The recent exponential increase in caesarean section (CS) rates in many countries including Ghana requires an understanding of the potential long-term consequences on child health. The present study investigated the relationship between CS delivery and risk of childhood overweight/obesity. A retrospective cohort study was conducted from October 2019 to March 2020 in Ghana. Using multi-stage sampling, 553 mother–child pairs aged 6–23 months were selected from ten health facilities during child welfare clinic (CWC) services. We assessed the association between delivery mode (caesarean v. vaginal) and subsequent body mass index for age (BMI/age Z-score) using hierarchical multivariable linear regression analysis. The prevalence of overweight/obesity (BMI/age Z-score > +2 sd) in children was 3⋅6 %. After adjusting for maternal gestational weight gain, macrosomia and child feeding practices, children who were born through CS had mean BAZ which was 0⋅105 standard units significantly higher than their colleagues who were delivered through normal vaginal [beta coefficient (β) 0⋅105, (95 % CI 0⋅03, 0⋅55)]. CS birth was also associated with 3⋅2 times higher odds of overweight/obesity than vaginal delivery (AOR 3⋅23; 95 % CI 1⋅14, 9⋅13). Consequently, CS delivery was associated positively with increased body mass (adiposity) in the study sample. The association between CS delivery and risk of childhood obesity was attenuated after adjusting for macrosomia. These results would be important for informing clinicians and expectant mothers in considering CS delivery.

Fat digestibility is decreased in old cats for unknown reasons. Subclinical gastrointestinal diseases and pancreatic dysfunction, both related to ageing, can affect food digestibility. The aim of the present study was to elucidate the prevalence of subnormal cobalamin concentration and pancreatic disease in old cats and study the relationship between both markers and fat digestibility. A total of sixty-four cats without evident signs of gastrointestinal disease were included and grouped according to age: (1) fifteen middle-aged (MA), aged 3–7 years; and (2) forty-nine old, aged 10–17 years. All cats were tested for serum cobalamin, specific feline pancreatic lipase (fPL) and feline trypsin-like immunoreactivity. Then, sixteen of the old cats were selected and grouped according to cobalamin and fPL concentrations: control (normal cobalamin and fPL); low vitamin B12 (cobalamin <290 ng/l; normal fPL); and high fPL (normal cobalamin; fPL >4 µg/ml). A food digestibility trial with a high-fat diet (21·6 %) was performed. In the old group, cobalamin was lower and fPL higher than in MA cats. Of the old cats (n 49), 14 % had subnormal cobalamin, 8 % had a severe increase in fPL, 2 % had both alterations and 14 % had a slight increase in fPL. By contrast, MA cats did not have cobalamin deficiency or an increase in fPL concentrations. Fat digestibility was lower in low vitamin B12 cats than control cats. Decreased fat digestibility is not present in all old cats but could be a characteristic of subclinical chronic gastrointestinal disease. Cobalamin concentration, as a marker of gastrointestinal disease, could be useful for the routine evaluation of old cats.

As the world's aging population grows, nutrition and health issues are becoming a major concern. The aim of the present study was to identify the factors associated with nutritional status among old age population. A community-based cross-sectional study was employed among randomly selected 739 elders over the age of 60 in Dire Dawa City administration, eastern Ethiopia. The validated full mini nutritional assessment tool and appetite test (SNAQ) was used to assess the nutritional status of the study population. Considering the ranked nature of the data, a bivariate and multivariable ordinal logistic regression model (under the generalised linear model) was conducted, with crude and adjusted odds ratios reported along with 95 % confidence intervals. Statistically significant associations are declared at P-value less than 0⋅05. In this study, 22 % (95 % CI: 19 %, 25 %) of elders were malnourished. Participants with >75 years old (AOR 4⋅95; 95 % CI 1⋅54, 8⋅4), being female (AOR 1⋅6; 95 % CI 1⋅1, 2⋅2), illiterate (AOR 1⋅5; 95 % CI 1⋅01, 2⋅2), severe depression (AOR 13⋅9; 95 % CI 8⋅2, 23⋅7) and with poor appetite (AOR 3⋅3; 95 % CI 2⋅3, 4⋅8) were important predictors of malnutrition among older age group. We found that the prevalence of malnutrition and the risk of malnutrition is a public health concern that warrants intervention in the area. Advanced age, illiteracy, depression and poor appetite were important risk factors for malnutrition among older age group. The identified risk factors will guide public health professionals and programmes in the design, implementation of interventions to improve the nutritional status of older age group.

