To establish the prevalence of double burden of malnutrition (DBM) and triple burden of malnutrition (TBM) among mother–child pairs in Malawi and explore their geographical distribution and associated multilevel factors.

Cross-sectional study using secondary data from the 2015–2016 Malawi Demographic and Health Survey using a mixed effects binomial model to identify multilevel factors associated with DBM and TBM. Georeferenced covariates were used to map the predicted prevalence of DBM and TBM.

All twenty-eight districts in Malawi.

Mother–child pairs with mothers aged 15–49 years and children aged below 60 months (n 4618 pairs) for DBM and between 6 and 59 months (n 4209 pairs) for TBM.

Approximately 5·5 % (95% confidence interval (CI): 4·7 %, 6·4 %) of mother–child pairs had DBM, and 3·1 % (95 % CI: 2·5 %, 4·0 %) had TBM. The subnational-level prevalence of DBM and TBM was highest in cities. The adjusted odds of DBM were threefold higher (adjusted Odds Ratio, AOR: 2·8, 95 % CI: 1·1, 7·3) with a higher proportion of wealthy households in a community. The adjusted odds of TBM were 60 % lower (AOR: 0·4; 95 % CI: 0·2, 0·8) among pairs where the women had some education compared with women with no education.

Although the prevalence of DBM and TBM is currently low in Malawi, it is more prevalent in pairs with women with no education and in relatively wealthier communities. Targeted interventions should address both maternal overnutrition and child undernutrition in cities and these demographics.

The high availability of energy-dense nutrient-poor discretionary foods in large serving and package sizes may have shifted portion size norms (described as a typical perception of how much people choose to eat from a given food at a single eating occasion) towards larger sizes. Few public health recommendations exist around appropriate discretionary food portion sizes. This qualitative study aimed to explore the underlying rationale of portion size norms of discretionary foods among Australian adults 18–65 years.

Four focus group sessions were conducted. Collected data were analysed using inductive thematic analysis.

Focus groups were held online via Zoom between September and October 2023.

Thirty-four participants were recruited in the study (mean age 38 years, 19 females).

The key themes raised from inductive analysis were personal factors, eating context factors and food environment factors relevant to the portion size norms. A framework was established to illustrate the interaction across these themes during the conceptualisation of the norms. For serving size availability, consumers found that there were limited serving size choices when making portion size selections and lacked the knowledge and skills in portion control.

These findings highlight the need to make positive changes to the current food environment and develop relevant public health guidelines around appropriate portion sizes to promote healthier portion size norms and enable better portion control.

To examine underlying political economy factors that enable or impede the integration of nutrition considerations into food system governance.

Comparative political economy analysis of data collected through (1) value chain analyses of selected healthy and unhealthy commodities and (2) food system policy analyses, using a theoretical framework focused on power, politics, interests and ideas.

Ghana and South Africa.

Value chain actors relevant to healthy and unhealthy foods (Ghana n 121; South Africa n 72) and policy stakeholders from government (Health, Agriculture, Trade and Industry, Finance), academia, civil society, development partners, Civil Society Organization (CSO) and private sector (Ghana n 28; South Africa n 48).

Nutrition was a stated policy priority in both countries; however, policy responsibility was located within the health sector, with limited integration of nutrition into food system sectors (including Agriculture, Trade and Industry). Contributing factors included a conceptions of policy responsibilities for nutrition and food systems, dominant ideas and narratives regarding the economic role of the food industry and the purpose of food system policy, the influence of large food industry actors, and limited institutional structures for cross-sectoral engagement and coordination.

Integrating nutrition into multi-sectoral food policy to achieve multiple food system policy goals will require strategic action across jurisdictions and regional levels. Opportunities included increasing investment in healthy traditional foods, strengthening urban/rural linkages and informal food systems, and strengthening institutional structures for policy coherence and coordination related to nutrition.

This study develops successful ageing profiles across six low- and middle-income countries (LMIC) and examines associations with fruit and vegetable (F&V) intake.

