In South Africa, as in many other countries, alcoholic beverages are not required to disclose nutritional information beyond alcohol by volume (ABV), limiting consumer awareness of energy and sugar intake. This study evaluated the extent of online nutritional information disclosure for alcoholic beverages in South Africa.

A cross-sectional analysis was conducted using data collected between April and September 2025. Alcoholic beverages were identified from the top five retailers by market share. A total of 3534 unique products were classified into six categories: beers, ready-to-drink beverages (RTD), red wines, white wines, sparkling wines and rosés, and spirits. Nutritional information was extracted from official brand websites, and a disclosure score was assigned based on nutrients reported. Data were analysed using chi-square and Kruskal–Wallis tests.

South Africa, April-to-September 2025.

N/A (product-level analysis).

ABV was disclosed for 83·3 % of beverages, while sugar was reported for only 33·0 % and < 3 % disclosed other nutrients or ingredient lists. Disclosure varied significantly by category (P < 0·0001): beers showed the widest variability (median score = 1, IQR = 1–6), white wines scored slightly higher (median = 2) and spirits the lowest (median = 0). In contrast, RTD showed consistently low disclosure, with a narrow distribution of scores (median = 1, interquartile range = 1–1).

Most alcoholic beverages sold in South Africa predominately disclose ABV and often omit disclosure of other key nutrients. These findings underscore the need for mandatory nutritional information disclosure for alcoholic beverages to support informed consumer choices, reduce overall alcohol consumption and address alcohol-related health risks.

Few studies have examined whether infant dietary diversity is prospectively associated with malnutrition risk in young children. We sought to assess whether dietary diversity and animal-source food (ASF) consumption were associated with malnutrition and body composition among children younger than 2 years at high risk of malnutrition.

Longitudinal cohort of HIV-exposed uninfected (HEU) or HIV-unexposed children with repeated measures of weight, length, circumferences and skinfold thicknesses from age 9 to 23 months from which WHO z-scores were calculated. FFQ assessed infants’ dietary diversity, flesh foods and egg intake. Cox proportional hazards were used to examine whether minimum dietary diversity (MDD, dietary diversity scores ≥ 5) and consumption of ASF were associated with malnutrition, defined as z-score < −2.

Western Kenya

Infants (n 232; 48 % female; 49 % HEU; growth z-scores above −2 at 9 months).

At 9 months, 42 % of infants met MDD, and mean z-scores were above −1 sd. Meeting MDD at 9 months was associated with a lower risk of stunting from 9 to 23 months (HR 0·51; 95 % CI: 0·33, 0·80) but not wasting or underweight. MDD at 9 months was associated with 86 % (95 % CI 0·11, 0·51) lower risk of low subscapular skinfolds; similar trends were observed for flesh foods.

In a cohort of Kenyan infants, MDD at 9 months was associated with reduced risk of stunting through the second year of life. Flesh food intake was associated with lower risk of low trunk adiposity. Improving dietary diversity during infancy may protect against early-life stunting.

Diet optimisation models have been developed to deal with the complexities of designing a sustainable diet. Diet acceptability is one aspect of a sustainable diet that has had limited integration into these models. This systematic review summarises and critically assesses the available literature regarding diet acceptability in optimisation studies.

A systematic search on Medline and EMBASE was implemented, followed by a snowballing search until no new articles were found. Inclusion criteria were as follows: (1) diet optimisation studies; (2) acceptability included in model; (3) outcome diet referred to as ‘acceptable’; (4) published between 2013–2025.

Diets.

Adult population.

A total of forty-nine studies were included in this review. Definitions of acceptability varied considerably. Analysis of the studies found six overarching themes were used to define acceptability in diets, with minimisation of deviation from observed diet and setting of lower and upper bounds on intake being most commonly used. Only 25 % of studies assessed the impact of acceptability models, objective functions and/or constraints, on the dietary output to some degree. Assessing three pathways (deduction, translation and induction) for defining and operationalising acceptability presents new opportunities to include citizens in the development of acceptable dietary models.

