The prevalence of obesity has increased in the last decades in the Western world. The aim of the present study was to examine the association between risk-taking behaviour in adolescence and adult obesity in men and women. Furthermore, we wished to describe social differences in obesity in Denmark.

Two population-based questionnaire studies (2004–2005 and 2006–2007) were used to collect information on weight and height, sociodemographic factors and factors regarding risk-taking behaviour during adolescence. Data were analysed using multivariate logistic regression.

Denmark.

Individuals aged 18–45 years (men: n 22 827, participation rate 71·0 %; women: n 20 870, participation rate 81·4 %).

The prevalence of overweight and obesity was respectively 37·8 % and 10·6 % in men and 20·1 % and 9·7 % in women. In both sexes, obesity was found to be associated with older age, low level of schooling and living outside the capital centre. In relation to risk-taking behaviour, young age (≤13 years) at first intercourse significantly increased the odds of being obese in adulthood (men: OR = 1·34, 95 % CI 1·04, 1·71; women: OR = 1·66, 95 % CI 1·27, 1·99). In women specifically, young age at start drinking alcohol (≤12 years) was associated with obesity.

Sociodemographic factors, in particular age, level of schooling and area of residence, are associated with obesity in both men and women. Risk-taking behaviour during adolescence seems to cluster in both obese men and obese women, however most convincingly in women.

To simulate effects of different scenarios of folic acid fortification of food on dietary folate equivalents (DFE) intake in an ethnically diverse sample of pregnant women.

A forty-four-item FFQ was used to evaluate dietary intake of the population. DFE intakes were estimated for different scenarios of food fortification with folic acid: (i) voluntary fortification; (ii) increased voluntary fortification; (iii) simulated bread mandatory fortification; and (iv) simulated grains-and-rice mandatory fortification.

Ethnically and socio-economically diverse cohort of pregnant women in New Zealand.

Pregnant women (n 5664) whose children were born in 2009–2010.

Participants identified their ethnicity as European (56·0 %), Asian (14·2 %), Māori (13·2 %), Pacific (12·8 %) or Others (3·8 %). Bread, breakfast cereals and yeast spread were main food sources of DFE in the two voluntary fortification scenarios. However, for Asian women, green leafy vegetables, bread and breakfast cereals were main contributors of DFE in these scenarios. In descending order, proportions of different ethnic groups in the lowest tertile of DFE intake for the four fortification scenarios were: Asian (39–60 %), Others (41–44 %), European (31–37 %), Pacific (23–26 %) and Māori (23–27 %). In comparisons within each ethnic group across scenarios of food fortification with folic acid, differences were observed only with DFE intake higher in the simulated grains-and-rice mandatory fortification v. other scenarios.

If grain and rice fortification with folic acid was mandatory in New Zealand, DFE intakes would be more evenly distributed among pregnant women of different ethnicities, potentially reducing ethnic group differences in risk of lower folate intakes.

To investigate club managers’ and parents’ experiences with food selection at handball halls in order to identify facilitators and barriers to the availability of healthy food.

Individual interviews with club managers (n 6) and focus groups (n 5) with parents (n 21) were conducted. Interviews were recorded and transcribed verbatim, transcripts were coded in NVivo and the analysis was guided by thematic analysis.

Interviews were conducted at five handball clubs with varying socio-economic user populations and sizes in the area of Oslo, Norway.

The club managers were responsible for food selection at the handball clubs. The participating parents had one or two active children between the ages of 6 and 12 years who took part in the clubs.

The club managers and parents generally described food selection at the handball halls as unhealthy and wanted a healthier selection of food. The club managers’ primary barriers to providing a healthier food selection included the potential to lose profits, limited facilities and time to prepare these foods. The parents often valued unhealthy food, as they believed that it supported the social environment and served as a reward for the children. Trainers were perceived as important role models for the promotion of healthy eating. The participants thought that national guidelines could facilitate healthy food environments in sports arenas.

Healthier food options in sports settings could be facilitated through national guidelines that describe healthy foods and establish who is responsible for providing healthy food selections.

To identify the food that has the greatest effect on the variation in the percentage of energy intake derived from fat and saturated fatty acids for the consumption of a Spanish population.

