The aim of the current study is to compare Seniors in the Community: Risk Evaluation for Eating and Nutrition, version II (SCREEN II) and Mini Nutritional Assessment – Short Form (MNA-SF), where each is used to identify nutritional risk prevalence among community-dwelling people aged 65 years and above in Bosnia and Herzegovina.

A cross-sectional study. Nutritional risk assessed using the nutritionist’s risk rating, anthropometric measurements, functional indicators, cognitive parameters, SCREEN II and MNA-SF.

The municipalities of Foca, East Sarajevo and Bijeljina, Bosnia and Herzegovina.

Eight hundred twenty-one community-dwelling individuals aged ≥65 years.

The prevalence of high nutritional risk per nutritionist’s risk rating, SCREEN II and MNA-SF was 26, 60, and 7 %, respectively. With the nutritionist’s rating score ≥5 as the criterion, the MNA-SF cut-off point of ≤11 (indicating any possible risk) had poor sensitivity (55·7 %), specificity (46·6 %) and AUC (0·563; P = 0·024). When the criterion of >7 was applied, good sensitivity (95·3 %) and specificity (88·9 %) were obtained for the MNA-SF cut-off score of ≤7. AUC for this comparison was 0·742 (considered fair). Cut-off points of <54 (AUC = 0·816) and <50 (AUC = 0·881) for SCREEN II (indicating moderate to high risk) corresponded with good sensitivity (82·2 %; 80·9 %) and fair specificity (72·1 %; 75·0 %).

MNA-SF may have a limited role in nutritional risk screening among community-dwelling seniors in Bosnia and Herzegovina. SCREEN II has promising results in regard to validity, but further studies are warranted.

To identify predictors of recovery in children with uncomplicated severe acute malnutrition (SAM).

This is a secondary data analysis from an individual randomised controlled trial, where children with uncomplicated SAM were randomised to three feeding regimens, namely ready-to-use therapeutic food (RUTF) sourced from Compact India, locally prepared RUTF or augmented home-prepared foods, under two age strata (6–17 months and 18–59 months) for 16 weeks or until recovery. Three sets of predictors that could influence recovery, namely child, family and nutritional predictors, were analysed.

Rural and urban slum areas of three states of India, namely Rajasthan, Delhi and Tamil Nadu.

In total, 906 children (age: 6–59 months) were analysed to estimate the adjusted hazard ratio (AHR) using the Cox proportional hazard ratio model to identify various predictors.

Being a female child (AHR: 1·269 (1·016, 1·584)), better employment status of the child’s father (AHR: 1·53 (1·197, 1·95)) and residence in a rental house (AHR: 1·485 (1·137, 1·94)) increased the chances of recovery. No hospitalisation (AHR: 1·778 (1·055, 2·997)), no fever, (AHR: 2·748 (2·161, 3·494)) and ≤ 2 episodes of diarrhoea (AHR: 1·579 (1·035, 2·412)) during the treatment phase; availability of community-based peer support to mothers for feeding (AHR: 1·61 (1·237, 2·097)) and a better weight-for-height Z-score (WHZ) at enrolment (AHR: 1·811 (1·297, 2·529)) predicted higher chances of recovery from SAM.

The probability of recovery increases in children with better WHZ and with the initiation of treatment for acute illnesses to avoid hospitalisation, availability of peer support and better employment status of the father.

This study aimed to examine the impact of different dietary patterns on stroke outcomes among type 2 diabetes mellitus (T2DM) patients in China.

Participants were enrolled by a stratified random cluster sampling method in the study. After collecting dietary data using a quantified FFQ, latent class analysis was used to identify dietary patterns, and propensity score matching was used to reduce confounding effects between different dietary patterns. Binary logistic regression and conditional logistic regression were used to analyse the relationship between dietary patterns and stroke in patients with T2DM.

A cross-sectional survey available from December 2013 to January 2014.

A total of 13 731 Chinese residents aged 18 years or over.

Two dietary patterns were identified: 61·2 % of T2DM patients were categorised in the high-fat dietary pattern while 38·8 % of patients were characterised by the balanced dietary pattern. Compared with the high-fat dietary pattern, the balanced dietary pattern was associated with reduced stroke risk (OR = 0·63, 95 %CI 0·52, 0·76, P < 0·001) after adjusting for confounding factors. The protective effect of the balanced model did not differ significantly (interaction P > 0·05).

