Enhancing nutritional knowledge and self-regulation among adolescents: efficacy of a multifaceted food literacy intervention

Understanding the influencing factors of adolescents' (12-17) healthy and unhealthy food choices and experiences in Tamil Nadu, India: a socioecological perspective

Adolescents' food choices are critical for long-term health, yet increasing consumption of unhealthy foods driven by environmental and social factors contributes to rising obesity and non-communicable diseases. This study explored the perceptions of parents, teachers, and adolescents regarding the factors influencing adolescent food choices in urban, slum, and rural areas of Tamil Nadu. Adolescents illustrated their preferred foods through drawings used emojis to express emotions related to their food choices. Employing Bronfenbrenner's ecological theory, thematic analysis revealed that key factors influencing both healthy and unhealthy food choices across all regions included taste preferences, textural appeal, food cravings, peer and media influence, and family practices. In urban areas, economic status, food access, and working parents led to unhealthy eating, worsened by the COVID-19 pandemic, while in rural areas, COVID-19 reinforced traditional, healthy eating habits. However, "eye eating", emerged as a coping strategy to reduce unhealthy food cravings in urban settings. In rural areas, nearby neighbourhoods and extended families supported the provision of home-cooked meals in the absence of working parents. In slums, food bloggers and the accessibility of affordable street foods were prominent influencers. Emotional states influenced food choices across all settings: unhealthy foods were associated with immediate gratification, as evident in the drawings displayed by adolescents, followed by guilt, while home-cooked meals, particularly in rural areas, were linked to comfort. Leveraging "eye eating" by visually promoting healthy foods in urban areas, and strengthening nutrition education through families and schools in rural settings, can guide tailored interventions for healthier adolescent diets.

Relationships between nutritional intake, appetite regulation, and mental health with body composition among female college students with overweight and obesity

Introduction

The prevalence of overweight and obesity among college girls is a significant public health concern. This cross-sectional study investigated the relationships between nutritional intake, appetite regulation, and mental health with body composition among overweight and obese college girls.

Methods

This study involved 72 college girls. Standardized instruments measured the corresponding variables. The data analysis utilized Pearson and Spearman correlations.

Results

Results show that energy and carbohydrate intake were positively correlated with body fat percentage and waist circumference (both p ≤ 0.007). Fat intake was positively correlated with all body composition variables (all p < 0.001). Anxiety was negatively correlated with all body composition variables (all p ≤ 0.027). Hunger at 0 min was positively correlated with body fat percentage and waist circumference (both p ≤ 0.002). Hunger at 60 min was positively correlated with BMI and waist circumference (both p ≤ 0.012). Desire to eat at 0 and 60 min were positively correlated with all body composition variables (all p ≤ 0.003). Desire to eat at 30 min was positively correlated with BMI (p = 0.005). Desire to eat at 90 min was negatively correlated with body fat percentage (p = 0.047). Fullness at 0 min was positively correlated with waist circumference (p = 0.040). Fullness at 30 min was positively correlated with body fat percentage and waist circumference (both p ≤ 0.018). Fullness at 120 min was negatively correlated with all body composition variables (all p ≤ 0.023). Prospective food consumption at 0 min was positively correlated with all body composition variables (all p < 0.001). Prospective food consumption at 30, 60, and 120 min was positively correlated with BMI (all p ≤ 0.008).

Discussion

Overall, overweight and obese college girls should manage energy intake, fat intake, carbohydrate intake, anxiety, and appetite regulation to reduce fat levels. Further research suggests exploring counterintuitive correlations between body composition with anxiety, desire to eat at 90 min, and fullness at 0 and 30 min, along with limitations related to causal relationships, measurement accuracy, the relationship with physical activity, and population diversity.

Identifying the causes of adolescent malnutrition in Nuwara-Eliya District, Sri Lanka

Malnutrition, a persistent illness, significantly reduces fat, muscle and bone levels, harming internal organs. The economic crisis in Sri Lanka has led to widespread malnutrition among children, including adolescents experiencing growth spurts. This study identifies factors influencing malnutrition in grade 10 pupils in the Nuwara-Eliya District, with the highest rates of malnutrition and also a multicultural area with many estate sector residents. Using a cross-sectional, quantitative approach, the data was collected from 379 respondents via a Likert scale questionnaire. Structural Equation Model (SEM) analysis was conducted using Smart PLS 4.0. Key findings indicate that environmental factors, such as access to clean water and sanitation, significantly influence adolescent malnutrition. A comprehensive strategy incorporating education, healthcare, and environmental improvements is essential for this. Ongoing observation, community engagement, and cooperative tactics are crucial for sustainable solutions. Addressing environmental issues and promoting a holistic approach to health education and infrastructure improvements are vital to combat adolescent malnutrition in vulnerable populations.

