Anaemia is common during pregnancy, and prenatal Fe supplementation is the standard of care. However, the persistence of anaemia despite Fe supplementation, particularly in HIV infection, suggests that its aetiology may be more complex and warrants further investigation. The present study was conducted to examine predictors of incident haematological outcomes in HIV-infected pregnant women in Tanzania.

Prospective cohort study. Cox proportional hazards and binomial regression models were used to identify predictors of incident haematological outcomes: anaemia (Hb < 110 g/l), severe anaemia (Hb < 85 g/l) and hypochromic microcytosis, during the follow-up period.

Antenatal clinics in Dar es Salaam, Tanzania.

Participants were 904 HIV-infected pregnant women enrolled in a randomized trial of vitamins (1995–1997).

Malaria, pathogenic protozoan and hookworm infections at baseline were associated with a two-fold increase in the risk of anaemia and hypochromic microcytosis during follow-up. Higher baseline erythrocyte sedimentation rate and CD8 T-cell concentrations, and lower Hb concentrations and CD4 T-cell counts, were independent predictors of incident anaemia and Fe deficiency. Low baseline vitamin D (<32 ng/ml) concentrations predicted a 1·4 and 2·3 times greater risk of severe anaemia and hypochromic microcytosis, respectively, during the follow-up period.

Parasitic infections, vitamin D insufficiency, low CD4 T-cell count and high erythrocyte sedimentation rate were the main predictors of anaemia and Fe deficiency in pregnancy and the postpartum period in this population. A comprehensive approach to prevent and manage anaemia, including micronutrient supplementation and infectious disease control, is warranted in HIV-infected women in resource-limited settings – particularly during the pre- and postpartum periods.

Snacks, stress and parties all contribute to the weight gain – the elusive ‘Freshman 15’ – that some college-goers unfortunately experience. The present study examines how à la carte snack choice changes on a university campus during each progressing week of the academic calendar.

How à la carte snack choices change on a university campus with each progressing week of the academic calendar was examined.

The data were collected from three large cafeterias (or dining halls) on Cornell University's campus during four semesters (Fall 2006, Spring 2007, Fall 2007 and Spring 2008), for 18 weeks in each semester.

After the à la carte snack items were divided into healthy snacks and unhealthy snacks, the percentage share for each food category was calculated.

Within each semester, the unhealthy snack food choices increased consistently by 0·4 % per week (β = 0·00418, P < 0·01). Furthermore, a sharp (8 %) increase occurred in the final two weeks of the semester. In contrast, healthy snack food choices decreased by almost 4 % (β = −0·0408, P < 0·01) in the final two weeks during the fall semester.

These results demonstrate an increased demand for hedonic, or unhealthy, snack foods as the college semester progresses and in particular at the very end of the semester. To counter this tendency towards unhealthy snacking, cafeterias and stores should make extra effort to promote healthy alternatives during the later weeks of the semester.

To explore the relationship between industry sponsorship of Ca supplementation studies in healthy children and study outcomes.

An electronic search for published randomized controlled trials (RCT) was conducted. We collected data on study design features aimed at reducing bias, statistical significance of results, authors’ conclusions and financial sponsorship of study. We used Fischer’s exact test to examine associations between sponsorship and study results and conclusions.

Healthy children between the ages of 9 and 18 years.

Nineteen trials met our inclusion criteria. Seventeen out of nineteen studies reported a statistically significant improvement of supplementation on bone mineral density. Subjects in eight of the seventeen studies had a baseline daily Ca intake of 800–1300 mg. There was no significant association between study design features and the results or conclusions of the studies. Three studies received government funding, two of which (66·7 %) concluded in favour of additional supplementation. Sixteen studies were either industry-funded or had mixed industry funding, thirteen (81·3 %) of which had a conclusion supporting Ca supplementation in children. There was no significant association between study sponsorship and authors’ conclusions.

The majority of RCT assessing the effects of Ca supplementation in healthy children are industry-funded and support Ca supplementation. The clinical significance of the outcomes measured in Ca supplementation studies should be considered when examining associations between study design and results. Further non-industry funded research is needed to thoroughly assess the impact of funding on authors’ conclusions in nutrition research.

Polycyclic aromatic hydrocarbons (PAH) are common dietary exposures that cross the human placenta and are classified as a probable human carcinogen. The aim of the present study was to investigate the potential impact of exposure to PAH-containing meat consumed during pregnancy on birth outcomes.

