Consumption of sugar-sweetened beverages (SSB) is associated with overweight and obesity in children and adolescents. Although existing research confirms the significance of economic and social factors as determinants of SSB intake, comparative studies on political factors and cross-national analyses are lacking. Research indicates that including women in the process of political decision-making promotes healthcare and child protection. This study examined how women’s parliamentary representation influences children’s and adolescents’ SSB intake compared with adults.

The study used cross-national food and beverage intake data from the Global Dietary Database. The outcome measurement was SSB consumption (g/day) for different population groups. We modelled SSB intake as a function of age groups, women’s parliamentary representation at the national level (the independent variable), regime types (the contextual factor) and import tariffs on SSB (the mediator) using country and time-fixed effects regression models.

One-hundred eighty-five countries across three waves from 2005 to 2015.

Different population groups.

The impact of female representation on reducing SSB consumption is more prevalent in children and adolescents than in adults. Furthermore, the effect of women’s parliamentary representation on SSB consumption among children and adolescents is conditional on a country’s democratic status. Finally, the marginal effect decreases when import tariffs on SSB are considered a link in a causal chain. No changes in adult SSB intake are statistically significant.

The findings suggest that the presence of women in the legislature can have a substantial impact on child and adolescent health.

To examine the effectiveness of a workplace sugar-sweetened beverage (SSB) sales ban on reducing SSB consumption in employees, including those with cardiometabolic disease risk factors.

A controlled trial of ethnically diverse, full-time employees who consumed SSB heavily (sales ban n 315; control n 342). Outcomes included standardised measures of change in SSB consumption in the workplace (primary) and at home between baseline and 6 months post-sales ban.

Sutter Health, a large non-profit healthcare delivery system in Northern California.

Full-time employees at Sutter Health screened for heavy SSB consumption.

Participants were 66·1 % non-White. On average, participants consumed 34·7 ounces (about 1 litre) of SSB per d, and the majority had an elevated baseline BMI (mean = 29·5). In adjusted regression analyses, those exposed to a workplace SSB sales ban for 6 months consumed 2·7 (95 % CI –4·9, –0·5) fewer ounces of SSB per d while at work, and 4·3 (95 % CI –8·4, –0·2) fewer total ounces per d, compared to controls. Sales ban participants with an elevated BMI or waist circumference had greater post-intervention reductions in workplace SSB consumption.

Workplace sales bans can reduce SSB consumption in ethnically diverse employee populations, including those at higher risk for cardiometabolic disease.

To assess seven-year time trends in energy balance-related behaviours in 14-year-old adolescents living in an urban area and to examine the influence of educational level and ethnicity on these time trends.

Second grade students (mean age 13·6 years) filled in questionnaires about the energy balance-related behaviours of breakfast consumption, fruit and vegetable consumption, physical activity and screen-time behaviour from school years 2006–2007 to 2012–2013. Energy balance-related behaviours were dichotomized and logistic regression analyses were used to examine time trends in healthy energy balance-related behaviours, including interaction terms for educational level and ethnicity.

Secondary schools in Amsterdam, the Netherlands.

Per school year, 2185–3331 children participated. The total sample included 19 244 students of Dutch, Surinamese, Turkish and Moroccan ethnic background.

A significant linear increase was found for positive screen-time behaviour (<2 h/d; OR per year=1·04; 95 % CI 1·03, 1·06). For daily vegetable consumption a non-linear negative trend was observed (school year 2012–2013 v. 2006–2007: OR=0·90; 95 % CI 0·80, 1·00). Time trends in screen time were significantly different across educational levels (P-interaction=0·002) and ethnic backgrounds (P<0·001), as were time trends in daily fruit consumption (P=0·017 and P=0·018, respectively) and, for ethnicity, trends in daily vegetable consumption (P<0·001).