Neighbourhood, school and home food environment associations with dietary behaviours in Hong Kong adolescents: the iHealth study

This study is the first to examine whether neighbourhood, school and home food environments were associated with dietary behaviours in Hong Kong adolescents; and whether off-campus lunch school policy, bringing lunch from home and parental rules for eating behaviours moderated the associations. We used data from the international Healthy environments and active living in teenagers - (Hong Kong) [iHealt(H)] study. Participants were healthy adolescents aged 11-18 years (N = 1299; Mage = 14.7 years; 57 % girls) and their parent/primary caregivers. Participants completed surveys with validated scales to assess dietary behaviours and perceived food environments. The Microscale Audit of Pedestrian Streetscapes and Geographic Information Systems data and software were used to objectively assess food environments. A higher number of bakeries, coffee shops, cafes and convenience stores in the neighbourhood was associated with higher consumption of vegetables and lower consumption of sugar-sweetened drinks in adolescents. Adolescents who frequently brought lunch from home to school consumed fatty foods and sugar-sweetened drinks less frequently and were more likely to eat fruits and vegetables. Greater availability of unhealthy food outlets at the school was associated with higher consumption of sugar-sweetened drinks, whereas more restaurants around the school was associated with higher consumption of fruits and vegetables. Home-made lunches and restrictive parental eating rules moderated the effects of food environments on adolescents' dietary behaviours. All food environmental contexts were associated with Hong Kong adolescents' dietary behaviours; however, the home and school environment appeared to be the most influential and should be targeted in public health interventions.

"What's for dinner?" understanding family food decision-making and wishes of children and their caregivers for plant-based alternatives in family main meals

Children are recognized as drivers of change for a sustainable future, beginning with their choices and actions at the dinner table. Therefore, plant-based food should appeal to children to empower them to encourage the family to choose plant-based alternatives during family meals. The current study aimed to investigate both the perspective of children (9- to 11-year-old) and their caregivers on family food decision-making, focusing on the transition to plant-based alternatives within the family. To gain insight into caregivers' perspectives, 36 caregivers participated in semi-structured qualitative interviews using self-taken photos of their dinner meals to guide the discussions. To understand children's perspectives, 37 children engaged in creative tasks with a design probe box, followed by a semi-structured qualitative interview. Most caregivers were willing to incorporate plant-based alternatives into their family main meals, either for the entire household or specifically for their child. Addressing children's and caregivers' perception is crucial in the transition to plant-based alternatives to ensure preferences of all family members are met. Governmental institutions and food companies can leverage these research findings to guide the development of appealing plant-based alternatives and create evidence-based consumer behaviour change programs, focusing on meal inspiration and healthiness, ensuring seamless integration into everyday eating habits.

New Dietary Trends-Meal Kit Delivery Services as a Source of Nutrients: A Scoping Review

Producers and distributors of meal kits promote their products by emphasising customisation and a health-conscious approach to eating. Consumers of these services expect that, for an appropriate fee, they will receive a nutritious and flavourful meal, tailored to their individual needs and conveniently delivered to their homes. This raises the question of whether meal kit companies meet these expectations and whether their products are prepared with the level of care claimed in their advertisements. This scoping review aims to present available evidence that offers insight into the nutritional content, safety, and acceptability of meal kit delivery services. In this context, we have identified 15 publications. To the best of our knowledge, this is the first scoping review to focus specifically on meal kits. The findings highlight the significant potential of meal kits and may contribute to efforts to enhance their quality. Available research on meal kit delivery services was conducted using calculation methods. Nutritional value studies involving analytical methods and intervention studies are necessary in order to expand the understanding of the potential of meal kits role in whole-food nutrition.

