The World Health Organization recommends countries adopt policies that encourage the creation of healthier food retail. In Australia, some organisations have created enforceable regulation for healthier food retail in settings under their contractual control. While progressive for public health, little evidence exists on the characteristics of individuals and organisations influencing sustainment of such initiatives. We explored the perspectives of those involved in a sustained (six year) real-world healthy vending initiative in a university setting in Melbourne, Australia. Qualitative interviews were undertaken with seven of the eight individuals involved in the initiative and informed by the Consolidated Framework for Implementation Research and the regulatory concept of social licence. Reflexive thematic analysis was used to generate themes on individual and organisational factors associated with sustainment. Two individual-level themes included participants enjoyment and skills for ‘getting the job done’ and working on innovative projects. Individual self-efficacy and enjoyment from working on innovative projects, combined with interviewees’ perception that their organisation had a role in leading social change, contributed to the initiative’s sustainment. Two organisation-level themes included the University leading innovation and having a responsibility to serve the needs of its community within the constraints of the need for ‘financial viability’ and the provision of ‘consumer choice’. This study brings to the fore evidence on the individual and organisational characteristics that contribute to the sustainment of a healthy food vending initiative from the perspective of those involved in implementation. Exploration of the importance of these characteristics to other food retail settings is required.

South Asians are among the fastest-growing immigrant population group in the United States (U.S.) with a unique disease risk profile. Due in part to immigration and acculturation factors, South Asians engage differently with behavioural risk factors (e.g. smoking, alcohol intake, physical activity, sedentary behaviour, and diet) for hypertension, which may be modified for the primary prevention of cardiovascular disease. Using data from the Mediators of Atherosclerosis in South Asians Living in America cohort, we conducted a cross-sectional analysis to evaluate the association between behavioural risk factors for cardiovascular disease and diet. We created a behavioural risk factor score based on smoking status, alcohol consumption, physical activity, and TV watching. We also calculated a Dietary Approaches to Stop Hypertension (DASH) dietary score based on inclusion of relevant dietary components. We used both scores to examine the association between engaging with risk factors for hypertension and the DASH diet among a cohort of South Asian adults. We found that participants with 3–4 behavioural risk factors had a DASH diet score that was 3 units lower than those with no behavioural risk factors (aβ: –3.25; 95% CI: –4.28, –2.21) and were 86% less likely to have a DASH diet score in the highest category compared to the lowest DASH diet score category (aOR: 0.14; 95% CI: 0.05, 0.37) in the fully adjusted models. These findings highlight the relationship between behavioural risk factors for hypertension among South Asians in the U.S.

The study aims to identify family child care home (FCCH) setting- and environment-level predictors related to providers’ perceived difficulty in implementing the Child and Adult Care Food Program (CACFP) recommendations for serving vegetables to children. This was a cross-sectional study, which used a validated paper-based survey with a multi-method data analysis approach. Participants were licenced FCCH providers (N = 943) in Nebraska, who were predominantly White (94%), non-Hispanic (97%), CACFP-participants (89%), and in urban areas (64%). Reflective latent variable modelling was conducted in Mplus to explore associations between dependent variable and predictors. Dependent variable was providers’ perceived difficulty to implement CACFP recommendations for serving vegetables. Predictors were providers’ mealtime practices, perceived barriers to serve healthy foods, CACFP participation, geographic location, food access, food insecurity, and child poverty. Qualitative comments (n=122) from the survey were analysed using direct content analysis approach. Providers’ perceived lack of time to prepare foods and perceived children’s taste preferences increased their perceived difficulty; and CACFP-participation decreased their perceived difficulty to implement CACFP recommendations for serving vegetables. Qualitative comments highlighted that providers felt discouraged to serve vegetables knowing that vegetables would likely be wasted because of children’s preferences. More tailored professional development is required to address FCCH providers’ perceived difficulty and build providers’ skills on preparing time saving, CACFP-reimbursable and appealing vegetable recipes, and on strategies to promote vegetable consumption in children.

