.Globally and nationally, only 64⋅5 and 49⋅2 % of infants received solid or semi-solid foods, respectively. The available evidence indicates that the time to initiate complementary feeding practices is still poor and varies by region. The aim of the present study was to assess the time to initiation of complementary feeding and its predictors among children aged 9–23 months in Meket District, Amhara Region, Ethiopia. A community-based retrospective cohort study was conducted from June to July 2022 among 459 systematically selected mothers/caregivers with their children from 9 to 23 months of age. The result of descriptive statistics was reported by table, frequency, Kaplan-Meier curve and percent. The proportional hazard model assumption was checked, and a Weibull regression model was used to see the predictors of timely initiation of complementary feeding. An adjusted hazard ratio with a 95 % confidence interval and a P-value of 0⋅05 were used to declare the significant predictors. The median time of complementary feeding initiation was 6 months. Attending primary education (adjusted hazard ration (AHR) 1⋅8; 95 % CI 1⋅16, 2⋅78), occupation of the mother (AHR 1⋅43; 95 % CI 1⋅04, 1⋅95), home delivery (AHR 1⋅61; 95 % CI 1⋅09, 2⋅37) and birth preparedness (AHR 1⋅37; 95 % CI 1⋅03, 1⋅81) were the predictors of time to complementary feeding initiation. The median time to complementary feeding initiation was consistent with the WHO recommendation. Maternal education, maternal employment, place of delivery and birth preparedness were the predictors of time to initiation of complementary feeding. Therefore, working with the education sector, increasing the delivery rate in health facilities, strengthening counselling on birth preparation, increasing maternity leave until 6 months of age and initiating corner feeding should be part of the complementary feeding practices promotion agenda.

Previous studies on the relationship between dairy consumption and hip fracture risk have reported inconsistent findings. Therefore, we aimed to conduct an algorithmically driven non-linear dose-response meta-analysis of studies assessing dairy intake and risk of developing incident hip fracture. Meta-analysis from PubMed and Google Scholar searches for articles of prospective studies of dairy intake and risk of hip fracture, supplemented by additional detailed data provided by authors. Meta-regression derived dose-response relative risks, with comprehensive algorithm-driven dose assessment across the entire dairy consumption spectrum for non-linear associations. Review of studies published in English from 1946 through December 2021. A search yielded 13 studies, with 486 950 adults and 15 320 fractures. Non-linear dose models were found to be empirically superior to a linear explanation for the effects of milk. Milk consumption was associated with incrementally higher risk of hip fractures up to an intake of 400 g/d, with a 7 % higher risk of hip fracture per 200 g/d of milk (RR 1⋅07, 95 % CI 1⋅05, 1⋅10; P < 0⋅0001), peaking with 15 % higher risk (RR 1⋅15, 95 % CI 1⋅09, 1⋅21, P < 0⋅0001) at 400 g/d versus 0 g/d. Although there is a dose-risk attenuation above 400 g/d, milk consumption nevertheless continued to exhibit elevated risk of hip fracture, compared to zero intake, up to 750 g/d. Meanwhile, the analysis of five cohort studies of yoghurt intake per 250 g/d found a linear inverse association with fracture risk (RR 0⋅85, 95 % CI 0⋅82, 0⋅89), as did the five studies of cheese intake per 43 g/d (~1 serving/day) (RR 0⋅81, 95 % CI 0⋅72, 0⋅92); these studies did not control for socioeconomic status. However, no apparent association between total dairy intake and hip fracture (RR per 250 g/d of total dairy = 0⋅97, 95 % CI 0⋅93, 1⋅004; P = 0⋅079). There were both non-linear effects and overall elevated risk of hip fracture associated with greater milk intake, while lower risks of hip fracture were reported for higher yoghurt and cheese intakes.

