Access to health care, nutrition and dietary habits among school-age children living in socio-economic inequality contexts: results from the "ForGood: Sport is Well-Being" programme

Dietary Habits and Nutritional Status of Youths Living in Rural and Semi-Urban Albania in the Ongoing Nutrition Transition: Preliminary Results

BACKGROUND

Albania is undergoing a demographic, epidemiological, and nutrition transition leading to an increased prevalence of overweight and obesity among new generations. Comprehensive studies on the nutritional status and dietary patterns of youths in the country are still lacking.

METHODS

A cross-sectional study was conducted on a convenience sample of students (10-18 years) attending secondary schools in rural and semi-urban areas (October-November 2024). Information collected included socio-demographic data, anthropometric measurements (weight, height), and adherence to the Mediterranean Diet (MD) (KIDMED). Factors influencing dietary patterns were investigated, with a multivariate logistic regression performed to identify key drivers for poor MD adherence (AOR 95% CI).

RESULTS

In total, 426 children (47.2% females) were interviewed. Over 20% of the sample was overweight or obese, with the prevalence of these diseases decreasing with age regardless of gender. The KIDMED score highlighted suboptimal MD adherence (4.6 ± 2.5 SD), with significant differences between females and males (4.1 ± 2.4 SD vs. 5.1 ± 2.4 SD, p < 0.001), especially in rural areas (3.9 ± 2.4 SD vs. 4.9 ± 2.5 SD, p = 0.003). Dietary quality tended to decline with age. Female gender was the strongest predictor of poor MD adherence (AOR 2.08 CI: 1.34-3.22; p = 0.001).

CONCLUSIONS

The MD is a cornerstone for ensuring the Albanian population's long-term health and well-being. This study holds significant public health relevance in a country with high mortality rates due to cardiovascular diseases. Future nutrition interventions focused on the poor MD adherence of new generations should take into consideration geographic, cultural, and social dimensions, including gender equality.

The Influence of Various Role Models on Children’s Pro-environmental Behaviours

Although most schoolchildren can dispose of their own litter, they are typically not sensitive to environmental issues in the school’s public areas. How do we improve children’s sensitivity to public environments and cultivate pro-environmental behaviours? Based on Bandura’s social learning theory, this study explored the effects of various role models (teachers and peers) on the pro-environmental behaviours of children aged 7–13. A field study was conducted in which examples of postprandial garbage disposal behaviours were provided using role models and the subsequent behaviours of the children were observed. We located the experiment in a real educational context and manipulated the type of role model (teacher or peer) and the behaviour being modelled (positive behaviours involving picking up litter or negative behaviours involving littering). The results showed that different role models had different effects on the subjects’ pro-environmental behaviours. Only positive demonstration by teachers significantly improved the subjects’ pro-environmental behaviours, that is, teachers’ picking up of garbage in front of children significantly improved the children’s attention to the environment and their adoption of pro-environmental behaviours. Positive demonstration by peers, negative demonstration by teachers and negative demonstration by peers had no impact on the children’s pro-environmental behaviours. The results demonstrate that teachers must be mindful of their role as role models in the educational environment and facilitate students’ development of pro-environmental behaviours.

Food and Nutrition Education Using Intuitive Method and NOVA Food Classification: Implications for Food Practices of Children and Adolescents Intuitive Method in Food and Nutrition Education

PURPOSE

To evaluate the impact of food and nutrition education interventions based on the intuitive method (IM) proposed by Johaan Henrich Pestalozzi (1746-1827) at different time periods on the food practices of children and adolescents.

DESIGN

This was a prospective comparative intervention program assessed by a pre-post survey at shorter term (3 months) and longer term (6 months).

SETTING

Two institutions that provide extracurricular social support for children and adolescents with social and economic vulnerabilities in the city of Lavras, Minas Gerais, Brazil. The shorter-term intervention was conducted in Institution A and the longer term one conducted in Institution B.

SUBJECTS

The sample consisted of 245 students aged between 5 and 14 years who attended the institutions. For each institution, they were divided into two groups (control and IM).

INTERVENTION

We compared the effectiveness of the interventions performed by the IM or by expository actions (control) in both institutions. Interventions were focused on the guidelines of the Food Guide for the Brazilian Population and dealt with food choices, meal preparation, commensality, and obstacles to healthy eating.

MEASURES

The assessed outcomes were food consumption according to NOVA food classification, cooking self-efficacy, and knowledge about food and nutrition.

ANALYSIS

Paired t-tests were used to compare food consumption before and after interventions. Adjusted logistic regression models were used to analyze the outcomes on food and nutrition knowledge and cooking self-efficacy.