A cross-sectional study of food consumption, using the 24-hour recall method for three non-consecutive days, one of which was a non-working day. Subjects were interviewed by trained interviewers in the subjects' homes. We used multiple linear regression for statistical analysis.

The citizens of Reus.

One thousand and sixty subjects over five years old, randomly selected from the population census of Reus.

In both sexes, the foods that mainly determine a high consumption of fat are oil and red meat while those that determine a lower consumption of fat are bread, savoury cereals and fruit. The foods that mainly determine a high consumption of saturated fatty acids are red meat and whole-fat dairy products while those that determine a low consumption are bread, savoury cereals and fruit.

In our population, feasible variations in the intake of some foods – less than one portion – would reduce the estimated percentage of energy intake derived from fat and saturated fatty acids by a quantity considered important for cardiovascular disease prevention. The periodic identification and quantification of the food that most affects the dietary fat profile will help in drawing up dietary guidelines with more reasonable strategies for consuming a healthier diet and decreasing the risk of developing nutritional disorders.

To explore if the secular trend in height is contributing to delay overweight rise among Brazilian adolescents.

Changes in BMI mean over time were fitted using linear regression including as independent variables survey year, height, survey-specific income quintiles, age and an interaction term of height × survey year. Overweight was defined as BMI≥25·0 kg/m2. Changes in overweight prevalence over time were fitted using Poisson regression.

Four national household surveys: 1974/5, 1989, 2002/3 and 2008/9.

Brazilian adolescents.

Mean values of height and BMI increased over the period, for both sexes and in all age ranges, except for girls aged 14–19 years from 1989 to 2002/3. The highest average increment and mean rate of height were between 1989 and 2002/3 and in 10–15-year-olds. The annual increment of height decreased from 2002/3 to 2008/9 in parallel with the increment in BMI rate. After fitting the regression model, the height × survey year interaction and per capita income were strong vectors to increase BMI mean. Changes in increment rate of height played a protective role against overweight in the last two periods for both sexes, mainly for girls. The period from 1989 to 2002/3 was the strongest vector associated with overweight in boys and the association decreased to the next period, from 2002/3 to 2008/9.

BMI and height of adolescents have increased in a wavering and alternate way throughout four decades in Brazil. The rate of height increment has played a protective role against overweight in adolescents.

To determine if limb lengths, as markers of early life environment, are associated with the risk of diabetes in China.

We performed a cohort analysis using data from the China Health and Retirement Longitudinal Study (CHARLS), and multivariable-adjusted Cox proportional hazard regression models were used to examine the associations between baseline limb lengths and subsequent risk of diabetes.

The CHARLS, 2011–2018.

The study confined the eligible subject to 10 711 adults aged over 45 years from the CHARLS.

During a mean follow-up period of 6·13 years, 1358 cases of incident diabetes were detected. When controlling for potential covariates, upper arm length was inversely related to diabetes (hazard ratio (HR) 0·95, 95 % CI (0·91, 0·99), P = 0·028), and for every 1-cm difference in knee height, the risk of diabetes decreased by about 4 % (HR 0·96, 95 % CI (0·93, 0·99), P = 0·023). The association between upper arm length and diabetes was only significant among females while the association between knee height and diabetes was only significant among males. In analyses stratified by BMI, significant associations between upper arm length/knee height and diabetes only existed among those who were underweight (HR 0·91, 95 % CI (0·83, 1·00), P = 0·049, HR 0·92, 95 % CI (0·86, 0·99), P = 0·031).

Inverse associations were observed between upper arm length, knee height and the risk for diabetes development in a large Asian population, suggesting early life environment, especially infant nutritional status, may play an important role in the determination of future diabetes risk.

To assess the current Na levels in a variety of processed food groups and categories available in the Argentinean market to monitor compliance with the National Law and to compare the current Na content levels with the updated Pan American Health Organisation (PAHO) regional targets.

Observational cross-sectional study.

Argentina. Data were collected during March 2022 in the city of Buenos Aires in two of the main supermarket chains. We carried out a systematic survey of pre-packaged food products available in the food supply assessing Na content as reported in nutrition information panels.

