Approximately one-third of children in the USA are either overweight or obese. Understanding the perceptions of children is an important factor in reversing this trend.

An online survey was conducted with children to capture their perceptions of weight, overweight, nutrition, physical activity and related socio-behavioural factors.

Within the USA.

US children (n 1224) aged 8–18 years.

Twenty-seven per cent of children reported being overweight; 47·1 % of children overestimated the rate of overweight/obesity among US children. A higher percentage of self-classified overweight children (81·9 %) worried about weight than did self-classified under/normal weight children (31·1 %). Most children (91·1 %) felt that it was important to not be overweight, for both health-related and social-related reasons. The majority of children believed that if someone their age is overweight they will likely be overweight in adulthood (93·1 %); get an illness such as diabetes or heart disease in adulthood (90·2 %); not be able to play sports well (84·5 %); and be teased or made fun of in school (87·8 %). Children focused more on food/drink than physical activity as reasons for overweight at their age. Self-classified overweight children were more likely to have spoken with someone about their weight over the last year than self-classified under/normal weight children.

Children demonstrated good understanding of issues regarding weight, overweight, nutrition, physical activity and related socio-behavioural factors. Their perceptions are important and can be helpful in crafting solutions that will resonate with children.

Research is limited on whether mistrust of tap water discourages plain water intake and leads to a greater intake of sugar-sweetened beverages (SSB). The objective of the present study was to examine demographic differences in perceptions of tap water safety and determine if these perceptions are associated with intake of SSB and plain water.

The study examined perceptions of tap water safety and their cross-sectional association with intake of SSB and plain water. Racial/ethnic differences in the associations of tap water perceptions with SSB and plain water intake were also examined.

Nationally weighted data from the 2010 HealthStyles Survey (n 4184).

US adults aged ≥18 years.

Overall, 13·0 % of participants disagreed that their local tap water was safe to drink and 26·4 % of participants agreed that bottled water was safer than tap water. Both mistrust of tap water safety and favouring bottled water differed by region, age, race/ethnicity, income and education. The associations of tap water mistrust with intake of SSB and plain water were modified by race/ethnicity (P < 0·05). Non-white racial/ethnic groups who disagreed that their local tap water was safe to drink were more likely to report low intake of plain water. The odds of consuming ≥1 SSB/d among Hispanics who mistrusted their local tap water was twice that of Hispanics who did not (OR = 2·0; 95 % CI 1·2, 3·3).

Public health efforts to promote healthy beverages should recognize the potential impact of tap water perceptions on water and SSB intake among minority populations.

Vitamin D insufficiency is known to be related to cardiometabolic disorders; however, the associations among serum 25-hydroxyvitamin D (25(OH)D) concentration and metabolic syndrome and cardiometabolic risk factors in children and adolescents have not yet been clearly delineated. For this reason, we investigated the relationship among serum 25(OH)D concentration and metabolic syndrome and cardiometabolic risk factors among Korean adolescents.

We performed a cross-sectional analysis and used hierarchical multivariate logistic regression analysis models to adjust for confounding variables.

We used the data gathered during the 2008–2009 Korea National Health and Nutrition Examination Survey (KNHANES).

Our subjects included 1504 Korean adolescents aged 12–18 years who participated in the KNHANES.

Vitamin D insufficiency, defined as 25(OH)D concentration <50 nmol/l, was found in 75·3 % of Korean adolescents and was associated with an increased risk of the prevalence of metabolic syndrome. Waist circumference and BMI were the most closely correlated cardiometabolic components of metabolic syndrome according to serum 25(OH)D status, but no significant relationship was found between serum 25(OH)D concentration and insulin resistance or for the risks for high blood pressure, hyperglycaemia, reduced HDL-cholesterol or hypertriacylglycerolaemia, with or without adjustment for confounding variables.

Low serum 25(OH)D concentration appears to be associated with several cardiometabolic risk factors and an increased risk of the prevalence of metabolic syndrome in Korean adolescents.

To quantify short- and long-term associations between dietary patterns defined a priori and bone mineral density (BMD) during adolescence.