Metabolic syndrome (MetS) is a widespread and complex health disorder. Dietary habits and consumption of simple sugars have been shown to play an important role in the prevention and treatment of MetS. This cross-sectional study was conducted in a population of 3380 adults from the Shiraz University of Medical Sciences (SUMS) employees’ health cohort. The healthy beverage index (HBI) and healthy beverage score (HBS) were calculated. Risk for MetS and its components, including blood pressure, fasting blood glucose, waist circumference, triglyceride levels, and high-density lipoprotein cholesterol, were measured using standardised protocols. Results showed a significant inverse association between higher adherence to HBI (OR = 0.60, 95% CI: 0.48–0.74, P < 0.001) and HBS (OR = 0.80, 95% CI: 0.65–0.97, P = 0.030) with lower risk of MetS. Also, we observed a significant association between higher level of HBI and HBS with decreased risk of hypertension, as a critical component of MetS. These findings support the notion that healthier beverage consumption, as indicated by higher HBI and HBS levels, may play a critical role in reducing the risk of MetS.

Animal source foods (ASF) are nutrient-dense and essential for the growth and development of children. The Bangladesh Demographic and Health Survey (BDHS) 2022 reported that approximately two-thirds of children aged 6–23 months consumed eggs/flesh foods. However, overall consumption patterns, trends, and factors influencing ASF intake among children in Bangladesh were not well-documented. Therefore, the study aimed to assess the trends and associated factors of ASF consumption among children aged 6–23 months in Bangladesh. A total of 9401 children were extracted from four consecutive BDHS (2011, 2014, 2017/18, and 2022). The Cochran-Armitage test was conducted to assess the trends in ASF consumption, while a two-stage multilevel mixed-effects logistic regression was performed to identify the associated factors. The consumption of ASF significantly increased to 79.1% in 2017/18 from 67% in 2011 but decreased to 73.3% in 2022. ASF consumption was found to be higher among children whose mothers were educated (AOR = 1.60, 95% CI = 1.30–1.98), employed in either agricultural (AOR = 1.27, 95% CI = 1.04–1.54) or non-agricultural (AOR = 1.36, 95% CI = 1.07–1.72) activities, pregnant (AOR = 2.54, 95% CI = 1.66–3.87), had received ANC 1–3 times (AOR = 1.43, 95% CI = 1.20–1.72) or ≥4 times (AOR = 1.59, 95% CI = 1.29–1.95), and was exposed to media (AOR = 1.21, 95% CI = 1.04–1.39). Furthermore, consumption increased with increasing the age of children, and the wealth of their families. However, children who experienced illness were less likely to consume ASF (AOR = 0.76, 95% CI = 0.68–0.86). The recent declines in ASF consumption emphasize the need for targeted interventions to increase ASF consumption among children in Bangladesh.

India’s nutrition transition has led to an increased burden of overweight/obesity (body mass index of ≥23 kg/m2), driven by lifestyle factors like poor diet, inactivity, and substance use, prompting public health interventions. However, these interventions lack supporting evidence, especially in rural areas, hindering effective strategies for this population. To address this evidence gap, this study used cohort data (baseline: 2018–19, follow-up: 2022–23) from the Birbhum Population Project (West Bengal, India) to analyse lifestyle risk factors and their association with incidence and remission of overweight/obesity among adults aged ≥18 years (sample: 8,974). Modified Poisson regression model was employed to attain the study objective. From 2017–2018 to 2022–2023, the prevalence of overweight/obesity increased from 15.2% (95% CI: 14.1%–16.4%) to 21.0% (95% CI: 19.7%–22.3%) among men and from 24.1% (95% CI: 22.9%–25.2%) to 33.8% (95% CI: 32.5%–35.1%) among women. Overall, 23.0% (95% CI: 21.8%–24.3%) of adults experienced incidence of overweight/obesity, while 13.9% (95% CI: 12.4%–15.6%) experienced remission. Use of motor vehicles among unemployed participants was associated with incident overweight/obesity (relative risk or RR: 1.058; 95% CI: 1.023–1.095; P: 0.001). Vigorous activity at home (including gardening, yard work, and household chores) was linked to higher odds of recovering from overweight/obesity (RR: 1.065; 95% CI: 1.008–1.125; P: 0.025). Frequent tobacco use (often/daily vs. none) was inversely associated with remission of overweight-obesity (RR: 0.689; 95% CI: 0.484–0.980; P: 0.038), as was each 1 ml in alcohol consumption (RR: 0.995; 95% CI: 0.991–0.999; P: 0.022). Discouraging habitual motor vehicle use may help prevent overweight/obesity, while promoting home-based activities may aid remission, particularly for women who are at higher risk for overweight/obesity.

