n-6 and n-3 long-chain PUFA play opposing roles in inflammation, anxiety and nociception, all of which are closely associated with chronic pain. We hypothesised that diets high in n-6 arachidonic acid (C20:4n-6, AA) and low in combined n-3 EPA (C20:5n-3, EPA) and DHA (C22:6n-3, DHA) would be associated with higher odds of painful temporomandibular disorder (TMD).

We analysed baseline data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Two 24-h dietary recall surveys quantified intake of long-chain n-6 and n-3 PUFA along with their precursors, linoleic acid (C18:2n-6, LA) and alpha linolenic acid (C18:3n-3, ALA), respectively. n-3 PUFA supplementation was quantified. Interviewer-administered questions assessed TMD. Survey multiple logistic regression estimated covariate-adjusted OR and 95 % confidence limits (CL) for associations between PUFA and TMD.

From 2008 to 2011, HCHS/SOL recruited 16 415 adults of Hispanic/Latino backgrounds (Cuban, Puerto Rican, Dominican, Mexican, Central/South American), through field centres located in Miami, FL; San Diego CA; Chicago, IL; and the Bronx, NY.

13 870 participants with non-missing data.

In analysis adjusted for covariates, each sd increase in dietary intake of C20:4n-6, AA was associated with 12 % higher odds of TMD (OR = 1·12, CL: 1·01, 1·24). Although the dietary intake of combined long-chain C20:5n-3, EPA and C22:6n-3 DHA was not associated with TMD, each sd increase in n-3 dietary supplement was associated with lower odds of TMD.

A diet rich in C20:4n-6, AA was associated with higher odds of painful TMD.

Early childhood obesity (ECO) significantly increased in the USA. ECO interventions lack focus on the prevention of ECO for infants under 2. Caregiver’s feeding styles (CFS) have been shown to affect ECO development, but studies on CFS are limited. This study examined socio-ecological factors associated with CFS for infants under 2 in Nevada.

This cross-sectional study utilising a survey examined the five CFS constructs: responsive (RP), non-responsive (NRP) Laissez-Faire, NRP pressuring, NRP restrictive and NRP indulgent. Descriptive analysis and logistic regression following a hierarchical modelling approach were used to determine the associations between the CFS constructs and socio-ecological factors (e.g. household, maternal mental health and infant feeding).

Clark County, Nevada.

304 caregivers with infants under 2.

NRP-feeding styles were associated with low-income households (e.g. NRP restrictive (adjusted OR (AOR) = 2·60, 95 % CI (1·01, 6·71))), water insecurity (e.g. NRP pressuring (AOR = 2·46, 95 % CI (1·00, 6·06)), young mothers (e.g. NRP-Laissez-Faire (AOR = 2·39, 95 % CI (1·00, 5·84))), lower maternal education (e.g. RP (AOR = 0·58, 95 % CI (0·33, 1·00))), mild risk for depression (e.g. NRP restrictive (AOR = 0·50, 95 % CI (0·28, 0·90))) and a moderate to severe risk for anxiety (e.g. NRP pressuring (AOR = 0·32, 95 % CI (0·14, 0·74))). There were no associations between infant-feeding factors and RP feeding.

Our study identified socio-ecological factors associated with dissimilarities in CFS in Nevada. These findings can be used to tailor educational approaches to address disparities in ECO.

This study aimed to examine the association between ultra-processed food intake and dyslipidaemia risk and whether this association varied by the polygenic score for dyslipidaemia in the adult Korean population.

Prospective cohort study.

Ultra-processed foods were identified under the NOVA classification. Participants were categorised into < 5, 5 to < 10, 10 to < 15, 15 to < 20 and ≥ 20 %E/d of ultra-processed food intake. The polygenic scores for dyslipidaemia were calculated from 53 950 SNPs. ORs and 95 % CIs were estimated using multivariate logistic regression models.