Dietary patterns were defined at 13 years old using a Mediterranean diet (MD) quality index, the Dietary Approaches to Stop Hypertension (DASH) diet index and the Oslo Health Study (OHS) dietary index. Linear regression coefficients were used to estimate associations between dietary patterns and forearm BMD at 13 and 17 years, measured by dual-energy X-ray absorptiometry.

Public and private schools of Porto, Portugal.

The EPITeen cohort comprising 1180 adolescents born in 1990, recruited at schools during the 2003/2004 school year and re-evaluated in 2007/2008.

In girls, at 13 years, mean BMD (g/cm2) in the first and third tertiles was 0·369 and 0·368 for the MD pattern, 0·368 and 0·369 for the DASH diet, and 0·370 and 0·363 for the OHS index. In boys, mean BMD (g/cm2) in the first and third tertiles was 0·338 and 0·347 for the MD pattern, 0·342 and 0·346 for the DASH diet, and 0·344 and 0·342 for the OHS index. None of these differences were significant. Mean BMD at 17 years and prospective variation were also not significantly different between tertiles of adherence to each score. However, a trend of increased BMD at 13 years with greater adherence to the MD pattern was observed in boys (adjusted coefficient = 0·248; 95 % CI 0·052, 0·444).

The selected dietary patterns may not capture truly important dietary differences in determining BMD or diet may not be, beyond nutrient adequacy, a limiting determinant of BMD.

To assess the effectiveness of facility-based care for children with severe acute malnutrition (SAM) in malnutrition treatment centres (MTC).

Early detection and treatment of SAM using locally adapted protocols; assessment of programme outcomes, including survival, default, discharge and recovery rates.

All forty-eight MTC in Jharkhand, India.

Children (n 3595) with SAM admitted to MTC (1 July 2009–30 June 2011).

Of children admitted, 55·0 % were girls, 77·7 % were 6–23 months old and 68·6 % belonged to scheduled tribes or castes; 34·4 % had oedema or medical complications. Of the 3418 programme exits, the proportion of children who died was 0·6 % (n 20), the proportion of children who defaulted was 18·4 % (n 628) and the proportion of children discharged was 81·0 % (n 2770). Children's average weight gain was 9·6 (sd 8·4) g/kg body weight per d and their average length of stay was 16·0 (sd 5·7) d. Among the 2770 children who were discharged from the programme, 39·4 % (n 1090) gained 15 % or more of their initial weight while 60·6 % (n 1680) gained less than 15 % of their initial weight.

MTC provide live-saving care for children with SAM as demonstrated by high survival rates. However, the protocols and therapeutic foods currently used need to improve to ensure the recovery of all discharged children. MTC should be reserved for children with complicated SAM; children with uncomplicated SAM should be admitted to a community-based programme for the management of SAM, at a lesser risk to children and a lesser cost to families and the health system.

In 2007 the Australian Division of World Action on Salt and Health (AWASH) launched a campaign to encourage the Australian government to take action to reduce population salt intake. The objective of the present research was to assess the impact of the Drop the Salt! campaign on government policy.

A review of government activities related to salt reduction was conducted and an advocacy strategy implemented to increase government action on salt. Advocacy actions were documented and the resulting outcomes identified. An analysis of stakeholder views on the effectiveness of the advocacy strategy was also undertaken.

Advocacy activities were coordinated through AWASH at the George Institute for Global Health in Sydney.

All relevant State and Federal government statements and actions were reviewed and thirteen stakeholders with known interests or responsibilities regarding dietary salt, including food industry, government and health organisations, were interviewed.

Stakeholder analysis affirmed that AWASH influenced the government's agenda on salt reduction and four key outputs were attributed to the campaign: (i) the Food Regulation Standing Committee discussions on salt, (ii) the Food and Health Dialogue salt targets, (iii) National Health and Medical Research Council partnership funding and (iv) the New South Wales Premier's Forum on Fast Foods.

While it is not possible to definitively attribute changes in government policy to one organisation, stakeholder research indicated that the AWASH campaign increased the priority of salt reduction on the government's agenda. However, a coordinated government strategy on salt reduction is still required to ensure that the potential health benefits are fully realised.

To determine public attitudes towards federal spending on nutrition assistance programmes and support for policies to improve the nutritional impact of the Supplemental Nutrition Assistance Program (SNAP).

