The major aim was to examine the interaction between visiting Kuwaiti Diwaniyyah, dietary habits and daily activities during Ramadan among Kuwaiti men.

An electronic questionnaire was used to collect data. The questionnaire included questions about various sociocultural factors, frequency of visiting Diwaniyyah, dietary habits and physical activity variables. For the sociocultural variables, age, level of education and governorate were collected. ANOVA, t test, Pearson’s correlation and regression were used.

Respondents came from different and various subgroups of the Kuwaiti population and from all six governorate

A total of 736 Kuwaiti men were selected from an opportunistic sample.

The results show that the food most eaten at night after Iftar in general was rice, meat and dairy products. Younger age groups eat more sweets, pastry, traditional sweets, dairy products and rice than the other age groups. The higher the frequency of visiting Diwaniyyah, the greater the consumption of these types of food at night. Also, older men eat fewer types of food and have lower physical activity levels at night during Ramadan than other age groups. Men with graduate educational levels who regularly visit Diwaniyyah consume more types of food at night than those who do not visit the Diwaniyyah. Age, social individuals and number of days visiting Diwaniyyah were associated with and predicted the number of types of food eaten at night during Ramadan.

The study findings reveal that during Ramadan, lifestyle behaviour changes among men, including the timing and number of meals, type and portion of food consumption and physical activity behaviour.

This study aimed to determine the prevalence of Lebanese adults living with underweight, overweight or obesity, assess and compare the cost of the Mediterranean Diet (MD) with that of the current dietary consumption pattern and explore diet cost as a determinant of living with underweight, overweight or obesity.

Data for this nationally representative cross-sectional study were collected through sociodemographic questionnaires, anthropometric measurements, the Arab Family Food Security Scale and dietary assessments using a validated FFQ and 24-h recalls. Diet costs were calculated based on 2023 market prices using purchasing power parity. Logistic regression was used to assess associations with BMI.

Lebanon, using data representative of the Lebanese adults’ population.

444 Lebanese residents aged 18–64 years.

Overall, 66·2 % of the participants were living with underweight (4·3 %), overweight (37·8 %) or obesity (24·1 %). On average, the cost of following MD ranged from Intl.$ 23·36 to Intl.$ 26·49/person/d, whereas a Lebanese adult spent Intl.$ 20·46 on consumption. Only 31·1 % of participants spent an amount equal to or greater than the minimum MD cost (Intl. $23·36/d). Participants who meet or exceed this threshold were 1·59 times more likely to be living with a healthy weight (aOR = 1·59, p = 0·043).

The high prevalence of Lebanese adults living with underweight, overweight or obesity is compounded by the unaffordability of a healthy MD. Improving the affordability of nutritious foods is crucial to promoting healthier dietary patterns and achieving better weight outcomes. Public health strategies should include economic, behavioural and policy-level interventions to enhance diet quality and affordability in crisis-affected populations.

This study aimed to assess the understanding, perceptions and preferences of different front-of-pack labelling (FOPL) formats among Thai consumers.

We conducted a mixed-methods study comprising a cross-sectional online survey and semi-structured interviews between February and March 2022. The survey assessed comprehension and preferences for six FOPL formats (Guideline Daily Amounts (GDA), Healthier Choice logo (HCL), warning labels (WLs), Nutri-Score, Health Star Rating and Traffic Light labels). Quantitative data were analysed using descriptive statistics, chi-square tests and multiple logistic regression. Qualitative data underwent thematic analysis.

Bangkok and metropolitan areas

Thai residents aged 12–78 years (n 410)

While awareness of existing labels was high (GDA: 95·4 %, HCL: 82·4 %), only 23·9 % regularly read GDA labels. WLs and Nutri-Score were the most effective at providing information to consumers in a format that translated into choosing healthier products. WLs demonstrated the highest effectiveness in guiding healthier choices. HCL received the highest agreement across multiple attributes, including packaging inclusion preference (59·8 %), visibility (58·5 %) and visual appeal (57·3 %), although effectiveness was not tested. Qualitative findings revealed preferences for colour-coded systems but identified barriers including time constraints, small font sizes and difficulty interpreting numerical information.

