Food intolerances are commonly reported and are predicted to have gastrointestinal health implications. We aimed to quantify the prevalence of food intolerances among US adults and identify culprit foods through a brief web-based survey.

We invited participation in an online cross-sectional survey involving a single questionnaire. Data were summarised using percentages or medians and interquartile range. Participant characteristics by self-reported food intolerance were compared using the Wilcoxon rank sum test and Pearson’s χ2 test. Adjusted analyses were performed using multivariable logistic regression.

The survey was internet-based via Amazon’s mechanical Turk, a crowdsourcing website for the completion of requester directed tasks.

Adults who were US-based internet users were invited at ages 18–80.

We collected 2133 survey responses (ages 18–79 years). The rate of food intolerance was 24·8 % (95 % CI 23·0, 26·6) in US adults. Younger (P < 0·01), female (P = 0·05) and Asian, African American or multiple race individuals (P < 0·01) predominated. Lactose intolerance was most common. Frequency of a non-lactose food intolerance was 18·1 % (95 % CI 16·5, 19·8). When categorised broadly, grains, fruit, lactose, fish, vegetables, alcohol and nuts were most troublesome for individuals in that order.

Self-reported food intolerance is common in US internet users. The effect of food on gastrointestinal symptoms and avoidant behaviours deserves further attention.

This study aimed to identify and meta-analyse the neuroimaging data and hence synthesise a brain map showing the neural correlates of watching food commercials.

Published studies were retrieved and included into the analysis if they evaluated brain responses to food commercials with functional MRI and reported results based on whole-brain analysis in standard brain coordinates.

No additional restriction was placed on the search, such as the publication year and age of participants.

Seven papers that composed of a total of 442 participants fulfilled the inclusion criteria. All of them recruited children or adolescents.

Food commercials caused larger brain responses than nonfood counterparts in the cuneus on both hemispheres, which played a role in dietary self-control and modulation of food craving. Other brain regions involved in food commercials processing included the left culmen, left middle occipital gyrus and the right superior parietal lobule, which could be related to reward, emotional responses and habit formation.

These neural correlates may help explain the food choice and eating behaviours of children and adolescents that might be relevant to the development of obesity.

During COVID-19, the Internet was a prime source for getting relevant updates on guidelines and desirable information. The objective of the present study was to determine the nutritional immunity information-seeking behaviour during COVID-19 in India.

Google Trends (GTs) data on relevant COVID-19 and nutritional topics were systematically selected and retrieved. Data on newly reported COVID-19 cases were also examined on a daily basis. The cross-correlation method was used to determine the correlation coefficient between the selected terms and daily new COVID-19 cases, and the joinpoint regression models were utilised to measure monthly percent change (MPC) in relative search volumes (RSV).

Online.

People using Google search during the period 1 January 2020–31 August 2020 in India.

The date of peak searches can be attributed to the COVID-19 guidelines announcement dates. All the nutritional terms showed a significant increase in average monthly percentage change. The higher than the average daily rise in COVID-19 cases leads to a higher than average increase in RSV of nutritional terms with the greatest association after 14–27 d. The highest mean relative search volume for nutritional terms was from Southern India (49·34 ± 7·43), and the lowest was from Western India (31·10 ± 6·30).

There was a significant rise in the Google searches of nutritional immunity topics during COVID-19 in India. The local/regional terms can be considered for better outreach of public health guidelines or recommendations. Further automation of Google Trends using programming languages can help in real-time monitoring and planning various health/nutritional events.

The current study aimed to investigate the relationship between nutrition literacy (NL) and food habits (FH) in adolescents, and the factors affecting the relationship.

The study used a cross-sectional design. The data were collected using socio-demographic information forms, the Adolescent Nutrition Literacy Scale (ANLS) and the Adolescent Food Habit Checklist (AFHC). The socio-demographic characteristics of adolescents were analysed using descriptive statistics, and the factors affecting NL and FH were determined using the t test, Mann–Whitney U test and ANOVA. The correlation between ANLS and AFHC scores was tested with correlation analysis, and linear regression analysis was employed to predict the change in the NL of adolescents at the level of FH.

The study was conducted in the city of Izmir in Turkey.

The study consisted of a total of 467 adolescents.