This study provides sufficient evidence to support the dietary intervention strategies to prevent stroke effectively. Maintaining a balanced dietary pattern, especially with moderate consumption of foods rich in quality protein and fresh vegetables in T2DM patients, might decrease the risk of stroke in China.

To evaluate the inclusion and exclusion of nutritional content in guidance materials related to nutritional care for hospitalised Ebola Virus Disease (EVD) patients of any age with the aim to provide recommendations for future revised nutritional care guidelines in Ebola Treatment Units (ETU).

Qualitative and quantitative analyses of ETU protocols and other guidance materials were conducted. Materials were obtained from practitioners, their organisations and governments active in EVD outbreaks since 2014.

Guinea, Liberia, Sierra Leone and Democratic Republic of Congo.

Guidance materials showed a wide variety of topics. Most contained information on different feeding phases during illness, the use of specialised products, what and how to feed children aged 0–23 months, and meal and snack frequency for different age groups. Most materials lacked guidance on how to assess or accommodate patients’ dietary preferences, how to obtain feedback on nutritional care from patients or how to assess whether patients need feeding support. These aspects are particularly relevant to prevent deterioration of the patients’ nutritional status. There was limited guidance on operational aspects of food preparation and provision.

Since 2014, numerous materials have been developed by organisations and governments on nutritional support in ETU. Although every EVD outbreak response must be contextualised because of the complexity of EVD and its case management, it is important to resolve technical differences and to provide comprehensive and more practical guidance. The findings of this study may inform future revised guidelines from normative UN organisations and governments of countries affected by EVD.

To test a culturally tailored obesity prevention intervention in low-income, minority preschool age children.

A three-group clustered randomised controlled trial.

Twelve Head Start centres were randomly assigned to a centre-based intervention, a combined centre- and home-based intervention, or control using a 1:1:1 ratio. The centre-based intervention modified centre physical activity and nutrition policies, staff practices, and child behaviours, while the home-based intervention supported parents for obesity prevention at home.

The primary end point was change in children’s BMI (kg/m2) at post-test immediately following completion of the 8-month intervention. Secondary end points included standardised scores for BMI (BMIz) and body weight (WAZ), and BMI percentiles (BMI pctl).

Three-year-old children enrolled in Head Start in San Antonio, Texas, with written parent consent (n 325), 87 % Latino, 57 % female with mean age (sd) of 3·58 years (0·29).

Change in BMI at post-test was 1·28 (0·97), 1·28 (0·87) and 1·41 (0·71) in the centre + home-based intervention, centre-based intervention and control, respectively. There was no significant difference in BMI change between centre + home-based intervention and control or centre-based intervention and control at post-test. BMIz (adjusted difference –0·12 (95 % CI, –0·24, 0·01), P = 0·06) and WAZ (adjusted difference, –0·09 (–0·17, –0·002), P = 0·04) were reduced for children in centre + home-based intervention compared with control group.

There was no reduction in BMI at post-test in children who received the intervention. Findings shed light on methodological challenges in childhood obesity research and offer future directions to explore health equity-oriented obesity prevention.

Developing health promotion activities, aimed at healthy food intake, is essential for improving quality of life and reducing the prevalence of chronic diseases. Thus, the objective of this study is to describe both dietary and nutrient intake, according to length of participation in a health promotion service (Programa Academia da Saúde – PAS).

A cross-sectional study was carried out with a representative sample of PAS units in vulnerable areas of the city. Dietary and nutrient intake were assessed, using the average of two 24-h recalls. Food was categorised according to the NOVA (a systematic grouping of all foods according to the nature, extent and purpose of the industrial processes they undergo) classification. The length of participation in PAS is presented in months and is then examined in tertiles for analysis.

Belo Horizonte – Brazil.

3372 adults (≥20 years).

Users in the third tertile of PAS (24·4–61·6 months) experienced less energy intake, lipids and ultra-processed foods, and more culinary preparations, compared to others. Users in the second (10·1–24·3 months) and third tertiles of PAS had higher carbohydrate intake, Ca and vitamin C v those in the first tertile (0–10 months).