Prospective birth cohort study. Only non-smoking women with singleton pregnancies, who were free from chronic disease such as diabetes and hypertension, were included in the study. Maternal consumption of PAH-rich meat was estimated through FFQ. Multiple linear regression was used to assess factors related to higher intake and the association between dietary PAH and birth outcomes.

Republic of Korea, 2006–2011.

Pregnant women (n 778) at 12–28 weeks of gestation enrolled in the Mothers and Children’s Environmental Health (MOCEH) study.

The multivariable regression model showed a significant reduction in birth weight associated with higher consumption level of foods rich in PAH, such as grilled or roasted meat, during pregnancy (β=−17·48 g, P<0·05 for every 1 point higher in meat score). Further adjusting for biomarkers of airborne PAH did not alter this association. There was no evidence that higher consumption level of PAH-rich meat shortens the duration of gestation (P=0·561). Regression models performed for birth length and head circumference produced negative effects that were not statistically significant.

Consumption of higher levels of barbecued, fried, roasted and smoked meats during pregnancy was associated with reduced birth weight. Dietary risk of PAH exposure in Korean women is of concern.

To describe the distribution of carotenoid intakes and important food sources of carotenoids in the diet of a representative population of older Australians.

Population-based cohort study.

Two post-code areas in the Blue Mountains, west of Sydney, Australia.

We studied 2012 (86%) of the 2334 participants aged 55 + years attending the 5-year follow-up of the cross-sectional Blue Mountains Eye Study (BMES), who completed a detailed semi-quantitative food-frequency questionnaire. The intakes for five carotenoids were studied: α-carotene, β-carotene, β-cryptoxanthin, lutein and zeaxanthin combined, and lycopene.

The mean intake per day for each carotenoid was: α-carotene, 2675 μg; β-carotene equivalents, 7301 μg; β-cryptoxanthin, 299 μg; lutein and zeaxanthin, 914 μg; lycopene, 3741 μg; retinol, 653 μg; total vitamin A, 1872 μg retinol equivalents. β-Carotene equivalents contribute a substantial proportion of total vitamin A intake (65%) in this population. Women had slightly higher intakes than men for α-carotene, β-carotene equivalents, and lutein and zeaxanthin (P<0.05) . Carrots and pumpkin were the main contributors to α-carotene and β-carotene equivalent intakes. Orange juice, oranges and papaw were the main contributors to β-cryptoxanthin intake. Broccoli, green beans and oranges contributed substantially to lutein and zeaxanthin intake. The main contributors to lycopene intake were tomatoes and bolognaise sauce.

Vitamin A intake in this population is high relative to the Australian Recommended Dietary Intake. Carotenoid intakes, particularly β-carotene, make a substantial contribution, particularly from fruit and vegetables. This study provides important information as a basis for examining associations between dietary carotenoid intake and eye disease in the BMES.

Dietary Fe deficiency has a high incidence in Pakistani children and may be associated with increased gastrointestinal absorption of trace metals such as Mn. Therefore, children residing in heavily polluted cities like Karachi may be prone to Mn toxicity. The present study investigated blood Mn concentrations in Karachi children of different Fe statuses.

A prospective observational study was conducted where children were classified into different categories of Fe status – normal Fe, borderline Fe deficiency, Fe deficiency and Fe-deficiency anaemia – using WHO criteria supported by measurements of soluble transferrin receptors. Blood Mn was determined for children in each category using graphite atomic absorption spectroscopy.

Three hospital outpatient departments in Karachi, Pakistan.

A total of 269 children (156 males, 113 females) aged 6–60 months from low-income families of Karachi.

Blood Mn concentrations were significantly higher in children with Fe-deficiency anaemia and Fe deficiency compared with those of normal Fe status (both P < 0·01). Blood concentrations of soluble transferrin receptors were higher in children with Fe-deficiency anaemia compared with those of borderline or normal Fe status (both P < 0·05).

These findings report for the first time high blood Mn concentrations in Fe-deficient children of this age group. There is therefore an urgent need to identify and remove environmental exposure to Mn in combination with health strategies aimed at eradicating childhood Fe deficiency.

The present study sought to determine the feasibility of an experimental research design to investigate the effects of exposure to magazine advertising on children's food choices.

