Search Results (214)

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

This study aimed to investigate food insecurity (FI) and its association with sociodemographic characteristics and behavioral and dental alterations in adolescents from a county in the inland of northeastern Brazil. Data on 192 adolescents aged 11–14 years were analyzed in the public school system in Juripiranga, Paraíba, Northeast Brazil. The adolescents and their guardians responded to the Brazilian Food Insecurity Scale, the Strength and Difficulties Questionnaire for the caregiver, the Strength and Difficulties Questionnaire for children and adolescents, and a sociodemographic questionnaire. Academic performance was observed by calculating the median of the final assessments of basic school subjects. The prevalence of FI was 69.19, and FI was associated with a family income of up to one minimum wage per month (prevalence ratio [PR]: 1.90; 95% confidence interval [95% CI]: 1.20–3.01), no practice of religion by the guardian (PR: 1.34; 95% CI: 1.04–1.73), behavior considered inappropriate by the guardian (PR: 1.33; 95% CI: 1.02–1.73), and academic performance (PR: 1.35; 95% CI: 1.05–1.72). FI is considered a complex and multifactorial problem that requires appropriate intervention to deal with multiple social determinants. The results point to the need for integrated public policies between the health, education, social assistance, and food security sectors. Full article

Background: While previous research on children’s diets has primarily focused on individual nutrients or foods, recent years have seen increasing attention to the analysis of dietary patterns. In school-aged children enrolled in the CroCOSI study, this research focused on identifying the dietary patterns and examining their potential links with childhood obesity. Methods: Data were collected from a nationally representative sample comprising 5608 children aged 7–10 years and their parents in this cross-sectional study. To evaluate the nutritional status of the children, BMI-for-age was assessed using z-score values. Results: A factor analysis using data from the FFQ revealed three dietary patterns: Western, Healthy, and Breakfast. Children who scored high for consumption of fruits, vegetables, fish, cheese, dairy products, and 100% fruit juice were categorized into the Healthy dietary pattern, whereas those with high scores for cereals and milk were assigned to the Breakfast dietary pattern. Conclusions: The Western dietary pattern did not show a significant relationship with obesity among school-aged children (OR = 1.00, 95% CI: 0.98–1.00; p = 0.11). The risk of obesity was lower among children following the Healthy (OR = 0.98, 95% CI: 0.98–0.99; p = 0.045) and Breakfast (OR = 0.96, 95% CI: 0.95–0.99; p = 0.001) dietary patterns.The results can help in creating food policies with the aim of reducing childhood obesity in Croatia. Full article

Background: Food insecurity and poor diet quality disproportionately affect U.S. children from low-income households, with summer school closures exacerbating risks. Federally funded programs like the Summer Food Service Program (SFSP) and SUN Bucks (Summer EBT) aim to address these challenges, yet evidence of their post-pandemic dietary impact remains limited. Objectives: This study examines the relationship between policy innovations, summer meal participation, food insecurity, and diet quality among children from low-income households in Prince George’s County, Maryland. Methods: A cross-sectional design analyzed data from 158 households in Prince George’s County Public Schools across two waves (early fall 2022 and 2023). Validated tools (USDA’s Six-Item Short Form and Dietary Screener Questionnaire) assessed food security and diet quality. Sociodemographic factors, program participation, and dietary deviations from the 2020–2025 Dietary Guidelines were analyzed. Multivariate logistic regression identified determinants of poor diet quality (≥2 guideline deviations), adjusting for ethnicity, age, and housing stability. Results: Only 32.28% of eligible households participated in summer meal programs, with non-participation driven by lack of awareness (53.68%) and transportation barriers (11.58%). Significant dietary gaps included inadequate whole grain intake (0.8 vs. 3.0 servings/day) and excessive added sugars (14% of daily calories). Summer meal participation was associated with reduced odds of poor diet quality (OR = 0.23, p = 0.030), while older age (OR = 52.97, p < 0.001) and very low food security (OR = 8.42, p = 0.036) increased risk. Hispanic ethnicity had lower odds (OR = 0.17, p = 0.019) despite higher baseline food insecurity. Conclusions: Summer meal participation was associated with improved dietary outcomes but faced systemic participation barriers. Findings support policy reforms, such as multilingual outreach and mobile meal distribution, to address identified gaps. Full article