Participants answered survey questions by telephone assessing support for SNAP spending and proposed programme policy changes.

USA.

Survey of 3024 adults selected by random digit dialling conducted in April 2012, including 418 SNAP participants.

A majority (77 %; 95 % CI 75, 79 %) of all respondents supported maintaining or increasing SNAP benefits, with higher support among Democrats (88 %; 95 % CI 86, 90 %) than Republicans (61 %; 95 % CI 58, 65 %). The public supported policies to improve the nutritional impact of SNAP. Eighty-two per cent (95 % CI 80, 84 %) of respondents supported providing additional benefits to programme participants that can only be used on healthful foods. Sixty-nine per cent (95 % CI 67, 71 %) of respondents supported removing SNAP benefits for sugary drinks. A majority of SNAP participants (54 %; 95 % CI 48, 60 %) supported removing SNAP benefits for sugary drinks. Of the 46 % (95 % CI 40, 52 %) of SNAP participants who initially opposed removing sugary drinks, 45 % (95 % CI 36, 54 %) supported removing SNAP benefits for sugary drinks if the policy also included additional benefits to purchase healthful foods.

The US public broadly supports increasing or maintaining spending on SNAP. The majority of respondents, including SNAP participants, supported policies to improve the nutritional impact of SNAP by restricting the purchase of sugary drinks and incentivizing purchase of healthful foods with SNAP benefits.

The neighbourhood built environment may affect walking behaviour of elders. However, such effects remain underexplored, especially in an Asian context. We examined associations of perceived environmental attributes with overall and neighbourhood-specific walking for transport in a sample of Chinese elders residing in Hong Kong, an ultra-dense Chinese metropolis.

Cross-sectional observational study using a two-stage stratified sampling strategy.

Hong Kong, China.

Chinese-speaking elders (n 484), with no cognitive impairment and able to walk without assistance, residing in thirty-two selected communities stratified by socio-economic status and walkability, were interviewer-administered validated measures of perceived neighbourhood environment and walking for transport.

Much higher levels of transport-related walking (mean 569 (sd 452) min/week) than found in Western samples were reported. The degree of perceived access to shops, crowdedness, presence of sitting facilities and easy access of residential entrance were independently positively related to both frequency of overall and within-neighbourhood walking for transportation. Infrastructure for walking and access to public transport were predictive of higher frequency of transport-related walking irrespective of location, while the perceived degree of land-use mix was predictive of higher levels of within-neighbourhood walking.

The provision of easy access to shops, residential entrances and sitting facilities in the neighbourhood may promote overall transport-related walking, while a good public transport network and pedestrian infrastructure linking destination-poor with destination-rich locations may compensate for the detrimental effects of living in less walkable neighbourhoods. Governmental investment in these micro- and macro-environmental features would help the promotion of an active lifestyle in elders.

Along with other countries having high and low-to-middle income, Mexico has experienced a substantial change in obesity rates. This rapid growth in obesity prevalence has led to high rates of obesity-related diseases and associated health-care costs.

Micro-simulation is used to project future BMI trends. Additionally thirteen BMI-related diseases and health-care costs are estimated. The results are simulated for three hypothetical scenarios: no BMI reduction and BMI reductions of 1 % and 5 % across the population.

Mexican Health and Nutrition Surveys 1999 and 2000, and Mexican National Health and Nutrition Survey 2006.

Mexican adults.

In 2010, 32 % of men and 26 % of women were normal weight. By 2050, the proportion of normal weight will decrease to 12 % and 9 % for males and females respectively, and more people will be obese than overweight. It is projected that by 2050 there will be 12 million cumulative incidence cases of diabetes and 8 million cumulative incidence cases of heart disease alone. For the thirteen diseases considered, costs of $US 806 million are estimated for 2010, projected to increase to $US 1·2 billion and $US 1·7 billion in 2030 and 2050 respectively. A 1 % reduction in BMI prevalence could save $US 43 million in health-care costs in 2030 and $US 85 million in 2050.

Obesity rates are leading to a large health and economic burden. The projected numbers are high and Mexico should implement strong action to tackle obesity. Results presented here will be very helpful in planning and implementing policy interventions.