Children were randomized to read either a magazine with food advertisements or a magazine with no food advertisements. They then chose two food items from the intervention ‘store’ to eat after the session. Data were also collected on attitudes to advertising and snack food preferences. Finally, participants’ parents were provided with a self-completion survey on food choices and other variables (n 24).

Three vacation care centres in regional New South Wales, Australia.

Children aged 5–12 years (n 47).

Children in the experimental condition were more likely to choose advertised foods than those in the control group. Interestingly, the majority reported taste and healthiness as the most important factors in snack food choices; however, when faced with the actual food choice, they predominantly chose unhealthy foods (eighty-two unhealthy and only twelve healthy items were chosen).

This was the first study to assess the effects on children of exposure to food advertising within the context of reading a child-targeted magazine. Importantly, even with the small sample size and venue limitations, we found that exposure to magazine advertising influenced food choices. Children's magazines are an under-researched and poorly regulated medium, with considerable potential to influence children's food choices. The present study shows that the methodology is feasible, and future studies could replicate this with larger samples.

To assess the intake inadequacy and food sources of zinc of people in China.

Diets of 68 962 subjects aged 2–101 years (urban 21 103, rural 47 859) in the 2002 China National Nutrition and Health Survey were analysed. Dietary intake was assessed using 24-hour recall for three consecutive days. Zinc intake inadequacy was calculated based on values suggested by the World Health Organization.

The median zinc intake ranged from 4.9 mg day− 1 (urban girls, 2–3 years) to 11.9 mg day− 1 (rural males, 19+ years). The zinc density of urban residents (2–3 to 19+ years) was 5.0–5.3 mg day− 1 (1000 kcal)− 1, significantly higher than that of their rural counterparts (4.7–4.8 mg day− 1 (1000 kcal)− 1). Differences in food sources of zinc from cereal grains (27.4–45.1 vs. 51.6–63.2%) and animal foods (28.4–54.8 vs. 16.8–30.6%) were found between urban and rural residents. Zinc from vegetables and fruits (8.2–13.8 vs. 9.7–12.4%) and legumes (1.3–3.3 vs. 2.5–3.4%) was comparable between urban and rural residents. The proportion of zinc intake inadequacy ranged between 2.8% (urban females, 19+ years) and 29.4% (rural lactating women). Rural residents had higher proportions of zinc intake inadequacy than their urban counterparts. Significantly higher proportions of zinc inadequacy were found in the category of phytate/zinc molar ratio >15 for both rural and urban residents.

About 20% of rural children are at risk of inadequate zinc intake, with phytate as a potential important inhibitor. Moreover, lactating women are also considered a vulnerable group.

Qualitative case study and mathematical model.

Belgium.

To evaluate the correlation between the polyamine mean concentration of the milk drunk during the first postnatal month and the appearance of allergy in children who drank this milk.

A model that describes the dependence of the allergy appearance with the spermine mean concentration of milk drunk during the first postnatal month was established.

This model shows that 5.02 nmol ml−1 of spermine is a critical value to prevent the appearance of allergy.

To examine changes in the Na content of lunch/dinner menu offerings at eight of the leading fast-food restaurants in the USA between 1997/1998 and 2009/2010.

Menu offerings and nutrient composition information for the menu items were obtained from archival versions of the University of Minnesota Nutrition Coordinating Center (NCC) Food and Nutrient Database. Nutrient composition information for lunch/dinner menu items sold by the fast-food restaurants included in the present study was updated in the database biannually. Menus were analysed for changes in mean Na content of all menu offerings (except beverages) and specific categories of menu items among all restaurants and for each individual restaurant.

USA.

Lunch/dinner food menu of eight leading US fast-food restaurants.

Between 1997/1998 and 2009/2010 the mean Na content of menu offerings across the eight restaurants increased by 23·4 %. Examining specific food categories, mean Na content of entrées by increased 17·2 % and that of condiments increased by 26·1 %. Only side dishes showed a decrease of 6·6 %. None of the restaurants examined had a decrease in Na across the lunch/dinner menu offerings over the 14 years examined.

Results suggest that over the time period studied there has been no meaningful reduction in the Na content of lunch/dinner menu offerings at the leading fast-food restaurants examined in the present study.

We examined associations between the frequency of fruit and vegetable (F&V) consumption and nutritional deficiencies among Brazilian schoolchildren.