Whilst dietary cholesterol guidelines have waivered through the years with historic restrictions lifted for the majority of the general population, recommendations to reduce saturated fat intake have been the mainstay of dietary guidelines since the 1980s and were recently reinforced by the Scientific Advisory Committee on Nutrition (SACN). Cholesterol metabolism is complex, with saturated fat known to have a more significant contribution at raising levels of low-density lipoprotein (LDL) cholesterol, a well-established risk factor for cardiovascular disease (CVD). However, it is clear from metabolic research that hyper-responsiveness to both dietary cholesterol and saturated fat exists; hence, for specific subsets of the population, reductions in both nutrients may be indicated. With this in mind, the current article aims to provide an overview of the mechanisms underlying biological variation in responsiveness and introduces research currently underway which will hopefully identify simple biomarkers that can be used to predict responsiveness and permit tailored, personalised, dietary advice. Eggs are a well-known source of dietary cholesterol whilst being low in saturated fat. A common question encountered in clinical practice is must individuals limit intake to manage blood cholesterol levels. This article summarises key recent papers which confirm that eggs can be enjoyed as part of a healthy balanced diet, whilst highlighting the need for further research in certain population groups, e.g. in individuals with diabetes.

Even though antiretroviral therapy (ART) access for human immunodeficiency virus (HIV)-infected children increased dramatically, anaemia has continued as a challenge regardless of a cluster of differentiation (CD4) count and viral load. Hence, the present study aimed to assess the determinants of iron deficiency anaemia among children living with HIV after the initiation of ART. An institution-based unmatched case–control study was conducted among consecutively selected 712 children on HIV care from 1 September to 30 October 2022 in the Metekel zone. A pre-tested and structured data extraction checklist was used to collect the data. Data were analysed using STATA version 16 software. Binary logistic regression was used to find the association between independent variables and anaemia. The level of statistical significance was declared at a value of P < 0⋅05. A total of 712 HIV-positive children (178 cases and 534 controls) were included in this study, with a completeness rate of 98⋅8 %. In multivariable analysis, variables that have a statistically significant association with anaemia were as follows: CD4 count <350 (Adjusted Odds Ratio [AOR] 2⋅76; 95 % CI 1⋅76, 4⋅34), World Health Organization (WHO) clinical stage III (AOR 7⋅9; 95 % CI 3⋅5, 17⋅91) and stage IV (AOR 7⋅8; 95 % CI 3⋅37, 18⋅1), cotrimoxazole prophylaxis therapy (AOR 0⋅5; 95 % CI 0⋅31, 0⋅8) and mid-upper arm circumference (MUAC) ≤11⋅5 mm (AOR 2⋅1; 95 % CI 1⋅34, 3⋅28). The present study found that CD4 count, WHO clinical stage, cotrimoxazole prophylaxis therapy and MUAC were significantly associated with anaemia in children on ART. Therefore, continuous screening of anaemia and nutritional treatment is essential in these patients.

Protein intake, sources and distribution impact on muscle protein synthesis and muscle mass in older adults. However, it is less clear whether dietary protein influences muscle strength. Data were obtained from the Researching Eating Activity and Cognitive Health (REACH) study, a cross-sectional study aimed at investigating dietary patterns, cognitive function and metabolic syndrome in older adults aged 65–74 years. Dietary intake was assessed using a 4-d food record and muscle strength using a handgrip strength dynamometer. After adjusting for confounders, in female older adults (n 212), total protein intake (β = 0⋅22, P < 0⋅01); protein from dairy and eggs (β = 0⋅21, P = 0⋅03) and plant food sources (β = 0⋅60, P < 0⋅01); and frequently consuming at least 0⋅4 g/kg BW per meal (β = 0⋅08, P < 0⋅01) were associated with higher BMI-adjusted muscle strength. However, protein from meat and fish intake and the coefficient of variance of protein intake were not related to BMI-muscle strength in female older adults. No statistically significant associations were observed in male participants (n = 113). There may be sex differences when investigating associations between protein intake and muscle strength in older adults. Further research is needed to investigate these sex differences.

Although customer support is critical to the wider uptake of nudging strategies to promote fruits and vegetables (FV) in institutional food service (FS) settings, empirical research is sparse and typically based on small convenience samples. An online survey was conducted to assess support, perceived effectiveness and intrusiveness of nine nudge types drawn from Münscher et al.'s Taxonomy of Choice Architecture. We focused on the setting of campus FSs across Canada. A national sample of post-secondary students regularly using campus FSs was used (N 1057). Support for changing the range of options (B3) was the highest, closely followed by changing option-related effort (B2) and changing option-related consequences (B4). Facilitating commitment (C2), changing default (B1) and providing a social reference point (A3) received lowest support. Furthermore, we extracted three clusters of respondents based on perceived effectiveness and intrusiveness of nudge types. Characterised by a relatively low level of perceived effectiveness and moderately high level of intrusiveness, Cluster 1 (61⋅7 % of the sample) reported the lowest support for nudges. Cluster 2 (26⋅6 %), characterised by intermediate effectiveness and low intrusiveness of nudging, reported a high level of support for nudges. Lastly, Cluster 3 (11⋅7 %), characterised by high perceived effectiveness of as well as high perceived intrusiveness, reported the highest level of support for nudges. Findings confirm overall support for FV nudging, with significant differences across nudge types. Differences in customers’ acceptance and perception across nudge types offer campus FS operators initial priors in selecting nudges to promote FV.