Despite mounting evidence that dietary factors might have a protective role against risk of cancer, few studies have assessed the relationship between diet diversity with colorectal cancer (CRC) and colorectal adenoma (CRA). Thus, we examined the relationship between dietary diversity score (DDS) and the odds of CRC and CRA. Overall, 129 CRC diagnosed patients, 130 CRA diagnosed cases and 240 healthy hospitalised controls were studied. DDS was calculated based on information on the usual diet that was assessed by a valid and reliable food frequency questionnaire (FFQ). Multivariate logistic regression was used to estimate the relationship between DDS and odds of colorectal cancer and adenoma. After adjusting for potential confounders, the diversity of grains is associated with the increased odds of CRC (ORgrains: 2·96 (1·05–8·32); P = 0·032), while the diversity of vegetables and fruits are associated with decreased odds of CRC (ORvegetables: 0·31 (0·16–0·62); P = 0·001, ORfruits: 0·37 (0·23–0·61); P < 0·001). The diversity of vegetables, fruits and dairy are inversely associated with odds of CRA (ORvegetables: 0·41 (0·21–0·78); P = 0·007, ORfruits: 0·58 (0·36–0·93); P = 0·021, ORdairies: 0·56 (0·37–0·83); P = 0·004). Also, higher DDS was related to decreased odds of both CRC (OR: 0·41 (0·23–0·72); P for trend = 0·002) and CRA (OR: 0·36 (0·21–0·65); P for trend = 0·001). Our results indicated that higher dietary diversity and particularly a diet varied in fruits and vegetables may reduce the odds of CRC and CRA. Also, the consumption of dairy products may decrease the odds of CRC, whereas the consumption of grains may increase the odds of CRC.

The objective was to evaluate the effects of dietary fish oil (FO) and vitamin E (VE) supplementation on sperm sensitivity to lipid peroxidation (LP) in dogs. Using an incomplete replicate 3 × 3 Latin square design, five dogs were allocated into three groups. One of the squares was incomplete and had two dogs that were used with three treatments. The dogs were assigned to three different treatments, fed a control diet of balanced commercial food (control group; CG), control diet supplemented with 54 mg FO/kg body weight0·75 per d (FO group; FG) and FO plus 400 mg VE per d (FO and VE group; FEG) for 60 d. Semen samples were collected on days 0 and 60 and divided into two halves, peroxidised and control, with or without ascorbate–Fe2+, respectively. LP was measured in both halves by chemiluminescence as counts per min/mg protein. Fatty acid profile was determined by GC. Data were analysed using the mixed procedure (SAS). On day 0, LP increased in all groups in the peroxidised samples (P < 0·05). However, on day 60 LP decreased in peroxidised samples of both the FG and FEG (P < 0·05), but there were no differences between the FG and FEG (P > 0·1). Additionally, on day 60 total n-3 was higher in the FG and FEG compared with the CG (P < 0·05). Supplementation with FO alone or together with VE decreased LP in peroxidised samples. These results could indicate a protective effect of n-3 on sperm. More studies are needed to understand the mechanism whereby FO and/or FO plus VE decrease LP in dogs’ sperm.