Modeling the Substitution of One Egg Increased the Nutrient Quality of Choline and Vitamin D in Exemplary Menus

Background/Objectives: Eggs, a nutritious and affordable food, are not widely consumed by adolescents, who show many nutrient inadequacies. Modeling dietary substitutions with eggs and their costs can provide dietary insights while considering economic constraints. This study theoretically modeled the impact of substituting an egg for another protein source, considering nutrient quality and cost, using exemplary menus with application to adolescents. Methods: The substitution was modeled in four different seven-day exemplary menus: (1) the Healthy U.S.-Style Dietary Pattern (HUSS), (2) Harvard Medical School's Heathy Eating Guide, (3) the National Heart, Lung, and Blood Institute's Dietary Approaches to Stop Hypertension (DASH) diet and (4) the Healthy U.S.-Style Vegetarian Dietary Pattern (HVEG). One egg replaced the gram amount and nutrient profile of a protein source food in each menu. Micronutrient quality was assessed using the Food Nutrient Index (FNI), scored 0-100. The Center for Nutrition Policy and Promotion Food Price Database informed the food prices. Pairwise t-tests compared the effects of egg substitution on micronutrient scores and daily costs. Results: The daily egg substitution increased FNI scores for choline and vitamin D in the HUSS (83 to 95 and 69 to 75, respectively), DASH (80 to 91 and 55 to 59, respectively), and HVEG (91 to 100 and 44 to 51, respectively), and choline alone (89 to 98) in the Harvard menu. Daily menu prices were not significantly different after the egg substitution (p > 0.01). Conclusions: Substituting one egg for another protein source food increased the micronutrient quality of choline and vitamin D in exemplary menus without increasing the cost; however, factors such as food preferences and the economic accessibility of eggs in different contexts should also be considered.

Immunonutrition in ERAS Protocol for Patients with Gynecologic Cancer: A Narrative Review of the Literature

In-hospital patients who are in the gynecologic oncology setting often suffer from malnutrition, which is one of the primary problems, the rate of which reportedly ranges from 28% to 70%. Malnutrition is a significant risk factor for immunosuppression, negatively impacting immune response and postoperative recovery capacity. At the time of the surgeries, due to their wide scope and aggressive treatments such as chemotherapy and radiotherapy, the situation becomes more serious. Those micronutrients taking part in immunonutrition, namely, arginine, omega-3 fatty acids, nucleotides, and antioxidants, have the potential to prevent inflammation, protect against infections, and promote healing after the surgery. Research has shown that immunonutrition can lower the risk of postoperative infection, promote the normal healing of wounds, and reduce the hospital stays of patients, as well as support malnutrition status during chemotherapy. This review is based on a literature search conducted in Medline, Scopus, Clinicaltrials.gov, Cochrane CENTRAL, and Google Scholar, with the last search date being November 2024. Some studies. found that perioperative immunonutrition decreases wound infections and affects some immune indexes in gynecologic oncology patients positively. However, factors such as non-compliant patients, high costs, and non-standard formulations can deter its wider use. Patient adherence drops postoperatively mainly due to nausea and decreased appetite, whereas the cost of enriched formulations acts as an economic barrier. Postoperative compliance drops from ~78% prior to surgery to ~28% due to nausea, anorexia, and chemotherapy. Additionally, cost remains a constraining factor since special formulas are 2-4 times that of normal nutrition. While immunonutrition reduces hospital stay (by ~2-3 days) and infection rate (by 25-40%), access is hindered by prohibitive initial costs and lack of insurance coverage. Approaches such as subsidized schemes, enhanced palatability, and cost-benefit analyses are required to increase adoption. In addition, the lack of standardized protocols makes the clinical community hesitant to adopt this approach. Immunonutrition is, despite these problems, still hoped to be the new adjunct to gynecologic oncology patients. In future studies, it is imperative to pay attention to the best formulations that produce the best outcomes and evaluate and implement guidelines that are based on evidence. Together, with these improvements, immunonutrition could very well be an integral part of perioperative care thus completing the process by which patients in intense treatments are benefited not only via treatment but also via quality of life.

Evaluation of e-healthy diet literacy and food consumption in people who have or have not received nutrition counseling

Aim: This study explores the relationship between e-healthy diet literacy and food consumption in individuals receiving nutrition counseling. Methods: Data were collected from 750 participants using a questionnaire covering socio-demographics, anthropometric data, food consumption habits, and the e-Healthy Diet Literacy Questionnaire (e-HDLQ). Results: Results showed that individuals receiving nutrition counseling had significantly higher total e-HDLQ scores and sub-factor scores for "Finding e-Healthy Diet Information (e-HDIF)," "Judging e-Healthy Diet Information (e-HDIJ)," and "Applying e-Healthy Diet Information (e-HDIA)" compared to those not receiving counseling (p < 0.01). Additionally, participants who consumed fresh fruits and vegetables had significantly higher "e-HDIJ" scores compared to non-consumers. Similarly, those who consumed sugar had higher "e-HDIJ" scores than those who avoided sugar (p < 0.01). This suggests that consuming fresh produce and sugar may positively impact the ability to evaluate dietary information. Interestingly, individuals who avoided bread and cereals scored significantly higher in the "e-HDIA" sub-factor than those who consumed these foods (p < 0.01). This indicates that abstaining from bread and grains may enhance the ability to apply dietary knowledge. Conclusion: In conclusion, the findings highlight the significant impact of nutrition counseling on digital diet literacy and suggest that dietary habits, such as consuming fresh produce, sugar, or avoiding bread and cereals, play an important role in shaping e-healthy diet literacy. These results offer valuable insights into improving dietary education and behavior in diverse populations.