20 044 Korean adults aged ≥ 40 years in the Health Examinees (HEXA) study, the Cardiovascular Disease Association Study (CAVAS) and the Korea Association Resource (KARE) study.

During median follow-ups of 4·09, 8·67 and 15·67 years in the HEXA, CAVAS and KARE studies, respectively, there were a total of 7331, 786 and 1732 incident dyslipidaemia events. Ultra-processed food intake was not significantly associated with dyslipidaemia risk. Compared with < 5 %E/d, the pooled OR (95 % CI) of ≥ 20 %E/d of ultra-processed food intake for dyslipidaemia incidence was 1·01 (0·90, 1·13; P for trend = 0·83). There was no interaction by dyslipidaemia-related genetic variations; ORs (95 % CIs) were 1·04 (0·89, 1·22; P for trend = 0·91) and 0·98 (0·84, 1·15; P for trend = 0·72) for individuals with high- and low-polygenic scores, respectively (P for interaction = 0·90).

No significant association was observed between ultra-processed food intake and the overall risk of dyslipidaemia, nor in subgroups of polygenic scores for dyslipidaemia among Korean adults with low ultra-processed food intake.

To evaluate the relationship between the food environment in favelas and the presence of arterial hypertension and diabetes among women in the context of social vulnerability.

A cross-sectional and partially ecological population-based study was conducted in a Brazilian capital city. The healthiness and availability of ultra-processed foods in the food environment were assessed through retailer audits using the AUDITNOVA instrument. The presence of diabetes and arterial hypertension was evaluated based on self-reported prior medical diagnosis. Logistic regression models were applied using generalised estimating equations, adjusted for age, education, race/skin colour and poverty status.

1882 adult women of reproductive age (20–44 years).

It was found that 10·9 % of women were hypertensive and 3·2 % had diabetes. The likelihood of having diabetes and arterial hypertension decreases with higher levels of healthiness in the food environment (diabetes (OR: 0·25; 95 % CI: 0·07, 0·97)/arterial hypertension (OR: 0·45; 95 % CI: 0·24, 0·81)) and increases with greater availability of ultra-processed foods in their living area (diabetes (OR: 2·18; 95 % CI: 1·13, 4·21)/arterial hypertension (OR: 1·64; 95 % CI: 1·09, 2·47)).

These results suggest that characteristics of the consumer food environment have a significant effect on the occurrence of chronic diseases among socially vulnerable women, adding to the existing evidence in the literature and highlighting the need for integrated health care.

To develop and evaluate the validity and reliability of the Street Food and Beverage Tool (SFBT).

This methodological study contains two phases: (a) tool development, which involves conducting a systematic review followed by expert evaluation of the items, the creation of a nutritional healthfulness index (NH), and pilot testing; and (b) evaluation of the Tool’s Validity and Reliability. Content validity was judged by an external technical group, which evaluated the adequacy and pertinence of each tool item. Construct validity was evaluated around schools by testing the hypothesis: In high-income areas, there will be greater availability of healthy food and beverages at street food outlets (SFO), as measured by the NH index. Inter-rater and test–retest reliabilities were assessed outside subway stations. Pearson’s correlation, Cohen’s kappa and Content validity Indexes were used for reliability and validation. A multinomial regression model was used to estimate construct validity.

Mexico City, Mexico.

80 SFO at subway station exits and 1066 around schools from diverse income areas.

The SFBT content validity index was satisfactory. The construct validity of the NH index indicated higher values in higher-Social Development Index areas. The NH index showed a positive linear correlation between raters and across the first and second evaluations. The majority of item availability (>60 %) showed moderate to strong kappa values for inter-rater and test–retest reliability.

The SFBT is a reliable and valid tool for assessing the availability of foods and beverages. Compared to other tools, it can measure the nutritional quality of SFO expressed as an NH index.

The current study is an attempt to explore under-five child malnutrition in a low-income population setting using the Extended Composite Index of Anthropometric Failure (ECIAF).