A cross-sectional analysis was conducted in mid-aged and older adults from the WHO Study of Global Ageing. Participants without chronic disease, cognitive impairment, depression or disability and with good physical, cardiovascular and respiratory function were considered to have successfully aged. Associations between F&V intake (serves/d) and successful ageing were examined using log-binomial regression adjusting for key confounders.

China, Ghana, India, Mexico, Russia and South Africa.

A total of 28 785 men and women aged 50 years and over.

Successful ageing ranged from 4 % in Mexico to 15 % in China. After adjustment, only Ghana showed an association between fruit intake and successful ageing, with an inverse association identified (prevalence ratio (PR) = 0·87, 95 % CI 0·78, 0·98). An inverse association between vegetable intake and successful ageing was found in China (0·97, 0·95, 0·98) but no other country. An inverse association was shown for both China (0·98, 0·96, 0·99) and Ghana (0·92, 0·84, 1·00) when considering fruit and vegetables combined.

Associations between F&V intake and successful ageing are inconsistent. Further studies on LMIC countries are needed to meet the challenges of the ageing population.

Māori, the Indigenous population of Aotearoa New Zealand, face a substantial burden of nutrition-related diseases, especially obesity and type 2 diabetes. Weight loss, through dietary change, is a central component of obesity and diabetes prevention and management; however, most approaches have not been designed with or evaluated specifically for Māori. The aim of this study was to review literature on the enablers and barriers to dietary change, for Māori.

Relevant literature published from January 2000 to May 2024 was identified by searches in Medline (Ovid), Embase (Ovid), Scopus, Indigenous health (informit), CINAHL (EBSCO), Web of Science and NZResearch. Studies included Māori and reflected enablers and barriers to dietary change for individuals/whānau (families). Data identifying the aims, methods, interventions, location, population studied and identified enablers and barriers to dietary change and responsiveness to Māori were extracted. Enablers and barriers to dietary change were mapped to a New Zealand Indigenous health framework, the Meihana model.

Settings included studies based in Aotearoa New Zealand, where participants were free living and able to determine their dietary intake.

Studies included at least 30 % Māori participants.

Twenty-two of the seventy-seven identified records met the inclusion criteria. Records included a diverse range of research approaches.

Using a relevant Indigenous model, this study highlights that multiple and diverse enablers and barriers to dietary change exist for Māori and the critical importance of developing interventions, in close partnership with Indigenous communities, grounded in Indigenous understandings of health.

Technological innovations in the online food delivery sector include the use of autonomous delivery vehicles. The aim of the present study was to investigate consumers’ intentions to use these services once they are widely available and their motivations for using them to access unhealthy food.

Online survey including a vignette describing a future world where autonomous food deliveries are in common use in both metropolitan and non-metropolitan areas.

Australia.

1078 Australians aged 18 years and older, nationally representative by sex, age and location (metropolitan v. non-metropolitan residence).

Around half of the sample reported intending to use an autonomous food delivery service at least once per week for fast food (53 %) and/or healthy pre-prepared food (50 %). Almost two-thirds (60 %) intended using autonomous vehicle deliveries to receive groceries. Around one in five (17 %) anticipated an increase in their fast-food intake as a result of access to autonomous delivery services compared with one in two (46 %) expecting others’ total fast-food intake to increase. The most common reason provided for using autonomous food deliveries was increased convenience. More frequent current fast-food ordering, higher socio-economic status, younger age and regional location were significantly associated with an anticipated increase in fast-food consumption.

The emergence of autonomous food delivery systems may bring both benefits and adverse consequences that in combination are likely to constitute a substantial regulatory challenge. Proactive efforts will be required to avoid negative public health nutrition outcomes of this transport evolution.

The objective of our study was to determine the prevalence of anaemia among 14–19 years school going girls, risk factors for it and profile of micronutrient status among rural girls from western state of India.

Using a cross-sectional design, we obtained information on socio-demography, menstruation, dietary habits, knowledge and daily consumption of the government recommended iron and folic acid (IFA) tablets, and anthropometry. Blood was collected to assess Hb, red blood cell indices, serumFe, folate and vitamin B12 levels.

Nagpur district, Maharashtra, India.