We surveyed 3997 food products, and the Na content of 760 and 2511 of them was compared with the maximum levels according to the Argentinean law and the regional targets, respectively. All food categories presented high variability of Na content. More than 90 % of the products included in the National Sodium Reduction Law were found to be compliant. Food groups with high median Na, such as meat and fish condiments, leavening flour and appetisers are not included in the National Law. In turn, comparisons with PAHO regional targets indicated that more than 50 % of the products were found to exceed the regional targets for Na.

This evidence suggests that it is imperative to update the National Sodium Reduction Law based on regional public health standards, adding new food groups and setting more stringent legal targets.

To describe the food consumption, nutrition knowledge and nutritional assessment of childbearing age women and their children, living in rural villages in Madagascar. The results presented are related to the Tany Vao research study.

A cross-sectional pilot study.

The study was carried out in Ampanitosoha village on Nosy Mitsio island in Madagascar.

32 women (14–49 years) and 36 children and adolescents (2–17 years).

70 % of the women lacked nutrition knowledge and did not reach the Minimum Dietary Diversity Index for Women cut-off. The median BMI was 21·1 kg/m2 but 55·2 % of the women exceeded the cut-off for waist-to-hip ratio, 51·7 % for waist-to-height ratio and 81·2 % for mid-upper arm circumference (MUAC). Almost all had adequate intake of energy, protein and carbohydrates, while 27·6 % had excessive fat intake and 75·9 % of added sugars. Over half of the women did not meet the micronutrients Reference Daily Intake (RDI). For children, the MUAC z-score was lower for boys than for girls (P-value = 0·041).

These results underline the importance of increasing women’s nutritional knowledge to promote healthy pregnancy and lactation. Moreover, it is fundamental to provide people living in rural areas with sustainable tools to improve dietary diversity and support long-term health.

Night shift workers are at a 20 to 40 % increased risk of metabolic diseases, which may be associated with their disrupted eating patterns. This qualitative study explores factors that influence night shift workers’ eating habits, within and outside of the workplace, to identify target areas for health promotion strategies.

Eligible participants resided in Australia, working at least three overnight shifts per month.

The photovoice method was used, whereby participants were asked to take photos that represent their typical eating habits. These photos were incorporated as prompts in a semi-structured interview, which explored factors influencing eating habits on night shifts and days-off and perceptions and enablers to healthy eating.

Ten participants completed the study. Thematic analysis generated four main themes, which were mapped onto the Social Ecological Model (SE Model). Aligned with the SE Model, our results show night shift workers’ eating habits are influenced by intrapersonal, interpersonal and (work) organisational levels. Participants reported that at work, appropriate food preparation facilities are required to enable healthy food choices. Poor shift work rostering leads to prolonged fatigue on days-off, limiting their ability and motivation to engage in healthy eating. Consequently, night shift workers seem to require additional supports from their social networks and enhanced food literacy skills, in order to adopt/ maintain healthy eating behaviours.

Night shift work creates individual and environmental barriers to healthy eating, which are present during and outside of work. Health promotion strategies for this population should include multiple approaches to address these barriers.

To examine the feasibility and implementation of an optimal defaults intervention designed to align grocery purchases with a diet recommended for people with or at-risk for type 2 diabetes.

This was a 5-week pilot randomised trial with three groups: in-person grocery shopping, shopping online and shopping online with ‘default’ carts. Participants were asked to shop normally in Week One, according to group assignment in Weeks Two–Four (intervention period), and as preferred in Week Five. All groups received diabetes-friendly recipes via email each intervention week.

Participants grocery shopped in person or online. Grocery receipt forms, enrolment information and exit surveys were collected remotely and used to assess feasibility and implementation.

Sixty-five adults with or at-risk for type 2 diabetes.

Sixty-two participants completed the exit survey and fifty-five submitted receipts all 5 weeks. Forty utilised recipes, 95 % of whom indicated recipes were somewhat or very useful. Orange chicken, quesadillas and pork with potato and apples were the most liked recipes. Most Defaults group participants accepted at least some default cart items. Recipes with the highest default acceptance were whole grain pasta and chicken, quesadillas with black beans and chicken with olives. Participants’ primary concerns about the intervention were costs associated with online shopping, inability to select preferred foods and some recipes including ingredients household members would not eat.

