There is an increasing need for valid, rapid diet screening tools. A significant association between the Prime Diet Quality Score (PDQS) and reduced risk of cardiovascular disease (CVD) has been demonstrated in the US but evidence of its use in Europe is lacking. The aim of this study was to amend the PDQS for a UK/Irish population and determine validity and reliability in those at risk of CVD. Participants were recruited via online adverts across the island of Ireland. The PDQS was amended for a UK/Irish population and participants completed PDQS and reference measure (4-day food diary (FD)) on two occasions. PDQS score was calculated directly from PDQS and indirectly from FDs. Validity was determined using Spearman correlation coefficients (SCCs) (r), intraclass correlation coefficients (ICCs) and weighted kappa. Reliability was determined using SCCs (r), ICCs, weighted kappa and coefficient of variation.

‘Data were available for n = 115 (Month 0) and n = 108 (Month 3) participants for validity and n = 110 for reliability assessment (PDQS completed at both timepoints)’. PDQS score from PDQS was significantly correlated with PDQS score from FDs at months 0 (r = 0.59, P < 0.01) and 3 (r = 0.65, P < 0.01), with similar associations observed via ICCs. Weighted kappa indicated moderate agreement. PDQS score at month 0 was significantly correlated with PDQS score at month 3 (r = 0.78, P < 0.01), with similar associations observed via ICCs. Weighted kappa indicated moderate agreement. Results indicate that the amended PDQS is a valid and reliable tool to determine diet quality in a UK/Irish population at risk of CVD.

This qualitative research sought to identify factors influencing patient choice of, and patient-related internal and external enablers and barriers to engagement with, type 2 diabetes (T2D) remission strategies offered by the Remission in diabetes (REMI.D) project. Patients had a choice of three diets: Total Diet Replacement (TDR)-Formula Food Products, TDR-Food, and Healthy lifestyle approach; and three activity pathways: Everyday life, General Practitioner referral, and Social hub. Semi-structured interviews were recorded and transcribed. Thematic analysis used the Framework Method and NVivo 12 to assist with generation and organisation of codes, inductive and deductive (Theoretical Domains Framework). The REMI.D project was a place-based approach (place in this case being defined as two local authorities with significant rates of deprivation) situated in the North East of England. Twenty patients out of a possible 65 patients took part. Areas of interest included: patient choice, patient intention, patient adherence, patient non-adherence, and patient stigma. Addition of a more moderate dietary strategy (not dissimilar to the diet in the Healthier You NHS Diabetes Prevention Programme) to the existing NHS England T2D Path to Remission programme may enable more patients to achieve remission or delayed progression with deprescribing of diabetes medications. Embedding a tailored physical activity path within or as a bolt-on to the NHS programme requires consideration. Limited resources should be targeted towards patients who identify with more barriers or fewer opportunities for health behaviour modification. Further research on use of virtual programmes in deprived areas is warranted.

Children with Severe Acute Malnutrition (SAM) are at risk of developmental problems. Psychosocial stimulation can improve the developmental outcomes of hospitalised children with SAM. However, the intervention has remained underutilised in health facilities in resource-poor settings. Moreover, there is limited evidence on the acceptability and feasibility of the intervention. We conducted a qualitative study to explore the acceptability and feasibility of integrating psychosocial stimulation interventions in the inpatient care of children with SAM in selected areas in the Silti Zone, Central Ethiopia. Nine focus group discussions and 15 key informant interviews were conducted with parents, health workers, and other stakeholders. The data were transcribed, translated, and analysed using a thematic approach. Caregivers and health workers had positive attitudes toward the intervention and perceived it beneficial for the children’s development, recovery, and bonding with the mothers. Health workers reported barriers such as lack of materials, time, and space, capacity building training, and supervision for the effective implementation of the intervention. At the household level, gendered factors such as the housework burden of mothers and the inadequate engagement of fathers in childcare were the main challenges to the implementation of the intervention. Overall, psychosocial stimulation intervention was found to be acceptable and feasible for routine implementation with inpatient care provided for children with SAM. The study recommends supporting health facilities, health workers, and partners with the necessary resources and skills to promote the implementation of stimulation interventions along with the existing care provided in health facilities in resource-poor settings.

