The relationship between sleep- and circadian rhythm-related parameters with dietary practices and food intake of sedentary adults: a cross-sectional study

We aimed to explore the link between sleep-related parameters and dietary practices. This cross-sectional exploratory study includes sedentary individuals between 20 and 59 years of age. We applied exigent inclusion and exclusion criteria, such as weight stability and without humor- or sleep-related diseases. Also, shift workers were not included. We evaluated sleep quality (by Pittsburg Sleep Quality Index; PSQI), sleepiness (by Epworth Sleepiness Scale), chronotype (by Morningness Eveningness Questionnaire; MEQ), and social jetlag from sleep dairy. Moreover, Food Practices Measurement Scale was used to assess dietary practices. Food intake estimates (i. e., energy, eating window, and late-night dinner eating) were derived from two 24-h food recalls (R24h). For analysis, dietary practices and energy intake from R24h were considered dependent variables, while PSQI, ESS, MEQ, STJ, EW, and LNDE were considered independent variables. Our sample comprises 42 adults (21 women and 21 men; 35.4 (12.5) y; 25.6 (5.21) kg/m2 BMI; 26.5 (7.97) % body fat). We verified that persons with poor sleep quality showed lower dietary practice scores (MD - 6.68; p = 0.021). Besides, in regression analysis, chronotype (β = 0.266; p = 0.039) was positively associated with dietary practices, and eating window was positively associated with energy intake (β = 267 kcal; p = 0.023). In contrast to our hypothesis, other sleep- and circadian-related variables were not associated with dietary practices or energy intake. In summary, we conclude that morning chronotype appears to be related to better dietary practices from the Food Guide for the Brazilian Population guide and that higher eating window was positively associated with energy intake.

Effect of using mobile phone communication on dietary management of Type 2 Diabetes Mellitus patients in Kenya

Purpose

Advancements in management of non-communicable diseases using regular reminders on lifestyle and dietary behaviors have been effectively achieved using mobile phones. This study evaluates the effects of regular communication using a mobile phone on dietary management of Type 2 Diabetes Mellitus (T2DM) among patients attending Kitui County Referral Hospital (KCRH) in Kenya.

Methods

Pre/post-study design among eligible and consenting T2DM patients visiting KCRH was used for this study. One hundred and thirty-eight T2DM patients were enrolled; 67 in the intervention group (IG) and 71 in the control group (CG). The IG received regular reminders on key dietary practices through their mobile phones for six months while the CG did not. The Net Effect of Intervention (NEI) and bivariate logistic regression were used to determine the impact of mobile phone communication intervention at p < 0.05. SPSS version 24 was used to analyze the data.

Results

The results revealed an increase of respondents who adhered to the meal plan in the IG from 47.8% to 59.7% compared to a decrease from 49.3% to 45.1% in CG with corresponding NEI increasing (16.1%) significantly (p < 0.05). The proportion of respondents with an increased frequency of meals increased from 41.8 to 47.8% in the IG compared to a reduction from 52.1% to 45.1% in the CG with corresponding NEI increasing (13.0%) significantly (p < 0.05).

Conclusion

Regular reminders on lifestyle and dietary behaviors using mobile phone communication improved adherence to dietary practices such as meal planning and frequency of meals in the management of T2DM.

Physical exercise practice was positively associated with better dietary practices of aged people during COVID-19 social distance: A cross-sectional study

BACKGROUND & AIMS

COVID-19 is a respiratory syndrome caused by SARS-CoV-2. In the absence of effective treatment and vaccines, social distance (SD) is essential to reduce the spread of the virus. However, SD generates several behavioral changes, especially in psychological (i.e., emotions and depressive symptoms) and lifestyle-related parameters (i.e., diet, physical activity, and sleep), and the aged people could be more susceptible to COVID-19 SD-related effects (i.e., loneliness, stress, fear, concerns about life, etc.). As such, we aimed to explore the relationship between lifestyle- (physical exercise practice and sleep quality) and psychological-related factors with the dietary practices derived from the Brazilian National Food Guide of older adult during the COVID-19 SD.

METHODS

A web-based survey was conducted in São Paulo, Brazil. Data were collected between August and December 2020 (a period of social isolation due to the COVID-19 pandemic). The questions were extracted from validated questionnaires to verify dietary practices (score of adhesion to the food guide for the Brazilian population), sleep quality (by Pittsburgh questionnaire), emotional food-related dimensions (by Three-factor Eating Questionnaire), and depression symptoms (by Beck's questionnaire).