The increase in positive screen-time behaviour is a positive finding. However, discouraging screen time and promoting other healthy behaviours, more specifically daily fruit and vegetable consumption, remain important particularly among adolescents enrolled in pre-vocational education and of non-Dutch ethnic background.

Typically, attention focuses on how nutrition affects physical health. The present study investigated the importance that parents attach to the impact of diet on mental performance when choosing food for their child.

Questionnaire.

Four European countries.

Parents of children aged 4–10 years (n 1574): England (n 397), Germany (n 389), Hungary (n 398) and Spain (n 390).

Most parents (80–85 %) considered the effect of food on four elements of mental performance (child’s ability to learn, attention, behaviour, mood) to be moderately, very, extremely (v. slightly, not at all) important in food choices; over 90 % considered healthiness of food and making food appealing to their child important; 79·8 % cost; 76·8 % convenience. Belief that food affects mental performance was 57·4 % (ability to learn), 60·5 % (attention); less than 40 % of parents agreed they were aware which foods had an effect. Parents with lower general interest in healthy eating were less likely to consider the effect of food on mental performance elements as important. Respondents from Germany were more likely to rate mental performance as important (except behaviour); those in Hungary less likely. The most important influence on parents’ decisions about feeding their child was their own experience, except Spain, where family/friends/health professionals were more important.

Nutrition affects brain development and cognitive functioning. Low prioritisation of the effect of food on mental performance indicates potential for educating parents.

To determine the reach, adoption, implementation and effectiveness of an intervention to increase children’s vegetable intake in long day care (LDC).

A 12-week pragmatic cluster randomised controlled trial, informed by the multiphase optimisation strategy (MOST), targeting the mealtime environment and curriculum. Children’s vegetable intake and variety was measured at follow-up using a modified Short Food Survey for early childhood education and care and analysed using a two-part mixed model for non-vegetable and vegetable consumers. Outcome measures were based on the RE-AIM framework.

Australian LDC centres.

Thirty-nine centres, 120 educators and 719 children at follow-up.

There was no difference between intervention and waitlist control groups in the likelihood of consuming any vegetables when compared with non-vegetable consumers for intake (OR = 0·70, (95 % CI 0·34–1·43), P = 0·32) or variety (OR = 0·73 (95 % CI 0·40–1·32), P = 0·29). Among vegetable consumers (n 652), there was no difference between groups in vegetable variety (exp(b): 1·07 (95 % CI:0·88–1·32, P = 0·49) or vegetable intake (exp(b): 1·06 (95 % CI: 0·78, 1·43)), P = 0·71) with an average of 1·51 (95 % CI 1·20–1·82) and 1·40 (95 % CI 1·08–1·72) serves of vegetables per day in the intervention and control group, respectively. Intervention educators reported higher skills for promoting vegetables at mealtimes, and knowledge and skills for teaching the curriculum, than control (all P < 0·001). Intervention fidelity was moderate (n 16/20 and n 15/16 centres used the Mealtime environment and Curriculum, respectively) with good acceptability among educators. The intervention reached 307/8556 centres nationally and was adopted by 22 % eligible centres.

The pragmatic self-delivered online intervention positively impacted educator’s knowledge and skills and was considered acceptable and feasible. Intervention adaptations, using the MOST cyclic approach, could improve intervention impact on children’ vegetable intake.

The study’s objective was to investigate multiple underlying social, economic and agricultural determinants of stunting among under-five children in three distinct ecological areas in rural Myanmar.

Repeated cross-sectional surveys in three states of Myanmar.

Rural households in Chin (mountainous), Magway (plains) and Ayeyarwady (delta).

From two purposively selected adjacent townships in each state, we randomly selected twenty villages and, in each village, thirty households with under-five children. Households in the first survey in 2016 were revisited in late 2017 to capture seasonal variations.

