To examine the associations of pregnant women’s dietary and sedentary behaviours with their children’s birth weight.

Secondary data analysis was conducted using data from a randomised controlled trial, Communicating Healthy Beginnings Advice by Telephone, conducted in Australia. Information on mothers’ socio-demographics, dietary and sedentary behaviours during pregnancy was collected by telephone survey at the third trimester. Birth weight data were extracted from the child’s health record book. Multinomial logistic regression models were built to examine the associations of pregnant women’s dietary and sedentary behaviours with children’s birth weight.

Participating families.

Pregnant women and their children.

A total of 1132 mother–child dyads were included in the analysis. The majority of infants (87 %, n 989) were of normal birth weight (2500 g to <4000 g), 4 % (n 50) had low birth weight (<2500 g) and 8 % (n 93) had macrosomia (≥4000 g). Mothers who ate processed meat during pregnancy were more likely to have macrosomia (adjusted risk ratio (ARR) 1·80, 95 % CI (1·12, 2·89)). The risk of macrosomia decreased as the number of dietary recommendations met by mothers increased (ARR 0·84, 95 % CI (0·71, 0·99)). Children’s birth weight was not associated with mothers’ sedentary time. Children’s low birth weight was not associated with mothers’ dietary and sedentary behaviours during pregnancy.

Maternal consumption of processed meat during pregnancy was associated with an increased risk of macrosomia. Increasing number of dietary recommendations met by mothers was associated with a lower risk of macrosomia. The findings suggested encouraging pregnancy women to meet dietary recommendation will benefit children’s birth weight.

To examine associations between geographic information systems (GIS)-assessed accessibility to small food stores, shopping patterns and dietary behaviours among small food store customers.

Residential addresses and customer shopping patterns (frequency of shopping, and previous purchase of fruits and vegetables) were gathered through customer intercept surveys. Addresses were geocoded, and GIS-assessed distance and driving time from the participants’ residence to the store were calculated. Dietary status and behaviours were assessed using an objective non-invasive measure of skin carotenoids, the National Cancer Institute Fruit and Vegetable Screener, and items to assess sugary beverage intake. Associations between distance and driving time, demographics, shopping frequency, prior reported purchase of fruits and vegetables at the store and dietary behaviours were examined.

Small food stores (n 22) across North Carolina.

Cross-sectional convenience samples of English-speaking customers aged 18 years or older (n 692).

Participants living closer to the small store had lower income and formal education, were more likely to be Black, more likely to have previously bought fruits and vegetables at the store and more frequently shopped at the store. In adjusted models, skin carotenoids (n 644) were positively associated with distance to the store from home in miles (P = 0·01).

Customers who lived closer to the stores were more frequent shoppers and more likely to have previously purchased fruits and vegetables at the store yet had lower skin carotenoids. These results support continued efforts to examine how to increase the availability and promotion of healthful foods at small food retail stores.

Job-related chronic stress has been discussed as a risk factor for weight change and metabolic disorders. The current study was conducted to understand the situations in which stress-induced eating occurs among office workers and how workers perceive stress to influence their daily eating practices and weight change.

In-depth, one-on-one interviews were conducted with office workers.

Metropolitan areas in South Korea.

Twenty-two office workers from thirteen companies participated in the study.

Most participants mentioned that they often felt work-related stress and reported various levels of perceived stress, as measured with open-ended questions. The main sources of work stress were (i) the nature of job characteristics, (ii) performance evaluations and (iii) relationships within the organisation. Participants linked stress with increased food consumption and cravings for sweet, savoury and greasy foods. Many participants emphasised the links between multiple health behaviours and stress. Not only dietary choices but also alcohol consumption, sleeping difficulty and insufficient physical activity were related to coping with work stress and demands. Finally, most participants who perceived work stress believed that their weight gain in adulthood was triggered by work stress.

It is necessary to consider promoting behavioural modifications to support weight management and providing a means for stress management and the minimisation of stress-inducing working environments for workers to maintain or achieve a healthy weight and to prevent chronic disease incidence.

To synthesise evidence of urban dietary behaviours (macronutrients, types of foods, dietary diversity and dietary practices) in two African countries in relation to postulated changes in the context of nutrition transition.