RESULTS

Results were from 229 aged people (mean age 66.5 ± 6.02 years old; mean BMI 27.5 ± 4.32 kg/m²; mean sleep duration 8.23 ± 1.41 h; Pittsburg sleep quality score 6.55 ± 4.83; dietary practice score 42.5 ± 6.47). In the adjusted-linear regression model, we verified that physical exercise practice at home (β = 2.179; 95% CI: 0.599 to 3.758; p = 0.007) during COVID-19 SD was positively associated with better dietary practices in aged people. In contrast, emotional eating was negatively associated with dietary practices (β = -0.051; 95% CI: -0.092 to - 0.009; p = 0.015).

CONCLUSION

We conclude that in aged people, physical exercise practice at home during COVID-19 SD was positively associated with better dietary practices, while emotional eating was negatively associated.

Dietary practices and nutritional status of children served in a social program for surrogate mothers in Colombia

BACKGROUND

Dietary practices are acquired in the family context and in turn can affect the health of family members, especially the nutritional status of children. The objective of this study was to determine the relationship between nutritional status and feeding practices in children from foster families served by the SOS Children's Villages program in Cartagena, Colombia.

METHODS

The study had a cross-sectional design. Through a non-probabilistic purposive sampling, 139 children from 0 to 5 years of age from the SOS Children's Villages Cartagena program were involved. The sociodemographic background of the participants was recorded and the nutritional status of the children was evaluated through anthropometric and biochemical measurements. Dietary practices were measured by means of a standardized questionnaire. Analyses were performed with Poisson regression models with robust variance. These regression models provided prevalence ratios (PR) with their respective 95% confidence intervals (95%CI).

RESULTS

Among dietary practices, it was observed that most families eat together at home (63.3%), watch television when they eat (55.4%), and have dietary norms (80.6%). Consumption of plant foods was predominantly high, especially vegetables (86.3%), fruits (92.1%), cereals (84.9%), root vegetables, and bananas (93.5%). Consumption < 4 times/week of soft drinks and industrialized juices increases 14.3 times the probability of low weight-for-height in the study population compared to the group that does not consume them. On the other hand, watching television while eating (PR: 2.82, 95%CI 1.32-4.69) and consumption of sweet snacks (PR: 2.24, 95%CI 1.03-4.87) increased the probability of low height-for-age; while having eaten norms at home decreased the probability of low height-for-age in the study population by 50%.

CONCLUSION

It is necessary to develop and implement interventions such as preventive measures and early diagnosis of inappropriate feeding behaviors to ensure adequate nutritional status among children under 5 years of age.

Dietary practices, beliefs and behaviours of adults with inflammatory bowel disease: a cross-sectional study

BACKGROUND

It is widely accepted that there is an association between diet and inflammatory bowel disease (IBD). Diet may play a role in disease pathogenesis but also in treatment and management of IBD. There is an increased interest in dietary aspects of people with IBD.

AIMS

To investigate dietary practices, beliefs and behaviours of adults with IBD in Ireland.

METHODS

An online questionnaire was adapted to explore dietary practices, beliefs and behaviours of people with IBD, and to identify any dietary modifications made due to their IBD.

RESULTS

A total of 475 participants (female n = 354, male n = 121) took part in this study, 62% had Crohn's disease and 38% had ulcerative colitis. Dietary restrictions were imposed in the hope of preventing a relapse by 85% of participants. The most reported foods avoided included fatty foods (68%), spicy foods (64%) and raw vegetables or fruit (58%). Low fibre white plain foods (74%) appeared to improve symptoms during a relapse. Participant's appetites were higher during remission (8.36, SD =  ± 1.95), compared to during relapse (3.71, SD =  ± 2.32) (P ≤ 0.001). Almost three-quarters (73%) avoided the same menu as others living in their household and 56% avoided eating out to prevent or for fear of causing a relapse. Additionally, 70% avoided food or drink they liked to try prevent a relapse.

CONCLUSION

These findings provide important insights into the dietary practices, beliefs and behaviours of adults with IBD. Its evident diet plays an important role, and our findings reiterate the importance of patient education and support.

Evaluating the impacts of school garden-based programmes on diet and nutrition-related knowledge, attitudes and practices among the school children: a systematic review

BACKGROUND

Previous evidence suggests that school garden-based programmes (SGBP) may be a promising yet cost-effective intervention to improve children's knowledge, attitudes and practices (KAP) on healthy eating. This review aimed to summarise and evaluate the evidence available on the impacts of SGBP in addressing diet and nutrition-related KAP among school-aged children.

METHODS

Five databases including PubMed, Embase, Cochrane, Web of Science and Scopus were searched until February 2021. Randomised, non-randomised controlled and pre-post intervention studies investigating the impacts of SGBP on at least one of the outcomes of interest including diet and nutrition-related knowledge, attitudes towards fruits and vegetables (F&V), food diversity and dietary practice among school-aged children were included. Study selection and data extraction were performed by one reviewer and checked for accuracy by the other two reviewers in accordance with PRISMA guideline. Quality appraisal for studies included was assessed using American Dietetic Association Quality Criteria Checklist.