The study had high retention, data were successfully collected remotely and the intervention was acceptable to most participants. Tailoring recipes to household preferences may be beneficial in future studies.

To identify factors influencing Black immigrant mothers’ perceptions and concerns about child weight and to compare children’s diet quality according to these perceptions and concerns.

Mothers’ perceptions and concerns about child weight were assessed with sex-specific figure rating scales and the Child Feeding Questionnaire, respectively. Participants’ weights and heights were measured and characterised using WHO references. Children’s dietary intakes were estimated using a 24-h dietary recall. Children’s diet quality was evaluated using the relative proportion of their energy intake provided by ultra-processed products, which were identified with the NOVA classification. χ2 tests, multivariate logistic regressions and t tests were performed.

Ottawa, Ontario, Canada.

Black immigrant mothers of Sub-Saharan African and Caribbean origin (n 186) and their 6–12-year-old children.

Among mothers, 32·4 % perceived their child as having overweight while 48·4 % expressed concerns about child weight. Girls and children with overweight or obesity were significantly more likely to be perceived as having overweight by their mothers than boys and normal-weight children, respectively. Mothers of children living with obesity, but not overweight, were significantly more likely to be concerned about their child’s weight than mothers of normal-weight children. Children’s diet quality did not differ according to mothers’ perceptions and concerns.

Children’s gender and weight status were major determinants of perceptions and concerns about child weight among Black immigrant mothers. Including knowledge about mothers’ perceptions and concerns about child weight will help nutrition professionals develop interventions tailored to specific family needs within the context of their cultural backgrounds.

The objective of the present study was to determine the knowledge and practices among Trinidad and Tobago school-attending adolescents towards energy drinks (ED), alcohol combined with energy drinks (AwED), weight-altering supplements (WAS) and vitamin/mineral supplements (VMS) and their experience of adverse effects associated with such use.

A cross-sectional, proportionate, stratified sampling strategy was adopted using a self-administered, de novo questionnaire.

Secondary schools throughout Trinidad and Tobago.

Students aged 15–19 years.

Five hundred and sixty-one students participated, an 84 % response rate; 43·0 % were male, 40·5 % East Indian and 34·1 % mixed race. VMS, ED, WAS and anabolic steroids were used by 52·4 %, 44·0 %, 8·9 % and 1·4 % of students, respectively, with 51·6 % of ED users using AwED. Predictors of use of AwED were males and students who played sport for their school (OR = 1·9; 95 % CI 1·2, 3·2 and OR = 2·6; 95 % CI 1·4, 4·7, respectively). Predictors of ED use were males and attendees of government secondary schools (OR = 1·7; 95 % CI 1·1, 2·4 and OR = 1·7; 95 % CI 1·2, 2·4, respectively). Side-effects, mainly palpitations, headaches and sleep disturbances, were reported in 20·7 % of dietary supplement users.

Many adolescent students in Trinidad and Tobago use dietary supplements, including ED and AwED, and about one-fifth of users experience side-effects. Identification of students at risk for ED, AwED and WAS use and education of students about the dangers of using dietary supplements need to be instituted to prevent potential adverse events.

Little is known about parents’ compensatory health beliefs (CHB) surrounding their children’s engagement in physical activity (PA). Our aim was to provide evidence regarding the nature of, and factors underpinning, parents’ PA-related compensatory beliefs for their children.

A qualitative descriptive approach and thematic content analysis were employed.

Parents were recruited from community sport and PA programmes.

Eighteen parents aged 32–52 years (mean age = 40·8 (sd 5·4) years; six males; twelve females).

Analyses indicated that parents compensate through ‘passive’ or ‘active’ means. Among parents who compensated, most described their provision of ‘treat’ foods/drinks and a minority described allowing extended sedentary time to their children. Parents’ reasons underpinning these beliefs related to their child’s general physical/health status and psychological characteristics, and their own motivation and mood state.

These findings provide the first evidence of unhealthy dietary and sedentary behaviour CHB that parents may hold regarding their children’s involvement in PA.