A total of 221 girls aged 14–19 years studying in twenty-four government institutes included.

57 % girls were anaemic, 84 % had deficiency of one or more micronutrients and 60 % were malnourished based on body mass index (BMI). The prevalence of Fe, vitamin B12 and folate deficiency was 37·7 %, 69·8 % and 1·4 %, respectively. Among anaemic girls, Fe and vitamin B12 deficiency was observed in 45·5 % and 67·5 %, respectively, v. among non-anaemic girls it was 27 % and 73 %, respectively. Fe deficiency was a predictor of anaemia and its severity. Girls residing in non-nuclear family were more likely to have anaemia. The consumption of daily non-vegetarian food and green leafy vegetables was 3 % and 3·6 %, respectively. Only 9 % consumed IFA tablets in the past 2 weeks.

Anaemia is common in adolescent girls, particularly associated with Fe and vitamin B12 deficiency. There is need to reconsider the approach to prevention of anaemia in adolescent girls, particularly before they become pregnant.

To investigate the association between food insecurity (FI) and diet quality in private sector service workers.

Data were collected via electronic questionnaires (2019) and the national register data (2018–2019). FI was measured using the Household Food Insecurity Access Scale (HFIAS) and diet quality using an FFQ and a modified Healthy Food Intake Index (mHFII). The associations between HFIAS and mHFII were studied using ANOVA and ordinal regression analysis.

Cross-sectional survey and register data for all municipalities in Finland in 2018–2019.

Individuals (n 6435) belonging to the Finnish Service Union United. The members are predominantly women and work mainly in retail trade, tourism, restaurant and leisure services, property maintenance and security services.

Overall diet quality, measured by mHFII, was significantly lower in those experiencing severe FI than in those who were food secure (8·0 v. 9·1). Additionally, those with severe FI were less likely to have higher (more optimal) scores in sugar-sweetened beverages (OR: 0·67), fibre-rich grains (OR: 0·79), vegetables (OR: 0·54), fruits and berries (OR: 0·61), vegetable oil (OR: 0·80), fish (OR: 0·65), milk (OR: 0·89) and nuts and seeds (OR: 0·66) than food-secure participants. Severe FI was associated with higher odds for less frequent consumption of red and processed meat (OR: 1·15, a higher score represents less frequent consumption).

Severe FI was linked to both lower overall diet quality and suboptimal consumption of several food groups. Individuals experiencing severe FI may be predisposed to accumulating dietary risk factors for chronic diseases.

This study examined changes food and drink purchasing during the first 3 months of the COVID-19 pandemic in England, and if changes varied by population subgroups.

We investigated changes in take-home food and drink purchasing and frequency of out-of-home (OOH) purchasing using an interrupted time series analysis design. The start of pandemic restrictions (the intervention) was defined as 16 March 2020, when first announced in the UK.

London and the North of England.

1245 households reporting take-home and 226 individuals reporting OOH purchases between January 2019 and mid-June 2020 from the GB Kantar Fast Moving Consumer Goods Panel.

The marginal mean estimate of total take-home energy purchased was 17·4 % (95 % CI 14·9, 19·9) higher during the pandemic restriction period compared with the counterfactual. Increases of 35·2 % (95 % CI 23·4, 47·0) in take-home volume of alcoholic beverages and 1·2 % (95 % CI 0·1, 2·4) in foods and drinks high in fat, salt and sugar were observed. Reductions in purchased energy from fruit and vegetables (–7·3 %, 95 % CI –10·9, –3·6), ultra-processed foods (–4·0 %, 95 % CI –5·2, –2·8) and in OOH purchasing frequency (–44·0 %, 95 % CI –58·3, –29·6) were observed. Changes in chocolate and confectionery, soft drink and savoury snack purchases levelled off over time. Changes in all studied outcomes varied by sociodemographic characteristics and usual purchasing.

Pandemic restrictions were associated with positive and negative changes in food and drink purchasing, which differed by individual characteristics. Future research should ascertain if changes persist and translate into changes in health.