RESULTS

A total of 10,836 records were identified, and 35 studies that met the inclusion and exclusion criteria were included. This includes 25,726 students from 341 schools and 8 nurseries from 12 countries. Intervention duration ranged from 6 weeks to 4 years with 18 studies involving a varied degree of parental participation. SGBP, which majorly includes school gardening activities, cooking lessons and nutrition education, demonstrated beneficial effects on children's nutritional knowledge, their attitudes and acceptability towards fruits and vegetables and children's dietary practices including the actual F&V consumption and dietary diversity. However, the impacts of SGBP on such outcomes were highly influenced by various social and environmental factors including the activities/components and duration of the intervention, parental involvement, sample size, and the age of children when interventions were first introduced.

CONCLUSION

These findings suggest that SGBP may be effective in promoting children's nutritional knowledge, attitudes and acceptability towards vegetables, however, the impacts may vary by the type, the extent, and the length of the programmes, and other factors such as parent involvement. Future SGBP is suggested to implement using a combined multidisciplinary approach targeting the children, parents, and community to effectively promote healthy eating among the children and prevent childhood obesity.

Health facility-based counselling and community outreach are associated with maternal dietary practices in a cross-sectional study from Tanzania

Background

Anemia and underweight among women are major public health challenges. Access to health services can improve dietary behaviors and women’s nutritional status. We examined whether exposure to health services is associated with women’s dietary practices in Tanzania.

Methods

Data come from a cross-sectional baseline survey among 5000 female primary caregivers who were randomly selected via two-stage sampling, prior to implementing a maternal and child nutrition program. We ran frequencies on women’s exposure to existing health facility-based counselling, community health worker visits, and attendance at women’s support groups. We examined associations between exposure to these interventions and maternal diets and adjusted for sociodemographic covariates using ordinary least squares regression and ordered logistic regression.

Results

A third of the sample (34.1%) had received any antenatal care (ANC) during their most recent pregnancy or had been advised by anyone about nutrition (37.0%). 68.0% had never had a community health worker (CHW) speak to them about their children’s health and 9.4% had participated in a women’s group. Only 8.0% of mothers ate more than usual during pregnancy and 7.1% ate more types of foods. After adjusting for mother’s age, education and household assets, women who received nutrition advice were 1.3 times (95% CI: 1.1, 1.7) more likely than mothers who did not to eat more during pregnancy. Receiving antenatal care (ANC) and advice on nutrition before, during, and after pregnancy and delivery were highly associated with the mother eating more types of foods. Hearing from a CHW about children’s health but not support group attendance was often associated with various dietary practices. Almost all measures of access to health services were significantly associated with mothers’ frequency of eating in the previous 24 h. Receiving advice on nutrition during pregnancy and after giving birth and CHW contact were associated with mothers’ dietary diversity in the previous 24 h.

Conclusions

Several program exposure variables—especially being counselled about nutrition—were associated with improved dietary practices. Improving service delivery at scale may contribute to improved dietary behaviors in larger populations, given the associations we describe, along with findings from the existing literature.

Emotional eating, binge eating, physical inactivity, and vespertine chronotype are negative predictors of dietary practices during COVID-19 social isolation: A cross-sectional study

Objectives

Coronavirus disease 2019 (COVID-19) emerged and rapidly spread worldwide. Several countries have imposed lockdown and isolation in attempt to mitigate viral spread. However, social isolation has a negative effect on psychological aspects, increasing stress, fear, anxiety, anger and emotional disturbance, as well as affecting sleep pattern and the practice of physical activity. Negative emotions and lifestyle changes trigger overeating, consequently affecting dietary practices. The aim of this study was to verify the prevalence of lifestyle factors (i.e., sleep time/quality and practice of physical exercise), eating behavior dimensions, chronotype, and association with dietary practices (planning, domestic organization, food choice, ways of eating) in home confinement during the COVID-19 pandemic in São Paulo, Brazil.

Methods

This cross-sectional study was conducted between April 27 and May 25, 2020. An anonymous online questionnaire (Microsoft Forms) was used for data collection by the snowball method. We verified dietary practices (outcome), eating behavior, physical exercise practice, sleep quality and duration, and chronotype (exposure variables). Sex, age, educational and social status were assessed as covariates and confounders. We evaluated 724 adults (585 women and 139 men). Mean age was 32.6 y (±11.3) for women and 33.5 y (±10.5) for men.