The present study assessed dietary diversity and anthropometric status of children attending early development centres in South Africa. In the Vhembe District of Limpopo province, South Africa, 273 children were conveniently chosen from 8 randomly selected early childhood development centres for a cross-sectional study. Data were gathered via a questionnaire administered by the interviewer in June 2021. Height, body weight and mid-upper arm circumference were measured to assess anthropometric status. A 24-h dietary recall was obtained to provide information on dietary diversity. The prevalence of underweight, wasting and stunting was 9, 4 and 26 %, respectively. More than half of the children had a low dietary diversity score, according to the Food and Agriculture Organization scoring system for children. Grains, roots, tubers, dairy products, other fruits and vegetables, and flesh-based foods were the highest consumed food groups. The lowest consumption was for eggs, vitamin A-rich fruits and vegetables, legumes and nuts. Height for age and weight for age were significantly associated with dietary diversity score, but not weight for height. Children who did not meet the reference value of greater than 4 for dietary diversity had a significant risk of being underweight (AOR 0⋅25, 95 % CI 0⋅08, 0⋅75) and stunted (AOR 0⋅32, 95 % CI 0⋅14, 0⋅74). The nutritional status of the children was impacted by a lack of adequate dietary diversity. Young children in rural areas need to receive a wide range of food to promote greater diversification of diets in order to diminish the risk of undernutrition.

Concurrent wasting and stunting (WaSt) is a serious form of malnutrition among young children, particularly vulnerable groups affected by the conflict. Understanding the prevalence and risk factors of WaSt among vulnerable children is important to develop effective intervention measures to reduce the burden of WaSt. The present study aimed to identify the prevalence of and risk factors for WaSt among marginalised children aged 6–59 months in Sana’a city, Yemen. A community-based cross-sectional design was conducted on a total sample size of 450 marginalised children aged 6–59 months who lived at home with their mothers. Multivariable logistic regression analysis was performed and the prevalence of WaSt was found to be 10⋅7 %. Children aged 24–59 months were protected from WaSt (adjusted odds ratio (AOR) 0⋅40, 95 % confidence interval (CI) 0⋅21, 0⋅75). A higher prevalence of WaSt was associated with male sex (AOR 2⋅31, 95 % CI 1⋅13, 4⋅71), no history of being breastfed (AOR 3⋅57, 95 % CI 1⋅23, 10⋅39), acute diarrhoea (AOR 2⋅12, 95 % CI 1⋅12, 4⋅02) and family income sources of assistance from others (AOR 2⋅74, 95 % CI 1⋅08, 6⋅93) or salary work (AOR 2⋅22, 95 % CI 1⋅10, 4⋅47). Continued breast- and bottle-feeding were not associated with WaSt in children aged 6–23 months. Mothers’ age, education and work status, family size and drinking water source were not associated with WaSt. Overall, we found that the prevalence of WaSt among marginalised children remained high. Interventions to improve household income, hygienic conditions and child feeding practices are necessary to promote child growth.