A cross-sectional, population-based study was performed. A short FFQ was used to assess consumption of fruits and vegetables (F&V) over the past month. The prevalence ratios (PR) and 95 % confidence intervals for stunting, obesity, anaemia, vitamin A and folate deficiencies, vitamin E and vitamin D insufficiencies were estimated for low F&V consumption frequency (vegetables ≤3 times/month and fruits ≤3 times/week) and compared with children with usual F&V consumption frequency (vegetables ≥1 time/week and fruits ≥4 times/week).

Acrelândia, Western Brazilian Amazon.

A total of 702 children aged 4–10 years.

Only 5 % of children consumed F&V ≥5 times/d. Prevalence of deficiency was 31 %, 15 %, 9 % and 2 % for vitamins D, A, E and folate, respectively. Overall, 6·3 % of children were anaemic, 3·3 % were stunted, 2·7 % were obese and 33 % had multiple nutritional deficiencies. Low frequency of F&V consumption was associated with lower plasma concentrations of carotenoids and vitamin E. Nutritional deficiencies were higher among non-consumers of F&V when compared with usual consumers: anaemia (PR=1·9; 95 % CI 1·0, 3·7), vitamin E insufficiency (PR=2·5; 95 % CI 1·5, 4·2), vitamin D insufficiency (PR=1·5; 95 % CI 1·1, 1·9) and stunting (PR=2·6; 95 % CI 1·1, 6·1).

In our study, the occurrence of nutritional deficiencies in children with low F&V consumption was twice as high as in children with usual F&V consumption, reinforcing the importance of effective actions to promote the consumption of F&V.

Recently, the general public opinion is that nutritional recommendations promote obesity rather than prevent it. We created the Recommended Finnish Diet Score (RFDS) that illustrates the Finnish nutrition recommendations and assessed whether this score is associated with BMI, waist circumference (WC) and body fat percentage (BF%).

Cross-sectional study included two phases of the National FINRISK 2007 Study. Diet was assessed using a validated FFQ. Height, weight, WC and BF% were measured, and BMI values were calculated. The RFDS was developed based on the national nutrition recommendations.

A large representative sample of the Finnish population.

Men (n 2190) and women (n 2530) aged 25–74 years.

The RFDS was inversely associated with WC in men (OR = 0·48, 95 % CI 0·28, 0·81, P < 0·05) and BF% in both men (OR = 0·44, 95 % CI 0·24, 0·82, P-trend < 0·05) and women (OR = 0·63, 95 % CI 0·37, 1·08, P-trend < 0·05). The inverse association of RFDS and BF% appeared stronger among older age groups (men: OR = 0·21 CI 0·07, 0·64, P-trend < 0·01; women: OR = 0·56, 95 % CI 0·25, 1·27, P-trend < 0·05) and among women with normal BMI (OR = 0·62, 95 % CI 0·36, 1·09, P-trend < 0·05). The RFDS was not associated with BMI.

A diet following nutrition recommendations is likely to help to maintain normal WC and BF%. These findings could be useful for dietary counselling and the prevention of obesity.

To describe adolescents’ eating patterns of traditional, global/non-local and mixed foods, and the factors that may influence food consumption, access and preferences, in a globalizing city.

A representative sample of school-going adolescents completed a cross-sectional survey including an FFQ designed to identify traditional and global foods. Student’s t test and ordinal logistic regression were used to examine weekly food intake, including differences between boys and girls and between adolescents attending private and public schools.

Vijayapura city, Karnataka State, India.

Adolescents (n 399) aged 13–16 years.

Compared with dietary guidelines, adolescents consumed fruit, green leafy vegetables, non-green leafy vegetables and dairy less frequently than recommended and consumed energy-dense foods more frequently than recommended. Traditional but expensive foods (fruits, dairy, homemade sweets and added fat) were more frequently consumed by private-school students, generally from wealthier, more connected families, than by public-school students; the latter more frequently consumed both traditional (tea, coffee, eggs) and mixed foods (snack and street foods; P≤0·05). Girls reported more frequent consumption of global/non-local packaged and ready-to-eat foods, non-green leafy vegetables and added fat than boys (P≤0·05). Boys reported more frequent consumption of eggs and street foods than girls (P≤0·05).