This article aims to study the different dietary fat types associated with obesity and coronary indices. A sample of 491 healthy adults was included in a cross-sectional manner. Dietary fats intake, obesity indices (conicity index (CI), body adiposity index (BAI), abdominal volume index (AVI), body roundness index (BRI), and weight-adjusted-waist index (WWI)), and cardiovascular indices (cardiometabolic index (CMI), lipid accumulation product (LAP), and atherogenic index of plasma (AIP)) were calculated and studied. Participants with an acceptable intake of omega-3 had a higher BRI score (1⋅90 ± 0⋅06 v. 1⋅70 ± 0⋅06). Participants with an unacceptable intake of cholesterol had a higher CI (1⋅31 ± 0⋅11 v. 1⋅28 ± 0⋅12; P = 0⋅011), AVI (20⋅24 ± 5⋅8 v. 18⋅33 ± 6⋅0; P < 0⋅001), BRI (2⋅00 ± 1⋅01 v. 1⋅70 ± 1⋅00; P = 0⋅003), WWI (11⋅00 ± 0⋅91 v. 10⋅80 ± 0⋅97; P = 0⋅032), and lower AIP (0⋅46 ± 0⋅33 v. 0⋅53 ± 0⋅33; P = 0⋅024). Total fat, saturated fat (SFA), and polyunsaturated fat (PUFA) intake had a significant moderate correlation with AVI and BRI. The monounsaturated fat (MUFA) intake had a significantly weak correlation with CI, AVI, BRI, WWI, and AIP. Cholesterol and omega-6 had weak correlations with all indices. Similar correlations were seen among male and female participants. The different types of fat intake significantly affected obesity and coronary indices, especially SFA and PUFA, as well as omega-3 and cholesterol. Gender and the dietary type of fat intake have a relationship to influence the indicators of both obesity and coronary indices.

The high fat content in Western diets probably affects placental function during pregnancy with potential consequences for the offspring in the short and long term. The aim of the present study was to compare genome-wide placental gene expression between rat dams fed a high-fat diet (HFD) and those fed a control diet for 3 weeks before conception and during gestation. Gene expression was measured by microarray and pathway analysis was performed. Gene expression differences were replicated by real-time PCR and protein expression was assessed by Western blot analysis. Placental and fetal weights at E17.25 were not altered by exposure to the maternal HFD. Gene pathways targeting placental growth, blood supply and chemokine signalling were up-regulated in the placentae of dams fed the HFD. The up-regulation in messenger RNA expression for five genes Ptgs2 (fatty acid cyclo-oxidase 2; COX2), Limk1 (LIM domain kinase 1), Pla2g2a (phospholipase A2), Itga1 (integrin α-1) and Serpine1 was confirmed by real-time PCR. Placental protein expression for COX2 and LIMK was also increased in HFD-fed dams. In conclusion, maternal HFD feeding alters placental gene expression patterns of placental growth and blood supply and specifically increases the expression of genes involved in arachidonic acid and PG metabolism. These changes indicate a placental response to the altered maternal metabolic environment.

A practical approach to determine apparent faecal digestibility using privately owned dogs may be a useful tool in evaluating differences in nutrient digestibility between dogs with various life stages. The aim was to develop a simple method that would suit such studies using the whitening agent titanium oxide (TiO2) as an indigestible marker. Forty privately owned, healthy male and female dogs of various breeds were included. Selection was based on an owner questionnaire. Means with their standard errors age and body weight (BW) of the dogs were 6·2 (0·6) years (range 1·0–13·0 years) and 22·3 (2·5) kg (range 5·0–43·2 kg), respectively. Owners were provided a commercial dry extruded diet supplemented with a commercially available TiO2 containing kibble (final dietary TiO2 content: 0·77 g/kg). Dogs were fed the diet for seven consecutive days at 480 kJ × BW0·75. On day 7, owners were asked to collect all faeces during 24 h and store faeces at −20°C. Faecal samples were analysed for DM, ash, N, crude fat (CF), crude fibre and Ti and gross energy (GE) and organic matter were calculated. Means with their standard errors apparent faecal digestibility of GE, DM, organic matter, N, CF and crude fibre was 83·7 (0·71), 77·4 (0·79), 83·0 (0·61), 77·7 (0·81), 94·3 (0·51) and 30·3 (4·85), respectively. No significant differences were observed in nutrient digestibility due to weight, age, sex or neuter status. The digestibility assay using a practical approach described here may be a promising tool to determine digestibility of dietary nutrients under free-living conditions. Owner compliance, however, is a potentially limiting factor.