Children’s eating habits are established early in life and parents play a major role therein. Pregnancy is a teachable moment for the promotion of healthy eating because many women are concerned about their babies’ health and have frequent contact with healthcare providers. We aimed to investigate the association between diet quality during pregnancy and the offspring. A total of 691 sets of data on pregnant mothers and their 3-year-old offspring were obtained from the Seiiku Boshi cohort study. Dietary intake was assessed using a validated food frequency questionnaire for mothers in mid-to-late pregnancy and a validated diet history questionnaire for Japanese preschool children at the 36-month checkup. Diet quality was scored using the Japanese Food Guide Spinning Top. Maternal diet quality score was categorised into quartiles, and the association between offspring and maternal diet quality score, adjusted for socioeconomic factors, was assessed using multiple linear regression. The total offspring diet quality score showed a linear trend with the maternal diet quality score (the mean increments (confidential intervals) for each quartile were –0.12 (–1.32–1.08), 1.54 (0.34–2.73), and 1.22 (0.03–2.42)). In particular, offspring vegetable dishes scored higher in all quartiles of maternal vegetable dish scores than in the lowest quartile (0.69 (0.21–1.17), 0.97 (0.50–1.45), and 1.36 (0.88–1.83)). A high diet quality score during pregnancy was positively associated with that of offspring, suggesting the importance of nutritional education in pregnant women to improve their diet quality.

The objective was to examine associations between social jetlag and diet quality among young adults in the US using nationally representative data from the 2017–2018 NHANES survey, and evaluate effect modification by gender and race/ethnicity. Social jetlag was considered ≥2-hour difference in sleep midpoint (median of bedtime and wake time) between weekends and weekdays. Diet quality was assessed with the Healthy Eating Index (HEI)-2015 and its 13 dietary components. Ordinal logistic models were run with diet scores binned into tertiles as the outcome. Models accounted for potential confounders and survey weights. Effect modification by gender and race/ethnicity was examined. The study sample included 1,356 adults aged 20–39 years. 31% of young adults had social jetlag. Overall, there were no associations between social jetlag and diet quality. However, interaction analysis revealed several associations were race-specific (P, interaction<0.05). Among Black adults, social jetlag was associated with lower overall diet quality (OR = 0.4, 95% CI 0.2, 0.8; i.e. less likely to be in higher diet quality tertiles) and more unfavourable scores on Total Vegetables (OR = 0.6, 95% CI 0.3, 1.0) and Added Sugar (i.e. OR = 0.6, 95% CI 0.4, 0.9). For Hispanic adults, social jetlag was associated with worse scores for Sodium (OR = 0.6, 95% CI 0.4, 0.9) However, White adults with social jetlag had better scores of Greens and Beans (OR = 1.9, 95% CI 1.1, 3.2). Within a nationally representative sample of US young adults, social jetlag was related to certain indicators of lower diet quality among Black and Hispanic Americans.

Maternal knowledge and attitudes towards nutrition are essential for achieving healthy dietary behaviours for a positive pregnancy outcome. Therefore, this study aimed to assess the level and determinants of knowledge and attitudes towards nutrition among pregnant women in the Minjar Shenkora district, Ethiopia. Institution-based cross-sectional study was conducted between June and August 2021 among 334 pregnant women who were selected using a systematic random sampling technique. Data were collected using a semi-structured questionnaire and analysed using SPSS version 21. Bivariate and multivariate logistic regression analyses were used to identify the determinants of nutritional knowledge and attitudes. P < 0.05, with a 95% CI was used to declare statistical significance. Overall, 69.2% and 44.0% of the pregnant women were not knowledgeable and had an unfavourable attitude toward nutrition, respectively. The educational status of pregnant women (P < 0.01) and access to nutritional information (P < 0.01) were significantly associated with nutritional knowledge, while the educational status of pregnant women (P < 0.01) was associated with nutritional attitude. Respondents’ knowledge of and attitudes toward nutrition were low. Pregnant women’s educational levels and access to nutritional information are strongly related to their nutritional knowledge. Likewise, the educational status of the pregnant women was significantly associated with their nutritional attitudes. Therefore, education and counselling on maternal nutrition are needed to improve healthy maternal nutrition tips in the study area.