Including acceptability into diet optimisation models is imperative as they can influence dietary structure, nutritional content, price and environmental impact, although they present certain trade-offs compared to other optimisation goals. Further work on real-world testing and contextualisation of these often-theoretical diets is needed, alongside testing and justification of the models’ parameters for acceptability.

This article explores the characteristics of Ghanaian households’ consumption of obesogenic v. protective foods, including their retail, distribution and origin.

A household food consumption survey was conducted using an adapted Prospective Urban and Rural Epidemiology study FFQ. Product pathways for selected obesogenic (processed meat, sugar-sweetened beverages (SSB) and biscuits) and protective (cooked vegetables, legumes and fish) foods were traced from retailers through distributors/wholesalers to producers.

Rural and urban communities in the Ashanti Region and selected retail/wholesale/producers nationwide.

612 households, 209 retailers and 185 wholesalers/distributors.

About 20 % of households consume SSB and confectionery weekly, and just 2 % consumed processed meat. Of the protective foods, fish had the highest proportion of households consuming weekly (74·5 %), followed by cooked vegetables (53·1 %) and legumes (22·8 %). Frequent SSB consumption is higher in younger (P < 0·001), male (P = 0·010), urban (P < 0·001) and more educated (P < 0·001) food purchaser households. Below 10 % of households followed the healthiest dietary pattern (high-protective-and-low-obesogenic) but higher in older and more educated food purchaser households. In contrast, most households (about 80 %) consumption patterns did not discriminate between obesogenic and protective foods. Generally, characteristics of purchasers from retail/wholesale outlets agree with those of households, where obesogenic foods were retailed to younger, less educated buyers than older, more educated ones. While the protective foods had a strong local producer presence, the obesogenic foods were predominantly imported.

Household consumption and retail/distribution of obesogenic foods are associated with socio-demographic characteristics, but obesogenic foods are almost entirely produced outside Ghana. Policies that regulate importation on health grounds can promote a healthier food environment.

To examine power and governance arrangements in food and nutrition policy formulation and agenda setting in South Africa.

Analysis of the policy implementation environment and in-depth interviews were conducted focusing on: existing policy content and priorities across food system sectors; institutional structures for cross-sectoral and external stakeholder engagement; exercise of power in relation to food system policies and opportunities to strengthen action on nutrition.

South Africa.

Interviews were conducted with forty-eight key stakeholders involved in the food and nutrition policy sphere: government sectors relevant to food systems (n 21), the private sector (n 4), academia (n 10), non-government organisations (n 11) and farmers (n 2).

This study found that there are power dynamics involved in shaping the planning agenda that is inadvertently generating a food system that undermines the right to food. The concept of nutrition governance remains poorly defined and applied in different ways and usually based on a relatively narrow interpretation – therefore limiting policy coherence and coordination. South Africa has strong legal institutions and practices, and social policies that support public provisioning of food, but a non-interventionist approach to the food system.

The right to food and nutrition, as outlined in the South African Constitution, has not yet been effectively utilised to establish a robust normative and legal basis for tackling the dual challenges of food insecurity and malnutrition. Currently, the governance of the food system is grappling with substantial obstacles, balancing the influence of powerful stakeholders who uphold the status quo against its responsibilities for food justice.

This article reports on the feasibility, acceptability of a trial design and results of ¡Coma, Muévase y Viva!, an adapted version of the Eat, Move, Live! Curriculum, a 10-week diet and lifestyle change intervention for low-income Latina and Indigenous Mexican women in rural Inland Southern California.

A pilot randomised intervention and wait-list controlled parallel trial.

Latina and Indigenous Mexican women participated in ¡Coma, Muévase y Viva!, the adapted version of the curriculum customised for Spanish speakers with a focus on health literacy, cultural norms and values, and delivered by community health workers/promotoras.