While interpretive labels, particularly WLs, are most effective for guiding consumers to healthier choices, successful implementation requires consideration of both consumer preferences and real-world usage constraints. Findings support replacing the current GDA system with an interpretive design, accompanied by comprehensive public education campaigns. These results provide evidence-based recommendations for FOPL policy development in Thailand.

This study examines aspects of women’s empowerment related to the nutritional status of under-five children in Bangladesh, including their age-appropriate food intake and access to healthcare during acute respiratory tract infection (ARI).

Three waves of the Bangladesh Demographic Health Survey (BDHS) data (2011, 2014 and 2017–2018) were pulled and utilised to construct three domains of the Survey-Based Women’s Empowerment Index, such as social independence, intrinsic agency and instrumental agency. The height-for-age Z (HAZ), weight-for-age Z (WAZ) and weight-for-height Z (WHZ) scores were used to measure the nutritional status of offspring. Two variables were generated to measure age-appropriate food intake and treatment-seeking from medically trained providers (MTP) at the commencement of ARI. Generalised structural equation modelling was performed to develop pathways between women’s empowerment and children’s nutritional status.

Data were collected from eight administrative divisions in Bangladesh.

A total of 18 706 married women aged 15–45 years residing with their husbands and having at least one under-five child.

Women’s social independence was positively associated with HAZ (0·25 (95 % CI: 0·22, 0·28)), WAZ (0·21 (0·18, 0·24)) and WHZ (0·06 (0·02, 0·09)). Intrinsic agency positively influenced HAZ (0·03 (0·02, 0·04)) and WAZ (0·02 (0·01, 0·02)). Both social independence and intrinsic agency promoted appropriate feeding, while instrumental agency had a negative effect on food consumption (–0·0026 (–0·005, –0·0002)). Both age-appropriate food intake and seeking treatment from MTP during recent ARI episodes improved nutritional outcomes of offspring.

Maternal social independence and intrinsic agency enhance the nutritional status, food consumption and healthcare access of offspring in Bangladesh.

We applied an innovative agent-based modelling approach to investigate how and to what extent spillover effects occur beyond dietary interventions.

We developed an agent-based model in NetLogo to simulate the dietary practices of the Dutch adult population during lunch and dinner, representing participants in the Dutch National Food Consumption Survey.

The model assessed spillover effects beyond a hypothetical workplace canteen intervention targeting increased plant-based protein consumption during lunch. Direct effects were defined as the percentage of non-vegetarian employees consuming a vegetarian lunch. Spillover effects were indicated by the percentage of plant-based protein consumed at dinner, influenced by dietary identity, habituation, social networks and eating location. Scenarios with varying direct effect sizes were simulated to compare plant-based protein consumption at dinner.

Simulations demonstrated a positive spillover effect at the population level, with plant-based protein consumption at dinner increasing over 3 years compared with baseline (no intervention). At direct intervention effect sizes up to 0·5, there was a linear increase in plant-based protein consumption at dinner (from 23·0 % (95 % CI 22·9, 23·2) at baseline to 32·3 % (95 % CI 31·8, 32·8)). Spillover effects plateaued beyond an effect size of 0·5, with no significant further increases observed.

Our application of agent-based modelling revealed that positive spillover effects of dietary interventions from the workplace to home can be achieved. Despite challenges, agent-based modelling might complement other approaches for studying spillover effects and supporting dietary behaviour change towards more sustainable diets.

Toddler drinks, sometimes referred to as toddler milks or formulas, are not recommended by health authorities because they have a higher sugar and lower protein content than cows’ milk. However, advertisement spending and retail sales of these products have grown in the USA, and there is a nutrition surveillance gap in purchaser characteristics.

Household purchases of toddler drinks between 2004 and 2020.

NielsenIQ consumer panel.

Panellists across the USA.