Results suggest that greater participation in PAS can improve dietary and nutrient intake, showing its potential to promote healthy lifestyles, prevent chronic diseases and offer longitudinal health care.

To report perspectives of participants in a food benefit programme that includes foods high in added sugar (FAS) restrictions and FAS restrictions paired with fruits and vegetables (F/V) incentives.

Randomised experimental trial in which participant perspectives were an exploratory study outcome.

Participants were randomised into one of three Supplemental Nutrition Assistance Program (SNAP)-like food benefit programme groups: (1) restriction: not allowed to buy FAS with benefits; (2) restriction paired with incentive: not allowed to buy FAS with benefits and 30 % financial incentive on eligible F/V purchased using benefits; or (3) control: same food purchasing rules as SNAP. Participants were asked questions to assess programme satisfaction.

Adults in the Minneapolis-St. Paul, MN metropolitan area, eligible for but not currently participating in SNAP who completed baseline and follow-up study measures (n 254).

Among remaining households in each group, most found the programme helpful in buying nutritious foods (88·2 %–95·7 %) and were satisfied with the programme (89·1 %–93·0 %). Sensitivity analysis results indicate that reported helpfulness and satisfaction with the programme may in some instances be lower among the restriction and the restrictions paired with incentive groups in comparison to the control group.

A food benefit programme that includes restriction on purchase of FAS or restriction paired with a financial incentive for F/V purchases may be acceptable to most SNAP-eligible households with children.

Certain factors, such as food quality, label content and grocery characteristics, may be considered when purchasing foods. Food availability in the home has been shown to influence dietary behaviours, also associated with delay discounting (DD). The present study sought to characterize the relationships between DD, food purchasing considerations and healthfulness of foods in the home.

A cross-sectional, online survey of adults (n 477) was conducted with the following measures: DD, consideration of food quality (nutrition, taste) and grocery characteristics (price, ease of preparation, shelf-life) while shopping, use of food labels and food availability in the home. DD was assessed by the area under the delay discounting curve (AUC) using a binary choice task. Greater AUC reflects lower DD. Structural equation modelling was used to allow AUC to simultaneously predict purchasing considerations and foods in the home.

Online survey.

Adult employees in south-east Alabama, USA.

DD was negatively associated with food label use and emphasis on food quality when shopping (P<0·001). In the final model, DD was associated with availability of healthful foods in the home and emphasis on food quality and grocery characteristics. About 33 % of the variance in shopping behaviours, 5 % in food label use, 7 % in availability of healthful foods and 4 % in availability of unhealthful foods was explained by DD.

Individuals with lower DD appear to be more thoughtful in making food purchasing decisions and have healthful foods available in the home more frequently than individuals with higher DD.

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 describe breastfeeding rates from early to late infancy and to examine associations between breastfeeding duration and infant growth, including rapid weight gain (RWG, > 0·67 SD increase in weight-for-age Z-score), among infants from low-income, racially and ethnically diverse backgrounds.

A short, prospective cohort study was conducted assessing breastfeeding status at infant ages 2, 4, 6, 9 and 12 months. Infant length and weight measurements were retrieved from electronic health records to calculate weight-for-length Z-scores and the rate of weight gain.

Pediatric clinic in the Southeastern USA.

Mother-infant dyads (n = 256).

Most participants were African American (48 %) or Latina (34 %). Eighty-one per cent were participating in the Special Supplemental Nutrition Program for Women, Infants and Children. Infants were breastfed for a median duration of 4·75 months, with partial more common than exclusive breastfeeding. At 12 months, 28 % of the participants were breastfeeding. Infants breastfed beyond 6 months had significantly lower growth trajectories than infants breastfed for 0–2 months (β = 0·045, se = 0·013, P = 0·001) or 3–6 months (β = 0·054, se = 0·016, P = 0·001). Thirty-six per cent of the infants experienced RWG. RWG was more common among infants who were breastfed for 2 months or less than 6+ month breastfed group (relative risk = 1·68, CI95 (1·03, 2·74), P = 0·03).