Adolescents’ eating patterns in a globalizing city reflect a combination of global/non-local and traditional foods, access and preferences. As global foods continue to appear in low- and middle-income countries, understanding dietary patterns and preferences can inform efforts to promote diversity and healthfulness of foods.

To describe the development of a short questionnaire including a wide range of personal, social and environmental constructs in relation to a healthy diet in an adolescent population.

The questionnaire was developed based on the literature, past experiences and feedback from a small pilot study (n 10). Test and retest (2 weeks later) of the questionnaire was done to investigate test–retest reliability. Data of four non-consecutive 24 h recalls were collected to investigate the predictive validity with food (fruit, vegetables, milk, snacks, soft drinks), nutrient (fibre, ascorbic acid, Ca, percentage energy from fat) and energy intakes.

At home, in the presence of a student.

Convenience sample of fifty-five Belgian-Flemish adolescents approached by university students for course credits.

Test–retest correlations of the constructs ranged between 0·51 and 0·78. Eleven of the eighteen final constructs were significantly associated with one or more of the five selected food items, all in the expected direction. Most significant associations with the food items were found for taste, perceived peers’ behaviour and availability of soft drinks at home. Fresh fruit and soft drinks were correlated with most constructs (seven) followed by snacks (five). Concerning energy and the selected nutrient variables, the findings were less clear.

The results are promising: the test–retest stability was moderate to good; most of the psychosocial constructs were significantly associated with one or more of the selected dietary variables. Future work in a larger sample of European adolescents is warranted.

To examine the associations between lifestyle factors and active commuting to school in Spanish adolescents.

Cross-sectional study. Lifestyle factors (overall/extracurricular physical activity, television viewing, reading as a hobby, sleep duration, breakfast/fruit intake, smoking and alcohol intake) as well as mode and duration of commuting to school were self-reported. Active commuters were defined as those adolescents who walked or cycled to school.

Secondary schools in Madrid, Spain.

Adolescents (n 2029) aged 13 to 17 years.

Similar percentages of adolescent boys (57·6 %) and girls (56·1 %) were classified as active commuters to school (P = 0·491). The analysis showed that only adequate sleep duration (OR = 1·35, 95 % CI 1·11, 1·66; P = 0·003) and breakfast consumption (OR = 0·66, 95 % CI 0·49, 0·87; P = 0·004) were independently associated with active commuting to school.

Only those behaviours that occur immediately before commuting to school (sleep and breakfast) are associated with active commuting in Spanish adolescents.

To characterize energy and macronutrient intakes in Brazil and to describe the top food items contributing to energy and macronutrient intakes.

Two non-consecutive 24 h dietary records were collected and energy and macronutrient data were adjusted for usual intake distribution. Descriptive statistics and ANOVA with the Bonferroni post hoc test were analysed using SAS version 9·1. Means and standard deviations were estimated for sex, age and income strata.

Nationwide cross-sectional survey, 2008–2009.

Nationally representative sample of individuals ≥10 years old (n32 749), excluding pregnant and lactating women (n 1254).

The average energy intake was 7958 kJ/d (1902 kcal/d) and mean energy density was 6·82 kJ/g (1·63 kcal/g). Added sugar represented 13 % of total energy intake and animal protein represented 10 %. The mean contribution of total fat to energy intake was 27 %, while the mean saturated fat contribution was 9 %. Compared with the lowest quartile of income, individuals in the highest income quartile had greater mean intakes of energy, added sugar, alcohol, animal protein, total fat, saturated fat, monounsaturated fat and trans fat. Rice, beans, beef, bread and coffee were among the top five foods contributing most to the intakes of energy, carbohydrates, protein, fat and fibre.

In general, Brazilians’ dietary intake is compatible with a high risk of obesity and non-communicable chronic diseases, being characterized by high intakes of added sugar and saturated fat. Income may be a major determinant of diet nutritional characteristics.

Increasing childhood asthma rates may be due to changing dietary lifestyle. We investigated the association of dietary intake of antioxidant vitamins and fatty acids with asthma in Japanese pre-school children.

Cross-sectional study.

School-based survey on lifestyle/diet and health status in children in Japan.

Parents of 452 children aged 3–6 years completed a questionnaire on the children's and parents’ lifestyle and demographics. Children were classified into asthma cases and non-asthma cases in accordance with the ATS-DLD (American Thoracic Society and Division of Lung Diseases of the National Heart, Lung, and Blood Institute) questionnaire. Children's diet was assessed using a 3 d dietary record completed by parents. Children's age, sex, BMI, history of food allergy, maternal age, parental history of allergy, maternal education, family size and second-hand smoking were included as covariates. Logistic regression models were used to examine the association between children's diet and asthma.