Panellists purchased sixty-six unique toddler drinks between 2004 and 2020. Out of 202 207 households in the panel, 2644 panellists purchased toddler drinks at least once during the study period. Most panellists who purchased toddler drinks had a household income above $60 000 and had graduated from college. Households purchasing toddler drinks spent an average of $102 dollars, 1·5 % of their total food spending, on toddler drinks annually. The share of spending on toddler drinks increased by approximately 0·02 percentage points each year during the study period, which was equivalent to a 54 % increase between 2004 and 2020 (95 % CI: 0·04, 4 × 10–3). The highest average household spending on toddler drinks was among Asian households, households with a single male head of household and households with children 2–6 years old.

Findings indicate that toddler drink purchasing patterns vary by household demographics and purchases have increased over time. Proactive efforts, including continued surveillance of toddler drink purchases and regulation of toddler drink marketing, are critical to promote consumption of age-appropriate beverages for young children.

To test the ‘Investigate Exposure’ step of the WHO’s CLICK framework and to investigate 12–16-year-old children’s exposure to paid-for digital food advertising in Finland.

The DIGITUTKA pilot study was carried out as part of the EU Joint Action Best-ReMap project. Data on paid-for digital food advertising that children were exposed to via their phones over a two-week period were captured using the RealityMeter application, following the ‘Investigate Exposure’ step of the CLICK framework. Data were collected between April and June 2022 and analysed in Excel, following a protocol outlined by WHO Europe. The WHO Europe Nutrient Profile Model (v1, 2015) was used to determine marketing permission.

Four schools in Finland

6th–9th grade students (n 34)

Out of the 17 820 captured advertisements, 2316 (13 %) were identified as food or beverage brands and products. The most commonly advertised products were ready-made and convenience foods and composite dishes (16 %, n 372) and energy drinks (9 %, n 202). The majority of the food and beverage advertisements (n 1291, 56 %) were not permitted to be marketed to children, with only one in ten (n 222, 9 %) permitted to be marketed to children. A third (35 %) of the food and beverage advertisements could not be identified due to missing information.

Children were exposed to a large number of food and beverage advertisements, most of which were not permitted to be marketed to children. To protect children’s health and prevent obesity, marketing restrictions should be combined with broader changes to the food environment and taxation.

The Spanish agricultural sector depends on seasonal agricultural migrant workers. This study aimed to examine the associations among dietary patterns, sociodemographic factors and food security among seasonal agricultural workers.

A cross-sectional multicentre study. The dietary pattern was evaluated according to the Spanish Society of Community Nutrition recommendations for the adult population. Descriptive analysis was disaggregated according to sex. Multi-adjusted logistic models were used to assess the association between dietary patterns and explanatory variables.

Work sites and temporary accommodations in four Spanish provinces: North Spain: Lleida and La Rioja, and South Spain: Almeria and Huelva.

Male and Female Seasonal Agricultural Migrant Workers (n 623).

The final sample consisted of 609 migrant agricultural workers. Of these, 36 % were female, and 61 % were classified as North African. Overall, 40 % of the participants adhered to the evaluated dietary pattern. Adherence was positively associated with North African nationality, being married or cohabiting and low socio-economic status. Not skipping meals due to economic constraints and receiving food aid emerged as key factors contributing to greater adherence to the assessed dietary pattern.

This study provides an initial insight into the dietary pattern of seasonal agricultural migrant workers in Spain. The findings indicate that external socio-economic and structural factors primarily shape their dietary habits. Policies aimed at enhancing food security, and other food coping strategies, such as access to food aid, are crucial for improving dietary adherence to a healthy dietary pattern.

To assess changes in (1) Na content of processed foods in the Canadian food supply and (2) the proportion of products meeting Health Canada’s voluntary Na reduction targets (SRT) between 2010 and 2020.