Cocoa-derived flavanols (CDF) may act as prebiotics. However, evidence is inconsistent, and the duration and dose of CDF intake needed to elicit any prebiotic effect are undefined. This randomized, double-blind, crossover study determined the effects of short-term, high-dose dietary supplementation with CDF versus matched placebo on gut microbiota composition in 8 healthy adults. A single faecal sample was collected 8 d after supplementation with 900 mg/d CDF or placebo. Gut microbiota composition and Bifidobacterium spp. and Lactobacillus spp. abundance were measured as secondary outcomes by 16S ribosomal ribonucleic acid (rRNA) amplicon sequencing and quantitative polymerase chain reaction, respectively. No between-treatment differences in the relative or absolute abundance of Bifidobacterium spp. (Cohen’s d = 0.89, P = 0.22) or Lactobacillus spp. (Cohen’s d = 0.42, P = 0.65) were detected. Shannon diversity (Cohen’s d = 0.38, P = 0.04) and overall community richness (Cohen’s d = 0.34, P = 0.06) were lower following CDF supplementation versus placebo, but no between-treatment differences in β-diversity or taxa relative abundances were observed. Findings are not consistent with a clear prebiotic effect of this short-term, high-dose CDF supplementation strategy relative to placebo.

Mitochondrial dysfunction is a common feature of brain disorders. Mitochondria play a central role in oxidative phosphorylation; thus changes in energy metabolism in the brain have been reported in conditions such as Alzheimer’s disease, Parkinson’s disease, and stroke. In addition, mitochondria regulate cellular responses associated with neuronal damage such as the production of reactive oxygen species (ROS), opening of the mitochondrial permeability transition pore (mPTP), and apoptosis. Therefore, interventions that aim to protect mitochondria may be effective against brain disorders. Fucoxanthin is a marine carotenoid that has recently gained recognition for its neuroprotective properties. However, the cellular mechanisms of fucoxanthin in brain disorders, particularly its role in mitochondrial function, have not been thoroughly discussed. This review summarises the current literature on the effects of fucoxanthin on oxidative stress, neuroinflammation, and apoptosis using in vitro and in vivo models of brain disorders. We further present the potential mechanisms by which fucoxanthin protects mitochondria, with the objective of developing dietary interventions for a spectrum of brain disorders. Although the studies reviewed are predominantly preclinical studies, they provide important insights into understanding the cellular and molecular functions of fucoxanthin in the brain. Future studies investigating the mechanisms of action and the molecular targets of fucoxanthin are warranted to develop translational approaches to brain disorders.

Dietary carotenoids are associated with lower risk of CHD. Assessment of dietary carotenoid intake using questionnaires can be susceptible to measurement error. Consequently, there is a need to validate data collected from FFQs which measure carotenoid intake. This study aimed to assess the performance of the Cardio-Med Survey Tool (CMST)-FFQ-version 2 (v2) as a measure of dietary carotenoid intake over 12-months against plasma carotenoids biomarkers and 7-Day Food Records (7DFR) in an Australian cardiology cohort. Dietary carotenoid intakes (β- and α-carotene, lycopene, β-cryptoxanthin and lutein/zeaxanthin) were assessed using the 105-item CMST-FFQ-v2 and compared to intakes measured by 7DFR and plasma carotenoid concentrations. Correlation coefficients were calculated between each dietary method, and validity coefficients (VCs) were calculated between each dietary method and theoretical true intake using the ‘methods of triads’. Thirty-nine participants aged 37–77 years with CHD participated in the cross-sectional study. The correlation between FFQ and plasma carotenoids were largest and significant for β-carotene (0.39, p=0.01), total carotenoids (0.37, p=0.02) and β-cryptoxanthin (0.33, p=0.04), with weakest correlations observed for α-carotene (0.21, p=0.21) and lycopene (0.21, p=0.21). The FFQ VCs were moderate (0.3–0.6) or larger for all measured carotenoids. The strongest were observed for total carotenoids (0.61) and β-carotene (0.59), while the weakest were observed for α-carotene (0.33) and lycopene (0.37). In conclusion, the CMST-FFQ-v2 measured dietary carotenoids intakes with moderate confidence for most carotenoids, however, there was less confidence in ability to measure α-carotene and lycopene intake, thus further research is warranted using a larger sample.