Stunting increased from 40·4 % to 42·0 %, with the highest stunting prevalence in Chin state (62·4%). Univariate Poisson regression showed factors contributing to child stunting varied across the regions. Adjusted Poisson regression models showed that child’s age and short maternal stature (aRR = 1·14 for Chin, aRR = 1·89 for Magway and aRR = 1·86 for Ayeyarwady) were consistently associated with child stunting across three areas. For Chin, village-level indicators such as crop consumption (aRR = 1·18), crop diversity (aRR = 0·82) and land ownership (aRR = 0·89) were significantly associated with stunting. In Magway, the number of household members (aRR = 1·92), wealth status (aRR = 0·46), food security status (aRR = 1·14), land ownership (aRR = 0·85) and in Ayeyarwady, women’s decision-making (aRR = 0·67) and indicators related to hygiene (aRR = 1·13) and sanitation (aRR = 1·45) were associated with stunting.

Area-specific factors were associated with stunting. Maternal short stature and child age were consistent determinants of stunting. A multi-sectoral local approach, including improvements in transport, is needed to address the intergenerational malnutrition problem.

We aimed to synthesise available evidence on the effects of community-based interventions in improving various dietary outcome measures.

Systematic review and meta-analysis.

We searched databases including Medline, EMBASE, PSYCINFO, CINAHL and the Cochrane registry for studies reported between January 2000 and June 2022. The methodological quality of the included studies was evaluated using the Cochrane risk of bias tools for each study type. For some of the outcomes, we pooled the effect size using a random-effects meta-analysis.

A total of fifty-one studies, thirty-three randomised and eighteen non-randomised, involving 100 746 participants were included.

Overall, thirty-seven studies found a statistically significant difference in at least one dietary outcome measure favouring the intervention group, whereas fourteen studies found no statistically significant difference. Our meta-analyses indicated that, compared with controls, interventions were effective in decreasing daily energy intake (MJ/d) (mean difference (MD): –0·25; 95 % CI: –0·37, –0·14), fat % of energy (MD: –1·01; 95 % CI: –1·76, –0·25) and saturated fat % of energy (MD: –1·54; 95 % CI: –2·01, –1·07). Furthermore, the interventions were effective in improving fibre intake (g/d) (MD: 1·08; 95 % CI: 0·39, 1·77). Effective interventions use various strategies including tailored individual lifestyle coaching, health education, health promotion activities, community engagement activities and/or structural changes.

This review shows the potential of improving dietary patterns through community-based CVD preventive interventions. Thus, development and implementation of context-specific preventive interventions could help to minimise dietary risk factors, which in turn decrease morbidity and mortality due to CVD and other non-communicable diseases.

This study aims at comparing two Italian case studies in relation to schoolchildren’s plate waste and its implications, in terms of nutritional loss, economic cost and carbon footprint.

Plate waste was collected through an aggregate selective weighting method for 39 d.

Children from the first to the fifth grade from four primary schools, two in each case study (Parma and Lucca), were involved.

With respect to the served food, in Parma, the plate waste percentage was lower than in Lucca (P < 0·001). Fruit and side dishes were highly wasted, mostly in Lucca (>50 %). The energy loss of the lunch meals accounted for 26 % (Parma) and 36 % (Lucca). Among nutrients, dietary fibre, folate and vitamin C, Ca and K were lost at most (26–45 %). Overall, after adjusting for plate waste data, most of the lunch menus fell below the national recommendations for energy (50 %, Parma; 79 %, Lucca) and nutrients, particularly for fat (85 %, Parma; 89 %, Lucca). Plate waste was responsible for 19 % (Parma) and 28 % (Lucca) of the carbon footprint associated with the food supplied by the catering service, with starchy food being the most important contributor (52 %, Parma; 47 %, Lucca). Overall, the average cost of plate waste was 1·8 €/kg (Parma) and 2·7 €/kg (Lucca), accounting respectively for 4 % and 10 % of the meal full price.

A re-planning of the school meals service organisation and priorities is needed to decrease the inefficiency of the current system and reduce food waste and its negative consequences.