Media Influence on the Perceived Safety of Dietary Supplements for Children: A Content Analysis of Spanish News Outlets

Background/Objectives: The influence of media on the public opinion, especially regarding health topics, is profound. This study investigates how Spanish media may reinforce a positive image of dietary supplements for children, potentially leading to harmful health attitudes and behaviors. Methods: The researchers conducted a quantitative content analysis of 912 news articles from Spanish media outlets discussing dietary supplements for children between 2015 and 2021. They used a frequency analysis and a proportion comparison to analyze variables such as the reach of news, tone of news, mentions of health professional consultation, association with natural products, media specialization, intertextuality, and headline mentions. Results: The study found a 60% increase in publications discussing dietary supplements for children during the study period. The content analysis indicates that these articles predominantly present dietary supplements in a positive light, often without robust scientific evidence. Furthermore, many do not emphasize the need for medical consultation, which may contribute to unsupervised consumption, particularly among minors. This highlights the critical importance of professional guidance when considering dietary supplements for children. Additionally, the frequent emphasis on the "natural" attributes of these products raises concerns regarding consumer perceptions and potential safety risks. Conclusions: The study reveals a problem regarding the portrayal of dietary supplements for children in Spanish media. The overly optimistic image, lack of scientific basis, and failure to recommend medical supervision may contribute to unsupervised consumption among minors, risking their health due to misinformed decisions influenced by media portrayal.

Analysis of Nutrition Knowledge After One Year of Intervention in a National Extracurricular Athletics Program: A Cross-Sectional Study with Pair-Matched Controls of Polish Adolescents

Background: Nutrition knowledge may be translated into adequate dietary intake and proper eating habits, so adolescent education programs focusing on improving eating habits and nutrition knowledge are needed. The aim of the cross-sectional study with pair-matched controls was to assess the Consumer Nutrition Knowledge Scale (CoNKS) results and its determinants after one year of intervention in a national extracurricular athletics program within a pair-matched sample of Polish adolescents. Methods: The #goathletics Study evaluated a Polish national extracurricular athletics program, 'Athletics for all', being a voluntary and free-of-charge physical activity program organized by the Polish Athletics Association. The study allowed comparing the intervention group of adolescents aged 10-14 years, participating in the program for at least 9 months (a school year) and a pair-matched group not participating in it, while the matching was based on city, gender, and age (each group: n = 506 adolescents, n = 281 females and n = 225 males). The nutrition knowledge was assessed using a Consumer Nutrition Knowledge Scale (CoNKS), and during the analysis, the following factors were taken into account: body weight, height, Body Mass Index (BMI), waist circumference, and waist-to-height ratio (WHtR). Results: The 'Athletics for all' program participation influenced not only the total CoNKS score (p < 0.0001) but also the scores in all studied areas-within procedural nutrition knowledge (p = 0.0002), declarative nutrition knowledge on nutrients (p = 0.0001), and declarative nutrition knowledge on calories (p < 0.0001), and program participants revealed a stronger understanding of all the studied areas compared to non-participating individuals. Gender, BMI, and central obesity tendency were not associated with the total CoNKS score (p > 0.05), or any of the studied areas (p > 0.05). The statistically significant differences in the number of correct answers were observed for four items within procedural nutrition knowledge, for four items within declarative nutrition knowledge on nutrients, and for four items within declarative nutrition knowledge on calories (p < 0.05), while for all of them, 'Athletics for all' program participants revealed a stronger understanding. Conclusions: One year of intervention in a national extracurricular athletics program significantly influenced the nutrition knowledge of the studied group of adolescents aged 10-14 years. While compared with the pair-matched control group of Polish adolescents, they were characterized by a stronger understanding of all areas of nutrition knowledge.