We aimed to analyse the association between processed food consumption and the risk of non-communicable diseases (NCDs) in South Africa. In this empirical study, we analysed nationally representative secondary data obtained from the South African Demographic and Health Survey (SADHS) VII. The survey included 13,288 occupied households, of which 11,083 were interviewed. In the interviewed households, 12,717 eligible adults aged 15 and older were identified and 10,336 were successfully interviewed. The study included four processed food groups (i.e. fried foods, takeaway foods/fast foods, salty snacks/packed chips, and processed meats) and eight NCDs (i.e. hypertension, cardiac arrest, cancer, stroke, hypercholesterolaemia, diabetes, chronic bronchitis, and asthma). As per the logistic regression results following adjustment, none of the disease states showed association with all four processed food groups. However, at least three processed food groups showed a significant positive association with hypertension, cardiac arrest, and diabetes. Two processed food groups showed significant positive association with stroke, and chronic bronchitis; one with hypercholesterolaemia and asthma; and cancer was not associated with any food groups. Processed meat and salted snacks/packed chips were each associated with five chronic conditions. In summary, we found that the consumption of any of the processed food groups increased the risk of NCDs in the South African population. Enabling policy and regulatory efforts in the production and distribution of processed foods, combined with improved awareness among the population need to be prioritised for immediate action. Facilitating the populations to choose traditional healthy diets would be a sustainable strategy for the prevention of NCDs.

Dietary diversification is a sustainable and appealing strategy for pregnant women to ensure a balanced dietary intake. In Ethiopia, despite the implementation of various nutritional initiatives, inadequate dietary diversity remains a significant factor contributing to adverse birth outcomes. Thus, this study aimed to assess the dietary diversity and associated characteristics among pregnant women attending antenatal care in Eastern Ethiopia. Institution-based cross-sectional study was conducted from April 28 to May 28, 2021. A total of 420 pregnant women were selected using a systematic random sampling technique. We used the adjusted odds ratio (AOR) and a 95% confidence interval to estimate the strength of the association. We used a p-value of 0.05 to declare statistical significance. Only 35.0% (95% CI: 30.5, 39.5) of the 420 pregnant women involved in this study received appropriate dietary diversity. Having an educational level of college and above (AOR 3.01, 95% CI: 1.19–7.5), being an urban dweller (AOR = 3.57, 95% CI: 1.68–7.52), eating three meals and above (AOR = 7.62, 95% CI: 2.88–9.03), and having ≤4 family sizes (AOR = 9.33, 95% CI: 4.06–10.4) were significantly associated with an adequate dietary diversity score among pregnant women. This study found that pregnant women had inadequate overall consumption of a diversified diet. Increasing meal frequency, enhancing women’s education, raising awareness of dietary diversity among rural inhabitants, and offering counselling on family planning utilisation during ANC services are all beneficial in promoting dietary diversity among pregnant women.

The objective of this study was to describe changes in sustainable dietary behaviours (those that support environmental, economic, and physical health) among a sample of US adults during the COVID-19 pandemic and to examine differences in changes by individuals’ race/ethnicity and socioeconomic status. Therefore, a cross-sectional online survey study was conducted in April 2021 (N = 1,488, mean age = 42.7 (SD = 12.6)) receiving outpatient care from Michigan Medicine, the University of Michigan health system. Enrolment quotas were established to ensure a diverse sample—one-third of participants identified as African American/Black, one-third Hispanic/Latino, one-third White, and one-third low-income. Participants reported engaging in more behaviours that are supportive of a sustainable diet one year into the COVID-19 pandemic compared to before. This is particularly true regarding ecologically and economically sustaining behaviours such as taking fewer trips to the grocery store, increased use of home grocery delivery, increased cooking at home, and greater consumption of healthy foods. Not all behaviour changes promoted sustainable food systems; namely, the use of farmer’s markets and Community Supported Agriculture (CSAs) declined. White and high-income participants were more likely than African American/Black, Hispanic/Latino, and low-income individuals to engage in ecologically and economically sustainable dietary behaviours during the pandemic. Meanwhile, African American/Black participants reported large increases in physical health sustainable dietary behaviours. To support the continuation of greater engagement with sustainable diets, policies that increase access to public transportation, limit the frequency with which consumers have groceries delivered, increase work-from-home options, and improve access for low-income populations should be prioritised.