Psychosocial stimulation is one of the recommended interventions in the management of hospitalised children with severe acute malnutrition (SAM). However, there is currently limited scientific evidence supporting the effectiveness of the intervention. The study aimed to examine the effects of psychosocial stimulation on the development, nutrition, and treatment outcomes of hospitalised SAM children. A cluster-randomised controlled trial was conducted among health facilities that provide inpatient care for children with SAM in Silti Zone, Ethiopia. Fifty-eight children enrolled in the intervention facilities were provided stimulation intervention during their inpatient care and for 6 months after discharge. Sixty-eight children enrolled from control health facilities received routine inpatient care without stimulation and were followed for six months. Health education was provided to all caregivers on child health-related topics. Child development and nutrition outcomes were assessed four times using Denver II-Jimma and anthropometric measurements while the length of hospitalisation was used to measure treatment outcome. Children in the intervention group showed significantly better scores in Personal Social (p=0.001, effect size=0.77), Fine Motor (p=0.001, effect size=1.87), and Gross Motor (p=0.001, effect size=0.78) developmental domains from baseline to end line. Language domain however showed a significant difference only after discharge and intervention children scored better at six months (p<0.001, effect size=0.59). The intervention significantly improved treatment outcomes (p=0.010), but no significant changes in nutritional outcomes were documented. The findings highlighted the benefits of the intervention and the need to promote these interventions in health facilities within resource-limited settings.

The ripening-dependent changes in antioxidant activities and phytochemical content of mango (Mangifera indica L.) cultivar Safaid Chonsa at various ripening stages were evaluated. The ripening time period was divided into five stages (RSI-RSV) and the pulp was subjected to proximate analysis, antioxidant potential, and UHPLC/MS-based non-targeted metabolite fingerprinting. Proximate analyses depicted variations in moisture, dry matter, fat, protein, carbohydrate, and energy parameters. Maximum DPPH activity (51%) was observed at stages III, IV, and V while FRSP increased 31% at RS V as compared to stage I. Total antioxidant capacity and total reducing power potential were maximum (295.7 and 345.71 µg AAE/mg extract, respectively at stage V. Total phenolic content increased from 3.57 µg GAE/mg extract to 5.72 µg GAE/mg extract from stage I to RSIII while 19% increase in total flavonoid content was observed at stage V as compared to stage I. UHPLC/MS analysis showed presence of Aconitic acid, methylisocitric acid, 4-O-methyl gallate, beta-glucogallin, xanthenes, sakebiose, Isobergaptene, Fructoselysine 6-phosphate, Citbismine C, and many others at different ripening stages of chonsa mango extracts. The results conclude that during the mango ripening stages, changes in phytochemical composition have positive correlation with antioxidantive potential. These phytochemicals have nutritional and nutraceutical effects on human health therefore ripening stage should be considered for consumption of mango.

The vitamin K (VK) levels vary greatly among different populations and in different regions. Currently, there is a lack of reference intervals for VK levels in healthy individuals, The aim of this study is to establish and validate the reference intervals of serum vitamin K1 (VK1) and vitamin K2 (VK2, specifically including menaquinone-4 (MK4) and menaquinone-7 (MK7)) levels in some healthy populations in Beijing. Serum VK1, MK4, and MK7 were firstly measured by high-performance liquid chromatography and mass spectrometry in 434 subjects. The reference intervals for three indicators were established by calculating the data of 2.5 and 97.5 percentiles. Finally, preliminary clinical validation was conducted on 60 apparent healthy individuals undergoing physical examination. In the young, middle-aged, and elderly groups, the reference intervals of VK1 were 0.180 ng/mL ∼ 1.494 ng/mL, 0.247 ng/mL ∼ 1.446 ng/mL, and 0.167 ng/mL ∼ 1.445 ng/mL, respectively. The reference intervals of MK4 were 0.009 ng/mL ∼ 0.115 ng/mL, 0.002 ng/mL ∼ 0.103 ng/mL, and 0.003 ng/mL ∼ 0.106 ng/mL, respectively. The reference intervals of MK7 were 0.169 ng/mL ∼ 0.881 ng/mL, 0.238 ng/mL ∼ 0.936 ng/mL, and 0.213 ng/mL ∼ 1.012 ng/mL, respectively. The reference intervals had been validated by the samples of healthy individuals for physical examination. In conclusion, the reference intervals of VK established in this study with different age groups have certain clinical applicability, providing data support for further multicentre studies.