Results

Emotional eating (EE) and binge eating (BE) were positively correlated (r = 0.66; P <0.001). Dietary practices were negatively correlated with BE (r = –0.41; P <0.001), EE (r = –0.33; P <0.001) and body mass index (r = –0.24; P <0.001). Linear regression demonstrated that EE (β = –0.1351; t = –2.841; P = 0.005; η_p² = 0.013), BE (β = –0.2580; t = –5.612; P < 0.001; η_p² = 0.050), no practice of physical exercise at home (β = –0.4271; t = –5.933; P < 0.001; η_p² = 0.055), being vespertine (β = –0.3435; t = 2.076; P = 0.038; η_p² = 0.019), and age (β = –0.082; t = –2.210; P = 0.027; η_p² = 0.008) are negative predictors of dietary practices. Finally, cognitive restraint (β = 0.1407; t = 3.858; P < 0.001; η_p² = 0.024), better sleep quality (β = 0.1768; t = 2.506; P = 0.012; η_p² = 0.010), receiving 4–10 wages per month (according to a minimum wage in Brazil that corresponds to US $ 183.01) (β = 0.2568; t = 2.573; P = 0.10; η_p² = 0.027) and 10 – 20 wages per month (β = 0.4490; t = 3.726; P < 0.001; η_p² = 0.027) are positive predictors of dietary practices.

Conclusion

Eating behavior, physical exercise, sleep, and social factors can be important predictors for dietary practices during COVID-19 social confinement. Longitudinal studies in Brazil are needed to confirm these findings.

Dietary practices of Iranian migrant women in the United Kingdom

This research investigates the role of migration on the dietary practices of Iranian migrant women in the United Kingdom. It takes into account previous studies that migration leads to poorer socio-economic status of women that limits their food choices. Conversely, a study in Britain reveals that Iranian migrants continue with their traditional Iranian food practices. This qualitative study was informed by social practice theory, which posits that practices depend on the integration of three key elements: materials, competences and meanings. The study participants were 22 first generation Iranian migrant women aged 24-64 residing in London. Data were collected through in-depth, semi-structured, individual interviews and were analyzed thematically. Findings reveal that despite the diminished socio-economic status of some recent migrant women, the widespread multicultural food stores (materials), the affordable food prices, coupled with the women's cooking skills and improved knowledge of healthy food (greater competences) result in colonizing their energy, time, skills and budget (competences) in preparing healthy foods amongst those living with family members. At a personal level, most single women without children acknowledged their improved knowledge as the key to eating a healthy diet in Britain. Some women, however, recognize resorting to overeating to cope with the psychological demands of migration. Future studies need to focus on identifying the best possible supports for the Iranian migrant women in Britain from the early stages of their migration.

Effectiveness of a nutrition education and intervention programme on nutrition knowledge and dietary practice among Princess Nourah Bint Abdulrahman University's population

OBJECTIVE

The study sought to assess the influence of nutrition education and intervention programmes on nutrition knowledge and dietary practice among both students and staff (including faculty) of Princess Nourah Bint Abdulrahman University in Saudi Arabia.

DESIGN

A pretest-posttest, non-randomised experimental study design was implemented at Princess Nourah Bint Abdulrahman University in Riyadh City between September 2019 and February 2020.

SETTING

Princess Nourah Bint Abdulrahman University is the largest women's university in the world and has eighteen colleges and institutions and around ninety academic programmes.

PARTICIPANTS

The survey was completed by 1824 participants (1350 students and 474 staff/faculty) before the intervention and by a different cohort of 1731 participants (1317 students and 414 staff/faculty) after the intervention. In total, an independent sample of 3555 staff and students participated. Participants were asked about dietary knowledge and practices. Dietary knowledge entailed food variety and nutrients, fast food and its poor nutritional value, and the influence of cooking style on the nutritional quality of food. Dietary practices involved eating breakfast; consuming salt/sugar, eating high-salt food; eating pre-packaged food and consumption of vegetables, fruits, supplements, water and caffeine.

RESULTS

The majority of the sample consisted of students (75·1 %) and had not been diagnosed with any disease (73·7 %). The result of the current study showed that nutrition knowledge improved after completion of the nutrition programme.

CONCLUSIONS

The nutrition awareness programme improved students' nutritional knowledge; however, there was no significant effect on their dietary practices. Future nutrition awareness programmes should separate activities for students and staff, focusing on one target population at a time.