To identify key school-level contexts and mechanisms associated with implementing a provincial school food and beverage policy.

Realist evaluation. Data collection included semi-structured interviews (n 23), structured questionnaires (n 62), participant observation at public events (n 3) and scans of school, school district and health authority websites (n 67). The realist heuristic, context + mechanism → outcome configuration was used to conduct the analysis.

Public schools in five British Columbia (BC), Canada school districts.

Provincial and regional health and education staff, private food vendors and school-level stakeholders.

We identified four mechanisms influencing the implementation of BC’s school food and beverage sales policy. First, the mandatory nature of the policy triggered some actors’ implementation efforts, influenced by their normative acceptance of the educational governance system. Second, some expected implementers had an opposite response to the mandate where they ignored or ‘skirted’ the policy, influenced by values and beliefs about the role of government and school food. A third mechanism related to economics demonstrated ways vendors’ responses to school demand for compliance with nutritional Guidelines were mediated by beliefs about food preferences of children, health and food. The last mechanism demonstrated how resource constraints and lack of capacity led otherwise motivated stakeholders to not implement the mandatory policy.

Implementation of the food and beverage sales policy at the school level is shaped by interactions between administrators, staff, parent volunteers and vendors with contextual factors such as varied motivations, responsibilities and capacities.

Evaluation of California Department of Public Health’s three-year social marketing campaign (Be Better) to encourage healthy eating and water consumption among Supplemental Nutrition Assistance Program-Education (SNAP-Ed) California mothers. Andreasen’s social marketing framework was used to outline the development and evaluation of the campaign.

Quantitative, pre-post cross-sectional study with three cohorts nested within survey years. Generalised estimating equation modeling was used to obtain population estimates of campaign reach and changes in mothers’ fruit and vegetable (FV) consumption and facilitative actions towards their children’s health behaviours.

CalFresh Healthy Living (California’s SNAP-Ed).

Three separate cohorts of SNAP mothers were surveyed (pre, post) between 2016 and 2018 inclusive. A total of 2229 mothers (ages 18–59) self-identified as White, Latina, African American or Asian/Pacific Islander participated.

Approximately 82 percent of surveyed mothers were aware of the campaign as assessed by measures of recall and recognition. Ad awareness was positively associated with mothers’ FV consumption (R2 = 0·45), with the proportion of FV on plates and with behaviours that facilitate children’s FV consumption and limit unhealthy snacks and sugary drinks (βs ranged from 0·1 to 0·7).

The campaign successfully reached 82 percent of surveyed mothers. Positive associations between California’s Be Better campaign and targeted health behaviours were observed, although the associations varied by year and media channel (i.e. television, radio, billboards and digital). Most associations between ad awareness and outcomes were noted in years two and three of the campaign, suggesting that more than 1 year of campaign exposure was necessary for associations to emerge.

The objective of this study was to explore the relationship between various forms of child nutritional disorders and early childhood development in Bangladesh.

We analysed data from the nationally representative cross-sectional 2019 Multiple Indicator Cluster Survey. Early childhood development was evaluated using the Early Childhood Development Index (ECDI), which comprised 10 yes-or-no questions across four domains: literacy-numeracy, physical well-being, socio-emotional development, and learning abilities. Nutritional disorders (e.g. stunting, wasting, and underweight) were measured based on the World Health Organization’s height and weight guidelines. To investigate the relationships between child development and nutritional disorders, we used multilevel logistic regression models.

Bangladesh.

Data of 9,455 children aged 3 and 4 years.

Approximately 38 % of the children analysed experienced a nutritional disorder, with stunting being the most prevalent at 28·15 %. Overall, 25·27 % did not meet expected developmental progress measured by the ECDI. Stunted children were more likely to be off track developmentally, while those without any nutritional disorder were more likely to be on track. Socio-demographic factors, including age, sex, attendance in early childhood education programme, maternal education, maternal functional difficulties, region, and income, were identified as determinants of ECDI.

Childhood nutrition and socio-demographic factors significantly affect multiple developmental domains and overall ECDI among children aged 3–4 years. Prioritising policies and programmes that improve nutrition and address these determinants are crucial for fostering optimal development in children.