Participants were randomised into the intervention (n 19) or wait-list control (n 16). Most were Latino (88 %), mothers (75 %) and foreign-born (87 %).

The adapted intervention was feasible and acceptable with 87·5 % of participants retained at three months. The intervention was delivered with high fidelity. Intervention compared to control participants reported success with predetermined prioritised goals (OR = 0·25, 95 % CI: 0·06, 0·99, P = 0·03) and showed a greater likelihood of cooking healthier food (OR = 4·87, 95 % CI: 1·04, 22·90, P = 0·05), enjoyment of cooking healthy meals (OR = 3·94, 95 % CI: 0·87, 17·92, P = 0·08) and doing physical activities (OR = 5·30, 95 % CI: 1·16, 24·24, P = 0·03). Healthy eating and physical activity as primary outcomes indicated the intervention group was more likely to eat healthy and be active (OR = 2·08, 95 % CI: 1·12, 3·89, P = 0·02).

The adapted intervention was feasible and acceptable and indicated an effect on dietary and lifestyle behaviour change with significant changes in meeting desired goals and engaging in healthy eating and physical activity.

Online food delivery (OFD) platforms increasingly shape food environments and dietary choices, yet it remains unclear whether platform-defined ‘healthy’ outlet categories align with evidence-informed assessments. This study assessed the healthiness of food outlets labelled as ‘healthy’ on a leading OFD platform in Victoria, Australia, using food environment classification tools.

Cross-sectional study using web-scraped outlet-level data. Outlets labelled ‘healthy’ were assigned to one of thirty-six predefined outlet types and classified using the DIGIASSESS index, an expert-informed food environment scoring tool. A supplementary menu-based sensitivity analysis was conducted in a stratified random 10 % subsample of outlets.

A leading OFD platform in Victoria, Australia.

We identified 12 938 unique food outlets, of which 1408 (9·2 %) were labelled ‘healthy’ by the platform and included in the primary analysis. A stratified random subsample of 166 outlets underwent menu-level review.

‘Healthy’-labelled outlets were most commonly Independent–Takeaway (11·8 %), Independent–Cereal-Based Café Meals (9·7 %) and Service Station Convenience Stores (7·4 %). Using DIGIASSESS, most ‘healthy’-labelled outlets were reclassified as ‘less healthy’ (n 1123; 79·7 %) or ‘unhealthy’ (n 180; 12·8 %), with 106 (7·5 %) classified as ‘healthy.’ The supplementary menu-based analysis showed similar classifications to DIGIASSESS (> 98 % agreement).

On this leading Australian OFD platform, the ‘healthy’ outlet category did not align with expert-informed assessments of outlet-type healthiness. Such misalignment risks misleading consumers and highlights the need for transparent, standardised criteria governing health-related outlet categories in digital food environments.

This study aimed to examine the association between protein intake and risk of sarcopenia, with a specific focus on protein sources, in middle-aged and older adults.

This was a 9-year follow-up study. Dietary protein intake was assessed by a validated FFQ with energy adjustment using the residual method. Sarcopenia was defined by using height-adjusted appendicular lean mass and grip strength. Adjusted OR for sarcopenia were calculated by multivariable logistic regression analysis.

Baseline surveys (2011–2014) for the Murakami and Uonuma cohorts assessed body size, lifestyle and medical history. Sarcopenia-related measurements were conducted in 2021–2022 in Murakami, Sekikawa, Uonuma and Minamiuonuma, Japan.

6232 individuals aged 40–74 years (mean age, 62·4 years; females, 54·8 %).

An inverse association between plant protein intake and sarcopenia was observed in males (Pfor trend = 0·018), although total and animal protein intakes were not. Animal-to-plant protein ratio was U-shaped in its association with sarcopenia; adjusted OR for the lowest and highest quintiles of the ratio compared to the middle quintile were 1·71 (95 % CI: 0·96, 3·07) and 1·97 (95 % CI: 1·10, 3·53), respectively, for males (Pfor quadratic term = 0·017), and 1·93 (95 % CI: 1·06, 3·51) and 1·65 (95 % CI: 0·90, 3·05), respectively, for females (Pfor quadratic term = 0·010).