This study used the Behaviour Change Wheel (BCW) and Theoretical Domains Framework (TDF) to identify parental factors that are associated with increasing their child’s fruit and vegetable consumption. The information gathered enabled a behavioural diagnosis and the identification of intervention functions to increase fruit and vegetable consumption in children.

A qualitative design using open-ended online survey methodology was utilised.

United Kingdom.

Twenty-eight parents of primary school-aged children (4–11 years) aged 29–51 years participated.

Thematic and summative analysis identified skills in preparation and cooking, awareness of and desire to increase fruit and vegetable intake, knowledge of the recommendations and better health for their child as the main facilitators. The main barriers were time and financial constraints, their child’s food preferences and refusal to eat fruit and vegetables, negative role modelling from parents and grandparents and beliefs that fruit and vegetable intake will increase with age. For behaviour change to occur, ‘knowledge’, ‘social influences’, ‘environmental context and resources’, ‘beliefs about consequences’ and ‘beliefs about capabilities’ need to be altered.

Novel findings suggest that future intervention development should focus on parental beliefs and skills around how to increase fruit and vegetable consumption as their child ages and expanding parental knowledge on the benefits of fruit and vegetable consumption such as mental and future health. The use of the TDF and BCW identified appropriate intervention functions that will guide future behaviour change techniques, modes of delivery and policy categories that best target increasing children’s fruit and vegetable consumption.

This commentary highlights the release of findings now available in the report International Food Policy Study Youth Surveys: Summary of Findings 2019–2021.

The survey data described in this commentary consist of repeated cross-sectional surveys conducted annually beginning in 2019.

Online surveys were conducted in 2019 to 2021 among respondents living in Australia, Canada, Chile, Mexico, the United Kingdom and the USA.

Survey respondents were youth aged 10–17 years in 2019 (n 12 031), 2020 (n 11 108) and 2021 (n 10 459).

The report described in this commentary summarises findings on food and nutrition behaviours, attitudes and knowledge among youth, including their diet sources and patterns, school nutrition environments, food security, diet intentions, weight perceptions and weight loss behaviours, sugary drink perceptions, awareness of public education and mass media campaigns, perceptions of food labels and exposure to food and beverage marketing.

Results from the IFPS Youth surveys provide important insights into key policies of global interest, including front-of-package nutrition labelling, levies on sugary beverages and restrictions on marketing unhealthy food and beverages to children. As policymakers continue to seek effective strategies to improve adolescent health outcomes, ongoing cross-country monitoring of food and nutrition-related indicators, such as the data from the International Food Policy Study, will be critical in assessing dietary trends and evaluating upcoming policies.

This study examined the relationship between reformulation and food price in Canadian packaged foods and beverages between 2017 and 2020.

Matched foods and beverages in the University of Toronto Food Label Information and Price 2017 and 2020 databases were analysed (n 5774). Price change by food category and by retailer were compared using Wilcoxon signed-rank tests. The proportion of products with changes in calories and nutrient levels were determined, and mixed-effects models were used to examine the relationship between reformulation and price changes. The Food Standards Australia New Zealand (FSANZ) nutrient profiling model was applied to calculate nutritional quality scores, and mixed-effects models were used to assess if changes in nutritional quality score were associated with price changes.

Large grocery retailers by market share in Canada.

Foods and beverages available in 2017 and 2020.

Food price changes differed by retailer and by food category (e.g. increased in Bakery, Snacks, etc; decreased in Beverages, Miscellaneous, etc.). Nutrient reformulation was minimal and bidirectional with the highest proportion of products changing in sodium (17·8 %; 8·4 % increased and 9·4 % decreased). The relationship between nutrient reformulation and price change was insignificant for all nutrients overall and was not consistent across food categories. Average FSANZ score did not change (7·5 in both years). For Legumes and Combination dishes, improvements in nutritional quality were associated with a price decrease and increase, respectively.

Stronger policies are required to incentivise reformulation in Canada. Results do not provide evidence of reformulation impacting food prices.

