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To assess the effectiveness of outpatient management with ready-to-use and supplementary foods for infants under 6 months (u6m) of age who were unable to be treated as inpatients due to social and economic barriers.
Design:
Review of operational acute malnutrition treatment records.
Setting:
Twenty-one outpatient therapeutic feeding clinics in rural Malawi.
Participants:
Infants u6m with acute malnutrition treated as outpatients because of barriers to inpatient treatment. The comparison group consisted of acutely malnourished children 6–9 months of age who were being treated at the same time in the same location in the context of two different randomised clinical trials.
Results:
A total of 323 infants u6m were treated for acute malnutrition (130 severe and 193 moderate). A total of 357 infants 6–9 months old with acute malnutrition (seventy-four severe and 283 moderate) were included as contemporaneous controls. Among infants u6m with severe acute malnutrition, 98 (75·4 %) achieved nutritional recovery; in comparison, 56 (75·7 %) of those with severe acute malnutrition 6–9 months old recovered. Among infants u6m with moderate acute malnutrition, 157 (81·3 %) recovered; in comparison, 241 (85·2 %) of those aged 6–9 months recovered.
Conclusions:
In a rural Malawian population of infants u6m who had generally already stopped exclusive breast-feeding and were now acutely malnourished, treatment with therapeutic or supplementary foods under the community management of acute malnutrition model was safe and effective. In settings where social and financial factors make hospital admission challenging, consideration should be given to lowering the recommended age of ready-to-use therapeutic and supplementary foods to infants u6m.
Restaurants may be important settings for interventions to reduce children’s energy intake. The objective of this study was to test the impact of a parent-focused social marketing campaign to promote healthy children’s meals on calories ordered and consumed by children at quick-service restaurants (QSR).
Design:
Using a repeated cross-sectional study design, two urban communities were randomised to intervention (IN) v. control (C) condition. A community-wide social marketing campaign was implemented in the IN community to empower Black and Latinx mothers who frequent QSR (priority population) to select healthier options for their child.
Setting:
Data were collected in 2016 at QSR located within the communities pre- and post-IN and analysed in 2017.
Participants:
Parents (n 1686; n 819 and n 867 for I and C conditions, respectively) were recruited after placing their QSR order; a survey, receipt and their child’s leftovers were collected.
Results:
Calories ordered did not differ significantly between the IN and C conditions (changeadj = –146·4 kJ (–35·0 kcal); 95 % CI –428·0 kJ (–102·3 kcal), 134·6 kJ (32·2 kcal)). In a sub-analysis of only the priority audience, children in the IN community ordered significantly fewer calories compared to C children in unadjusted models (changeunadj = –510·4 kJ (–122·0 kcal); 95 % CI –1013·4 kJ (–242·2 kcal), –7·5 kJ (–1·8 kcal)), but the trend did not persist after adjusting for covariates (changeadj = –437·2 kJ (–104·5 kcal); 95 % CI –925·5 kJ (–221·2 kcal), 50·6 kJ (12·1 kcal)). Calories consumed followed similar trends.
Conclusion:
The campaign did not significantly reduce children’s QSR calories ordered or consumed. However, a quantitatively important mean reduction in calories was suggested among the priority audience, indicating potential for community-wide promotion of healthful children’s meals.
Online food delivery (OFD) platforms offer consumers a convenient and fast delivery service of foods and drinks sourced from foodservice partners (e.g. restaurants, quick service restaurants). There is a need to assess the impact of this emergent segment of the foodservice sector on diet and diet-related health. The aim of this narrative review was to describe the OFD sector in Australia, its use and identify potential ways to include OFD platforms in existing public health nutrition policy.
Design:
A search was conducted in peer-reviewed and grey literature. Sources were analysed and synthesised to report the characteristics of OFD platforms, delivery process, users and potential drivers of usage. The aim and scope of public health nutrition policies were analysed to identify ways of including OFD platforms.
Setting:
Australia.
Participants:
General population.
Results:
There are three main operators with 9000–16 000 foodservice partners based predominantly in the main cities of Australia. OFD revenue has grown by 72 % in the last 5 years and is predicted to increase driven by usage by working adults with high disposable income who demand convenience. Current policies and initiatives aimed at manufacturers, retailers and foodservice outlets do not specifically regulate OFD platforms, although there is scope for these to be extended to such platforms.
Conclusions:
OFD platforms are disruptors of the foodservice sector. Innovative and consistent health policy options that target the unique challenges and opportunities posed by OFD platforms are required to limit the potentially negative impact of OFD platforms on diet and diet-related health.
This study aimed to identify correlates of nutrition label awareness and use, particularly subgroup differences among consumers. Two label types were assessed: (1) nutrition facts tables (NFt) in Australia, Canada, Mexico, UK, and USA and (2) front-of-package (FOP) labels, including mandatory Guideline Daily Amounts (Mexico), voluntary Health Star Ratings (Australia) and voluntary Traffic Lights (UK).
Design:
Respondents were recruited using Nielsen Consumer Insights Global Panel (n 21 586) and completed online surveys in November–December 2018. Linear regression and generalised linear mixed models examined differences in label use and awareness between countries and label type based on sociodemographic, knowledge-related and dietary characteristics.
Setting:
Australia, Canada, Mexico, UK and USA.
Participants:
Adults (≥18 years).
Results:
Respondents from the USA, Canada and Australia reported significantly higher NFt use and awareness than those in Mexico and the UK. Mexican respondents reported the highest level of FOP label awareness, whereas UK respondents reported the highest FOP label use. NFt use was higher among females, ‘minority’ ethnic groups, those with higher nutrition knowledge and respondents with ‘adequate literacy’ compared with those with ‘high likelihood of limited literacy’. FOP label use was higher among those with a ‘high likelihood of limited literacy’ compared with ‘adequate literacy’ across countries.
Conclusions:
Lower use of mandatory Guideline Daily Amount labels compared with voluntary FOP labelling systems provides support for Mexico’s decision to switch to mandatory ‘high-in’ warning symbols. The patterns of consumer label use and awareness across sociodemographic and knowledge-related characteristics suggest that simple FOP labels may encourage broader use across countries.
To investigate changes in mean sugar content of non-alcoholic beverages (overall and sugar-sweetened beverages (SSB)) available for purchase in Australia and to compare signatories v. non-signatories of the Australian Beverages Council voluntary pledge from 2018
Design:
Retrospective observational study.
Setting:
Australia.
Participants:
About 1500 non-alcoholic beverages per year included in the FoodSwitch Monitoring Datasets for 2015–2019.
Results:
Overall, mean sugar content fell by 1·3 g/100 ml (17·1 %) from 7·5 g/100 ml in 2015 to 6·2 g/100 ml in 2019. SSB have accounted for about 56 % of all beverages available for purchase since 2015. Between 2015 and 2019, the sugar content of SSB dropped by about 10 % (0·8 g/100 ml). Soft drinks and milk-based drinks were the categories with the largest decrease in sugar content. The greater reduction in sugar observed for beverages overall than SSB suggests at least some of the overall decrease in sugar content is due to the appearance of new products with low or no sugar rather than reformulation. Over the same period, beverages with added non-nutritive sweeteners increased from 41 % to 44 %. The decrease in sugar content for all beverages and SSB was, in general, larger for non-signatories than signatories of the voluntary industry pledge.
Conclusions:
Between 2015 and 2019, the small reduction in sugar content of non-alcoholic beverages in Australia resulted from the combined effects of introducing low- or no-sugar products and reformulation of some categories of SSB. Further policy and regulatory measures are required to reap the most benefit that sugar reduction among non-alcoholic beverages can bring to population health.