An imbalanced intake of plant and animal proteins may increase the risk of sarcopenia, highlighting the importance of balanced protein intake.

The ‘Food Insecurity among European University Students during the COVID-19 Pandemic’ (FINESCOP) study investigates food insecurity (FI) and factors associated with FI among university students in nine European countries.

A cross-sectional, web-based survey design was employed. The Food Insecurity Experience Scale (FIES) was used for standardised assessment of FI across the study sites.

The study was conducted at nine universities in different European countries.

A total of 3250 cases were included in the joint analysis, with FI assessed using the standardised FAO-developed FIES.

The findings reveal considerable regional disparities in FI, with moderate or severe FI (FImod + sev) prevalence rates ranging from 3·1 % at an Italian university to 32·1 % at Ege University in Türkiye. Seven out of nine universities had FImod + sev prevalence rates above 10 %, exceeding the European 3-year average (2021–2023) of 7·8 %, with rates in most universities surpassing their respective national populations. Logistic regression analysis controlling for country-level fixed effects highlighted factors associated with higher odds of FI, including being born outside Europe, lower parental education, reliance on student loans and receiving food assistance.

While the FIES provides standardised assessments across diverse contexts, the survey’s timing during the COVID-19 pandemic may limit the findings’ generalisability to non-pandemic periods. Future research should adopt longitudinal designs and refine the FIES to enhance its applicability in diverse settings. This study emphasises that university students in Europe have unique vulnerabilities to FI, which must be recognised to create effective interventions and further research into its structural causes.

Price promotions influence food choices and are disproportionately applied to foods high in fat, sugar and salt (HFSS), consumption of which is a known contributor to poor diet and diet-related non-communicable diseases. This study evaluates the effectiveness of (1) restricting price promotions of HFSS products and (2) allowing such promotions but restricting communications regarding them in changing purchasing behaviours.

Between-subjects randomised controlled trial with three arms: (1) reduced price, labelled a price promotion (‘Usual Practice’); (2) reduced price, not labelled a price promotion (‘No Communication’) and (3) standard price (‘No Promotion’). Participants selected food and drinks for 2 d in a one-off shop, without restrictions on the number of items to purchase or the budget, at a simulated online supermarket. We measured total energy (kcal) in basket, total cost, total number of items, energy density (kcal/100 g) and proportion of the basket that was HFSS.

Simulated online supermarket.

Adults representative of the UK population (n 9004).

There were no significant differences in energy in baskets between groups, after controlling for age, sex, household income, ethnicity and deprivation. No significant differences were found between groups’ baskets for total cost, energy density or proportion HFSS. Participants in the ‘Usual Practice’ group selected significantly more items than the ‘No Promotion’ group (11·4 v. 11·1; P = 0·003).

No significant effects of restricting price promotions, or communications of them, were found for purchasing behaviours in a simulated online supermarket. Further price-based interventions, especially in real-world settings, are needed to provide robust policy recommendations.

To analyse the association between telework and household food insufficiency in the United States.

Cross-sectional study. Probit regression models were used to examine the association between telework (having at least one teleworking household member) and food insufficiency. Sensitivity analyses were conducted to examine the relationship across income levels and time periods.

United States Census Bureau’s Household Pulse Survey, Phases 3·1 to 3·10 (April 2021 to October 2023).

326 876 households with income below 200 % of the federal poverty line (FPL).

Telework was associated with a 4·4 percentage point decrease in the probability of food insufficiency among households with low income (predicted probabilities: 20·3 % (telework) v. 24·5 % (no telework); P < 0·01). The inverse relationship between telework and food insufficiency held across income levels (< 100 % FPL and 100–200 % FPL) and time periods (pandemic and post-pandemic).