There was a statistically significant relationship between NL of adolescents and their gender, education level of the father, grade, BMI values and daily lifestyle behaviours (DLB), as well as between their FH and DLB. There was a positive and significant relationship between ANLS and AFHC. The ANLS and its subscales were found to have a statistically significant effect on AFHC. According to the linear regression analysis, the nutritional habits of adolescents were found to be significantly affected by NL (β = 0·357).

As ANLS scores increased, AFHC scores were determined to increase as well. This finding shows that the FH of adolescents have changed positively with increase in their NL.

To provide a micro-investigation into the long-term effects and process of implementation of a nudge intervention on food choice in sports canteens.

Multi-method case study.

Eight products were added to the range of foods and drinks in two football canteens in the Netherlands for 3 and 15 weeks, serving as a baseline period. In the intervention period, these products were promoted with the use of salience, scarcity, availability and default nudges, for 26 and 16 weeks, respectively. Aside from the collection of sales and revenue data, reach, acceptability, adherence and applicability were measured using observations, questionnaires and interviews.

Questionnaires were filled in by seventy and fifty-nine visitors of the canteens. Four interviews were held with board members and canteen personnel.

Mixed results were obtained regarding the suitability of nudges to be used to promote healthy eating in sports clubs. Sales and revenue data did show positive trends, the intervention was seen as acceptable by all stakeholders and the intervention had a large reach. However, adherence to the intervention in both canteens and the effects of the nudges on the total consumption pattern were low. Factors were identified that promoted or hindered the intervention at an individual, interventional and organisational level.

Nudges seem to be a valuable addition to other efforts to combat unhealthy eating. However, the extent of their impact as a single intervention tool is limited in the current food-abundant environment.

To examine the effects of exposure to conflicting nutritional information (CNI) through different forms of media on nutrition-related confusion and backlash among consumers in the UK.

Cross-sectional survey administered via Qualtrics among 18–75-year-old participants in the UK. The sample was stratified by age and gender with quotas defined according to the 2011 UK census distribution.

Qualtrics’ Online panel of respondents in the UK.

676 participants comprising nearly an equal number of females (n 341) and males (n 335) and a majority (58·6 %) from households whose income was <£30 000.

Our findings showed that nearly 40 % of respondents were exposed to some or a lot of CNI. We found that while exposure to CNI from TV and online news increased nutrition confusion, CNI from health professionals increased backlash. Exposure to CNI from social media and health websites was associated with reduced backlash. We also found that nutrition confusion and backlash were negatively associated with exercise behaviour and fruit and vegetable consumption, respectively.

Our study supports the theoretical pathways that explain the influence of CNI exposure on nutrition-related cognitive and behavioural outcomes. Additionally, different types of online information sources are associated with these outcomes to varying degrees. In the context of obesity and diabetes rates in the UK, our findings call for (a) further experimental research into the effects of CNI on consumers’ diet-related cognitions and behaviours and (b) multi-stakeholder, interdisciplinary approaches to address this problem.

To determine whether disparities exist in the nutritional quality of packaged foods and beverage purchases by household income, education and race/ethnicity and if they changed over time.

We used Nielsen Homescan, a nationally representative household panel, from 2008 to 2018 (n = 672 821 household-year observations). Multivariate, multilevel regressions were used to model the association between sociodemographic groups and a set of nutritional outcomes of public health interest, including nutrients of concern (sugar, saturated fat and Na) and calories from specific food groups (fruits, non-starchy vegetables, processed meats, sugar-sweetened beverages and junk foods).

Household panel survey.

Approximately 60 000 households each year from the USA.

Disparities were found by income and education for most outcomes and widened for purchases of fruits, vegetables and the percentage of calories from sugar between 2008 and 2018. The magnitude of disparities was largest by education. Disparities between Black and White households include the consumption of processed meats and the percentage of calories from sugar, while no disparities were found between White and Hispanic households. Disparities have been largely persistent, as any significant changes over time have been substantively small.

Policies to improve the healthfulness of packaged foods must be expanded beyond SSB taxes, and future research should focus on what mediates the relationship between education and diet so as not to exacerbate disparities.