Data from the Bangladesh Demographic and Health Survey 2017–2018 were analysed. Malnutrition using ECIAF was estimated using stunting, wasting underweight and overweight. Multilevel logistic regression models identified factors associated with malnutrition. Geospatial analysis was conducted using R programming.

Bangladesh.

Children under 5 years of age.

In Bangladesh, as indicated by the ECIAF, approximately 40·8 % (95 % CI: 39·7, 41·9) of children under five experience malnutrition, whereas about 3·3 % (95 % CI: 2·9, 3·7) were overweight. Children of parents with no formal education (56·3 %, 95 % CI: 50·8, 61·8), underweight mothers (53·4 %, 95 % CI: 50·4, 56·3), belonging to the lowest socio-economic strata (50·6 %, 95 % CI: 48·3, 53·0), residing in rural areas (43·3 %, 95 % CI: 41·9, 44·6) and aged below 3 years (47·7 %, 95 % CI: 45·2, 50·2) demonstrated a greater age- and sex-adjusted prevalence of malnutrition. The Sylhet division (Eastern region) exhibited a higher prevalence of malnutrition (> 55·0 %). Mothers with no formal education (adjusted OR (AOR): 1·51, 95 % CI: 1·08, 2·10), underweight mother (AOR: 1·54, 95 % CI: 1·03, 1·83), poorest socio-economic status (AOR: 2·14, 95 % CI: 1·64, 2·81), children aged 24–35 months (AOR: 2·37, 95 % CI: 1·97, 2·85) and fourth and above birth order children (AOR: 1·41, 95 % CI: 1·16, 1·72) were identified key factors associated with childhood malnutrition while adjusting community- and household-level variations.

In Bangladesh, two out of five children were malnourished, and one in thirty-five children was overweight. Continuous monitoring of the ECIAF over time would facilitate tracking changes in the prevalence of different forms of malnutrition, helping to plan interventions and assess the effectiveness of interventions aimed at addressing both undernutrition and overweight.

Poor diets and food insecurity during adolescence can have long-lasting effects, and Métis youth may be at higher risk. This study, as part of the Food and Nutrition Security for Manitoba Youth study, examines dietary intakes, food behaviours and health indicators of Métis compared with non-Métis youth.

This observational cross-sectional study involved a cohort of adolescents who completed a self-administered web-based survey on demographics, dietary intake (24-h recall), food behaviours, food security and select health indicators.

Manitoba, Canada

Participants included 1587 Manitoba grade nine students, with 135 (8·5 %) self-identifying as Métis, a distinct Indigenous nation living in Canada.

Median intake of sugar was significantly higher in Métis (89·2 g) compared with non-Métis (76·3 g) participants. Percent energy intake of saturated fat was also significantly higher in Métis (12·4 %) than non-Métis (11·6 %) participants. Median intakes of grain products and meat and alternatives servings were significantly lower among Métis than non-Métis (6·0 v. 7·0 and 1·8 v. 2·0, respectively) participants. Intake of other foods was significantly higher in Métis (4·0) than non-Métis (3·0). Significantly more Métis participants were food insecure (33·1 %) compared with non-Métis participants (19·1 %). Significantly more Métis participants ate family dinners and breakfast less often than non-Métis participants and had lower self-reported health. Significantly more Métis participants had a BMI classified as obese compared with non-Métis participants (12·6 % v. 7·1 %).

The dietary intakes observed in this study, both among Métis and non-Métis youth, are concerning. Many have dietary patterns that put them at risk for developing health issues in the future.

To investigate the concordance between Australian government guidelines for classifying the healthiness of foods across various public settings.

Commonly available products in Australian food service settings across eight food categories were classified according to each of the seventeen Australian state and territory food classification guidelines applying to public schools, workplaces and healthcare settings. Product nutrition information was retrieved from online sources. The level of concordance between each pair of guidelines was determined by the proportion of products rated at the same level of healthiness.

Australia.

