To analyse differences in the prevalence of prediabetes (PD), undiagnosed diabetes (UDD) and diagnosed diabetes (DD) and associated factors between Brazilian and English older adults.

Cross-sectional study.

England and Brazil.

5301 participants of the English Longitudinal Study of Ageing study and 1947 participants of the Brazilian Longitudinal Study of Aging study classified as non-diabetics, PD, UDD and DD.

The prevalence of PD, UDD and DD was 48·6, 3 and 9·6 % in England and 33, 6 and 20 % in Brazil. In England, the increase in age, non-white skin colour, smoking, general obesity and abdominal obesity were associated with PD, UDD and DD, whereas hypertriglyceridaemia, low HDL levels, hypertension and stroke were associated with UDD and DD. In Brazil, the increase in age was associated with DD and UDD, non-white skin colour and smoking were associated with UDD and abdominal obesity and hypertriglyceridaemia were associated with all three conditions. CVD in England and schooling in Brazil were associated with PD and DD. A sedentary lifestyle was associated with DD in both samples.

The prevalence of diabetes was higher in the Brazilian sample. Different associated factors were found in the two samples, which may be related to differences in nutritional transition, access to healthcare services and the use of such services.

To examine patterns of taxed and untaxed food and beverage shopping across store types after Mexico’s sugary drink and non-essential food taxes, the nutritional quality of these patterns and the socio-economic characteristics associated with them.

We performed k-means cluster analyses using households’ percentage of food and beverage purchases from each store type (i.e. convenience stores, traditional shops (e.g. bodegas, tiendas, mom-and-pop shops), supermarkets, wholesalers and others). We calculated adjusted mean proportions of taxed and untaxed products (ml or g/capita per d) purchased in each pattern. We studied the associations between households’ SES and shopping patterns using multinomial logistic regressions. Within shopping patterns, we obtained mean volumes and proportions of taxed and untaxed food and beverage subgroups and calculated the proportion of products purchased at each store type.

Mexico.

Urban Mexican households (n 5493) from the Nielsen Mexico Consumer Panel Survey 2015.

We found four beverage shopping patterns and three food shopping patterns, driven by the store type where most purchases were made. For beverages, 48 % of households were clustered in the Traditional pattern and purchased the highest proportion of taxed beverages. Low-SES households had the highest probability of clustering in the Traditional beverage shopping pattern. For foods, 35 % of households were clustered into the Supermarket pattern. High-SES households had the highest probability of clustering in the Supermarket food shopping pattern.

The combination of store types where Mexican households purchase packaged foods and beverages varies. However, households in all shopping patterns and SES purchase taxed beverages mainly at traditional stores. Store-level strategies should be developed to intervene on traditional stores to improve the healthfulness of purchases.

To investigate the association between the Children’s Dietary Inflammatory Index (C-DIITM) scores and atherogenic risk in Brazilian schoolchildren.

A cross-sectional representative study. Three 24-h dietary recalls were performed to evaluate food consumption and to calculate C-DII scores. Blood samples were collected for the lipid profile analysis (serum total cholesterol (TC), HDL-cholesterol, LDL-cholesterol, VLDL-cholesterol and triglycerides (TAG)) and to determine atherogenic indexes (Castelli risk indexes I and II, lipoprotein combined index (LCI), and atherogenic index of plasma and atherogenic coefficient (AC)). A semi-structured questionnaire was used to obtain sociodemographic characteristics and screen time. Body fat was assessed by dual-energy X-ray absorptiometry. We compared the distributions of outcomes by C-DII categories using multivariable linear regression.

Viçosa, Minas Gerais, Brazil.

Three hundred seventy-eight children between the ages of 8 and 9 years.

The mean C-DII score was 0·60 ± 0·94, and the prevalence of dyslipidaemia was 70 %. Children with hypercholesterolaemia and hypertriglyceridaemia had higher C-DII scores. The C-DII was directly associated with atherogenic risk. Every 1 sd of C-DII was associated with a 0·07 (0·01, 0·13), 1·94 (0·20, 3·67), 0·06 (0·002, 0·12) and 0·12 (0·02, 0·22) units higher TC:HDL cholesterol ratio, LCI, AC and accumulation of altered dyslipidaemia markers (high TC + high LDL-cholesterol + high TAG + low HDL-cholesterol), respectively.

Dietary inflammatory potential, as estimated by the C-DII, is directly associated with atherogenic risk in Brazilian schoolchildren. This results reinforce the importance of effective nutritional policies to promote healthy eating habits and improve children’s lipid profiles.

To evaluate the association between the age of cow milk introduction and childhood growth.

A secondary analysis of a prospective cohort study.

Toronto, Canada.

Healthy children <5 years of age enrolled in the TARGet Kids! practice-based research network. The primary exposure was the age of cow milk introduction. The primary outcome was height-for-age z-score. Secondary outcomes were volume of cow milk consumed (cups/d) and BMI z-score. Outcomes were measured at the last visit before 5 years of age. Multiple linear regression was used to examine these relationships.