This review collates the published reports that focus on microbial and viral illnesses that can be transmitted by breast milk, donor milk and powdered infant formula (PIF). In this context, we attempt to define a risk framework encompassing those hazards, exposure scenarios, vulnerability and protective factors.

A literature search was performed for reported cases of morbidity and mortality associated with different infant feeding modes.

Exclusive breast-feeding is the recommended for infant feeding under 6 months, or failing that, provision of donated human milk. However, the use of PIF remains high despite its intrinsic and extrinsic risk of microbial contamination, as well as the potential for adverse physiological effects, including infant gut dysbiosis.

Viable pathogen transmission via breast-feeding or donor milk (pasteurised and unpasteurised) is rare. However, transmission of HIV and human T-cell lymphotropic virus-1 is a concern for breast-feeding mothers, particularly for mothers undertaking a mixed feeding mode (PIF and breast-feeding). In PIF, intrinsic and extrinsic microbial contamination, such as Cronobacter and Salmonella, remain significant identifiable causes of infant morbidity and mortality.

Disease transmission through breast-feeding or donor human milk is rare, most likely owing to its complex intrinsically protective composition of human milk and protection of the infant gut lining. Contamination of PIF and the morbidity associated with this is likely underappreciated in terms of community risk. A better system of safe donor milk sharing that also establishes security of supply for non-hospitalised healthy infants in need of breast milk would reduce the reliance on PIF.

Supplemental Nutrition Assistance Program (SNAP) benefits are rapidly depleted after distribution. This phenomenon, known as the benefit cycle, is associated with poor nutrition and health outcomes. However, to date, no study has evaluated trends in food expenditures before and after households receive benefits using prospective data, and whether these trends vary by household characteristics.

Generalised estimating equations were used to model weekly household food expenditures during baseline (pre-benefit) and intervention months by vendor (restaurants and food retailers). Food retailer expenditures were further evaluated by food category (fruits and vegetables and foods high in added sugar). All expenditures were evaluated by household composition, demographics and economic means.

Minneapolis-St. Paul, Minnesota, metropolitan area.

Low-income households (n 249) enrolled May 2013–August 2015.

Weekly food retailer expenditures did not vary during baseline (pre-benefit), but demonstrated a cyclical pattern after households received benefits across all household characteristics and for both food categories, particularly for fruits and vegetables. Households with greater economic resources spent more throughout the month compared with those with fewer resources. Households with lower food security status experienced more severe fluctuations in spending compared with more food secure households.

Cyclical food purchasing was observed broadly across different household characteristics and food categories, with notable differences by household economic means and food security status. Proposed SNAP policy changes designed to smooth food expenditures across the benefit month, such as increased frequency of benefit distribution, should include a focus on households with fewest resources.

To investigate the family structure and affluence-related inequality in adolescent eating behaviour.

Multivariate binary logistic regression and path analyses were employed to evaluate the impact of family structure and affluence on the consumption of fruits, vegetables, sweets and soft drinks among adolescents.

The cross-national Health Behaviour in School-aged Children study in 2013/2014 across forty-one countries.

Adolescents aged 11–15 years old (n 192 755).

Adolescents from a non-intact family were less likely to eat daily fruits (OR 0·82; 95 % CI 0·80, 0·84), vegetables (OR 0·91; 95 % CI 0·89, 0·93) and sweets (OR 0·96; 95 % CI 0·94, 0·99), but were more likely to consume soft drinks (OR 1·14; 95 % CI 1·11, 1·17), compared with their counterparts from an intact family. Adolescents who had the lowest family affluence scores (FAS) were less likely to eat daily fruits (OR 0·51; 95 % CI 0·49, 0·53), vegetables (OR 0·58; 95 % CI 0·56, 0·60) and sweets (OR 0·94; 95 % CI 0·90, 0·97), but were more likely to consume soft drinks (OR 1·25; 95 % CI 1·20, 1·30), compared with their counterparts who had the highest FAS. Across countries, a wide range of social inequality in daily consumption of foods was observed.

Among adolescents in Europe, Canada and Israel, there was a high level of family structure and family affluence inequalities in daily food consumption. Different aspects of family socio-economic circumstances should be considered at the national level designing effective interventions to promote healthy eating among adolescents.