No human participants.

Approximately half (56 %) of the 967 food and drink products assessed were classified as the same level of healthiness across all fifteen ‘traffic light’-based systems. Within each setting type (e.g. schools), pairwise concordance in product classifications between guidelines ranged from 74 % to 100 %. ‘Vegetables’ (100 %) and ‘sweet snacks and desserts’ (78 %) had the highest concordance across guidelines, while ‘cold ready-to-eat foods’ (0 %) and ‘savoury snacks’ (23 %) had the lowest concordance. In addition to differences in classification criteria, discrepancies between guidelines arose from different approaches to grouping of products. The largest proportion of discrepancies (58 %) were attributed to whether products were classified as ‘Red’ (least healthy) or ‘Amber’ (moderately healthy).

The results indicate only moderate concordance between all guidelines. National coordination to create evidence-based consistency between guidelines would help provide clarity for food businesses, which are often national, on how to better support community health through product development and reformulation.

The Mediterranean diet (MD) is a dietary pattern associated with several health benefits, including reduction of risk for various cancers. We conducted a study to investigate associations between adherence to the MD and colorectal cancer (CRC) subtype risk among Moroccan adults.

A matched case–control study.

The five major university hospitals in Morocco.

A total of 3032 subjects (1516 CRC patients and 1516 controls) matched on age, sex and centre were recruited between September 2009 and February 2017 at five major hospitals in Morocco. Diet was assessed using a validated FFQ. Adherence to the MD was assessed through a score, ranging from 0 (no adherence) to 10 (maximal adherence) and divided into three categories (low, middle and high). Conditional logistic regression was performed to calculate multivariable OR and 95 % CI with low adherence (score 0–3) as referent, adjusting for potential confounding factors.

Close adherence to the MD (score 6–9) was associated with reduced risk of CRC (ORa = 0.74, 95 % CI 0.63, 0.86), rectal cancer (ORa = 0.73, 95 % CI 0.58, 0.90) and colon cancer (ORa = 0.74, 95 % CI 0.60, 0.92).

Our study, conducted in a southern Mediterranean population, adds to the evidence suggesting a protective effect of MD against CRC risk.

Early education and care (ECEC) is part of the everyday life of most children in developed economies, presenting exceptional opportunity to support nutrition and ongoing food preferences. Yet, the degree to which such opportunity is captured in policy-driven assessment and quality ratings of ECEC services is unknown.

Abductive thematic analysis was conducted, guided by key domains of knowledge in nutrition literature and examining identified themes within these domains.

ECEC services (n 38) in Queensland, Australia.

Data were a random sample of field notes pertaining to mealtimes and food provision (n 182) collected as evidence to inform quality ratings during assessment visits to ECEC services.

The field notes mapped to three theory-driven domains: provisions, practices and education. Reflecting policy specification, health, hygiene and safety were a key focus, but food quality and quantity were not. Assessors noted the promotion of child autonomy at mealtimes, yet little evidence pertaining to characteristics of educator-child interactions.

Despite evidence that childhood nutrition is crucial for optimal development and learning, the quality and quantity of food are not directly assessed. Relationships and interactions at mealtimes provide an environment ideal for promoting learning and development, yet the policy guiding inspection and assessment of ECEC services directs focus to a more limited lens of safety, hygiene and promotion of ‘healthy foods’. Our findings identify a narrow conceptualisation of mealtimes focused on ‘health’ as limiting the potential to leverage mealtimes as places to support children’s nutrition and attendant development and learning.

Ultra-processed beverages (UPB) have known adverse impacts on health, but their impact on the environment is not well understood across different environmental indicators. This study aimed to quantify the environmental impacts of water-based UPB and bottled waters sold in Australia and assess the impacts of various scenarios which may reduce such impacts in the future.