The goal of this study is to evaluate university students’ perceptions of tap water safety and water filter use and determine how these perceptions and behaviours affect water and sugar-sweetened beverage intake.

Cross-sectional; online survey conducted in Fall 2021.

A large, public Midwestern university in the USA.

Seven-hundred ninety-three university students.

Students who experienced food insecurity, were on a Pell grant, were first-generation college students or were racial/ethnic minorities were less likely to trust tap water safety. Tap water filtration behaviour also varied by age and race/ethnicity. Students who did not agree with the statement ‘my local tap water is safe to drink’ had lower odds of consuming ≥ 3 cups of total water per day (OR = 0·45, 95 % CI: 0·32, 0·62), lower odds of consuming tap water ≥ 3 times/d (OR = 0·46, 95 % CI: 0·34, 0·64), higher odds of drinking bottled water ≥ 1 time per day (OR = 1·80, 95 % CI: 1·22, 2·66) and higher odds of drinking SSB ≥ 1 time per day (OR = 1·47, 95 % CI: 1·01, 2·14) than those who agreed. Students who always or sometimes filtered their tap water had lower odds of consuming ≥ 3 cups of total water per day (OR = 0·59, 95 % CI: 0·39, 0·90) than students who never filtered their tap water.

Tap water perceptions and behaviours affect tap and bottled water and SSB intake among university students. Tap water perceptions and behaviours in this demographic provide important context for university programming promoting healthy beverage initiatives.

Government policy guidance in Victoria, Australia, encourages schools to provide affordable, healthy foods in canteens. This study analysed the healthiness and price of items available in canteens in Victorian primary schools and associations with school characteristics.

Dietitians classified menu items (main, snack and beverage) using the red, amber and green traffic light system defined in the Victorian government’s School Canteens and Other School Food Services Policy. This system also included a black category for confectionary and high sugar content soft drinks which should not be supplied. Descriptive statistics and regressions were used to analyse differences in the healthiness and price of main meals, snacks and beverages offered, according to school remoteness, sector (government and Catholic/independent) size, and socio-economic position.

State of Victoria, Australia

A convenience sample of canteen menus drawn from three previous obesity prevention studies in forty-eight primary schools between 2016 and 2019.

On average, school canteen menus were 21 % ‘green’ (most healthy – everyday), 53 % ‘amber’ (select carefully), 25 % ‘red’ (occasional) and 2 % ‘black’ (banned) items, demonstrating low adherence with government guidelines. ‘Black’ items were more common in schools in regional population centres. ‘Red’ main meal items were cheaper than ‘green’% (mean difference –$0·48 (95 % CI –0·85, –0·10)) and ‘amber’ –$0·91 (–1·27, –0·57)) main meal items. In about 50 % of schools, the mean price of ‘red’ main meal, beverages and snack items were cheaper than ‘green’ items, or no ‘green’ alternative items were offered.

In this sample of Victorian canteen menus, there was no evidence of associations of healthiness and pricing by school characteristics except for regional centres having the highest proportion of ‘black’ (banned) items compared with all other remoteness categories examined. There was low adherence with state canteen menu guidelines. Many schools offered a high proportion of ‘red’ food options and ‘black’ (banned) options, particularly in regional centres. Unhealthier options were cheaper than healthy options. More needs to be done to bring Victorian primary school canteen menus in line with guidelines.

To determine whether the ‘Read for Nutrition’ programme would increase liking and consumption of broccoli (a target vegetable) in preschool children and test acceptability and practicality of the programme.

Pilot pre-post intervention study, where childcare teachers received training and coaching followed by reading the book ‘Monsters Don’t Eat Broccoli’ multiple times with the children during a three-week intervention.

Five classrooms of Educare, Lincoln, Nebraska in 2018.

Sixty-nine (11 to 16 children per classroom) preschool-aged children and sixteen teachers (minimum, three per classroom).