Systematic review and meta-analyses, including six online databases and grey literature, 1971–2018 (Protocol CRD42017067718).

Urban Ghana and Kenya.

Population-based studies of healthy adolescents and adults.

The forty-seven included studies encompassed 20 726 individuals plus 6526 households. Macronutrients were within WHO-recommended ranges: mean energy intake was 1867 kcal/d (95 % CI 1764, 1969) and the proportions of macronutrients were carbohydrate 61·2 % (58·4, 64·0), fat 25·3 % (22·8, 28·0) and protein 13·7 % (12·3, 15·1). The proportion of population consuming fruit and vegetables was 51·6 %; unhealthy foods, 29·4 %; and sugar-sweetened beverages (SSBs), 39·9 %. Two-thirds (68·8 %) consumed animal-source proteins. Dietary diversity scores were within the mid-range. Meal patterns were structured (typically three meals per day), with evidence lacking on snacking or eating out.

Population-level diets fell within WHO macronutrient recommendations, were relatively diverse with structured meal patterns, but some indications of nutrition transition were apparent. The proportion of population consuming fruit and vegetables was low compared to healthy-eating recommendations, and consumption of SSBs was widespread. A paucity of evidence from 1971 to 2010 precluded a longitudinal analysis of nutrition transition. Evidence from these two countries indicates which aspects of dietary behaviours may be contributing to increasing overweight/obesity, namely a low proportion of population consuming fruit and vegetables and widespread consumption of SSBs. These are potential targets for promoting healthier diets.

To identify the prevalence of unhealthy dietary behaviours and their social-ecological influences in adolescents.

The study used a sequential explanatory mixed-methods design, which begins with the collection of quantitative data, followed by the collection of qualitative data to explain and enrich the quantitative findings. Quantitative data were collected via a global school-based student health survey and were analysed using quantitative approaches. Qualitative data were obtained via focus group discussions and were analysed thematically.

Middle and high secondary schools in Taza city, Morocco.

Our quantitative analyses included 764 students (14–19 years). For the qualitative part, seventeen focus group discussions were conducted with 100 participants (fifty-six adolescents, twenty-six parents and eighteen teachers).

Of total student participants, 46·1 % skipped breakfast, 60·6 % had inadequate intake of fruits and vegetables (F&V), 39·4 % consumed soft drinks and 28·0 % consumed fast foods. All of these dietary behaviours could coexist in the same person except for inadequate intake of F&V. Gender, academic performance, age, perceived family income and education level of mother were associated with unhealthy dietary behaviours. Qualitative findings identified seven themes regarding social-ecological influences on adolescents’ dietary behaviours: cognitive, affective/biological, lifestyle, outcome expectation, social network, accessibility/availability and macro-level influences.

The prevalence of unhealthy dietary behaviours in our study group is a concern. Dietary behaviours are the result of inseparable interactions among social-ecological influences. Modifiable factors identified may be useful when designing a future intervention aimed at improving breakfast and F&V consumption and reducing fast/snack-food consumption among adolescents.

The current review aimed to synthesise the literature on food literacy interventions among adolescents in secondary schools, the attitudes and perceptions of food literacy interventions in secondary schools, and their effects on dietary outcomes.

The systematic review searched five electronic databases from the earliest record to present.

The studies selected for the review were from sixteen countries: Australia (n 10), Canada (n 1), China (n 1), France (n 1), Greece (n 2), Iran (n 1), South Africa (n 1), South India (n 1), Kenya (n 1), Norway (n 2), Portugal (n 1), Denmark (n 1), Northern Ireland (n 1), USA (n 17), UK (n 1) and Sweden (n 2).

Adolescents aged 10–19 years.

Forty-four studies were eligible for inclusion. Adolescents with greater nutritional knowledge and food skills showed healthier dietary practices. Studies found a mixed association between food literacy and long-term healthy dietary behaviour. Two studies showed an improvement in adolescents’ cooking skills and food safety knowledge; six studies showed an improvement in overall food safety knowledge; six studies showed an improvement in overall food and nutritional knowledge; and two studies showed an improvement in short-term healthy dietary behaviour.