Mild-to-moderate iodine deficiency remains a problem worldwide, including in Norway. Of particular, concern is fertile, pregnant and lactating women. The Norwegian Dairy Council developed a digital iodine-specific dietary screener (I-screener) for the assessment of iodine intake levels but has yet to be validated. The aim was thus to investigate the relative validity of the I-screener by comparing estimates of iodine intake from the I-screener against a single 24-hour recall (24HR) and urinary iodine concentration (UIC) in fertile women. Healthy females were recruited in Bergen in August–December 2021. Six spot-urine samples from six consecutive days were collected into a pooled sample to assess UIC. Each participant completed a single administration of the I-screener and the 24HR. The estimated daily iodine intake from the I-screener was compared with the estimations from the 24HR and UIC. Seventy-two women aged 19–39 completed the study. The median UIC was 76 μg/l. Compared with the 24HR, the I-screener placed 83 % of the participants in the same/adjacent tertial, with a slight agreement between the methods (Cohen's kappa = 0⋅187). The present study shows an acceptable correlation between the I-screener and the 24HR (r = 0⋅318), but not between the I-screener and UIC (r = 0⋅122). Despite its varying iodine estimate abilities, the I-screener may be used as an initial screening tool to rank fertile women on an individual level into deficient inadequate, and sufficient iodine intake. However, due to the relatively high risk of misclassification, further assessment of iodine status should follow.

We investigated the association of household food insecurity (HFI) with developmental delays in 36–59-month-old preschool children (n 7005) using cross-sectional data from the 2018 Ecuadorian National Health and Nutrition Survey. HFI was assessed with the Food Insecurity Experience Scale and developmental delays with the Early Childhood Development Index. Log-binomial regression models estimated the association of HFI with global (overall) developmental delay (GDD) and delays in four individual developmental domains, adjusting for covariates. Nearly half of the children lived in households with marginal (24⋅5 %) or moderate-severe HFI (21⋅7 %). Eighteen percent were identified with GDD. Delays in the individual domains of literacy-numeracy, social-emotional, physical and cognitive development were identified for 64, 21⋅5, 3⋅3 and 3⋅1 %, respectively. GDD was more likely among preschool children from households with marginal (aPR = 1⋅29; 95 % C.I. = 1⋅10, 1⋅49) and moderate-severe HFI (aPR = 1⋅30; 95 % C.I. = 1⋅11, 1⋅51). Social-emotional development delays were also more likely among those from households with marginal (aPR = 1⋅36; 95 % C.I. = 1⋅19, 1⋅56) and moderate-severe HFI (aPR = 1⋅33; 95 % C.I. = 1⋅15, 1⋅54) different from the other three domains. Several other potentially modifiable risk (violent discipline, maternal depressive symptoms) and protective factors (adequate child stimulation, higher maternal education, handwashing with soap/detergent) were also independently associated with GDD and/or literacy-numeracy and cognitive delays. Our findings suggest that HFI is an independent risk factor for GDD and social-emotional developmental delays in Ecuadorian preschoolers. They underscore the importance of strengthening and expanding poverty reduction, food security and early childhood development policies and interventions to improve the opportunities for children to achieve their full developmental potential.

NutriProfiel® is a tool to measure micronutrient status and to assess diet quality. It consists of measurement of micronutrient status in blood and a short food frequency questionnaire (FFQ) (‘Eetscore-FFQ’). Based on the results, individuals receive a dietary advice. In this study, we evaluated the application of NutriProfiel in athletes (‘NutriProfiel-Sport’) by assessing the coverage of nutrient intake of the Eetscore-FFQ (part 1) and by evaluating athlete's dietary behaviour after using NutriProfiel-Sport and their satisfaction with this tool (part 2). For part 1, data of 419 athletes were used. We evaluated the coverage of nutrient intake of the Eetscore-FFQ using first and second MOMents (MOM1 and MOM2) sum scores of food items in the questionnaire. Forty-eight athletes were involved in part 2. They gave blood samples for micronutrient status measurement and were asked to complete the Eetscore-FFQ at baseline and after 3 months, as well as a questionnaire on their satisfaction with NutriProfiel-Sport. Results showed that for most nutrients, MOM1 and MOM2 scores were above 80 %, meaning that nutrient intake was sufficiently covered by the Eetscore-FFQ. No difference in diet quality was observed between baseline and after 3 months. Nevertheless, a majority of athletes reported the NutriProfiel-Sport results and advice as useful. On a scale from 0 to 10, NutriProfiel-Sport was graded with a mean (±sd) score of 7⋅6 (±0⋅8). In conclusion, NutriProfiel-Sport is a potential valuable and appreciated tool for athletes and the Eetscore-FFQ as part of this tool sufficiently covers nutrient intake in athletes.