Perceived role of hot food in the pathogenesis of oesophageal cancer: a qualitative study in the Arsi Zone, Oromia, Central Ethiopia

Observational studies in Ethiopia have identified a positive association between hot wheat porridge consumption and oesophageal carcinoma. However, a single dietary intake cannot be a sufficient predictor of cancer among populations that have diverse dietary practices. The present study was carried out to explore the community's perspectives on the role of hot foods in the pathogenesis of oesophageal cancer in Ethiopia. Focus group discussions were conducted from May to August 2019 among purposefully selected 112 participants. Data were collected by using open-ended questions; memo writing, audio recordings and photo pictures. All tape-recorded interviews were transcribed verbatim and inductively coded using Atlas.ti Version 7.0.71 software. Finally, the analysis was performed according to the standard thematic framework analysis techniques. The finding showed that hot foods (porridge, coffee and soup) consumption patterns were perceived as the principal dietary risk of oesophageal cancer. Cooking in unventilated rooms, monotonous cereal-based foods, poor vegetable, and fruit intake, not taking milk with porridge, eating fast, swallowing large bolus of hot porridge and exposure to carcinogens in foods were regarded as predisposing dietary practices to oesophageal carcinoma. Socio-demographic, economic and cultural backgrounds were reported as the underlying risk factors associated with oesophageal cancer. There was a strong perception within the community that oesophageal cancer is linked to several but sequentially interlinked dietary and related practices. Cumulative thermal injuries from the consumptions of hot food could be the immediate dietary risk factors associated with increased risk of oesophageal cancer.

Factors influencing dietary practices in a transitioning food environment: a cross-sectional exploration of four dietary typologies among rural and urban Ugandan women using Photovoice

BACKGROUND

Healthy and sustainable dietary practices offer a possible solution to competing tensions between health and environmental sustainability, particularly as global food systems transition. To encourage such dietary practices, it is imperative to understand existing dietary practices and factors influencing these dietary practices. The aim of this study was to identify multi-level factors in lived rural and urban Ugandan food environments that influence existing dietary practices among women of reproductive age (WRA).

METHODS

A mixed methods study was conducted. Multiple correspondence analysis followed by hierarchical cluster analysis were performed on dietary data collected among a sample (n = 73) of Ugandan WRA in Kampala (urban) and Wakiso (rural) districts to elicit dietary clusters. Dietary clusters, which were labelled as dietary typologies based on environmental impact and nutrition transition considerations, were reflective of dietary practices. Following this, a smaller sample of WRA (n = 18) participated in a Photovoice exercise and in-depth interviews to identify factors in their social, physical, socio-cultural and macro-level environments influencing their enactment of the identified dietary typologies, and therefore dietary practices.

RESULTS

Four dietary typologies emerged: 'urban, low-impact, early-stage transitioners', 'urban, medium-impact, mid-stage transitioners', 'rural, low-impact, early-stage transitioners' and 'rural, low-impact, traditionalists'. Although experienced somewhat differently, the physical environment (access, availability and cost), social networks (parents, other family members and friends) and socio-cultural environment (dietary norms) were cross-cutting influences among both urban and rural dietary typologies. Seasonality (macro-environment) directly influenced consumption of healthier and lower environmental impact, plant-based foods among the two rural dietary typology participants, while seasonality and transportation intersected to influence consumption of healthier and lower environmental impact, plant-based foods among participants in the two urban dietary typologies.

CONCLUSION

Participants displayed a range of dietary typologies, and therefore dietary practices. Family provides an avenue through which interventions aimed at encouraging healthier and lower environmental impact dietary practices can be targeted. Home gardens, urban farming and improved transportation could address challenges in availability and access to healthier, lower environmental impact plant-based foods among urban WRA.

Do women who consult with naturopaths or herbalists have a healthy lifestyle?: a secondary analysis of the Australian longitudinal study on women's health

Background

Australians report consulting with a naturopaths or herbalists to improve their wellbeing, yet little is known about the associations between these consultations and the patients’ health behaviours. This cross-sectional study aimed to examine the relationship between health behaviour and consultations with naturopaths or herbalists in three age cohorts of Australian women.

Methods

Women aged 19–25 years, 31–36 years, and 62–67 years from the Australian Longitudinal Study on Women’s Health (ALSWH) were surveyed regarding smoking, alcohol or drug use, physical activity and dietary behaviour; and whether they consulted with naturopath/herbalists in the last 12 months. Associations were analysed using multivariable logistic regression.

Results

A total of 9151 (19–25 years), 8200 (31–36 years) and 11,344 (62–67 years) women were included in the analysis. Between 7.3 and 11.9% of women reported to have consulted with naturopaths/herbalists in the last 12 months. Women of all cohorts consulting with naturopath/herbalist were less likely to smoke (19-25 yrs.: Odds Ratio [OR] 0.61; 31–36 years: OR 0.58; 62–67 years: OR 0.29), more likely to report at least moderate levels of physical activity (19-25 yrs.: OR 1.41; 31–36 years: OR 1.34; 62–67 years: OR 1.34), and the use of vegetarian diets(19-25 yrs.: OR 1.40; 31–36 years: OR 1.77; 62–67 years: OR 2.28), compared to women not consulting with naturopaths/herbalists. Women consulting with naturopaths/herbalists however were also more likely to have used marijuana (19-25 yrs.: OR 1.18; 31–36 years: OR 1.42), or illicit drugs in the last 12 months (19-25 yrs.: OR 1.24; 31–36 years: OR 1.40).