Telework is associated with reduced household food insufficiency in the United States. Policies and interventions aimed at promoting telework adoption, and equitable telework opportunities may serve as valuable tools in addressing food hardship and advancing public health goals.

To identify interactions between the food, beverage and nutrition supplement industry and nutrition professionals (NP) in Australia.

The study employed a cross-sectional analysis of interactions by using an online survey including open and closed questions.

Australia.

156 practicing NP were recorded, 118 of them included in the analysis, 86 of which were dietitians.

Among respondents, eighty-eight (75 %) reported having previously received promotional material from industry, and seventy-four (66 %) have attended industry-sponsored educational events for professional development. Fifty-six (47 %) reported receiving gifts from industry in the past year. Of those who have received promotional or educational material, eleven (12 %) found it not useful at all, while others declared it slightly to extremely useful. Further analysis revealed that professional bodies and networks acted as intermediaries between industry and NP and that there were differences in judgement based on the specific industry they receive the material from.

The Australian food, beverage and nutrition supplement industry is attempting to actively engage with NP to promote their products through trusted sources. NP’ opinions on this vary, and further research is needed to examine the scope and impact of these interactions.

To systematically summarise people's health-related values and preferences related to fat intake.

We searched five databases for studies reporting people's perspectives on fats. Screening, data extraction and risk of bias assessment were performed by two independent reviewers. Data was analysed using a convergent integrated approach and the certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation methodology.

Qualitative and quantitative studies from any country or language.

Primary studies of adults, with or without cardiometabolic conditions.

From 52 166 records, we included eleven quantitative and two qualitative studies; studies were primarily conducted in high-income countries. Five main themes were identified: (i) negative perception of fat in food, (ii) positive perception of vegetable oil as being beneficial to health, (iii) willingness to lower fat consumption, (iv) willingness to pay for healthier fat content and (v) barriers towards unsaturated fat consumption. The most frequently reported themes were negative perception of fat and willingness to consume low-fat products, while prioritising vegetable oil as a healthy fat. The evidence certainty for these themes was very low to moderate, rated down for risk of bias and indirectness issues.

People's perception of fats and oils in diets is complex and often contradictory; most viewed high-fat products as unhealthy and associated with weight gain, while vegetable oils were generally perceived as beneficial. However, views varied significantly depending on sex, age and dietary patterns. Overall, the evidence supporting these perceptions is of moderate to very low certainty and to inform guideline recommendations more research is needed.

To identify and synthesise the educational and programmatic components most consistently associated with effective school-based food and nutrition education (SBFNE) for children and adolescents.

An umbrella review was conducted in accordance with PRISMA 2020 guidelines. We systematically searched CLEO, EDUCAT+, PubMed and Google Scholar through December 2022 for eligible literature reviews and meta-analyses. Included reviews were assessed for methodological quality and synthesised at the component level using qualitative and quantitative approaches.

Reviews examined SBFNE interventions delivered primarily during regular school hours in primary and secondary education settings worldwide.

Forty-four literature reviews synthesising evidence from 1651 primary studies (1115 unique) were included. Across reviews, twenty distinct educational and programmatic components were identified and standardised. Components most frequently reported and consistently associated with positive dietary behaviour change included Family Engagement, Focused on Behaviour Change, Multicomponent Approaches and Integration into the School Curriculum. Other components – such as Cultural Inclusivity and Environmental Sustainability – were examined less frequently but were associated with positive dietary outcomes in the reviews that assessed them. Several components, including Peer Support, Technology-Based Engagement and Community Engagement, demonstrated mixed or context-dependent effects, reflecting variability in implementation and study design. No component was consistently associated with adverse dietary outcomes.

By shifting the analytic focus from individual interventions to cross-cutting components, this umbrella review clarifies which elements most consistently underpin effective SBFNE. The resulting component framework provides a practical, transferable foundation to inform program design, evaluation and policy decision-making and to strengthen the equity, coherence and effectiveness of SBFNE initiatives.