Neural tube defects (NTD) are serious, life-threatening birth defects. Staple food fortification with folic acid (vitamin B9) is a proven, effective intervention to reduce NTD birth prevalence. Mandatory food fortification with folic acid was implemented in South Africa (SA) in 2003. This article provides an overview of NTD birth prevalence in SA, pre- and post-fortification, and evaluates current folic acid fortification regulations.

Fortification effectiveness data in SA were reviewed using published studies and national reports on NTD birth prevalence pre- and post-folic acid fortification. Current folic acid fortification regulations in SA were evaluated by experts.

Regulations were assessed using national health guidelines, legislation and regulations. NTD birth prevalence data were sourced from the published literature.

None.

Significant reductions in the birth prevalence of spina bifida and anencephaly and improved maternal folate levels have been achieved following the introduction of folic acid fortification in SA. However, there is poor overall regulatory compliance in some instances and a gap in current regulations that excludes the fortification of cake flour in SA.

While the SA NTD birth prevalence has decreased by 30% post-fortification, the regulatory exclusion of cake flour fortification is a significant and growing issue. Proposed 2016 regulatory amendments to address this gap urgently require finalisation and enactment by government to prevent negating benefits achieved to date and to ensure continued improvement. Fortification monitoring requires strengthening to ensure widespread compliance with policies, particularly in underserved areas.

This study aimed to determine differences in food consumption by the NOVA food categories in South Africa and Ghana and how they relate to poverty and food supply systems.

This study used a cross-sectional design to assess household food acquisition and lived poverty index.

The study was conducted in Khayelitsha and Mount Frere, urban and rural communities in South Africa, respectively, and Ahodwo and Ejuratia, urban and rural communities in Ghana, respectively.

An adult in charge of or knowledgeable about household food acquisition and consumption was selected to participate in the study.

A total of 1299 households participated in the study. Supermarkets were a prominent source of ultra-processed foods for households in South Africa, while informal outlets were an important source of ultra-processed foods in Ghana. Consumption of unprocessed foods was higher among South African households (58·2 %) than Ghanaian households (41·8 %). In South Africa, deprivation was associated with increased odds of infrequent consumption of both unprocessed foods (OR 3·431 P < 0·001) and ultra-processed foods (OR 2·656 P < 0·001) compared with non-deprivation. In Ghana, no significant differences were observed between deprived households and non-deprived households in relation to the consumption of the NOVA food classes.

Different food supply systems and poverty are associated with household acquisition of the different NOVA food classes. Policies should be geared towards formal shops in South Africa and informal shops in Ghana to reduce the consumption of key obesogenic foods.

To describe the economic, lifestyle and nutritional impact of the COVID-19 pandemic on parents, guardians and children in Malaysia, Indonesia, Thailand and Vietnam.

Data from the SEANUTS II cohort were used. Questionnaires, including a COVID-19 questionnaire, were used to study the impact of the pandemic on parents/guardians and their children with respect to work status, household expenditures and children’s dietary intake and lifestyle behaviours.

Data were collected in Malaysia, Indonesia, Thailand and Vietnam between May 2019 and April 2021.

In total, 9203 children, aged 0·5–12·9 years, including their parents/guardians.

Children and their families were significantly affected by the pandemic. Although the impact of lockdown measures on children’s food intake has been relatively mild in all countries, food security was negatively impacted, especially in Indonesia. Surprisingly, in Malaysia, lockdown resulted in overall healthier dietary patterns with more basic food groups and less discretionary foods. Consumption of milk/dairy products, however, decreased. In the other countries, intake of most food groups did not change much during lockdown for households based on self-reporting. Only in rural Thailand, some marginal decreases in food intakes during lockdown persisted after lockdown. Physical activity of children, monthly household income and job security of the parents/guardians were negatively affected in all countries due to the pandemic.

The COVID-19 pandemic has significantly impacted societies in South-East Asia. To counteract negative effects, economic measures should be combined with strategies to promote physical activity and eating nutrient-adequate diets to increase resilience of the population.

To construct an evidence-based practice programme for the nutrition management of older adults in nursing homes. The programme will provide a basis for improving or solving the nutrition management problems of older adults in nursing homes.