This repeated, cross-sectional study used foods from the 2010 (n 6929), 2013 (n 9366), 2017 (n 10 324) and 2020 (n 15 797) collections of the University of Toronto’s Food Label Information and Price database, categorised into Health Canada’s Na categories. Quantile regression was used to assess changes in Na content. Firth’s bias-reduced logistic regression was used to evaluate changes in the proportion of foods meeting the SRT, and trends were assessed with Cochran–Armitage tests.

Canada.

Processed foods.

Between 2010 and 2020, 54 % (7/13) of major categories had a left shift (reduction) in their Na distribution, 15 % (2/13) had a right shift (increase), 15 % (2/13) had both a left and right shift and 15 % (2/13) did not change. The proportion of products meeting the average targets and maximum levels increased 6 % and 4 % from 2010 to 2013 and 4 % and 3 % from 2013 to 2017, then decreased 3 % and 1 % between 2017 and 2020, with trends for improvement over time (P-trend < 0·001).

Although many categories decreased in Na, some did not change or increased in Na and improvements in the proportion of products meeting the SRT were modest and occurred early on. Further actions, such as implementing accountability initiatives that promote industry adherence to voluntary SRT or introducing mandatory measures, alongside frequent and transparent monitoring are needed to reduce Na in processed foods in Canada.

To model the potential value for money of implementing proposed unhealthy food advertising restrictions on Western Australian (WA) transport-owned assets to prevent obesity-related diseases.

A cost–benefit analysis using a societal perspective was undertaken to model the policy intervention over a 30-year time horizon. The effectiveness of the intervention was based on a similar policy implemented in the United Kingdom by Transport for London, adapted to the WA context. The ACE-Obesity Policy model, a validated multi-state lifetable Markov model, was used to assess the expected health (quantified as health-adjusted life years (HALY)) and economic outcomes of the intervention’s impact on unhealthy food consumption. The potential costs of policy development and monitoring and revenue impacts on government and industry (outdoor advertising companies) were included in the modelled analysis.

Western Australia.

Greater Perth population.

The cost of implementing the policy was estimated at A$28 million (95 % uncertainty intervals (UI): $23, $35), 71 % borne by the government and the remaining by outdoor advertisers. A mean population weight reduction of 0·58 kg (95 % UI: 0·28, 0·90) was estimated, which translated to 5906 health-adjusted life years gained (95 % UI: 2750, 9084) with a monetary value of A$1374 million (95 % UI: $642, $2112). Eight percent of the monetised benefits were attributed to healthcare cost savings, while 92 % were associated with monetised health gains. The intervention was estimated to generate a net-present value of $1346 million (95 % UI: $614, $2082) and benefit–cost ratio of 50 (95 % UI: 23, 81).

Policy to restrict advertising of unhealthy foods on WA transport-owned assets is likely to represent excellent value for money.

The present study examined the association of screen and sleep time, physical fitness and eating behaviour with Mediterranean diet (MD) adherence in a sample of preschoolers from Granada, Spain.

A cross-sectional, non-randomised design was employed. A multilinear regression model with backward elimination was used for analysis.

Variables included age, screen time, hours of nightly sleep, physical fitness, food approach and food avoidance. The developed model met assumptions of multiple regression in terms of linearity, homoscedasticity, normality, independence and non-multicollinearity.

Data were collected from 653 of the 2250 three-to-six-year-old children attending the eighteen schools invited to take part in the present study. Data on children’s behaviours were parent-reported using validated questionnaires.

Better sleep time and lower screen time and food avoidance were found to be predictive of MD adherence. These variables explained 15 % of the variance in preschoolers’ MD adherence.

The present study suggests that sleep and screen time and food avoidance are important components to consider when targeting improvements in MD adherence in preschoolers. Future research should explore the way in which parental health behaviours influence their children’s health habits in order to better understand the outcomes.

To assess the exposure of Austrian children to TV high in fat, sugar and/or salt (HFSS) food and beverage ads and identify changes in HFSS food advertising after the implementation of self-regulatory measures of marketing restriction.

