional topics are discussed, including the regulatory and legal framework, outsourcing, quality assurance, standardisation, education, and international context. Specific pharmacy preparation topics, often with a research component and a strong focus on product care, are highlighted, including paediatric dosage forms, swallowing difficulties and feeding tubes, hospital-at-home care, reconstitution of oncolytic drugs and biologicals, total parenteral nutrition (TPN), advanced therapy medicinal products (ATMPs), radiopharmaceuticals and optical tracers, clinical trial medication, robotisation in reconstitution, and patient-centric solid oral dosage forms. Conclusions: The widespread acceptance of pharmacy preparations in the Netherlands is the result of a unique combination of strict adherence to tailored regulations that ensure quality and safety, and patient-oriented flexibility in design, formulation, and production. This approach is further reinforced by the standardisation of a broad range of formulations and procedures across primary, secondary and tertiary care, as well as by continuous research-driven innovation to develop new medicines, formulations, and production methods. Full article

Healthy food service guidelines (HFSG) comprise food, nutrition, behavioral design, and other standards to guide the purchasing, preparation, and offering of foods and beverages in worksites and institutional food service. To date, there have been few attempts to synthesize evidence for HFSG effectiveness in non-K-12 or early childhood education sectors, particularly at worksites and institutional food services. We conducted a scoping review to achieve the following: (1) characterize the existing literature on the effectiveness of HFSG for improving the institution’s food environment, financial outcomes, and consumers’ diet quality and health, and (2) identify gaps in the literature. The initial search in PubMed and Web of Science retrieved 10,358 articles; after screening and snowball searching, 68 articles were included for analysis. Studies varied in terms of HFSG implementation settings, venues, and outcomes in both U.S. (n = 34) and non-U.S. (n = 34) contexts. The majority of HFSG interventions occurred in venues where food is sold (e.g., worksite cafeterias, vending machines). A diversity of HFSG terminology and measurement tools demonstrates the literature’s breadth. Literature gaps include quasi-experimental study designs, as well as interventions in settings that serve dependent populations (e.g., universities, elderly feeding programs, and prisons). Full article

Background: Addressing undernutrition and malnutrition requires a multi-pronged approach targeting different populations with appropriate interventions. Knowledge and perception (K&P) of Individuals and communities about nutrition to human health relationship/continuum is a prerequisite for addressing malnutrition in rural and mountain communities. Assessing K&P is essential for developing strategic interventions to up-scaling K&P of communities and achieving nutrition security. Homestead gardens are a proven intervention for achieving nutrition security for all family members of gardeners. Methods: This paper includes homestead gardeners from the Himalayan Mountain Region (HMR) as respondents. We developed a scale to assess the K&P of respondents, based on ratings from 20 judges. A total of 134 issues/items have been retained in the scale from macronutrients, micronutrients, minerals, and vitamins. A framework has also been developed and adopted for the study. A knowledge and perception index (KPI) has been developed based on the respondents’ responses. We have reviewed and analysed the national policy interventions for augmenting the K&P of the study community to achieve nutrition security. Results: The nutrition K&P of respondents are inadequate and far from the desirable level. Policy review and analysis indicate that the creation of K&P in the community to contribute to self and family nutrition security was previously highly neglected. Conclusions: The policy process of national, state, and county/district-level development sectors in developing countries under the HMR may take the initiative to ensure self-nutrition security by creating K&P of the community on nutrition issues. The designed scale is prudent requires testing and validation for measuring farmers’ K&P on nutrition, which may be adopted in future studies and policymaking not only nationally but also from an international perspective. Full article

As digital technologies and food environments evolve, ensuring children’s food safety has become a pressing public health priority. This study examines how the policy discourse on children’s dietary safety in Korea has shifted over time by applying Latent Dirichlet Allocation (LDA) topic modeling to news articles from 2010 to 2024. Using a large-scale news database (BigKinds), the analysis identifies seven key themes that have emerged across five phases of the national Comprehensive Plans for Safety Management of Children’s Dietary Life. These include experiential education, data-driven policy approaches, safety-focused meal management, healthy dietary environments, nutritional support for children’s growth, customized safety education, and private-sector initiatives. A significant increase in digital keywords—such as “big data” and “artificial intelligence”—highlights a growing emphasis on data-oriented policy tools. By capturing the evolving language and priorities in food safety policy, this study provides new insights into the digital transformation of public health governance and offers practical implications for adaptive and technology-informed policy design. Full article

Food safety concerns related to pesticide residues in fruits and vegetables have increased globally, particularly in regions where monitoring programs are scarce or inconsistent. This study provides the first multi-year evaluation of pesticide contamination and associated dietary risks in Cape Verde, an African island nation increasingly reliant on imported produce. A total of 570 samples of fruits and vegetables—both locally produced and imported—were collected from major markets across the country between 2017 and 2020 and analyzed using validated multiresidue methods based on gas chromatography coupled to Ion Trap mass spectrometry (GC-IT-MS/MS), and both gas and liquid chromatography coupled to triple quadrupole tandem mass spectrometry (GC-QqQ-MS/MS and LC-QqQ-MS/MS). Residues were detected in 63.9% of fruits and 13.2% of vegetables, with imported fruits showing the highest contamination levels and diversity of compounds. Although only one sample exceeded the maximum residue limits (MRLs) set by the European Union, 80 different active substances were quantified—many of them not authorized under the current EU pesticide residue legislation. Dietary exposure was estimated using median residue levels and real consumption data from the national nutrition survey (ENCAVE 2019), enabling a refined risk assessment based on actual consumption patterns. The cumulative hazard index for the adult population was 0.416, below the toxicological threshold of concern. However, when adjusted for children aged 6–11 years—taking into account body weight and relative consumption—the cumulative index approached 1.0, suggesting a potential health risk for this vulnerable group. A limited number of compounds, including omethoate, oxamyl, imazalil, and dithiocarbamates, accounted for most of the risk. Many are banned or heavily restricted in the EU, highlighting regulatory asymmetries in global food trade. These findings underscore the urgent need for strengthened residue monitoring in Cape Verde, particularly for imported products, and support the adoption of risk-based food safety policies that consider population-specific vulnerabilities and mixture effects. The methodological framework used here can serve as a model for other low-resource countries seeking to integrate analytical data with dietary exposure in a One Health context. Full article

West Africa faces persistent food and nutrition insecurity despite agricultural efforts, exacerbated by population growth, climate change, and socio-economic vulnerabilities. This study argues that integrating food processing principles with nutrition-sensitive agriculture (NSA) and nutrition-smart agriculture (NSmartAg) offers a transformative solution for human health. Therefore, we delineate these interconnected concepts and highlight their synergistic potential for a nutrition-focused food system. Likewise, critical analysis of key regional challenges, including infrastructural weaknesses, policy gaps, and gender inequities, was made prior to identifying significant opportunities for leveraging food processing as a strategic entry point to accelerate the implementation of NSA and NSmartAg. Based on these insights, six strategic pathways are proposed to achieve this objective: (i) integrating food processing into policies; (ii) investing in interdisciplinary R&D that puts nutrition and health benefits at the forefront of desired outcomes along with others; (iii) strengthening farmer and food processor capacities; (iv) improving agri-food infrastructure; (v) fostering multi-sectoral collaboration; and (vi) prioritizing youth engagement and market development. By adopting these integrated strategies, West African countries can build more resilient, equitable, and nutrition-centered food systems, ultimately improving public health outcomes and fostering sustainable regional development. Full article