This study presents a quantitative environmental impact assessment of a major sub-category of UPB (water-based UPB, including soft drinks, energy drinks, cordials and fruit drinks) and non-UPB (bottled waters) in Australia. Alternative mitigation scenarios based on existing health and environmental targets were also modelled using sales projections for 2027. Sales data from Euromonitor International were matched with environmental impact data from peer-reviewed lifecycle assessment databases. Environmental impact indicators included greenhouse gas emissions, land use, eutrophication potential, acidification potential, water scarcity and plastic use.

The Australian beverage supply in 2022 and projected sales for 2027.

N/A

Environmental impacts of UPB were higher than bottled waters. UPB accounted for 81–99 % of total environmental impacts, partly driven by the volume of sales. Reformulation, reducing UPB consumption and increasing recycling all led to meaningful reductions in environmental impacts but with diverse effects across different environmental indicators. The largest reductions occurred when policy scenarios were combined to represent a suite of policy actions which aimed to meet health and environmental targets (30–82 % environmental savings).

The results indicate that implementing a suite of policies which act to target multiple drivers of environmental harm are likely to lead to the most environmental benefits.

To characterise children’s lunchbox contents for food, waste and packaging.

A cross-sectional study was conducted. Lunchboxes were photographed at two time points on the same day: before first morning break to capture food and packaging and post-lunch break to capture food waste. Contents were coded using an audit tool developed using REDCap.

Twenty-three sites across metropolitan Adelaide, South Australia including fourteen preschools and nine primary schools in low (n 8), medium (n 7) and high (n 8) socioeconomic areas.

Preschool (ages 3–5 years) to Grade 7 primary school (ages 6–13 years) students.

673 lunchboxes were analysed. Grain foods dominated (with at least half of them being discretionary varieties), with 92 % of lunchboxes having at least one item from that category, followed by fruits (78 %), snacks (62 %), dairy (32 %) and vegetables (26 %). Lunchboxes of preschool children contained more fruits (92 % v. 65 %; χ2(1) = 73·3, P < 0·01), vegetables (36 % v. 16 %; χ2(1) = 34·0, P < 0·01) and dairy items (45 % v. 19 %; χ2(1) = 53·6, P < 0·01), compared to lunchboxes of primary school children. Snack foods were more prevalent in primary school (68 %) than preschool (55 %; χ2(1) = 11·2, P < 0·01). Discretionary foods appeared more frequently, and single-use packaging accounted for half (53 %) of all packaging in lunchboxes, primarily from snacks and grain foods. Preschool children had less single-use packaging but more food waste. Vegetables were the most wasted food group.

Sandwiches, fruits and various snacks are typical lunchbox foods, often accompanied by single-use packaging. Considering both health and environmental factors in lunchbox choices could benefit children and sustainability efforts in schools.

While fast-food is typically considered highly processed, an analysis to demonstrate this has yet to be conducted. Therefore, the objective of this research was to examine the menu items and ingredients from six fast-food restaurant menus using the NOVA classification.

Cross-sectional study.

Data were collected from the top six highest selling US restaurants, per each food category, identified using the Quick Service and Fast Casual Restaurants (QSR) 2020 report.

A total of 740 menu items were identified and classified according to their degree of processing based on ingredient lists using the NOVA classification: minimally processed (MPF), culinary processed ingredient (CPF), processed (PRF) or ultra-processed (UPF). In addition, individual ingredients that appeared on at least three menus were classified into NOVA groups, and the twenty most common ingredients were identified based on frequency of appearance in ingredient lists.

Across all menus, 85 % (range: 70–94 %) of items were UPF with only 11 % (range: 6–25 %) being MPF (P < 0·001). Additionally, 46 % of the ingredients that appeared on at least three menus were ultra-processed ingredients. Three ultra-processed ingredients appeared on all six menus: natural flavours, xanthan gum and citric acid.

These findings show that the vast majority of menu items from major fast-food restaurants are UPF, and there are few options for MPF. Fast-food companies should consider reformulation or the addition of MPF to the menu to increase healthful food options for their patrons.