Ultra-processed foods, as classified by NOVA, provide a substantial and rising share of dietary energy worldwide. Manufactured from cheap refined ingredients and cosmetic additives, they are engineered for hyper-palatability, long shelf life and profit and are widely perceived as convenient, low-cost options. This commentary argues that such perceptions of ‘cheapness’ are misleading once health, equity and environmental impacts are considered.

Breastfeeding is a critical component of infant nutrition, and breastfed infants are less likely to become stunted or obese reducing the risk of non-communicable diseases in adult life. Optimal breastfeeding practices remain a challenge worldwide; as adolescents are the mothers and fathers of tomorrow, integrating DOHaD-informed knowledge into school curricula is called for. However, research indicates adolescents have low awareness of the importance of the first 1000 days of life, only see specific elements as relevant to them, and gender-related differences exist in their comprehension. This study evaluated the impact on adolescents of an in-class presentation on parenting and the benefits of breastfeeding in high schools in 5 African countries. Pre- and post-intervention questionnaires were completed by 345 pupils (182 girls, 163 boys, mean age 17.9 years). Analysis indicated the education session impacted pupils’ perceptions of parenting and changed which aspects of breastfeeding they viewed as most and least interesting. A statistically significant difference was evident between genders on the importance of cost-benefits; more boys saw relevance for fathers that no cost is incurred for formula. Boys also ranked the potential to reduce diabetes healthcare costs in adult life higher than girls. Girls preferentially ranked breastfed babies crying less, being easier to feed at night, and diaper changing being less gross as benefits for fathers. School-based education can engage adolescents and impact knowledge and attitudes about breastfeeding. Awareness of differences in girls’ and boys’ perceptions of relevance will enable educational content to be targeted to attract and inform both genders.

People with severe mental illness (SMI) die 10–20 years earlier than the general population, largely due to non-communicable diseases (NCDs) such as hypertension and diabetes and risk factors such as hypercholesterolaemia. This cross-sectional study gathered data from people with SMI from three national mental health institutions in South Asia. Data was collected based on the WHO Stepwise approach to NCD risk factor surveillance and the prevalence of screening, diagnosis and treatment for diabetes, hypertension, and hypercholesterolaemia was assessed. Logistic regression models assessed the associations of sociodemographic characteristics with NCD screening. Three thousand nine hundred and eighty nine participants were recruited. Screening prevalence varied by country and disease, with hypertension being the most commonly screened NCD (Bangladesh = 52.5% [50.0–55.1], India = 43.1% [40.3–45.9], Pakistan = 60.9% [58.2–63.5]), and cholesterol was the least common (Bangladesh = 4.1% [3.2–5.2], India = 14.8% [12.9–17.0], Pakistan = 9.6% [8.1–11.3]). Characteristics such as BMI, age and education level were positively associated with screening, and females were more likely to be screened than males. There are low levels of screening for NCDs among individuals with SMI accessing tertiary institutions in South Asia, with significant sociodemographic disparities. Standardised screening protocols tailored to South Asian populations could mitigate the increased risk of NCDs in this population.

Hypertension (HTN) is the primary cause of preventable cardiovascular-related deaths globally, representing the most important modifiable risk factor for preventing such deaths. Nearly 700 million of the 1.3 billion adults with HTN worldwide remain untreated, most of whom live in low-and middle-income countries, including East Africa. Barriers to the diagnosis of HTN also impact treatment adherence after diagnosis and the initiation of treatment. This scoping review used a qualitative synthesis method to describe studies examining the cultural and contextual factors influencing HTN treatment adherence in East Africa and the lived experiences of patients with HTN to gain a better understanding of these factors in the region. A total of 34 studies, 25 qualitative and 9 mixed-methods designs from five East African nations were included in the final review. Reported influencing factors are classified into individual, structural, and social factors. Lack of HTN literacy and limited risk perception were often cited as individual barriers to adherence, along with mental health challenges, including fear of stigma, while trust and HTN literacy enhanced adherence. Inconsistent healthcare delivery, lack of access, and financial constraints were the most reported structural factors. Social norms surrounding health behaviours and attitudes towards HTN treatment were identified as key determinants of adherence at the social level. The findings underscore the complex interplay of individual, structural, and social factors associated with HTN treatment adherence in East Africa, offering practical ways to enhance adherence in the region at all three levels.