The study is based on guideline evidence and Delphi method. The evidence was comprehensively searched, assessed and summarized, and the best evidence and a preliminary programme for nutrition management of older adults in nursing homes were aggregated. Then, the Delphi method was used to assess the applicability of the preliminary programme and the obstacle factors to modify, supplement and improve the nutrition management programme.

Baseline survey data were collected from three nursing homes in Ningxia, China, and guideline evidence was obtained through systematic searches of the Cochrane Library, PubMed and other scientific databases, as well as relevant official websites.

A total of 350 older adults residing nursing homes and 160 nurses participated in the baseline survey. To ensure the programme’s applicability and identify potential implementation obstacles, fifteen experts from local grade A hospitals, nursing homes and community health centres were consulted for review.

A fourteen-item, fifty-six-best-evidence nutrition management programme for older adults in nursing homes was developed based on five guideline evidences and baseline survey findings.

This is a systematic and comprehensive nutritional management programme for older adults in nursing homes based on guideline evidence, which can provide a standardised basis for the implementation of scientific nutritional management in nursing homes in Ningxia. Managers should promote the translation of evidence into practice in accordance with the specific circumstances of individual nursing homes.

To evaluate whether changes in starch intake (in terms of amount and food sources) were associated with increments in dental caries among adults.

This is an 11-year longitudinal study (2000–2011) with duplicate assessments for all variables. A 128-item FFQ was used to estimate intake of starch (g/d) and six starch-rich food groups (potatoes, potato products, roots and tubers, pasta, wholegrains and legumes). Dental caries was assessed through clinical examinations and summarised using the number of decayed, missing and filled teeth (DMFT score). The relationship between quintiles of starch intake and DMFT score was tested in linear hybrid models adjusting for confounders.

Northern and Southern regions of Finland.

922 adults, aged 30–88 years.

Mean starch intake was 127·6 (sd: 47·8) g/d at baseline and 120·7 (55·8) g/d at follow-up. Mean DMFT score was 21·7 (6·4) and 22·4 (6·2) at baseline and follow-up. Starch intake was inversely associated with DMFT score cross-sectionally (rate ratio for highest v. lowest quintile of intake: –2·73, 95 % CI –4·64, –0·82) but not longitudinally (0·32, 95 % CI –0·12, 0·76). By food sources, the intakes of pasta (–2·77, 95 % CI –4·21, –1·32) and wholegrains (–1·91, 95 % CI –3·38, –0·45) were negatively associated with DMFT score cross-sectionally but not longitudinally (0·03, 95 % CI –0·33, 0·39 and –0·10, 95 % CI –0·44, 0·24, respectively).

Changes in the amount and sources of starch intake were not associated with changes in dental caries. Further studies should be conducted in different settings and age groups while focusing on starch digestibility and specific sources of starch.

Online 24-h dietary recall tools are commonly used in nationwide nutrition surveys to assess population diets. With a steep rise in the development of new and more advanced 24-h dietary recall tools, the decision of which tool to use for a national nutrition survey becomes increasingly challenging. Therefore, this short communication outlines the process of selecting a 24-h dietary recall tool for a national nutrition survey in New Zealand.

To identify suitable 24-h dietary recall tools, a review of peer-reviewed and grey literature was conducted (2019–2022). Data on functionalities, validation, usability and adaptability were extracted for eighteen pre-specified tools, which were used in the subsequent evaluation process.

Six of the eighteen tools had new relevant publications since 2019. The fourteen new publications described six validation studies and eight usability studies. Based on pre-selection criteria (e.g. availability, adaptability, previous use in national surveys), three tools were shortlisted: ASA24, Intake24 and MyFood24. These tools were further evaluated, and expert advice was sought to determine the most suitable tool for use in the New Zealand context.

A comprehensive yet time- and cost-efficient approach was undertaken to identify the potential use of online 24-h dietary recall tools for a national nutrition survey. The selection process included key evaluation criteria to determine the tools’ suitability for adaptation within the New Zealand context and ultimately to select a preferred tool. A similar approach may be useful for other countries when having to select 24-h dietary recall tools for use in national nutrition surveys.