Among 1981 children, introduction of cow milk at a younger age was associated with greater height by 3–5 years of age (P < 0·001). Each month earlier that cow milk was introduced was associated with 0·03 higher height-for-age z-score unit (95 % CI –0·05, –0·02) or 0·1 cm (95 % CI –0·15, –0·12 cm). At 4 years of age, the height difference between a child introduced to cow milk at 9 v. 12 months was 0·4 cm (95 % CI –0·45, –0·35 cm). There was no association between the timing of cow milk introduction and volume of cow milk consumed per day or BMI z-score.

Earlier introduction of cow milk was associated with greater height but not with weight status in children aged 3–5 years. Further research is needed to understand the casual relationship between earlier cow milk consumption and childhood height. These findings may be important for paediatricians and parents when considering when to introduce cow milk.

The aim of this study was to determine the relationship between dietary total antioxidant capacity (dTAC) and risk of breast cancer among Iranian women.

In this hospital-based case–control study, dietary intake of participants was collected using a 168-item validated FFQ. Dietary TAC was assessed using FRAP assay considering. Logistic regression was used to obtain ORs for breast cancer across quartiles of dTAC.

Cancer Institute, Iran.

We included 412 women with pathologically confirmed breast cancer and 456 apparently healthy controls.

Mean dTAC was 11·3 ± 5·8 for cases and 12·1 ± 7·9 for controls. A trend towards significant inverse association was seen between dTAC and odds of breast cancer in the whole population; such that after controlling for several potential confounders, individuals in the highest quartile of dTAC were 0·39 times less likely to have breast cancer than those in the lowest quartile (0·61; 95 % CI: 0·38, 0·99, P < 0·05). In the stratified analysis by menopausal status, we found that postmenopausal women with the greatest dTAC had lower odds for breast cancer, compared with those with the lowest dTAC (0·47; 95 % CI: 0·24, 0·93, P < 0·05). This association strengthened after additional adjustment for BMI (0·28; 95 % CI: 0·11, 0·72, P < 0·05). No significant association was seen between dTAC and odds of breast cancer in premenopausal women.

We found that dietary TAC was inversely associated with risk of breast cancer, in particular among postmenopausal women. Prospective cohort studies are needed to confirm these findings.

To explore the relationship between parameters of Na and K excretion using 24-h urine sample and mild cognitive impairment (MCI) in general population.

This is a cross-sectional study.

Community-based general population in Emin China.

Totally, 1147 subjects aged ≥18 years were selected to complete the study, with a multistage proportional random sampling method. Cognitive status was assessed with Mini Mental State Examination (MMSE) questionnaire and timed 24-h urine specimens were collected. Finally, 561 participants aged ≥35 years with complete urine sample and MMSE data were included for the current analysis and divided into groups by tertiles of 24-h urinary sodium to potassium ratio (24-h UNa/K) as lowest (T1), middle (T2) and highest (T3) groups.

The MMSE score was significantly lower in T3, compared with the T1 group (26·0 v. 25·0, P = 0·002), and the prevalent MCI was significantly higher in T3 than in T1 group (11·7 % v. 25·8 %, P < 0·001). In multiple linear regression, 24-UNa/K (β: −0·184, 95 % CI −0·319, −0·050, P = 0·007) was negatively associated with MMSE score. In multivariable logistic regression, compared with T1 group, 24-h UNa/K in the T2 and T3 groups showed 2·01 (95 % CI 1·03, 3·93, P = 0·041) and 3·38 (95 % CI 1·77, 6·44, P < 0·001) fold odds for presence of MCI, even after adjustment for confounders. More augmented results were demonstrated in sensitivity analysis by excluding individuals taking anti-hypertensive agents.

Higher 24-h UNa/K is in an independent association with prevalent MCI.

To investigate to what extent promotions in Dutch supermarket sales flyers contribute to a healthy diet and whether there are differences between supermarket types.

A cross-sectional study investigating promotions on foods and beverages (n 7825) in supermarket sales flyers from thirteen Dutch supermarket chains (8-week period), including ten traditional, two discount and one organic supermarket chain(s). Promoted products were categorised by food group (e.g. bread), contribution to a healthy diet (yes/no), degree of processing (e.g. ultra-processed), promotion type (temporary reduction in price, volume-based promotions or advertised only) and percentage discount of price promotions. Differences between supermarket chains in the degree of healthiness and processing of products and the types of price promotions were investigated.

In total, 70·7 % of all promoted products in supermarket sales flyers did not contribute to a healthy diet and 56·6 % was ultra-processed. The average discount on less healthy products (28·7 %) was similar to that of healthy products (28·9 %). Less healthy products were more frequently promoted via volume-based promotions than healthy products (37·6 % v. 25·4 %, P < 0·001). Discount supermarket chains promoted less healthy (80·3 %) and ultra-processed (65·1 %) products more often than traditional supermarket chains (69·6 % and 56·6 %, respectively).