The present study was conducted to determine nutritional anaemia using haemoglobin levels of female nursing undergraduates studying at Farasan Island with the purpose to intervene at a point, before the potential problems become serious later in life. In total, 130 apparently healthy, female students of Department of Nursing were recruited by a random sampling method to collect information on socio-demographic, lifestyle and anthropogenic characteristics, and dietary habits including breakfast skipping. Haemoglobin content was estimated using Sahli's Haemoglobinometer and observations were interpreted as per WHO's criteria for anaemia. Body mass index (BMI) was recorded using a digital weighing machine. Correlation between haemoglobin concentration, breakfast skipping and body mass index of study participants was assessed by Pearson's correlation. Data analyses were done using Origin software. Overall, 51⋅6 % (n = 67) students were all together anaemic with 28⋅5 % (n = 37) had mild anaemia, 15⋅4 % (n = 20) moderate and 7⋅69 % (n = 10) had severe anaemia. Of these, 20⋅8 % (n = 27) were underweight, 63⋅8 % (n = 83) normal weight and 15⋅4 % (n = 20) were above normal weight (over weight and obese). The Hb content showed a positive correlation with the BMI and exhibited an increasing trend with increase in the BMI among study participants (P < 0⋅05). Questionnaire analyses revealed that the majority (96⋅9 %, n = 126) of students were taking junk food as bulk of their meal. A strong negative correlation was recorded between Hb contents and breakfast skipping tendencies (r = −0⋅987, P < 0⋅05). Findings of the present study are of high significance for public health professionals and educators to prioritise actions that could motivate these future nurses to adapt healthy lifestyles to strategically combat nutritional anaemia.

Recent genome-wide association studies (GWAS) on the dietary habits of the Japanese population have shown that an effect rs671 allele was inversely associated with fish consumption, whereas it was directly associated with coffee consumption. Although meat is a major source of protein and fat in the diet, whether genetic factors that influence meat-eating habits in healthy populations are unknown. This study aimed to conduct a GWAS to find genetic variations that affect meat consumption in a Japanese population. We analysed GWAS data using 14 076 participants from the Japan Multi-Institutional Collaborative Cohort (J-MICC) study. We used a semi-quantitative food frequency questionnaire to estimate food intake that was validated previously. Association of the imputed variants with total meat consumption per 1000 kcal energy was performed by linear regression analysis with adjustments for age, sex, and principal component analysis components 1–10. We found that no genetic variant, including rs671, was associated with meat consumption. The previously reported single nucleotide polymorphisms that were associated with meat consumption in samples of European ancestry could not be replicated in our J-MICC data. In conclusion, significant genetic factors that affect meat consumption were not observed in a Japanese population.