To develop and validate a web-based self-diagnostic questionnaire on school food service offer aimed at food service managers (FSM) by: (i) identifying relevant indicators of school food offer, developing a questionnaire and validating the concept using an expert panel; (ii) validating the questions by comparing the FSM’s responses with observations by dietitians and (iii) undergoing a qualitative evaluation of the tool through direct observation and short interviews.

Mixed methods.

Quebec, Canada.

Nine experts validated the theoretical constructs and indicators on which the questionnaire was based. Inter-rater reliability tests were conducted with thirty-nine FSM, who then participated in interviews about platform functionality satisfaction. Twenty school stakeholders participated in the survey pertaining to their use of the personalised report.

The questionnaire focused on the main school food service’s lunchtime offer and comprised twenty-six questions. The overall strength of agreement was good, and all questions’ strengths of agreement were fair to excellent except for one question. Qualitative data reached saturation and showed that navigation through the questionnaire was fluid. Improvements were suggested to increase user-friendliness and simplicity of both the platform and questionnaire. Results from the survey showed that all respondents were either satisfied or very satisfied with their personalised report.

We successfully developed and validated a web-based self-diagnostic questionnaire. The final version facilitates knowledge mobilisation with school stakeholders and offers a new opportunity for the assessment and surveillance of school food offer.

We examined the measurement and mediating role of social support in dietary intake among participants in Texercise Select, an intervention for improving lifestyle behaviours.

Quasi-experimental study. Participants reported their dietary intake, level of social support measured by the new Social Support for Healthy Eating scale, sociodemographics and disease profile. We conducted exploratory factor analysis for scale evaluation and structural equation modelling for mediation analysis to test if changes in dietary-specific social support mediate the relationship between the intervention and changes in dietary intake.

Texas.

Community-dwelling middle-aged and older adults completed a self-reported survey at baseline and 3-month follow-up (intervention group n 211, comparison group n 175).

The majority of the sample was aged ≥70 years (mean 74·30, sd 8·54), female (82·1 %) and had at least two chronic conditions (63·5 %). The acceptable levels of reliability and validity of the dietary-specific social support scale were confirmed. Compared with the comparison group, the intervention group reported improved intake of fruit/vegetables and water, and improved dietary-specific social support. Improved dietary-specific social support mediated the association between intervention and change in fruit/vegetable intake, controlling for sociodemographics, number of chronic conditions and geographic residence. About 12 % of intervention effect was mediated by social support.

The current study confirms positive intervention effects on healthy eating, and highlights social support relating to dietary behaviours that may be helpful for healthy eating. Future research should investigate additional social support for developing healthy eating behavioural skills.

Few studies have validated FFQ estimates of dietary glycaemic index (GI) and load (GL). We investigated how well our estimates of overall GI and GL from FFQs correlate with estimates from repeated 24 h recall data to validate overall GI and GL in the Adventist Health Study-2 (AHS-2).

The AHS-2 is a prospective population-based cohort of 95 873 Seventh-day Adventist adult church members enrolled from 2002 to 2007 to investigate diet, cancer and mortality.

A 204-item FFQ was used to assess race- and gender-specific validity of GI and GL and 24 h recall data, from the calibration sub-study, were used as the reference.

The 734 calibration study participants were randomly selected by church and included approximately equal numbers of blacks and whites but were otherwise similar to the whole cohort with respect to gender, age, education and vegetarian status.

The deattenuated correlation coefficients for overall GI ranged from 0·19 (95 % CI −0·06, 0·53) in black men to 0·46 (95 % CI 0·40, 0·60) in black women, with both non-black men and women falling between those values (0·45 (95 % CI 0·35, 0·65) and 0·38 (95 % CI 0·27, 0·57), respectively). GL correlations were somewhat higher for all study participants. When looking at the entire cohort, the deattenuated validity correlation value for overall GI was (r 0·38, 95 % CI 0·36, 0·47) and GL was (r 0·39, 95 % CI 0·34, 0·49).

Our findings support the cautious use of our FFQ in epidemiological studies when assessing associations of overall GI and GL with disease risk. However, observed differences by race should be considered when interpreting results.