Conclusions

Consultations with a naturopath or herbalist are associated with positive health behaviours that are protective of internationally important non-communicable diseases. Psychoactive drug use is also reported among women visiting a naturopath or herbalist. Further research is needed to understand the role naturopaths play in advising patients with regards to health and non-healthy behaviours.

Dietary behaviours in the context of nutrition transition: a systematic review and meta-analyses in two African countries

OBJECTIVE

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.

DESIGN

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

SETTING

Urban Ghana and Kenya.

PARTICIPANTS

Population-based studies of healthy adolescents and adults.

RESULTS

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.

CONCLUSIONS

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.

Prevalent bariatric dietary practices: Is India on the same page?

Background:

In the past decade, there has been an increase in the number and types of bariatric procedures in India. It is, thus, important to monitor prevalent bariatric practices.

Aim:

To identify prevalent pre- and post-operative dietary practices by bariatric professionals across India.

Materials and Methods:

Data regarding various pre- and post-surgery dietary practices were collected using an Internet-based survey. Thirty-three bariatric professionals including dietitians (n = 25) and surgeons (n = 8) across the country participated in the survey. The data were analysed, and prevalent dietary practices were identified.

Results:

Five (20%) dietitians were not involved in the pre-surgery consultation. Nineteen (70%) professionals put all patients on a low-calorie pre-surgery diet regardless of their body mass index, with a preference (n = 21; 77.7%) for liquid diet. Twenty-three (70%) professionals put patients on post-surgery liquid diet for 1–2 weeks. Thereafter, 28 (84.8%) professionals recommended soft diet for 2–4 weeks. Twenty-seven (81%) professionals used protein shakes (as opposed to dietary sources) as their primary source of protein for the first 3 months post-surgery. Fourteen (36%) professionals stopped protein shake supplements within 6 months post-surgery. Ten (30%) professionals reported whey protein aversions in >25% of the patients. Twenty-three (71%) professionals advocated a meal with <30% of carbohydrates for up to 1 year. Twenty-eight (84%) professionals used portion control method for meals.

Conclusion:

Our study reflects that prevalent dietary practices among Indian bariatricians are in line with national and international guidelines.

Diet and inflammatory bowel disease: The Asian Working Group guidelines

INTRODUCTION

These Asian Working Group guidelines on diet in inflammatory bowel disease (IBD) present a multidisciplinary focus on clinical nutrition in IBD in Asian countries.

METHODOLOGY

The guidelines are based on evidence from existing published literature; however, if objective data were lacking or inconclusive, expert opinion was considered. The conclusions and 38 recommendations have been subject to full peer review and a Delphi process in which uniformly positive responses (agree or strongly agree) were required.

RESULTS

Diet has an important role in IBD pathogenesis, and an increase in the incidence of IBD in Asian countries has paralleled changes in the dietary patterns. The present consensus endeavors to address the following topics in relation to IBD: (i) role of diet in the pathogenesis; (ii) diet as a therapy; (iii) malnutrition and nutritional assessment of the patients; (iv) dietary recommendations; (v) nutritional rehabilitation; and (vi) nutrition in special situations like surgery, pregnancy, and lactation.

CONCLUSIONS

Available objective data to guide nutritional support and primary nutritional therapy in IBD are presented as 38 recommendations.

International migration and dietary change in Mexican women from a social practice framework

Migration from lower- and middle-income to high-income countries is associated with dietary change, and especially with the adoption of a modern, less healthy diet. In this article we analyze the dietary changes experienced by Mexican migrants, employing as a theoretical framework the concept of social practice. According to this framework, practices integrate material elements, meanings and competences that provide their conditions of possibility. Practices are shared by members of social groups, and interact with other competing or reinforcing practices. Between 2014 and 2015, we conducted semi-structured interviews with 27 women, international return migrants living in Tijuana, Mexico. The interview guide asked about history of migration and dietary change. We found three main areas of dietary change: from subsistence farming to ready meals, abundance vs. restriction, and adoption of new food items. The first one was associated with changes in food procurement and female work: when moving from rural to urban areas, participants substituted self-produced for purchased food; and as migrant women joined the labor force, consumption of ready meals increased. The second was the result of changes in income: participants of lower socioeconomic position modified the logic of food acquisition from restriction to abundance and back, depending on the available resources. The third change was relatively minor, with occasional consumption of new dishes or food items, and was associated with exposure to different cuisines and with learning how to cook them. Public health efforts to improve the migrants' diets should take into account the constitutive elements of dietary practices, instead of isolating individuals from their social contexts.