Average total consumption of broccoli increased 35 % (0·14 ounces or 0·05th cup) after the ‘Read for Nutrition’ programme (t = 2·66; P = 0·01; 95 % CIs (0·035, 0·246)) for all children. Proportional consumption increased for children who received ≥ five exposures to the book (t46 = 2·77; P = 0·008). Exposures to the book predicted proportional consumption (β = 0·365; P = 0·002). Liking of broccoli increased (W69 = 2·2, P = 0·03) as well. Teachers rated the programme as acceptable, practical and enjoyable to children and to themselves.

Programmes such as ‘Read for Nutrition’ have the potential to improve children’s vegetable liking and consumption in early care and education settings with only book readings and no exposure to a real vegetable.

We examined the association between serum antioxidant status and mortality from influenza and pneumonia in US adults.

Serum concentrations of antioxidants included vitamin C, vitamin A, vitamin E, sum of α- and β-carotene, β-cryptoxanthin, lutein + zeaxanthin and lycopene. We computed total antioxidant capacity (TAC) as a measure of composite antioxidant status in serum. Survey-weighted Cox proportional hazard models were used to compute hazard ratios (HR) and 95 % CI comparing quartiles of each antioxidant and TAC.

Data from the US National Health and Nutrition Examination Survey (NHANES)-III.

A total of 7428 NHANES-III participants ≥45 years of age.

With a weighted-median follow-up of 16·8 years, 154 participants died from influenza/pneumonia. After adjustment for covariates, serum vitamin C, the sum of α- and β-carotene and TAC were nonlinearly associated with influenza/pneumonia mortality, with the statistically significant smallest HR at the third quartile v. the first quartile (HR = 0·38 (95 % CI: 0·19, 0·77), 0·29 (0·16, 0·51) and 0·30 (0·15, 0·59), respectively). HR comparing the fourth v. the first quartiles were weaker and nonsignificant: 0·57 (95 % CI: 0·27, 1·17), 0·70 (0·41, 1·19) and 0·65 (0·31, 1·35), respectively. Serum lycopene had a monotonic association with influenza/pneumonia mortality (HR = 0·43 (95 % CI: 0·23, 0·83) comparing the fourth v. the first quartile, Pfor trend = 0·01).

The current study suggests that antioxidant intake as reflected by serum concentrations may reduce mortality risk from influenza or pneumonia in the US general population. These findings warrant further confirmation in other populations with different settings (e.g. a shorter-term association with influenza infection).

To determine predictors of the association between being a Veteran and adult food security, as well as to examine the relation of potential covariates to this relationship.

Data collected during 2011–2012, 2013–2014 and 2015–2016 National Health and Nutrition Examination Survey (NHANES) were pooled for analyses. Veterans (self-reported) were matched to non-Veterans on age, race/ethnicity, sex and education. Adjusted logistic regression was used to determine the odds of Veterans having high food security v. the combination of marginal, low and very low food security compared with non-Veterans.

2011–2012, 2013–2014 and 2015–2016 NHANES.

1227 Veterans; 2432 non-Veterans.

Veteran status had no effect on the proportion of food insecurities between Veterans and non-Veterans reporting high (Veterans v. non-Veteran: 79 % v. 80 %), marginal (9 % v. 8 %), low (5 % v. 6 %) and very low (8 % v. 6 %) food security (P = 0·11). However, after controlling for covariates, Veterans tended to be less likely to have high food security (OR: 0·82 (95 % CI 0·66, 1·02), P = 0·07). Further, non-Hispanic White Veterans (OR: 0·72 (95 % CI 0·55, 0·95), P = 0·02) and Veterans completing some college (OR: 0·71 (95 % CI 0·50, 0·99), P < 0·05) were significantly less likely to experience high food security compared with non-Veterans.

This study supports previous research findings that after controlling for covariates, Veterans tend to be less likely to have high food security. It also highlights ethnicity and level of education as important socio-economic determinates of food security status in Veterans.