Identifying dietary patterns in different environments attended by children is relevant to guide public politics. The aim of this study was to analyse the factors associated with dietary patterns of children under 2 years of age in childcare centres and at homes. This transversal study was enrolled in municipal childcare centres of Guaratuba, Paraná, Brazil. Food consumption data from 256 children were obtained by the food record method. From the consumption data, four dietary patterns were identified by factor analysis using the principal component method in each environment. ‘Traditional’ patterns were observed in both environments; the ‘less healthy’ pattern was found only at homes. Other patterns identified in childcare centres include ‘snacks’, ‘nutritive’ and ‘pasta and meats’; at homes, it was possible to identify patterns such as ‘milk and cereals’ and ‘mixed’. Children over 12 months presented higher scores for all the patterns in both environments. Obese children had lower scores for all the patterns in childcare centres. There was an association between maternal age below 21 years and higher adherence to a ‘less healthy’ pattern, maternal level of education less than 8 years and lower adherence to the ‘mixed’ pattern and lower familiar income per capita and higher adherence to the ‘snacks’ and ‘traditional’ patterns in childcare centres. In conclusion, adherence to dietary patterns was associated with socio-economic, demographic variables and nutritional status and further studies are needed, especially those with a longitudinal design, enabling the monitoring of dietary patterns.

Despite the fact that health facilities in Ethiopia are being built closer to communities in all regions, the proportion of home deliveries remains high, and there are no studies being conducted to identify low birth weight (LBW) and premature newborn babies using simple, best, alternative, and appropriate anthropometric measurement in the study area. The objective of the present study was to find the simple, best, and alternative anthropometric measurement and identified its cut-off points for detecting LBW and premature newborn babies. A health facility-based cross-sectional study was conducted in the Dire Dawa city administration, Eastern Ethiopia. The study included 385 women who gave birth in health facility. To evaluate the overall accuracy of the anthropometric measurements, a non-parametric receiver operating characteristic curve was used. Chest circumference (AUC = 0⋅95) with 29⋅4 cm and mean upper arm circumference (AUC = 0⋅93) with 7⋅9 cm proved to be the best anthropometric diagnostic measure for LBW and gestational age, respectively. Also, both anthropometric measuring tools are achieved the highest correlation (r = 0⋅62) for LBW and gestational age. Foot length had a higher sensitivity (94⋅8 %) in detecting LBW than other measurements, with a higher negative predictive value (NPV) (98⋅4 %) and a higher positive predictive value (PPV) (54⋅8 %). Chest circumference and mid-upper arm circumference were found to be better surrogate measurements for identifying LBW and premature babies in need of special care. More research is needed to identify better diagnostic interventions in situations like the study area, which has limited resources and a high proportion of home deliveries.

Zinc (Zn) is an essential mineral and its deficiency manifests in non-specific clinical signs that require long time to develop. The response of swine intestine to Zn restriction was evaluated to identify early changes that can be indicative of Zn deficiency. Twenty-seven pigs (body weight = 77⋅5 ± 2⋅5 kg) were assigned to one of three diets: diet without added Zn (Zn-restricted diet, ZnR), and ZnR-supplemented with either 50 (Zn50) or 100 mg of Zn/kg of diet (Zn100) of Zn supplied by ZnCl2. After 32 d consuming the diets, serum Zn concentration in ZnR pigs was below the range of 0⋅59–1⋅37 μg/ml considered sufficient, thereby confirming subclinical Zn deficiency. Pigs showed no obvious health or growth changes. RNA-seq analysis followed by qPCR showed decreased expression of metallothionein-1 (MT1) (P < 0⋅05) and increased expression of Zn transporter ZIP4 (P < 0⋅05) in jejunum and ileum of ZnR pigs compared with Zn-supplemented pigs. Ingenuity pathway analysis revealed that Zn50 and Zn100 induced changes in genes related to nucleotide excision repair and integrin signalling pathways. The top gene network in the ZnR group compared with Zn100 was related to lipid and drug metabolism; and compared with Zn50, was related to cellular proliferation, assembly and organisation. Dietary Zn concentrations resulted in differences in genes related to immune pathways. Our analysis showed that small intestine presents changes associated with Zn deficiency after 32 d of Zn restriction, suggesting that the intestine could be a sentinel organ for Zn deficiency.