Dietary practices and inflammatory bowel disease

The etiology of inflammatory bowel disease (IBD) remains elusive but it is believed to result from incompletely understood interactions between environmental triggers in a potentially genetically susceptible host and a subsequent aberrant immune response. Its incidence is increasing worldwide at an unprecedented rate, outpacing what genetic influences alone could instigate. The increasingly integral role played by eating in social life has led patients to gravitate to diet and food in their consultations with physicians and other health care professionals, in an attempt to improve, control, or even "cure" IBD through diet. Diet is a modifiable factor, and both patients and healthcare professionals have fuelled resurgent interest in the role of diet in maintaining IBD remission. Despite significant and increasing interest, there is a lack of credible evidence to support dietary modification or restrictions to prevent relapse of IBD. However, recent studies have shown that more than half of the patients believe that diet plays an important role in triggering relapse, leading to self-imposed dietary restrictions, some of which can have adverse consequences. This underpins the need for physicians and health care professionals to have a better understanding of dietary practices, in triggering, perpetuating, and improving IBD. This review examines and discusses the evidence behind this.

Food security and nutritional status of children under-five in households affected by HIV and AIDS in Kiandutu informal settlement, Kiambu County, Kenya

BACKGROUND

HIV and AIDS affect most the productive people, leading to reduced capacity to either produce food or generate income. Children under-fives are the most vulnerable group in the affected households. There exists minimal information on food security status and its effect on nutritional status of children under-fives in households affected by HIV and AIDS. The aim of this study was to assess food security and nutritional status of children under-five in households affected by HIV and AIDS in Kiandutu informal settlement, Kiambu County.

METHODS

A cross-sectional analytical design was used. A formula by Fisher was used to calculate the desired sample size of 286. Systematic random sampling was used to select the children from a list of identified households affected by HIV. A questionnaire was used to collect data. Focus group discussion (FGD) guides were used to collect qualitative data. Nutri-survey software was used for analysis of nutrient intake while ENA for SMART software for nutritional status. Data were analyzed using SPSS computer software for frequency and means. Qualitative data was coded and summarized to capture the emerging themes

RESULTS AND DISCUSSION

Results show that HIV affected the occupation of people with majority being casual laborers (37.3 %), thus affecting the engagement in high income generating activities. Pearson correlation coefficient showed a significant relationship between dietary diversity score and energy intake (r = 0.54 p = 0.044) and intake of vitamin A, iron, and zinc (p < 0.05). A significant relationship was also noted on energy intake and nutritional status (r = 0.78 p = 0.038). Results from FGD noted that HIV status affected the occupation due to stigma and frequent episodes of illness. The main source of food was purchasing (52.7 %). With majority (54.1 %) of the households earning a monthly income less than US$ 65, and most of the income (25.7 %) being used for medication, there was food insecurity as indicated by a mean household dietary diversity score of 3.4 ± 0.2. This together with less number of meals per day (3.26 ± 0.07 SD) led to consumption of inadequate nutrients by 11.4, 73.9, 67.7, and 49.2 % for energy, vitamin A, iron, and zinc, respectively. This resulted to poor nutritional status noted by a prevalence of 9.9 % in wasting. Stunting and underweight was 17.5 and 5.5 %, respectively. Qualitative data shows that the stigma due to HIV affected the occupation and ability to earn income.

CONCLUSIONS

The research recommends a food-based intervention program among the already malnourished children.

Predictors and risks of body fat profiles in young New Zealand European, Māori and Pacific women: study protocol for the women's EXPLORE study

BACKGROUND

Body mass index (BMI) (kg/m(2)) is used internationally to assess body mass or adiposity. However, BMI does not discriminate body fat content or distribution and may vary among ethnicities. Many women with normal BMI are considered healthy, but may have an unidentified "hidden fat" profile associated with higher metabolic disease risk. If only BMI is used to indicate healthy body size, it may fail to predict underlying risks of diseases of lifestyle among population subgroups with normal BMI and different adiposity levels or distributions. Higher body fat levels are often attributed to excessive dietary intake and/or inadequate physical activity. These environmental influences regulate genes and proteins that alter energy expenditure/storage. Micro ribonucleic acid (miRNAs) can influence these genes and proteins, are sensitive to diet and exercise and may influence the varied metabolic responses observed between individuals. The study aims are to investigate associations between different body fat profiles and metabolic disease risk; dietary and physical activity patterns as predictors of body fat profiles; and whether these risk factors are associated with the expression of microRNAs related to energy expenditure or fat storage in young New Zealand women. Given the rising prevalence of obesity globally, this research will address a unique gap of knowledge in obesity research.