Association was found between tea and neural tube defects. However, few studies investigated the relationship between tea consumption and blood folate levels. We aimed to investigate the association between tea consumption and plasma folate concentrations among women aged 18–30 years in different ethnicities of China.

Data were obtained from a national cross-sectional study conducted from 2005 to 2006 of women aged 18–30 years in China. Socio-demographic characteristics and lifestyle were obtained from a questionnaire. Dietary folate intake was determined by 24-h dietary recall. Plasma folate concentrations were measured by a microbiological assay. Multiple linear regression model was used to calculate partial regression coefficients after adjusting for confounding factors.

Nine provinces or autonomous regions in China.

A total of 2932 women aged 18–30 years in China.

After stratifying by ethnicity and tea type, tea consumption was significantly positively associated with plasma folate levels in Han women who drank unfermented tea weekly (β = 0·067, and P = 0·037) or daily (β = 0·119, and P = 0·031) and in Uighur women who drank fermented tea weekly (β = 0·325, and P = 0·028). For women who drank unfermented tea in Han ethnicity, weekly and daily tea drinkers had 6·77 % (95 % CI: 6·36 %, 7·21 %) and 7·13 % (95 % CI: 6·40 %, 7·96 %) increase in plasma folate concentration compared with no tea drinkers.

There is a suggestion of possible positive association between unfermented tea drinking in Han ethnicity and plasma folate concentrations, for Chinese women aged 18–30 years. The relationship between tea drinking in other ethnic groups and plasma folate still needs to be further explored.

We examined whether breakfast frequency was associated with chronic inflammatory, as assessed by high-sensitivity C-reactive protein (CRP) concentration.

Cross-sectional study.

Kailuan community, China.

Included were 70 092 Chinese adults without CVD and cancer in 2014 with CRP concentrations <10 mg/l, when breakfast frequency was assessed via a questionnaire, and plasma CRP concentration was measured.

Breakfast frequency was associated with CRP concentration (P-trend < 0·001). The adjusted mean CRP was 1·33 mg/l (95 % CI 1·23, 1·44) for the ‘no breakfast’ group and 1·07 mg/l (95 % CI 1·0, 1·14) for the ‘breakfast everyday’ group (P-difference < 0·001), adjusting for age, sex, diet quality, total energy, obesity, education, occupation, marital status, smoking, alcohol consumption, blood pressure, sleep parameters, fasting blood glucose and lipid profiles. Consistently, the adjusted OR for CRP ≥ 1·0 mg/l and CRP ≥ 3·0 mg/l were 1·86 (95 % CI 1·73, 2·00) and 1·27 (95 % CI 1·15, 1·40), respectively, when comparing these two breakfast consumption groups (P-trend < 0·001 for both). The associations were more pronounced among older adults, relative to those who were younger (P-interaction < 0·001). Significant association between breakfast skipping and elevated CRP concentration was observed in those with poor diet quality, but not those with good diet quality.

Habitually skipping breakfast is associated with elevated concentrations of CRP. Future prospective studies including repeated assessment of inflammatory biomarkers and a collection of detailed information on type and amount of breakfast foods are warranted.

To evaluate the association between the consumption of ultra-processed foods (UPF) and the practice of breast-feeding in children under 2 years of age assisted by the conditional cash transfer programme, Bolsa Família Programme (PBF).

A cross-sectional study. The consumption of UPF and the practice of breast-feeding were assessed using a structured 24-h recall. Associations were calculated using hierarchical Poisson regression, adjusted at the last level by socio-economic, demographic and environmental variables from previous hierarchical levels.

Six counties from the state of Alagoas, Brazil.

Children aged 6−24 months, assisted by PBF.

A total of 1604 children were evaluated, 11·7% of whom were overweight, and most had consumed UPF (90·6%) in the last 24 h. The most consumed UPF were biscuits, chocolate milk and baby food with 74·8, 66·8 and 24·9%, respectively. Through multivariable analysis, an association was found between lower consumption of UPF in the continuation of breast-feeding until the second year of life (prevalence ratio (PR) 0·91, 95 % CI 0·86, 0·96) and in the first year of life (PR 0·93, 95 % CI 0·88, 0·99).