The aim of this study was to examine the relationship between nutrition knowledge and nutritional adequacy among Japanese university students. This cross-sectional study was conducted in 2018 at a university located in Hyogo Prefecture, Kobe, Japan, and 801 students from various academic disciplines were enrolled. Eligible participants were students aged more than 18 years, encompassing all years of study. Nutrition knowledge data were obtained using a nutrition knowledge questionnaire (NKQ) for Japanese adults. Participants were classified into three nutrition knowledge groups according to their total NKQ scores [mean ± standard deviation; all (64.7 ± 15.4%), low (48.1 ± 13.8%), medium (68.3 ± 2.8%), and high (78.5 ± 4.2%)]. Participants reported their dietary habits in the preceding month using a brief self-administered diet history questionnaire. Differences in nutritional adequacy among groups were determined using logistic regression and covariance analyses, adjusted for potential confounding factors. The adequacy of each nutrient was quantified as the proportion of participants with nutrient intake that fell outside the reference range. Although the intakes of only a few nutrients and foods were associated with nutrition knowledge, the total number of nutrients below the estimated average requirement was lower in the high nutrition knowledge group (3.1 ± 2.7) than in the low nutrition knowledge group (3.6 ± 2.9) (P = 0.046). In conclusion, the nutrition knowledge level of Japanese university students is associated with nutritional adequacy but may partially affect eating habits. Future longitudinal studies must clarify the causal and dose-response relationships between nutrition knowledge and dietary habits.

Participant recruitment and retention are consistently recognised as significant, costly challenges in nutrition intervention trials. Decentralised study procedures address some of the recruitment and retention limitations in traditional trial methodology. Understanding participant perceptions and experiences of decentralised methods in nutrition studies is key to improving trial design and conduct. The aim of this study was to explore participant opinions about remote delivery of a dietary supplement intervention trial. Adults enrolled in a clinical trial of a milk fat globule membrane nutritional supplement for improvement of psychological wellbeing were invited to take part in a post-intervention interview. Interviews were conducted over video conferencing and transcribed. Using a semi-structured interview format six aspects of trial design were discussed: general processes, written instructions, contact throughout the study, self-collection of saliva samples, wearable device use, and cognitive assessment. Thematic analysis derived themes from the data for each of the aspects of trial conduct discussed. Seventy-three participants completed the interview. Interviewees reported a positive overall experience of the remote delivery procedures used. Accessible communication between researchers and participants and clear written instructions were identified as key to participant experience. Recall of instructions and adherence to the nutritional intervention was difficult for some respondents with suggestions made for facilitating this in future remote delivery nutrition studies. Use of wearables, in-home saliva sampling, and self-administered cognitive assessments were feasible and acceptable to most participants. The remote delivery of a nutritional intervention trial, including self-collected biological samples, is feasible and positively viewed by participants.

Increasing food intake or eating unhealthily after exercise may undermine attempts to manage weight, thereby contributing to poor population-level health. This scoping review aimed to synthesise the evidence on the psychology of changes to eating after exercise and explore why changes to eating after exercise occur. A scoping review of peer-reviewed literature was conducted in accordance with the Joanna Briggs Institute guidance. Search terms relating to exercise, eating behaviour, and compensatory eating were used. All study designs were included. Research in children, athletes, or animals was excluded. No country or date restrictions were applied. Twenty-three studies were identified. Ten experimental studies (nine acute, one chronic) manipulated the psychological experience of exercise, one intervention study directly targeted compensatory eating, seven studies used observational methods (e.g. diet diaries, 24-h recall) to directly measure compensatory eating after exercise, and five questionnaire studies measured beliefs about eating after exercise. Outcomes varied and included energy intake (kcal/kJ), portion size, food intake, food choice, food preference, dietary lapse, and self-reported compensatory eating. We found that increased consumption of energy-dense foods occurred after exercise when exercise was perceived as less enjoyable, less autonomous, or hard work. Personal beliefs, exercise motivation, and exercise enjoyment were key psychological determinants of changes to eating after exercise. Individuals may consume additional food to refuel their energy stores after exercise (psychological compensatory eating), or consume unhealthy or energy dense foods to reward themselves after exercise, especially if exercise is experienced negatively (post-exercise licensing), however the population-level prevalence of these behaviours is unknown.