Ultra-processed foods (UPF) are often energy dense and low in nutrients. High consumption of UPF has been associated with non-communicable diseases, premature mortality and environmental impacts. The objective of this study was to assess UPF consumption in relation to diet quality and associated greenhouse gas (GHG) emissions, previously not examined in Iceland. Data from the Icelandic National Dietary Survey (2019–2021, n 822) were utilised. The NOVA classification system was used classifying all food and drinks reported. Dietary GHG emissions were quantified using an open-source life cycle assessment database. On average, 45 %±15 of the total calories consumed daily were derived from UPF, ranging from 24 % in the lowest quartile (UPFQ1) to 64 % in the highest quartile (UPFQ4). The energy contribution of UPF considered to fall within the Icelandic dietary guidelines was 4 %±4. UPFQ4 had significantly lower consumption of, e.g. red meat, fruits, vegetables and whole grains and higher consumption of, e.g. refined grains, sweets and soft drinks, compared with UPFQ1. UPFQ4 had a significantly higher energy intake, added sugar intake and lower intake of, e.g. proteins and iodine. The median (interquartile range (IQR)) share of dietary GHG emissions was 21 % (IQR: 11–34) of total kg CO2-eq/d, while significantly lower in UPFQ4 compared with UPFQ1. Almost half of the daily energy intake of Icelandic diets was derived from UPF, reflecting relatively poor diet quality. However, dietary GHG emissions were relatively low in high consumers of UPF, reflecting higher meat consumption in low consumers of UPF. Findings underline the urgency of policy implementation, aligning food consumption with dietary guidelines.

Sub-Saharan Africa (SSA) is currently undergoing rapid urbanisation, a transition that is closely linked to the adoption of sedentary lifestyles and Westernised dietary habits. This shift has contributed to a substantial rise in obesity and diet-related non-communicable diseases (DR-NCDs), placing a significant strain on already burdened healthcare systems. Among the key modifiable risk factors driving this epidemiological transition are changes in dietary patterns. Western-style diets have been shown to promote inflammation and trigger metabolic and immune dysregulation, factors that underlie the development of DR-NCDs. Conversely, many Tanzanian heritage diets incorporate a diverse array of nutrient-rich foods prepared using techniques that minimise the use of oils, sweeteners and preservatives. These diets predominantly use whole grains, legumes and fruits, foods high in dietary fibre and nutraceuticals. Nutraceuticals are known to have both immunomodulatory and metabolic benefits and could potentially counteract the negative effects associated with Western-style diets. However, the limited scientific documentation of these heritage diets endangers future research into their potential health benefits. This underscores the need for targeted efforts to preserve and promote traditional dietary practices. In this review, we summarise the diversity of heritage diets from four distinct tribes in Northern Tanzania – the Maasai, Chagga, Pare and Hadzabe – who have historically exhibited low rates of DR-NCDs but are now experiencing rapid urbanisation and lifestyle changes. We briefly describe the dietary patterns of these tribes and examine the potential links between the declining usage of traditional dietary practices and the rising prevalence of DR-NCDs in Tanzania.