Breastfeeding beyond 6 months is associated with the prevention of accelerated growth among infants from low-income, racially and ethnically diverse backgrounds, suggesting progress toward health equity.

The present longitudinal study assessed whether changes in socio-economic status (SES) from infancy to adolescence were associated with plasma lipoprotein concentrations in adolescence, of which low HDL-cholesterol (HDL-C) and high LDL-cholesterol (LDL-C), TAG and total cholesterol (TC) concentrations are associated with higher cardiovascular risk.

SES, assessed using the modified Graffar Index, was calculated at 1, 5, 10 and 16 years. Principal components factor analysis with varimax rotation extracted two orthogonal SES factors, termed ‘environmental capital’ and ‘social capital’. Generalized linear models were used to analyse associations between environmental and social capital at 1 and 16 years and outcomes (HDL-C, LDL-C, TAG, TC) at 16 years, as well as changes in environmental and social capital from 1–5, 5–10, 10–16 and 1–16 years, and outcomes at 16 years.

Santiago, Chile.

We evaluated 665 participants from the Santiago Longitudinal Study enrolled at infancy in Fe-deficiency anaemia studies and examined every 5 years to age 16 years.

Social capital in infancy was associated with higher HDL-C in adolescence. Environmental capital in adolescence was associated with higher LDL-C and TC during adolescence. Changing environmental capital from 1–16 years was associated with higher LDL-C. Changing environmental capital from 1–5 and 1–16 years was associated with higher TC.

Improvements in environmental capital throughout childhood were associated with less healthy LDL-C and TC concentrations in adolescence. We found no evidence of associations between changing environmental capital and HDL-C or TAG, or changing social capital and HDL-C, LDL-C, TAG or TC.

Children are frequently exposed to unhealthy food marketing on digital media. This marketing contains features that often appeal to children, such as cartoons or bold colours. Additional factors can also shape whether marketing appeals to children. In this study, in order to assess the most important predictors of child appeal in digital food marketing, we used machine learning to examine how marketing techniques and children’s socio-demographic characteristics, weight, height, BMI, frequency of screen use and dietary intake influence whether marketing instances appeal to children.

We conducted a pilot study with thirty-nine children. Children were divided into thirteen groups, in which they evaluated whether food marketing instances appealed to them. Children’s agreement was measured using Fleiss’ kappa and the S score. Text, labels, objects and logos extracted from the ads were combined with children’s variables to build four machine-learning models to identify the most important predictors of child appeal.

Households in Calgary, Alberta, Canada.

39 children aged 6–12 years.

Agreement between children was low. The models indicated that the most important predictors of child appeal were the text and logos embedded in the food marketing instances. Other important predictors included children’s consumption of vegetables and soda, sex and weekly hours of television.

Text and logos embedded in the food marketing instances were the most important predictors of child appeal. The low agreement among children shows that the extent to which different marketing strategies appeal to children varies.

To examine the association between language use – predominantly English, English and Spanish equally and predominantly Spanish – and food insecurity among Hispanic adults residing in the USA, 1999–2018.

Pooled cross-sectional study design.

United States.

15 073 Hispanic adults.

Compared with Hispanic adults who predominantly spoke English and after adjusting for age, sex, family income-to-poverty ratio, education level and employment status, Hispanic adults who spoke English and Spanish equally (OR = 1·28, 95 % CI = 1·05, 1·56) or predominantly Spanish (OR = 1·25, 95 % CI = 1·04, 1·49) had higher odds of food insecurity. After stratifying by country of birth, language use was associated with higher odds of food insecurity only for Hispanic adults born outside of the USA, but not for Hispanic adults born in the USA. Hispanic adults born outside of the USA who spoke English and Spanish equally (OR = 1·27, 95 % CI = 1·04, 1·55) or spoke predominantly Spanish (OR = 1·24, 95 % CI = 1·04, 1·48) had higher odds of food insecurity when compared with those who predominantly spoke English.

Foreign-born Hispanic adults who speak predominantly Spanish, or English and Spanish equally, have higher odds of food insecurity. Food and nutrition assistance programmes that serve Hispanic immigrants should make sure to provide linguistically and culturally appropriate services to this population.