This cross-sectional study aimed to identify patterns of food preparation and examine their demographic and socio-economic drivers, along with impacts on health and nutritional status, physical activity, and diet quality. Dietary data from a national-representative sample (n = 5005, 3–84 years) of the Portuguese National Food, Nutrition, and Physical Activity Survey (IAN-AF 2015/16) were classified by preparation locations (at or away from home) and analysed via hierarchical clustering. Logistic regression models were used to examine associations between demographic and socio-economic factors and food preparation patterns and between these patterns and health and nutritional status, physical activity, and diet quality. The most common food preparation pattern (followed by 45.4% of participants) represented the highest intake of foods prepared by away-from-home establishments. Adolescents (vs. children, OR = 0.29, 95%CI = 0.17, 0.49) and older adults (vs. adults, OR = 0.37, 95%CI = 0.26, 0.53) had lower odds of following this pattern, whereas adult men (vs. women, OR = 4.20, 95%CI = 3.17, 5.57) had higher odds. Higher education, higher household income, and having children/adolescents in the household also increased the odds of eating foods prepared away from home, whereas living in rural areas or in food-insecure households decreased the odds. Noticeably, adults consuming more foods prepared away from home had lower odds of being overweight or obese (OR = 0.74, 95%CI = 0.56, 0.97), but higher odds of sedentarism (OR = 1.45, 95%CI = 1.08, 1.96) and poor diet (OR = 3.01, 95%CI = 2.08, 4.34) compared to those consuming more foods prepared at home by themselves. Dietary patterns marked by high away-from-home food preparation prevail. While these correlated with higher socio-economic status, sedentarism, and poorer diet — relatively to patterns with greater reliance on homecooked food — they were not linked to higher odds of obesity.

Previous studies have assessed how supplementing with Garcinia cambogia affects glycaemic control and liver enzyme levels; nevertheless, the results were not consistent. The study aimed to evaluate the impact of Garcinia cambogia on glycaemic control and liver enzymes through a systematic review and meta-analysis. Searches were conducted from the beginning through February 2023, using online databases (Scopus, Web of Science, PubMed, and Cochrane Library). Trials examining the impact of Garcinia cambogia on serum levels of fasting blood sugar (FBS), serum level of insulin, alanine transaminase (ALT), and aspartate transaminase (AST) in adults were included. The overall estimates and their 95% confidence intervals (CIs) were calculated using a random-effects model. This meta-analysis includes nine publications with 444 participants. The results showed that Garcinia cambogia has no significant effect on FBS (weighted mean difference (WMD): 1.02 mg/dl, 95% CI: −1.29, 3.33), insulin (WMD: −0.12 mU/L, 95% CI: −1.50, 1.25), AST (Hedges’ g: −0.08, 95% CI: −0.43, 0.26), and ALT (Hedges’ g: 0.27, 95% CI: −0.20, 0.73). Subgroup analysis showed that Garcinia cambogia significantly increased insulin levels in females and also increased insulin and FBS levels in those with a BMI ≥30 kg/m2. Nevertheless, the administration of Garcinia cambogia for more than 8 weeks significantly decreased insulin levels. This meta-analysis showed that supplementation with Garcinia cambogia has no significant effect on FBS, insulin, ALT, or AST levels compared with control groups; however, it seems that increasing the duration of the intervention may have a decreasing effect on insulin levels.