Food literacy interventions conducted in a secondary-school setting have demonstrated a positive impact on healthy food and nutritional knowledge. However, there appears to be limited evidence supporting food literacy interventions and long-term dietary behaviours in adolescents. More evidence-based research is required to adequately measure all domains of food literacy and more age-specific food literacy interventions.

The main objective of the present study was to develop and evaluate a nutrition education curriculum to enhance young children’s dietary behaviours and nutrition and health knowledge.

A randomized controlled design was utilized. The intervention was designed to improve children’s nutrition and health knowledge and preferences for fruits and vegetables through classroom lessons and activities, including direct instruction and tastings (implemented twice per week for 6 weeks).

The study took place in elementary schools in a Midwestern US state.

One hundred and thirty-one 2nd grade children from ten classrooms (n 82 intervention, n 49 control) participated.

Multiple regression analyses that adjusted se for clustering by classroom were used to test hypotheses. Children in the intervention condition demonstrated significantly higher scores on the nutrition and health survey (β=0·47, P=0·001) and showed greater preferences for fruits and vegetables at post-test than the control group (β=0·19, P=0·003).

Findings suggest that a short, 6-week intervention that aligns with educational standards has the ability to significantly enhance children’s outcomes and thus may be a more feasible option for teachers to incorporate into their classrooms than what is currently available.

To examine associations between availability of fast-food restaurants and convenience stores in the home and school neighbourhoods, considered separately and together, and adolescents’ fast-food and sugar-sweetened beverage (SSB) intakes.

Cross-sectional observational study.

East London, UK.

Adolescents (n 3089; aged 13–15 years) from the Olympic Regeneration in East London (ORiEL) Study self-reported their weekly frequency of fast-food and SSB consumption. We used food business addresses collected from local authority registers to derive absolute (counts) and relative (proportions) exposure measures to fast-food restaurants and convenience stores within 800 m from home, school, and home and school combined. Associations between absolute and relative measures of the food environment and fast-food and SSB intakes were assessed using Poisson regression models with robust standard errors.

Absolute exposure to fast-food restaurants or convenience stores in the home, school, or combined home and school neighbourhoods was not associated with any of the outcomes. High SSB intake was associated with relative exposure to convenience stores in the residential neighbourhood (risk ratio=1·45; 95 % CI 1·08, 1·96) and in the home and school neighbourhoods combined (risk ratio=1·69; 95 % CI 1·11, 2·57).

We found no evidence of an association between absolute exposure to fast-food restaurants and convenience stores around home and school and adolescents’ fast-food and SSB intakes. Relative exposure, which measures the local diversity of the neighbourhood food environment, was positively associated with SSB intake. Relative measures of the food environment may better capture the environmental risks for poor diet than absolute measures.

Excess meat consumption, particularly of red and processed meats, is associated with nutritional and environmental health harms. While only a small portion of the population is vegetarian, surveys suggest many Americans may be reducing their meat consumption. To inform education campaigns, more information is needed about attitudes, perceptions, behaviours and foods eaten in meatless meals.

A web-based survey administered in April 2015 assessed meat reduction behaviours, attitudes, what respondents ate in meatless meals and sociodemographic characteristics.

Nationally representative, web-based survey in the USA.

US adults (n 1112) selected from GfK Knowledgeworks’ 50 000-member online panel. Survey weights were used to assure representativeness.

Two-thirds reported reducing meat consumption in at least one category over three years, with reductions of red and processed meat most frequent. The most common reasons for reduction were cost and health; environment and animal welfare lagged. Non-meat reducers commonly agreed with statements suggesting that meat was healthy and ‘belonged’ in the diet. Vegetables were most often consumed ‘always’ in meatless meals, but cheese/dairy was also common. Reported meat reduction was most common among those aged 45–59 years and among those with lower incomes.

The public and environmental health benefits of reducing meat consumption create a need for campaigns to raise awareness and contribute to motivation for change. These findings provide rich information to guide intervention development, both for the USA and other high-income countries that consume meat in high quantities.

The study aimed to examine nutrition label use and dietary behaviours among ethnically diverse middle- and high-school students, in Texas, USA.