METHODS/DESIGN

A cross-sectional design to investigate 675 NZ European, Māori, and Pacific women aged 16-45 years. Women are classified into three main body fat profiles (n = 225 per ethnicity; n = 75 per body fat profile): 1) normal BMI, normal body fat percentage (BF%); 2) normal BMI, high BF%; 3) high BMI, high BF%. Regional body composition, biomarkers of metabolic disease risk (i.e. fasting insulin, glucose, HbA1c, lipids), inflammation (i.e. IL-6, TNF-alpha, hs-CRP), associations between lifestyle factors (i.e. dietary intake, physical activity, taste perceptions) and microRNA expression will be investigated.

DISCUSSION

This research targets post-menarcheal, premenopausal women, potentially exhibiting lifestyle behaviours resulting in excess body fat affecting metabolic health. These behaviours may be characterised by specific patterns of microRNA expression that will be explored in terms of tailored solutions specific to body fat profile groups and ethnicities.

TRIAL REGISTRATION

ACTRN12613000714785.

Association between behavioural factors and BMI-for-age among early adolescents in Hulu Langat district, Selangor, Malaysia

OBJECTIVE

This paper investigates the association between behavioural factors and BMI-for-age among early adolescents (10-11 years old) in Hulu Langat district, Selangor.

METHODS

This cross-sectional study was conducted among 333 primary school students. Body weight and height of the students were measured and their BMI-for-age was calculated. Eating behaviours, energy intake, energy expenditure, physical activity, and screen time were assessed using the Eating Behaviours Questionnaire and a 2-day dietary and physical activity recall, respectively. Data were analysed using multiple linear regression analysis.

RESULTS

The prevalence of overweight and obesity (28.2%) was about twice the prevalence of thinness (11.1%). The mean energy intake and energy expenditure of the students was 1772±441kcal/day and 1705±331kcal/day, respectively. Three in five of the students (60.1%) skipped at least one meal and 98.2% snacked between meals daily. A majority of them (55.3%) were sedentary. Low energy intake (p<0.05) and low energy expenditure (p<0.05) were associated with high BMI-for-age. Energy expenditure (β=-0.033) and energy intake (β=-0.090) significantly explained 65.1% of the variances in BMI-for-age (F=119.170, p<0.05).

CONCLUSION

These findings suggested that promoting healthy eating and active lifestyle should be targeted in the prevention and management of obesity among early adolescents.

Supporting cardiovascular risk reduction in overweight and obese hypertensive patients through DASH diet and lifestyle education by primary care nurse practitioners

PURPOSE

To describe an intervention among overweight and obese hypertensive patients, encouraging Dietary Approaches to Stop Hypertension (DASH) diet and lifestyle changes, designed and led by a primary care nurse practitioner (NP).

DATA SOURCES

A pre- and postintervention quasi-experimental time-series design was implemented over 2 months. Intervention included three group classes and two individual counseling telephone calls. Forty-five hypertensive patients enrolled, with a mean age of 55 years and mean initial BMI of 32. Twenty-six (58%) completed the program. Standard instruments (Rapid Eating Assessment for Patients [REAP] and Partners in Health [PIH] questionnaires) were used to evaluate diet and lifestyle factors before and after the program.

CONCLUSIONS

Participants had statistically significant improvements in diet and lifestyle scores on both REAP and PIH questionnaires, as well as statistically significant weight loss (average 3.6 pounds lost) over the 2-month intervention period.

IMPLICATIONS FOR PRACTICE

This NP-led primary care intervention on diet and lifestyle showed early success in improving the health of overweight and obese hypertensive patients. Investment in NP-led diet and lifestyle counseling should be considered among high-risk patients in the primary care setting.

Household dietary practices and family nutritional status in rural Ghana

A cross-sectional study involving 400 mothers was conducted in the Manya Krobo district of Ghana with the objective of studying household dietary practices, quality of diets and family nutritional status of rural Ghana. A combination of methods, including structured interviews using questionnaire, dietary assessments and anthropometry was used to collect data for the study. The data obtained was analyzed using Statistical Package for Social Sciences (SPSS) Version 10 in Windows. Means and standard deviations were generated for continuous variables and frequency distribution for categorical variables. Most women consumed meals three times a day but only a few (12.5%) cooked all three meals at home. Breakfast and lunch were the two main meals purchased from food vendors. The most frequently consumed food items on daily basis were the starchy staples, maize, fish, pepper, onion, tomato and palm fruits. The nutritional qualities of diets were poor in terms of calcium and the B-vitamins. A significant proportion of the women were nutritionally at risk of being either underweight (12%), overweight (17%) or obese (5%). For adequate nutrition in this population, nutrition education intervention programs aimed at improving nutrient intake through improved diet diversity and increased use of local foods rich in calcium and the B-vitamins needs to be undertaken. There is also the need to intensify education on excessive weight gain and its attendant health problems in the area.