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

Objective: The objective of this article was to perform a comparative analysis of the changes in the availability of commercial food establishments around the schools in a Brazilian capital city. Methods: This is a comparative analysis between two cross-sectional panels performed in 2012 and 2019 in Florianópolis, Santa Catarina, Brazil. Secondary data from different sources were used. The location data of schools and establishments were georeferenced. For the analysis of the surroundings of schools, a network buffer of 800 m was considered. The establishments were classified based on the foods they primarily sold: fresh, mixed and ultra-processed foods. The chi-square and Wilcoxon tests were applied for the analyses, considering a significance level of 95% (p < 0.05). Results: The number of food establishments around schools increased by 63%. There was a statistically significant growth in mixed (p = 0.008) and ultra-processed (p = 0.024) food- selling establishments. Conclusion: We conclude that the increase in establishments selling ultra-processed foods around schools at the expense of establishments selling fresh food deserves attention. This condition requires public policies that help promote healthier environments, thus contributing to the health of schoolchildren. Full article

School food policy (SFP) that promotes nutritional behaviour is a national priority. Despite the role of school principals, teachers, and food service staff (FSS) in implementing SFP, their contribution to the current state of school food policy remains unexplored. The study aims to explore the perspective of these stakeholders on the effectiveness of SFP, barriers, and future recommendations for effective implementation. A qualitative study using 24 key informants interviews including principals (n = 6), teachers (n = 12), and FSS (n = 6) was conducted. From the list of private secondary schools, six schools were randomly selected. Principals, teachers, and FSS were selected through purposive sampling. A thematic approach was adopted for the data analysis. Interview data were categorised into three broad themes: (1) availability of school food policy, (2) barriers to enforcement, and (3) recommendations. Most participants stated that policy implementation is not enforced. The barriers are non-prioritised funding, resistance to change, and time constraints. The recommendations include regular training, activity manual development, seasonal food promotion, nutrition education, and leadership support. The study provides a deeper understanding of the role of key stakeholders in the current state of the effectiveness of SFP implementation. The inclusion of stakeholders is essential for a successful school food policy. Full article

Background: Food waste is a significant global issue with environmental, social, and economic consequences. In 2022, approximately 1.05 billion tons of food were wasted worldwide, with 220 million tons lost during the production and processing stages. Strategies to reduce food waste include full food utilization and the reuse of clean leftovers, which promote food security, efficient resource use, and the valorization of nutrients found in food. Objective: The aim of this study was to map existing scientific literature on nutritional intervention programs that incorporate full food utilization and the reuse of clean leftovers as tools for promoting sustainability and reducing food waste. The review seeks to consolidate existing knowledge, support public policy development, and encourage the adoption of sustainable food practices. Methods: A scoping review was conducted based on the Joanna Briggs Institute (JBI) manual and following the PRISMA-ScR checklist. The search was conducted in four scientific databases (PubMed, Embase, Cochrane Library, and Virtual Health Library) and included articles published between 2014 and 2025. Intervention studies promoting full utilization of plant-based foods and the reuse of clean leftovers were included. Results: After analyzing 2268 studies, 14 relevant studies were selected, with interventions including culinary workshops and educational programs on using parts of food typically discarded, such as peels and seeds. These programs were successful in reducing waste and promoting more sustainable and nutritious diets. Conclusions: Nutritional intervention programs that promote full food utilization and clean leftover reuse are effective in reducing waste and fostering sustainable diets. To maximize their impact, these practices should be integrated into public policies and scaled in institutional settings such as schools, hospitals, and community kitchens. Full article