The aims of this study were to (1) compare diet quality between patients with heart failure (HF) and age- and sex-matched community-dwelling healthy older adults and (2) determine whether having HF was associated with a lower Healthy Eating Index-2015 (HEI-2015) score and risk of micronutrient deficiency. The HEI-2015 and macro- and micronutrient intakes of patients with HF were compared with healthy older adults (N 102; 55–92 years old; 53 % female). A paired t-test or Wilcoxon singed-rank test, McNemar's test, and conditional logistic regression were used to assess the association between diet quality and HF status. Median values for HEI-2015 and the number of micronutrient deficiency were used to dichotomise into groups in the conditional logistic regression. There was no significant between-group difference in the HEI-2015 total score (P 0⋅059), whereas the whole grain component was lower in patients with HF than in healthy older adults (3⋅1 ± 3⋅5 v. 4⋅5 ± 3⋅1, P 0⋅037; respectively). Total caloric intake was lower in patients with HF than in healthy older adults (1683 ± 595 v. 2104 ± 670 kcal; P < 0⋅001). Patients with HF had a higher average number of micronutrient deficiencies than healthy older adults (4[2, 6] v. 1[0, 4], respectively, P < 0⋅001). Patients with HF had four times higher odds of being in a high micronutrient deficiency group than healthy older adults, controlling for socio-demographics and body mass index (adjusted odds ratio [95 % confidence interval]: 4⋅04[1⋅06, 15⋅41]). Our findings demonstrate that diet quality measured by nutritional intake identifies patients with HF with lower caloric intake and higher micronutrient deficiencies compared with age- and sex-matched healthy older adults.

Personalised nutrition (PN) is an emerging field that bears great promise. Several definitions of PN have been proposed and different modelling approaches have been used to claim PN effects. We tentatively propose to group these approaches into two categories, which we term outcome-based and population reference approaches, respectively. Understanding the fundamental differences between these two types of modelling approaches may allow a more realistic appreciation of what to expect from PN interventions presently and may be helpful for designing and planning future studies investigating PN interventions.

Strawberry contains many bioactive compounds such as vitamin C and polyphenols as well as folate, a vitamin that is especially important for women of childbearing age. We investigated the effects of the acute consumption of strawberry on the serum levels of vitamin C and folate, and on the antioxidant potential of low-density lipoprotein (LDL). In a randomised, placebo-controlled, double-blind, crossover study, twenty-three healthy female volunteers (age 22⋅5 ± 1⋅4 years) ingested 500 g of a strawberry purée beverage or a sugar content-matched placebo beverage. Blood samples were collected at fasting and at 0⋅5, 1, 2 and 4 h post-ingestion. The serum concentrations of vitamin C and folate were significantly elevated from 0⋅5 to 4 h after the strawberry beverage ingestion (P < 0⋅001); the levels peaked at 2 h, with peak levels of 15⋅0 ± 2⋅5 μg/ml for vitamin C and 14⋅4 ± 7⋅0 ng/ml for folate. Notably, at 1 h after the strawberry beverage ingestion, the LDL oxidation lag time was significantly prolonged (P < 0⋅05), suggesting that the antioxidant potential of LDL was increased. After the ingestion of either beverage, the serum levels of glucose and insulin reached a peak at 0⋅5 h and then quickly returned to baseline levels. These results suggest that strawberries are a useful source of vitamin C and folate and may help enhance the antioxidant potential of LDL in healthy young women.

Plums are abundant in bioactive compounds which have been associated with numerous health benefits. In the present study, we aimed at examining the impact of plum supplementation on lipid profile of individuals. Electronic bibliographical databases were searched for relevant randomised clinical trials. Articles meeting our eligibility criteria were included for data extraction and final analysis. Weighted mean difference (WMD) was estimated using a random-effect model. Of the total articles retrieved in the initial search, nine articles were found to be eligible to be included in the analysis. Our results show that plum supplementation significantly improves total cholesterols levels in the unhealthy individuals. Moreover, plum supplementation reduces the LDL-c levels in the pooled sample (WMD = −11⋅52 mg/dl; 95 % CI −21⋅93, −1⋅11, P = 0⋅03, I2 = 98⋅7 %) and also in some of the subgroups of individuals (dried plum, unhealthy subjects, duration more than 8 weeks). Moreover, it had a significant reducing effect on TC levels just in unhealthy subjects. Although plum supplementation did not have any significant impact on serum levels of TG nor HDL-c. Our results show that supplementation with plums is potentially effective in reducing serum total cholesterol and LDL-c.