The nutritional status is a determinant of the immune response that promotes a cellular homeostasis. In particular, adequate selenium levels lead to a better antioxidant and immune response. The aim of this work is to assess whether blood selenium levels, at time of SARS-CoV-2 infection, have an impact on the development and severity of COVID-19. A systematic review and meta-analysis of comparative and descriptive studies using MeSH terms, selenium and COVID-19 was performed. We searched bibliographic databases up to 17 July 2022 in PubMed and ScienceDirect. Studies that reported data on blood selenium levels were considered. A total of 629 articles were examined by abstract and title, of which 595 abstracts were read, of which 38 were included in the systematic review and 11 in the meta-analysis. Meta-analysis was conducted to mean difference (MD) with a 95 % confidence interval (CI), and heterogeneity was tested by I2 with random factors with a MD between selenium levels, mortality, morbidity and healthy subjects with a P-value of 0⋅05. Selenium levels were higher in healthy people compared to those in patients with COVID-19 disease (six studies, random effects MD: test for overall effect Z = 3⋅28 (P = 0⋅001), 97 % CI 28⋅36 (11⋅41–45⋅31), P < 0⋅00001), but without difference when compared with the degree of severity in mild, moderate or severe cases. In conclusion, the patients with active SARS-CoV-2 infection had lower selenium levels than the healthy population. More studies are needed to evaluate its impact on clinical severity through randomised clinical trials.

Hypertension remains a public health issue in Cameroon, though lifestyle and dietetic measures are the main approaches for the prevention and management of hypertension. The present study aimed at evaluating the impact of a Dietary Approaches to Stop Hypertension (DASH) diet using local foodstuffs on the status of hypertensive patients at the Ngaoundere Regional Hospital. A case–control study was carried out with 160 hypertensive patients divided into two groups, a test and a control group. A food questionnaire was used to evaluate the food habits of patients and design the sheet of the DASH diet to provide a maximum of 2000 kcal/d. The DASH diet was administered to the test group (eighty-eight patients), while the control group (seventy-two patients) consumed their normal diet. Both groups were followed up for 8 weeks. The systolic and diastolic blood pressures (SBP, DBP), body mass index (BMI), triglycerides, HDL-c, LDL-c and total-cholesterol levels of patients of the two groups were measured before and after the intervention. The results indicate that the DASH diet improves all the markers of hypertension in the test group with significant decreases in BMI, SBP, DBP, LDL-c and total-cholesterol. Patients of the control group had fourteen and seven times more risk of having increased systolic and diastolic pressures, respectively, and are thus exposed to hypertension complications. The DASH diet established in this study is therefore effective for the management of hypertension.

Increasingly most people have their meals outside their homes and are vulnerable to illnesses caused by unsafe foods. Unsafe food preparation and supply by vendors have made food safety a concern for public health. The present study evaluated the nutrition knowledge, attitude and food safety and hygienic practices of street food vendors (SFVs) in Northern Ghana. An analytical cross-sectional study design was conducted among 424 SFVs, and the data were collected using questionnaires and observation. The mean ± sd nutrition knowledge score of the SFVs was 7⋅08 ± 1⋅75 in which the majority of the participants (68⋅6 %) knew foods that help fight diseases and build immunity. The mean ± sd food safety and hygienic practice score was 7⋅61 ± 2⋅66 with more than half of the participants reportedly not using hand gloves while preparing and serving food. Factors that were associated with food safety and hygienic practices of the SFVs were level of education (β = −0⋅36, P < 0⋅001), number of hours worked (β = 0⋅15, P = 0⋅002), food hygiene and safety knowledge (β = 0⋅21, P = 0⋅002), having a business certificate (β = −0⋅15, P = 0⋅004) and having medical check-up (β = 0⋅11, P = 0⋅029). The food safety and hygienic practices of the SFVs may constitute a food safety risk to consumers. Improving food safety and hygiene knowledge may be important but regular monitoring and check-up by the FDA could result in SFVs following the required food safety and hygienic practices.