Background: The prevalence of overweight and obesity has increased over the last three decades, becoming a major public health concern. This issue is particularly pressing in terms of the impact it has on the population of the Kingdom of Saudi Arabia (KSA). Thus, the aim of this research was to explore the nutritional and lifestyle habits of youth in the Al-Ahsa region of the KSA. Methods: This cross-sectional study included a total of 1270 secondary-school boys and girls (15–19 years) from all five of the Al-Ahsa Governorate districts. BMI and waist circumference measurements were recorded using anthropometric measurements, and the lifestyle–Arab Teens Lifestyle Survey (ATLS) was used to measure sedentary and eating habits. Results: Chi-square analysis revealed that a higher proportion of females (90.68%) than males (79.18%) exceeded two hours of daily sedentary time. Frequent sugary drink consumption (>3 times per week) was similar in males (67.40%) and females (66.11%). Students from different geographical locations showed significant differences in exceeding cut-off scores for fast food (χ² = 24.503, p < 0.001), cakes/doughnuts (χ² = 8.414, p = 0.015), sweets/candy (χ² = 19.613, p < 0.001), and energy drinks (χ² = 21.650, p < 0.001). Conclusions: Al-Ahsa is the largest governorate in the KSA. It has some of the largest health risks regarding obesity and poor lifestyle habits. This study highlights the major need for future research and policy interventions. Full article

Agroforestry systems (ASs) are increasingly recognized as effective strategies for ecological restoration and sustainable land use in semi-arid regions. This study aimed to evaluate the implementation and early outcomes of an AS established in a degraded urban area in the Brazilian semi-arid region. Specifically, we analyzed the system’s establishment process, estimated its costs, assessed structural development over time, and compared species performance and carbon accumulation across different biodiversity arrangements. After three years, the system accumulated 17.69 Mg ha⁻¹ of carbon and demonstrated significant basal area growth, particularly among fast-growing species such as Ceiba glaziovii, Gliricidia sepium, and Moringa oleifera. These species enhanced overall system productivity and likely contributed to increases in soil organic matter, facilitating the establishment of more demanding, slow-growing species. Cost analysis indicated a total implementation and maintenance estimate of BRL 57,468.79 ha⁻¹ (USD 11,096.29) over three years, with irrigation and maintenance accounting for 44.39%, labor and site preparation 31.59%, and seedling production 24.02%. Although the system proved viable under institutional support, its replicability for smallholders remains dependent on reliable water access or implementation aligned with the rainy season. The use of nursery seedlings enhanced seedling survival and system feasibility. The broader adoption of agroforestry in semi-arid regions will require supportive public policies and technical assistance. Strengthening government programs such as PNAE and PRONAF is essential, as these initiatives can promote system adoption by facilitating access to credit while also reducing costs, particularly when short-cycle crops grown within the system are sold to local schools. It is important to note that agroforestry costs vary depending on the intended objectives, species diversity, and arrangement design. Therefore, technical assistance is critical to guiding smallholders in selecting and implementing context-appropriate systems. Our findings reinforce the potential of agroforestry systems to promote carbon sequestration, restore degraded lands, and support food security and sustainable development in climate-vulnerable regions. Full article

Background/Objectives: The prevalence of obesity is high among children living with disability. The present study aimed to examine the perceptions of parents and caregivers of children living with disability regarding children’s energy balance related behaviors (EBRBs) and their determinants. Methods: Parents/caregivers of children living with disability (n = 45) from Thessaly, Crete and Attica Regions of Greece, participated in semi-structured interviews between November and December 2023. The interviews were recorded, transcribed and transferred to N-VIVO software. The results were analyzed according to the framework of the socio-ecological model, using deductive thematic analysis. Results: Parents/caregivers reported that eating habits of children living with disability and their physical activity levels were poorer compared to the general population. At an individual level, certain disabilities may affect children’s food preferences and parents’ ability to prepare healthy foods. At a familial level, financial difficulties may influence healthy eating, whereas some parents/caregivers act as children’s role models to encourage them to be physically active. Home food environments may also influence children’s eating patterns and peer influence on their EBRBs. At a community level, lack of trained personnel, available amenities/equipment and food education initiatives and the availability of unhealthy foods in school canteens were described as major barriers to healthy EBRBs. At an organizational level, lack of accessible/safe facilities, the marginalization/stigma that children living with disability may experience and lack of dietitians/nutritionists in health centers were named as the main factors influencing children’s EBRBs. Conclusions: The findings of this study highlight the importance of designing multi-sectoral policy interventions to promote healthy EBRBs and tackle obesity in children living with disability in Greece. Full article