Compared with children with the lowest intake tertile for vitamin C and vitamin E, those in the highest were significantly inversely associated with asthma; adjusted OR (95 % CI) were 0·35 (0·14, 0·88) and 0·32 (0·12, 0·85), respectively. A statistically significant trend was also observed. Fruit intake showed an inverse but insignificant association with asthma. There were no associations of any type of fatty acids with asthma.

These data suggest that children with high intakes of vitamins C and E may be associated with a reduced prevalence of asthma.

India has proposed legislating an upper limit of trans fat in partially hydrogenated vegetable oils and mandating trans fat labelling in an effort to reduce intakes. The objective of the present study was to examine the complexities of regulating trans fat in India by examining the policy processes involved and the perceived implementation challenges.

Semi-structured interviews (n 18) were conducted with key informants from various sectors. Interviewees were asked about sources of trans fat in the food supply, existing policies that may influence trans fats and perceived challenges related to the proposed trans fat regulation, in addition to questions tailored to their area of expertise. Interview data were organised based on common themes.

Interviews were conducted in India.

Interviewees were key informants from various sectors including agriculture, trade, industry and health.

Several themes were identified related to the complexity of regulating trans fat in India. A lack of trans fat awareness, the large unorganised retail sector, a need for suitable alternative products that are both acceptable to consumers and affordable, and a need to build capacity were crucial factors affecting India's ability to successfully regulate trans fat. The limited number of food inspectors will create an additional challenge in terms of enforcement of trans fat regulation.

Although India will face challenges in regulating trans fat, legislating an upper limit of trans fat in partially hydrogenated vegetable oils will likely be the most effective approach to reducing it in the food supply. Ongoing engagement with industry, agriculture, trade and processing sectors will prove essential in terms of product reformulation.

To understand who engages in home gardening and whether gardening is associated with fruit and vegetable intake and weight status.

A national cross-sectional survey.

Online survey panel in the USA.

Adults aged 18–75 years representing the US population with respect to gender, age, race/ethnicity, income and geographic region (n 3889).

Approximately 30 % of survey respondents reported growing edible plants in a home garden. Gardeners were more likely to be White or Asian, employed, have higher income, be married, have children in the household and live in rural areas. Gardeners were less likely to be obese and more likely to meet US dietary recommendations for fruit and vegetable consumption. In multivariable analyses, home gardens remained associated with fruit and vegetable intake and BMI when controlling for a range of socio-demographic characteristics and level of rurality.

The current study identifies who is gardening in the USA and provides useful information for public health efforts to increase gardening as a nutrition intervention. Future research should examine the benefits of home gardening and interventions to increase home gardening using more rigorous designs.

To explore the perceptions of soldiers participating in a US Army Office of The Surgeon General’s worksite health promotion programme (WHPP) on the local food environment within their campus-style workplace.

Focus groups were conducted to evaluate the perceived effectiveness of the WHPP implementation. Further exploration of focus group data through thematic analysis focused on perceived contributions of the military campus-style food environment to soldiers’ nutrition behaviours.

Three US Army installations located in the continental USA.

Active duty soldiers (n 366) participating in one of the fifty-eight focus groups.

Soldiers shared a common belief of self-discipline and personal responsibility as the foothold to nutrition behaviour change. Soldiers described aspects of the military campus-style food environment as factors impeding achievement of optimal nutrition. Collectively, soldiers perceived the proximity and density of fast-food restaurants, lack of healthy alternatives on the installation and the cost of healthy food as inhibitors to choosing healthy foods. Overwhelmingly, soldiers also perceived time constraints as a factor contributing to unhealthy food choices.

Although nutrition behaviour is individually driven, soldiers perceived the military campus-style food environment inhibits healthy decision making. Nutrition programming in military WHPP must integrate food environment changes to improve soldiers’ nutrition behaviour outcomes. Applicable to the military, food choice behaviour studies suggest environmental changes must be appealing to young adults. Considerations for environmental changes should include an increased portion size for healthy options, broadened use of soldiers’ daily food allowances on local produce and increased availability of grab-and-go options.