The considerable amount of original and generic types of skinfold calipers available is a source of systematic measurement error. This study is a brief report that critically examines the original and illustrated structural configuration of the three main types of skinfold calipers. For more than half a century, the Harpenden®, Lange® and Slim Guide® skinfolds calipers have been widely used in clinical and research settings. It is well established that the physical, mechanical and functional specificity of each type of skinfold caliper makes its interchangeable use impossible. Our report suggests that commercially available technical specifications are insufficient to judiciously choose a skinfold caliper. The area of the jaws, the coefficient of spring and the static and dynamic downward pressure of each type of skinfold caliper must be determined in the metrological laboratory and added to the technical user manual. Choosing a type of skinfold caliper for regular use, without conflict of commercial interest, requires a critical understanding of the physical, mechanical and functional characteristics that configure it. Therefore, a new downward static calibration test and the first eligibility flowchart for a skinfold caliper have been proposed. Finally, the information gathered in this report may be useful for manufacturers of anthropometric instruments and health professionals who use the skinfold technique as a tool for diagnosis and nutritional control.

The Supplemental Nutrition Assistance Program-Education identified food pantries as a targeted setting for policy, system, and environmental (PSE) interventions to promote healthy eating among households who rely on pantries to supplement their food needs. The present study sought to identify factors influencing capacity and readiness to implement healthy eating PSE interventions in food pantries. Qualitative interviews were conducted via zoom with twenty-six community residents with experience receiving SNAP benefits and twelve SNAP-Ed staff in rural and urban counties in Ohio to identify themes and indicators related to community/organisational capacity and readiness to implement healthy eating PSE interventions in food pantries. Themes and related indicators generated based on inductive and deductive coding of interview transcripts were prioritised and weighted by eleven community nutrition experts during a virtual consensus conference. Five themes emerged; expert-derived weights (scaled low, 0 to high, 1) reflect the perceived importance of each to implementation of healthy eating PSE interventions in food pantries: food pantry capacity and logistics [0⋅252], networks and relationships [0⋅228], community nutrition practitioner capacity [0⋅212], food pantry user characteristics [0⋅156], and stigma and stereotypes [0⋅1⋅52]. Overall, seventeen indicators were identified reflecting these themes. Successful and sustained PSE interventions at food pantries will require a tailored approach that considers food pantries’ capacity, needs and opportunities within the community, and capacity of community nutrition practitioners. The themes and indicators identified provide guidance for responsive PSE approaches in food pantries that meet communities where they are.

Relatively little is known about how the diet of chronically undernourished children may impact cardiometabolic biomarkers. The objective of this exploratory study was to characterise relationships between dietary patterns and the cardiometabolic profile of 153 3–5-year-old Peruvian children with a high prevalence of chronic undernutrition. We collected monthly dietary recalls from children when they were 9–24 months old. At 3–5 years, additional dietary recalls were collected, and blood pressure, height, weight, subscapular skinfolds and fasting plasma glucose, insulin and lipid profiles were assessed. Nutrient intakes were expressed as average density per 100 kcals (i) from 9 to 24 months and (ii) at follow-up. The treelet transform and sparse reduced rank regress'ion (RRR) were used to summarize nutrient intake data. Linear regression models were then used to compare these factors to cardiometabolic outcomes and anthropometry. Linear regression models adjusting for subscapular skinfold-for-age Z-scores (SSFZ) were then used to test whether observed relationships were mediated by body composition. 26 % of children were stunted at 3–5 years old. Both treelet transform and sparse RRR-derived child dietary factors are related to protein intake and associated with total cholesterol and SSFZ. Associations between dietary factors and insulin were attenuated after adjusting for SSFZ, suggesting that body composition mediated these relationships. Dietary factors in early childhood, influenced by protein intake, are associated with cholesterol profiles, fasting glucose and body fat in a chronically undernourished population.

The present study aimed to investigate the nutritional constituents of common market available spices in the United Arab Emirates. Seven commonly consumed spices namely, ginger (Zingiber officinale), cinnamon (Cinnamomum verum), black seed (Nigella sativa), fenugreek (Trigonella foenum-graecum), cardamom (Elettaria cardamomum), cloves (Syzygium aromaticum) and saffron (Crocus sativus) were obtained from local markets. Proximate analyses were performed according to AOAC procedures. Assessment of major (Ca, K, Mg, Na, P and S) and minor (Co, Cu, Fe, Mn and Zn) elements was conducted using inductively coupled plasma optical emission spectrometry (ICP-OES). Findings revealed varying macronutrient, micronutrient and mineral contents which are highly valuable for dietary purposes. The present study demonstrates that these edible spices could be used for nutritional support, due to their micro and macronutrient contents.