This study aimed to quantify the carbon footprint of elementary school lunch menus across six major urban school districts in the United States and to simulate the effect of sustainable food policies on carbon emissions reductions while ensuring nutritional requirements remain adequate. We analyzed a total of twenty distinct meals per district selected from a four-week period and calculated their carbon emissions using life cycle assessment data. We then modeled three scenarios to reduce carbon emissions: (1) a reduction in beef meal offerings to one day per month, (2) an introduction of one entirely plant-based day per week, and (3) a combination of scenarios 1 and 2. Our findings revealed that beef-containing meals had the highest carbon emissions, while plant-based meals had the lowest. Implementing the one monthly beef meal scenario led to an average savings of 34% in emissions, while the plant-based day scenario led to a 32% reduction in emissions. Combining both policies resulted in an average reduction of 43% in emissions. Importantly, our nutritional analysis demonstrated that implementing these sustainable food policies resulted in meals with statistically similar macronutrient and micronutrient profiles and contributed to increased dietary fiber intake. These results highlight the potential environmental and health benefits of adopting sustainable nutrition policies in elementary schools. Full article

Background/Objectives: Eggs, a nutritious and affordable food, are not widely consumed by adolescents, who show many nutrient inadequacies. Modeling dietary substitutions with eggs and their costs can provide dietary insights while considering economic constraints. This study theoretically modeled the impact of substituting an egg for another protein source, considering nutrient quality and cost, using exemplary menus with application to adolescents. Methods: The substitution was modeled in four different seven-day exemplary menus: (1) the Healthy U.S.-Style Dietary Pattern (HUSS), (2) Harvard Medical School’s Heathy Eating Guide, (3) the National Heart, Lung, and Blood Institute’s Dietary Approaches to Stop Hypertension (DASH) diet and (4) the Healthy U.S.-Style Vegetarian Dietary Pattern (HVEG). One egg replaced the gram amount and nutrient profile of a protein source food in each menu. Micronutrient quality was assessed using the Food Nutrient Index (FNI), scored 0–100. The Center for Nutrition Policy and Promotion Food Price Database informed the food prices. Pairwise t-tests compared the effects of egg substitution on micronutrient scores and daily costs. Results: The daily egg substitution increased FNI scores for choline and vitamin D in the HUSS (83 to 95 and 69 to 75, respectively), DASH (80 to 91 and 55 to 59, respectively), and HVEG (91 to 100 and 44 to 51, respectively), and choline alone (89 to 98) in the Harvard menu. Daily menu prices were not significantly different after the egg substitution (p > 0.01). Conclusions: Substituting one egg for another protein source food increased the micronutrient quality of choline and vitamin D in exemplary menus without increasing the cost; however, factors such as food preferences and the economic accessibility of eggs in different contexts should also be considered. Full article

Background/Objectives: Childhood eating behaviors result from a complex interplay of familial, social, and environmental factors, influenced by socioeconomic and cultural contexts. These behaviors impact dietary habits, nutritional status, and long-term health. Using the Social Ecological Model (SEM), this narrative review synthesizes evidence on key determinants of childhood eating behaviors and proposes a framework for multi-level interventions. Methods: A structured literature search was conducted across PubMed, PsycINFO, and CINAHL, focusing on studies published between January 2014 and September 2024. Keywords related to childhood eating behaviors, familial determinants, and social influences were used to identify relevant studies. Inclusion criteria centered on empirical research examining how social and familial factors impact childhood eating behaviors within the SEM framework. Results: The review highlights critical determinants, including parental feeding practices, home food environments, peer influences, screen time, school meal programs, and socioeconomic disparities. These factors interact across multiple levels, emphasizing the importance of holistic interventions that target both individual behaviors and broader systemic influences. Conclusions: Addressing childhood eating behaviors requires a multi-level approach that integrates caregiver education, peer-led interventions, improved food environments, and supportive policies. Healthcare providers and policymakers play a crucial role in implementing strategies that foster healthier dietary behaviors and mitigate childhood obesity risks. Full article