RESULTS

Subjects receiving IM interventions decreased mean intake of ultra-processed food (3.56 to 1.50 portions; P< .001) and had greater odds of increasing self-efficacy with cooking (OR = 2,33-4,17). Both methods were effective regarding teaching about food and nutrition. Intervention period did not homogeneously impact these outcomes.

CONCLUSIONS

The use of food and nutrition education interventions presented positive outcomes on the food practices of the participants. The IM is an alternative method to educate children and adolescents about healthy eating practices.

The exacerbated prevalence of acute malnutrition and growth retardation in Roma children living in camps

Background

Child malnutrition is still a concern in marginalized groups of populations, such as immigrants living in very low socio-economic conditions. Roma children are within the most hard-to-reach populations, susceptible to undernutrition and growth retardation. In the city of Rome (Italy), the Hospital “Bambino Gesù”, in collaboration with the Catholic Association Community of Saint’Egidio, is dedicating free services for the health and nutritional needs of vulnerable people.

Methods

A retrospective analysis was conducted on immigrant children visited at different ages (0–11 years old). Records including nutritional and growth assessment were collected from 2016 up to May 2020. Malnutrition was classified following the WHO 2006 standards. Data for Roma children living in extra-urban camps and non-Roma immigrant children living in urban areas were analyzed, odds ratios and univariate binary regressions were performed to investigate the risk of malnutrition within the two groups.

Results

A sample of 414 children (57% under-five; 51.9% Roma), was included in the database. In the under-five children, underweight accounted for 7.6%, stunting for 11.7%, and wasting for 2.9%. The first year of life was the most crucial for nutritional status. Compared to the counterpart, Roma children accounted for nearly the total rate of malnutrition (wasting 4.8% vs. 1%; stunting 21.4% vs. 2%; underweight 14.2% vs. 1%). Univariate logistic regression confirmed under-five Roma children being at the highest risk of stunting at 12 months (OR: 16.1; CI 2–132; p = 0.01).

When considering the 176 school-aged children, undernutrition affected most Roma children (13% vs 1.9%), followed by stunting (5.8% vs 0.9%). Univariate logistic regression confirmed that Roma school-aged children were more likely to be underweight (OR: 7.8; CI 1.6–37.6; p = 0.01).

Conclusions

Malnutrition in immigrant children is still of high concern in Italy. Its prevalence in Roma children living in extra-urban camps exceeds that of immigrant children living in urban areas and the rates of underweight, stunting and wasting of Roma children living in the Balkans. This exacerbating condition highlights the need of better assisting this fragile population that is at most risk of poverty, food insecurity and social exclusion in Italy, particularly during this pandemic crisis.

Actions Targeting the Double Burden of Malnutrition: A Scoping Review

BACKGROUND

In many developing countries, nutritional and epidemiological transitions are contributing to continuous undernutrition and escalating overnutrition, resulting in coexisting forms of malnutrition often referred as the "double burden of malnutrition" (DBM). This complex phenomenon constitutes an unprecedented challenge to global public health and has been prioritized by international health organizations, prompting governments to swift action. Specifically, five years ago the World Health Organization proposed a roadmap to tackle the DBM though so-called "double-duty actions". The objective of this review was to synthesize the literature on interventions which address the DBM.

METHODS

We developed a scoping review to identify interventions addressing the DBM. We searched PUBMED for papers reporting interventions until December 2019. Articles examining interventions, government policies, or tools at the individual, household, or community level to address the double burden of malnutrition were included.

RESULTS

Seven articles met the inclusion criteria. Three were from sub-Saharan Africa, one was from Southeast Asia, and one was from Central America. Two were modelling studies, with one covering 24 low-income countries and the other focusing on Ghana.

CONCLUSION

Notwithstanding the pressing issue of the DBM, there is a paucity of studies examining double-duty actions despite the attention that it has garnered within the global nutrition community. Whilst nutrient deficiencies may be curbed by poverty reduction measures, for obesity prevention nutrition, education and promotion of physical activity, along with the encouragement of local food production, may be instrumental.

Cognitive Function and Consumption of Fruit and Vegetable Polyphenols in a Young Population: Is There a Relationship?

Scientific evidence has shown the relationship between consumption of fruits and vegetables and their polyphenols with the prevention or treatment of diseases. The aim of this review was to find out whether the same relationship exists between fruits and vegetables and cognitive function, especially memory, in a young population. The mechanisms by which polyphenols of fruits and vegetables can exert cognitive benefits were also evaluated. These compounds act to improve neuronal plasticity through the protein CREB (Camp Response Element Binding) in the hippocampus, modulating pathways of signaling and transcription factors (ERK/Akt). In the same way, brain-derived neurotrophic factor (BDNF) is implicated in the maintenance, survival, growth, and differentiation of neurons. All these effects are produced by an increase of cerebral blood flow and an increase of the blood’s nitric oxide levels and oxygenation.