The School Physical Activity and Nutrition (SPAN) survey is a cross-sectional statewide study using a self-administered questionnaire to assess nutrition and physical activity behaviours. Height and weight measurements were used to determine BMI. Multivariable logistic regression was used to determine associations between nutrition label use and dietary behaviours, with gender, grade, ethnicity, BMI, parent education, socio-economic status and nutrition knowledge as covariates.

Participants from 283 schools, weighted to represent Texas youth.

SPAN 2009–2011 included 6716 8th and 11th graders (3465 girls and 3251 boys). The study population consisted of 39·83 % White/Other, 14·61 % African-American and 45·56 % Hispanic adolescents; with a mean age of 14·9 years, and 61·95 % at a healthy weight, 15·71 % having overweight and 22·34 % having obesity.

Adolescents who did not use nutrition labels had 1·69 times greater odds of consuming ≥1 sugary beverages/d (P<0·05). Adolescents who used nutrition labels had 2·13 times greater odds of consuming ≥1 fruits and vegetables/d (P<0·05). Adolescents who used nutrition labels had significantly higher healthy eating scores than those who did not (P<0·001). For every 1-point increase in nutrition knowledge, adolescents had 1·22 greater odds of using nutrition labels.

Nutrition label use is associated with healthier dietary behaviours in adolescents. Intervention strategies for youth should include efforts to teach adolescents to use labels to make healthy food choices.

To evaluate the effect of a participant-customised nutrition education programme on glycated Hb (HbA1c), blood lipids, blood pressure, BMI and dietary behaviours in patients with type 2 diabetes mellitus.

A randomised controlled trial. The control group (n 41) received education materials. The intervention group (n 41) received the same education materials and participated in eight weekly (2–2·5 h) group nutrition education sessions and follow-up sessions. Outcomes were assessed at 6 and 12 months. An intention-to-treat analysis was conducted. ANCOVA compared the groups (adjustments for baseline values, age, sex and clinic).

Two community health centres, Moretele sub-district (North West Province), South Africa.

Adults (aged 40–70 years) with type 2 diabetes, HbA1c ≥8 %.

Differences in HbA1c (primary outcome) were −0·64 % (P=0·15) at 6 months and −0·63 % (P=0·16) at 12 months in favour of the intervention group. Starchy-food intake was significantly lower in the intervention group, 9·3 v. 10·8 servings/d (P=0·005) at 6 months and 9·9 v. 11·9 servings/d (P=0·017) at 12 months. Median energy intake was significantly lower in the intervention group at 12 months (5988 v. 6946 kJ/d, P=0·017). No significant group differences in BMI, lipid profile, blood pressure and intakes of macronutrients, vegetables and fruits were observed.

Nutrition education was not efficacious on HbA1c; however, it improved specific dietary behaviours. Group education and hands-on activities appeared to contribute to the improvement. Optimal goal setting and self-efficacy training/assessment could benefit future nutrition education programmes for people with type 2 diabetes mellitus in resource-limited settings.

The present study validates a revised scale measuring individuals’ level of the ‘engagement in dietary behaviour’ aspect of ‘critical nutrition literacy’ and describes how background factors affect this aspect of Norwegian tenth-grade students’ nutrition literacy.

Data were gathered electronically during a field trial of a standardised sample test in science. Test items and questionnaire constructs were distributed evenly across four electronic field-test booklets. Data management and analysis were performed using the RUMM2030 item analysis package and the IBM SPSS Statistics 20 statistical software package.

Students responded on computers at school.

Seven hundred and forty tenth-grade students at twenty-seven randomly sampled public schools were enrolled in the field-test study. The engagement in dietary behaviour scale and the self-efficacy in science scale were distributed to 178 of these students.

The dietary behaviour scale and the self-efficacy in science scale came out as valid, reliable and well-targeted instruments usable for the construction of measurements.

Girls and students with high self-efficacy reported higher engagement in dietary behaviour than other students. Socio-economic status and scientific literacy – measured as ability in science by applying an achievement test – did not correlate significantly different from zero with students’ engagement in dietary behaviour.