Lack of nutrition knowledge and poor dietary practices have profound adverse implications on nutritional status particularly among displaced children. Evidence of the effectiveness of nutrition education interventions in improving the nutritional status of internally displaced schoolchildren in Cameroon is scarce. The study objective was to assess the effects of nutrition education on the nutritional status of internally displaced schoolchildren in the West and Littoral Regions of Cameroon. A pre-test-post-test randomised experimental study design was used with an experimental and control group of 160 children from ten primary schools and their caregivers. Anthropometric, biochemical, and clinical signs of malnutrition, dietary, and health status of the children were evaluated, and the caregiver’s nutrition knowledge was assessed in both groups at baseline and end-line with the aid of standard anthropometric and biochemical equipment and recorded in pretested questionnaires. Nutrition education was carried out only with the caregivers of children in the test group. In the test group, significant beneficial outcomes were noticed only for Bitot’s spot (p = 0.047), pallor (0.025), frequency of consumption of fruits (p = 0.002) and vegetables (p = 0.036), caregiver’s nutrition knowledge (p = 0.000), all health-seeking practices of the children (p < 0.05) except immunisation (p = 0.957). No significant change was seen in any of the parameters studied among the participants in the control group. Nutrition education alone was not effective in improving the nutritional status of the children and should be implemented together with other food-based nutrition interventions to improve the nutritional status of internally displaced schoolchildren in the West and Littoral Regions of Cameroon.

Child care environments offer an ideal setting for feeding interventions. CELEBRATE Feeding is an approach implemented in child care environments in two Maritime Provinces in Canada to support responsive feeding (RF) to foster children’s self-efficacy, self-regulation, and healthy relationships with food. This study aimed to describe RF in child care using established and enhanced scoring frameworks.

The Environment and Policy Assessment and Observation (EPAO) was modified to reflect RF environments and practices, resulting in our modified EPAO and a CELEBRATE scale. Observations were conducted in 18 child care rooms. Behaviours and environments were scored on both scales, creating 21 RF scores, with a score of ‘3’ indicating the most responsiveness. Descriptive analyses of the scores were conducted. The overall room averages were Mean (M) = 41.00, Standard Deviation (SD) = 7.07 (EPAO), and M = 37.92 SD = 6.50 (CELEBRATE). Most responsive scores among rooms within our EPAO and CELEBRATE scales, respectively, were ‘educators not using food to calm or encourage behaviour’ (M = 2.94, SD = 0.24; M = 2.98, SD = 0.06) and ‘not requiring children to sit at the table until finished’ (M = 2.89, SD = 0.47; M = 2.97, SD = 0.12). The least responsive scores within the EPAO were ‘educator prompts for children to drink water’ (M = 0.78, SD = 0.94) and ‘children self-serving’ (M = 0.83, SD = 0.38). The least responsive in the CELEBRATE scale were ‘enthusiastic role modelling during mealtime’ (M = 0.70, SD = 0.68) and ‘praise of mealtime behaviour unrelated to food intake’ (M = 0.74, SD = 0.55). The CELEBRATE scale captured unique observation information about RF to allow documenting change over time with detailed measurement to inform and support nutrition interventions within child care environments.

This study aimed to compare the differences in the intake of food groups and nutrients between Japanese adults who consumed the recommended daily vegetable intake (350 g/day) and those who did not. Dietary information was obtained from one-day dietary records collected from the 2016 National Health and Nutrition Survey, which was conducted in 46 prefectures in Japan. The participants aged ≥20 years (n = 21,606; 53.8% women) were classified into the < and ≥350 g/day groups. Inter-group differences for 17 food groups and 27 nutrients were assessed as percentages of consumers (food groups only) and energy-adjusted intake (units/MJ/d or % of total energy intake). Overall, 29% of participants consumed ≥350 g/day of vegetables. The ≥350 g/day group had a higher percentage of consumers and energy-adjusted intakes for all vegetable subgroups than the <350 g/day group. For other food groups, the ≥350 g/day group had higher percentages of consumers for all food groups, except for cereals, eggs, and condiments and seasonings, which showed no significant differences. However, the ≥350 g/day group had a significantly higher energy-adjusted intake for potatoes and other tubers, mushrooms, meats, and condiments and seasonings but a significantly lower value for cereals, eggs, savoury snacks and confectionaries, and beverages. The ≥350 g/day group had a significantly higher intake of almost all (25/27) nutrients, including sodium, than the <350 g/day group. Participants with vegetable intake ≥350 g/day might have a more favourable intake of food groups and nutrients; however, watching for salt intake is necessary when promoting vegetable intake.