All ads shown on five popular TV channels for Austrian children/teenagers were coded over 4 d (360 h) using the WHO TV Monitoring Protocol, to identify food/beverage marketing, marketing strategies, target audience and presence in peak viewing times. Nutrient analysis was performed using nutrient profile models (NPM), which classify foods as permitted or not permitted for marketing to children: WHO EURO NPM for international comparability and Austria’s NPM for local regulatory compliance. Results were compared with pre-regulatory Austrian TV monitoring data.

Austria.

None.

Of 9099 ads captured, 17·0 % were for foods and beverages. Most promoted products not permitted for marketing to children according to WHO EURO NPM (81·8 %) and Austria’s NPM (83·8 %). On all channels, the advertising rate for food ads rose throughout the day, culminating during child/teen peak viewing times in the evening. A mix of marketing strategies and persuasive appeals was used; emotional themes (e.g. friendship, holidays and enjoyment) were more common in not permitted ads, compared with permitted ads. Not permitted ads featured elements appealing to children/teenagers significantly more often than permitted ads.

Despite self-regulatory measures of marketing restriction, children and teenagers in Austria are still exposed to a high number of advertisements for HFSS foods using impactful emotional marketing strategies on TV. To protect children from this influence, further regulations are called for.

Newfoundland and Labrador (NL) introduced Canada’s first excise tax on sugar-sweetened beverages (SSB) in 2022. Industry marketing practices in response to SSB taxation may affect public health impacts. We examined changes in posted beverage pricing and marketing of taxable and non-taxable beverages in NL before and after the SSB tax was implemented.

Pre-/post-observational study with in-store audits of beverage prices and marketing. Changes including pricing discounts and promotions were assessed at the individual beverage level for pre/post-tax implementation years.

Eighty food stores (grocery, convenience, drug and dollar) in NL, Canada.

There was no evidence of a change in posted shelf prices between pre/post years. There was a significant increase (+2·5 %, χ2 = 9·693, P = 0·002) in proportion of discounted taxable SSB with no change in non-taxable beverages (P = 0·350). There were no significant differences in change of number of promotions for taxable SSB (+5·2 [−0·1, 10·5], F = 3·789, P = 0·053) nor non-taxable beverages (+3·4 [–1·0, 7·7], F = 2·268, P = 0·134).

The lack of change in posted prices of taxable SSB indicates that the NL SSB tax was not communicated at the point of decision-making. While some marketing changes post-tax were observed, results should be interpreted cautiously as they cannot be attributed definitively to the tax. Existing literature implies that industry may adapt marketing conduct to counteract beverage taxes. Such changes were limited in NL, suggesting retailers may have opted not to display the tax rather than attempt to actively counteract it. Lack of transparency surrounding the tax may neutralise intended behavioural effects.

Across school and community-based contexts, nutritional education interventions are often associated with improvements in a range of food-related and health-related outcomes. The aim of this study was to investigate whether the nutritional education component of the Holiday Activities and Food (HAF) programme in England was similarly associated with changes in these outcomes for children who attend.

A quasi-experimental, mixed-factorial 3 (School) × 3 (Group) × 2 (Time) design was employed. Outcome variables were liking and frequency of trying new foods, perceived cooking competence and health-related quality of life.

Pre-post data were collected at three primary schools in one local authority in the North East of England at two time points (before and after the summer holidays).

A non-probability, purposive sample of 169 children (mean age = 9·4 years, sd = 0·54) self-selected into groups of children who did not attend HAF over the summer holidays (No HAF; n 123), attended their school-based HAF club (HAF; n 29) or attended their school-based HAF club alongside a bespoke nutritional education programme (NEP) (HAF NEP; n 17).

Kruskal–Wallis and Mann–Whitney U analyses found no significant between-group differences for any outcome, apart from perceived cooking competence. HAF NEP was associated with improved perceived cooking competence.

Standard HAF was not associated with improved outcomes related to nutritional education. The HAF NEP group was associated with improved cooking competence only. The lack of significant findings in the intervention groups suggests that further research into HAF nutritional education is required.