It was found that the studied population had a high consumption of UPF, which harmed continued breast-feeding. We highlight the importance of strengthening public policies aimed at the promotion, protection and support of breast-feeding and healthy complementary feeding aimed at populations that have difficulties in physical and economic access to a healthy and adequate diet.

To evaluate the relationship between neighbourhood food environment perceptions and obesity among Supplemental Nutrition Assistance Program-Education (SNAP-Ed) or Expanded Food and Nutrition Education Program (EFNEP) participants.

A cross-sectional study conducted during SNAP-Ed or EFNEP programme participation in six states in the Midwest US between May 2016 and November 2017.

Community centres, food pantries and other SNAP-Ed or EFNEP recruitment locations.

Convenience sample of 1743 low-income, adult nutrition education programme participants.

Controlling for participant location and other demographic variables, those who perceived that a large selection of fruits and vegetables were available to them were 22 % less likely to be obese (adjusted odds ratio 0·78, 95 % CI 0·63, 0·97). In addition, participants who perceived the distance to the grocery store where they purchased most of their groceries to be greater than 5 miles were 1·36 times more likely to be overweight or obese than those who travelled shorter distances for their groceries.

SNAP-Ed or EFNEP participants’ weight status may be associated with their perceptions of their neighbourhood food environments. Programmes incorporating nutrition education and food access initiatives should attempt to better understand participant perceptions in order to address barriers in their efforts and to ensure that healthy food is accessible to low-income residents.

There remain inconclusive findings from previous observational epidemiological studies on whether consumption of artificially sweetened soft drinks (ASSD) increases the risk of gastrointestinal (GI) cancer. We investigated the associations between the consumption of ASSD and the risk of GI cancer using a meta-analysis.

Systematic review and meta-analysis.

PubMed and EMBASE were searched using keywords until May 2020 to identify observational epidemiological studies on the association between the consumption of ASSD and the risk of GI cancer.

Twenty-one case–control studies and seventeen cohort studies with 12 397 cancer cases and 2 474 452 controls.

In the random-effects meta-analysis of all the studies, consumption of ASSD was not significantly associated with the risk of overall GI cancer (OR/relative risk (RR), 1·02; 95 % CI, 0·92, 1·14). There was no significant association between the consumption of ASSD and the risk of overall GI cancer in the subgroup meta-analyses by study design (case–control studies: OR, 0·95; 95 % CI, 0·82, 1·11; cohort studies: RR, 1·14; 95 % CI, 0·97, 1·33). In the subgroup meta-analysis by type of cancer, consumption of ASSD was significantly associated with the increased risk of liver cancer (OR/RR, 1·28; 95 % CI, 1·03, 1·58).

The current meta-analysis of observational epidemiological studies suggests that overall, there is no significant association between the consumption of ASSD and the risk of GI cancer.

The association between 25-hydroxyvitamin D (25(OH)D) and maternal depression (MD) is deemed to be inconclusive. The current analysis aimed to quantify the relationship between 25(OH)D serum concentrations, the main indicator of vitamin D nutritional status, and MD.

Dose–response meta-analysis.

A systematic search in PubMed, Embase and Web of Science from inception to June 2019.

Relevant observational studies reporting risk estimates and 95 % CI of random effects for 25(OH)D concentration on MD were identified.

Twelve observational studies with thirteen independent reports involving 10 317 pregnant women were included. Compared with the lowest category of 25(OH)D, the pooled OR for the highest category of MD was 0·49 (95 % CI 0·35, 0·63); a high heterogeneity was observed (P = 0·001, I2 = 82·1 %). A non-linear association between 25(OH)D and MD was found (P for non-linearity = 0·001); the dose–response analysis indicated that the lowest pooled OR was at blood 25(OH)D concentrations of 90–110 nmol/l. Subgroup analyses suggested a stronger association between 25(OH)D and MD in summer time (OR 0·25, 95 % CI 0·08, 0·43) than in other seasons (OR 0·68, 95 % CI 0·52, 0·83) (P for interaction = 0·008). A visual inspection of funnel plot and Begg’s and Egger’s tests did not indicate any evidence of publication bias.

Low circulating 25(OH)D is associated with MD, and our analysis suggests that they influence each other. Further randomised controlled trials would be needed to determine the direction of causation.