Insulin resistance is a significant cross-point for the manifestation of several chronic diseases in children and adults. The aim of the present study was to investigate the possible relationship of certain dietary patterns and breakfast consumption habits with insulin resistance in children.

A representative sample of 1912 schoolchildren (aged 9–13 years) participated in a cross-sectional epidemiological study, the Healthy Growth Study, which was initiated in May 2007 and completed in June 2009.

It was conducted in seventy-seven primary schools in four large regions in Greece.

Dietary intake, breakfast consumption, anthropometric and physical examination data, biochemical indices and socio-economic information collected from parents were assessed in all children. Principal components analysis was used to identify dietary patterns.

A dietary pattern of increased consumption of margarine, sweets (candies, lollipops, jellies, traditional fruit in heavy syrup) and savoury snacks (chips, cheese puffs and not home-made popcorn) was associated with homeostasis model assessment of insulin resistance index (HOMA-IR; β = 0·08, P < 0·001) in multivariate models. Children in the third tertile of this dietary pattern had a 2·51 (95 % CI 1·30, 4·90) times higher risk of insulin resistance (HOMA-IR > 3·16) than those in the first tertile. Breakfast consumption had an inverse correlation with insulin resistance, but the correlation lost its significance after adjustments for waist circumference, birth weight, parental BMI and socio-economic status.

Increased consumption of margarine, sweets and savoury snacks, which is a common dietary pattern in childhood, was positively associated with insulin resistance, while breakfast consumption had an inverse association with HOMA-IR, in schoolchildren (aged 9–13 years). Identification of dietary behaviours that might affect insulin resistance in children offers valuable advice in cardiometabolic risk prevention strategies.

The present study assessed the impact of the 2009 food packages mandated by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) on dietary intake and home food availability in low-income African-American and Hispanic parent/child dyads.

A natural experiment was conducted to assess if the revised WIC food package altered dietary intake, home food availability, weight and various lifestyle measures immediately (6 months) following policy implementation.

Twelve WIC clinics in Chicago, IL, USA.

Two hundred and seventy-three Hispanic and African-American children aged 2–3 years, enrolled in WIC, and their mothers.

Six months after the WIC food package revisions were implemented, we observed modest changes in dietary intake. Fruit consumption increased among Hispanic mothers (mean = 0·33 servings/d, P = 0·04) and low-fat dairy intake increased among Hispanic mothers (0·21 servings/d, P = 0·02), Hispanic children (0·34 servings/d, P < 0·001) and African-American children (0·24 servings/d, P = 0·02). Home food availability of low-fat dairy and whole grains also increased. Dietary changes, however, varied by racial/ethnic group. Changes in home food availability were not significantly correlated with changes in diet.

The WIC food package revisions are one of the first efforts to modify the nutrition guidelines that govern foods provided in a federal food and nutrition assistance programme. It will be important to examine the longer-term impact of these changes on dietary intake and weight status.

The present study aimed to assess the relationship between dietary habits, change in socio-economic status and BMI Z-score and fat mass in a cohort of South African adolescents.

In the longitudinal study, data were collected at ages 13, 15 and 17 years on a birth cohort who have been followed since 1990. Black participants with complete dietary habits data (breakfast consumption during the week and at weekends, snacking while watching television, eating main meal with family, lunchbox use, number of tuck shop purchases, fast-food consumption, confectionery consumption and sweetened beverage consumption) at all three ages and body composition data at age 17 years were included in the analyses. Generalized estimating equations were used to test the associations between individual longitudinal dietary habits and obesity (denoted by BMI Z-score and fat mass) with adjustments for change in socio-economic status between birth and age 12 years.

Birth to Twenty (Bt20) study, Soweto-Johannesburg, South Africa.

Adolescents (n 1298; 49·7 % male).

In males, the multivariable analyses showed that soft drink consumption was positively associated with both BMI Z-score and fat mass (P < 0·05). Furthermore, these relationships remained the same after adjustment for socio-economic indicators (P < 0·05). No associations were found in females.

Longitudinal soft drink consumption was associated with increased BMI Z-score and fat mass in males only. Fridge ownership at birth (a proxy for greater household disposable income in this cohort) was shown to be associated with both BMI Z-score and fat mass.