This study compared red meat, white meat and vegetable consumption before, during and after COVID-19 pandemic among older adults in regional China. Data were collected from urban individuals aged 60+ years in Nanjing municipality in 2018, 2021 and 2023. Differences in food intake frequencies between participants and survey years were examined. Logistic regression models were employed to identify influencing factors of meat, and vegetable consumption. Totally, 13 792 participants were analysed, with 4355, 4622 and 4815 from 2018, 2021 and 2023 surveys, respectively. The mean weekly intake frequency (sd) in 2018, 2021 and 2023 was, separately, 3·85 (sd 2·83), 3·21 (sd 2·90) and 4·71 (sd 3·94) for red meat; 1·38 (sd 1·21), 2·08 (sd 1·90) and 2·73 (sd 2·55) for white meat; and 10·98 (sd 4·84), 10·00 (sd 5·04) and 10·34 (sd 5·04) for vegetable. Moreover, 23·2, 32·6 and 52·3 % of participants met the recommendation for meat intake, while 53·7, 46·8 and 49·6 % reached vegetable intake recommendation before, during and after COVID-19 pandemic, respectively. Meat intake was positively associated with education, marital status and drinking, but negatively associated with age. Additionally, education and marital status were in negative relation to vegetable consumption, while smoking and drinking were positively associated with vegetable intake. The older residents consumed less red meat and vegetable but more white meat during COVID-19 pandemic, and their consumption levels of meat and vegetable went up after the pandemic. These findings highlight the need for targeted interventions to support older adults’ dietary habits during emergency events.

Excessive consumption of energy drinks poses significant risks, including the development of various non-communicable diseases. This trend is driven by a combination of the desire to remain alert and the strategic use of catchy advertising slogans by manufacturers, particularly targeting young adolescents. Unlike tobacco products, which are similarly linked to such diseases, Nigeria lacks legislation requiring energy drink manufacturers to warn consumers about potential adverse health effects. This paper argues that the absence of such regulation constitutes a violation of the right to health in Nigeria. It concludes by advocating for the Nigerian government to enact laws mandating energy drink manufacturers to include clear health warnings on their products.

The objective of this study was to explore the knowledge and attitudes regarding seafood safety and consumption, along with preferences and environmental issues in coastal Bangladesh. A cross-sectional, consumer-based survey was conducted in Bangladesh from September to November 2023, targeting 1100 participants aged 18 years and older across seven coastal districts. Convenience sampling and in-person interviews were used for the data collection. The average knowledge and attitude scores toward seafood safety and consumption were 48.2% and 63.5%, respectively. Several factors influenced seafood safety and consumption knowledge, including age, education level, family size, religion, and residence in coastal areas (all P < 0.05). In contrast, attitudes toward seafood safety and consumption were shaped by education level, family size, employment status, seafood allergies, and history of seafood poisoning (all P < 0.05). The most commonly consumed seafood was rupchanda, followed by shrimp. Most participants consumed seafood for its health benefits, with no significant seasonal impact on seafood consumption. Overfishing and climate change were recognised as the most alarming environmental dangers identified by the participants. Coastal communities in Bangladesh have demonstrated moderate attitudes, but relatively low knowledge of seafood safety and consumption. Targeted educational programmes, including community workshops on safe handling and storage, school-based programmes on marine conservation, and digital campaigns via SMS/social media, are needed to improve seafood safety knowledge, while promoting sustainable consumption practices is crucial for addressing environmental concerns like overfishing. Additionally, improving market accessibility and highlighting the health advantages of seafood can drive more informed and healthier consumption choices.

Building on the success of the Soft Drinks Industry Levy (SDIL), new tax proposals have been considered in the public health policy debate in the UK. To inform such debate, estimates of the potential impacts of alternative tax scenarios are of critical importance. Using a modelling approach, we studied the effects of two tax scenarios: (1) a hypothetical excise tax designed to tax food products included in the Sugar Reduction Programme (SRP), accounting for pack size to reduce the convenience of purchasing larger quantities at once; (2) an ad valorem tax targeting products based on the UK Nutrient Profile Model (NPM). Simulations of scenario 1 show a reduction in sugar purchased of up to 38 %, with the largest decreases observed for sweet confectionery with a tiered tax, similar in structure to the SDIL. Expected food reformulation in scenario 1 led to further decreases in sugar purchased for all categories. In scenario 2, under the assumption that the tax would not affect purchases of healthier products, a 20 % tax on less healthy products would reduce total sugar purchased by 4·3 % to 14·7 % and total energy by 4·7 % to 14·8 %. Despite some limitations and assumptions, our results suggest that new fiscal policy options hold a significant potential for improving diet quality beyond what has been achieved by the SDIL and SRP. An estimated increase in consumer expenditures in both scenarios suggests that attention needs to be paid to potentially regressive effects in the design of any new food taxes.