Lifestyle has been associated with in vitro fertilisation (IVF) success rates, but studies on diet and IVF outcomes are inconclusive. We studied associations between adherence to the Dutch guidelines for a Healthy diet 2015 and pregnancy chances among women receiving modified natural cycle in vitro fertilisation (MNC-IVF). This prospective cohort study utilised data from 109 women undergoing MNC-IVF between 2014 and 2018 at University Medical Centre Groningen enrolled in a study examining associations between metabolic profile of follicular fluid and oocyte quality. Adherence to dietary guidelines was assessed by daily food records quantified based on the Dutch Healthy Diet (DHD) 2015 Index. IVF outcomes (i.e. positive pregnancy test, ongoing pregnancy, and live birth) were obtained from patient records. Statistical analyses involved Cox proportional hazard regression analyses while adjusting for maternal covariates age, smoking, and Body Mass Index (BMI), and stratified for treatment, age, BMI, and energy intake. Women were 31.5 ± 3.3 years old, and had a BMI of 23.5 ± 3.5 kg/m2. Higher DHD2015 adherence was linked to a reduced probability of achieving an ongoing pregnancy (HR = 0.77, 95%CI: 0.62–0.96), live birth (HR = 0.78, 95%CI: 0.62–0.98), and showed a non-significant trend towards a lower probability of a positive pregnancy test (HR = 0.85, 95%CI: 0.71–1.01). Associations were particularly present among women undergoing MNC-ICSI (n = 87, p-for-interaction = 0.06), with shorter duration of infertility (n = 44, p-for-interaction=0.06), being overweight (n = 31, p-for interaction = 0.11), and having higher energy intakes (n = 55, p-for-interaction = 0.14). This explorative study suggests inverse trends between DHD2015 adherence and MNC-IVF outcomes, encouraging well-powered stratified analyses in larger studies to further explore these unexpected findings.

Foods are frequently marketed to children through the inclusion of a wide range of elements on the packages. Several studies conducted in different countries around the globe have shown that products marketed to children are usually high in sugar and other nutrients associated with non-communicable diseases. The present exploratory cross-sectional study aimed at providing additional evidence on the composition of products marketed to children by analysing the disclosure of additives in such products. Data were collected at nine supermarkets in two Uruguayan cities between August and October 2021. All packaged products available in each supermarket were surveyed using a cell phone app, except for culinary ingredients. All the information from the labels was extracted. Products marketed to children were identified based on the presence of indicators of child-directed marketing on the package. The disclosure of additives was analysed based on the information available in the ingredient list. The prevalence of food additive disclosure was calculated. Of the 7,343 products included in the database, 573 (7.8%) were classified as marketed to children. Candies and cookies were the categories with the largest number of products marketed to children. The great majority of the products marketed to children disclosed at least one food additive (93.5%). These products tended to more frequently notify colourings, antioxidants, acidity regulators, raising agents, stabilisers, humectants, anticaking agents, and glazing agents compared to products not marketed to children. These findings underscore the need to expand the current scope of regulations on marketing targeted at children beyond nutrients to include additives potentially linked to adverse health effects, such as artificial colourings.

This study aimed to investigate the impact of Astragalus dregs — the residue after the extraction of principal active components — on the growth performance, antioxidant capacity, and immune function of fattening pigs. Twenty-four 130 days of age fattening pigs were randomly assigned to the control group and experimental group (supplemented with 10% Astragalus dregs). The production performance was evaluated by average daily gain (ADG), average daily feed intake (ADFI) and diarrhoea rates. Additionally, nutrient digestibility, blood biochemical parameters, antioxidant capacity, and immune function factors were analysed. The group supplemented with Astragalus dregs showed a trend towards improved ADG and ADFI and reduced diarrhoea rates (p > 0.05). Moreover, it significantly enhanced the digestibility of dry matter, crude protein, and ether extract (p < 0.05). Blood analysis revealed that globulin and total protein were increased, and glucose, cholesterol and triglyceride levels were decreased (p < 0.05) in the group supplemented with Astragalus dregs. The antioxidant capacity was significantly promoted by elevated T-AOC, GSH-px, and SOD activities and reduced malondialdehyde levels (p < 0.05). The immune function factors demonstrated that IgA, IgG, IgM, and anti-inflammatory cytokines IL-10 and IL-22 were significantly increased, meanwhile pro-inflammatory cytokines IL-2 and IL-6 were decreased (p < 0.05).

These findings indicate that Astragalus dregs, as a dietary supplement, may enhance growth performance, antioxidant capacity and immune function in fattening pigs. It is suggested that future studies should explore the optimal supplementation ratio of Astragalus dregs in pig diets.