Dietary electrolyte balance (dEB) is known to affect acid−base status and mineral metabolism, but is rarely considered in diet formulation for pigs. Yet, the use of a wide variety of local feedstuffs in Europe contributes to lowering the dEB and increasing the fibre content. Hence, mineral requirements may be modified and skeletal health affected. Therefore, the effects of a lower dEB and a higher dietary Ca level on acid−base balance and mineral status were assessed in young pigs fed a diversified diet. A total of twenty-four weaned pigs were fed a control moderate-dEB diet (C) or a diversified moderate-dEB (D), low-dEB (D-A) or low-dEB supplemented with Ca (D-CA) diet. Growth performance, venous blood gas and chemistry, urine pH, mineral balance and femur characteristics were determined. With an equivalent dEB compared with the C diet, the D diet caused an acidification of the urine and increased the excretion of P as a result of a higher dietary content of S. Low-grade metabolic acidosis occurred in piglets fed the D-A diet with changes at systemic and urine levels. A higher excretion of ammonia and P in urine was observed and some bone characteristics tended to be negatively affected. Ca supplementation partially counteracted the effects of low-grade acidosis. Urine excretion of P and ammonia was alleviated and bone characteristics improved. In conclusion, a higher Ca supply must be considered in more diversified diets to counteract the risk of evolving towards low-grade metabolic acidosis which can negatively affect bone.

This paper describes a 4-month pilot study that tested the suitability of a physical activity intervention for first graders (children aged 6 and 7 years) in a public school in Santiago, Chile. Teachers were trained to deliver the programme in the classroom during the school day. Teachers were surveyed to determine if this intervention fit within their curriculum and classroom routines and they reported in a focus group that it was suitable for them. All children actively participated in the programme and positive changes in their attitudes towards physical activity were observed by their teachers. Anthropometrics, blood pressure and hand grip strength were measured in the students. A significant reduction was observed in children with high waist circumference ≥ 90th percentile, and in mean systolic blood pressure. However, statistical power values for those comparisons were rather low. Anthropometry and hand grip strength were not modified. The latter calculations and the lack of a control group are showing the weaknesses of this pilot study and that further research with a larger sample size and an experimental design is strongly needed.

Dietary acculturation may explain the increasing risk of diet-related diseases among African immigrants in the United States (US). We interviewed twenty-five Ghanaian immigrants (Youth n 13, Age (Mean ± sd) 20 y ± 5⋅4, Parents (n 6) and Grandparents (n 6) age 58⋅7 ± 9⋅7) living in New York City (NYC) to (a) understand how cultural practices and the acculturation experience influence dietary patterns of Ghanaian immigrants and (b) identify intergenerational differences in dietary acculturation among Ghanaian youth, parents and grandparents. Dietary acculturation began in Ghana, continued in NYC and was perceived as a positive process. At the interpersonal level, parents encouraged youth to embrace school lunch and foods outside the home. In contrast, parents preferred home-cooked Ghanaian meals, yet busy schedules limited time for cooking and shared meals. At the community level, greater purchasing power in NYC led to increased calories, and youth welcomed individual choice as schools and fast food exposed them to new foods. Global forces facilitated nutrition transition in Ghana as fast and packaged foods became omnipresent in urban settings. Adults sought to maintain cultural foodways while facilitating dietary acculturation for youth. Both traditional and global diets evolved as youth and adults adopted new food and healthy social norms in the US.