The majority of promoted products via supermarket sales flyers do not contribute to a healthy diet. As promotions are an important determinant of food purchasing decisions, supermarkets do not support healthy choices. Future studies should identify barriers that withhold supermarket chains from promoting more healthy foods in supermarket sales flyers.

The purpose of the current study was to investigate associations between spicy food intake and serum lipids levels in Chinese rural population.

Information on spicy food flavour and intake frequency was obtained using a two-item questionnaire survey. Dietary data were collected using a validated thirteen-item FFQ. Fasting blood samples were collected and measured for total cholesterol (TC), TAG, HDL-cholesterol and LDL-cholesterol. Multivariate linear and logistic regression models were employed to examine the relationship between spicy food and serum lipids levels according to the spicy food flavour and intake frequency, respectively.

A cross-sectional study in Henan Province.

38 238 participants aged 18–79 years old.

Spicy flavour and intake frequency were consistently associated with decreased TC and non-HDL-cholesterol levels but mildly associated with elevated TAG levels. Each level increment in spicy flavour was inversely associated with high TC (OR: 0·91; 95 % CI 0·88, 0·93) and high non-HDL-cholesterol (OR: 0·88; 95 % CI 0·85, 0·91) but positively associated with high TAG (OR: 1·04; 95 % CI 1·01, 1·07). Similarly, 1-d increment in spicy food intake frequency was also inversely associated with high TC (OR: 0·92; 95 % CI 0·91, 0·94) and high non-HDL-cholesterol (OR: 0·91; 95 % CI 0·89, 0·93) but positively associated with high TAG (OR: 1·04; 95 % CI 1·02, 1·06).

Spicy food intake was mildly associated with increased risk of abnormal TAG level, significantly associated with decreased risk of abnormal TC and non-HDL levels. Spicy food intake may be contribute to the management of lipid levels.

To develop a greenhouse gas emissions (GHGE) database for Japanese foods using three different approaches, compare the results of estimated diet-related GHGE and determine major food contributors among Japanese adults.

Cross-sectional. Three GHGE databases were developed: (1) a literature-based method including a literature review of life cycle assessment studies of Japanese foods and (2) production- and (3) consumption-based input–output tables (IOT)-applied methods using the Japanese IOT. All databases were linked to the Japanese food composition table and food consumption data. Diet-related GHGE was estimated based on each database and the 4-d dietary record data. Diet-related GHGE were compared in both total and food group level between the databases.

Japan.

392 healthy adults aged 20–69 years.

The mean diet-related GHGE significantly differed according to the calculation methods: 4145 g CO2-equivalent (CO2-eq)/d by the literature-based method, 4031 g CO2-eq/d by the production-based method and 7392 g CO2-eq/d by the consumption-based IOT-applied methods. It significantly differed in food group level as well. Spearman’s correlation coefficients between three methods ranged from 0·82 to 0·86. Irrespective of the methods, the top contributor to GHGE was meat (19·7–28·8 %) followed by fish and seafood (13·8–18·3 %).

Although the identified major food contributors to GHGE were comparable between the three methods, the estimated GHGE values significantly differed by calculation methods. This finding suggested that caution must be taken when interpreting the estimated diet-related GHGE values obtained using the different calculation methods of GHGE.

To identify dietary patterns associated with subclinical atherosclerosis measured as coronary artery calcification (CAC).

Cross-sectional analysis of data from the Brazilian Longitudinal Study of Adult Health. Dietary data were assessed using a FFQ, and a principal component factor analysis was used to derive the dietary patterns. Scree plot, eigenvalues > 1 and interpretability were considered to retain the factors. CAC was measured using a computed tomography scanner and an electrocardiography-gated prospective Ca score examination and was categorised into three groups based on the CAC score: 0, 1–100 and >100 Agatston units. Multinomial regression models were conducted for dietary patterns and CAC severity categories.

Brazil, São Paulo, 2008–2010.

Active and retired civil servants who lived in São Paulo and underwent a CAC exam were included (n 4025).

Around 10 % of participants (294 men, 97 women) had a detectable CAC (>0), 6·5 % (182 men, 73 women) had a CAC of 1–100 and 3·5 % (110 men, 23 women) had a CAC > 100. Three dietary patterns were identified: convenience food, which was positively associated with atherosclerotic calcification; plant-based and dairy food, which showed no association with CAC; and the traditional Brazilian food pattern (rice, legumes and meats), which was inversely associated with atherosclerotic calcification.

Our results showed that a dietary pattern consisting of traditional Brazilian foods could be important to reducing the risk of atherosclerotic calcification and prevent future cardiovascular events, whereas a convenience dietary pattern was positively associated with this outcome.

The Cambodian population has experienced an increase in the proportion of stunted children who have overweight mothers during a period of rapid social and economic growth. We aimed to identify socio-economic factors associated with this household-level double burden over time.

We used data from four Cambodia Demographic and Health Surveys from 2000 to 2014 to study the impact of socio-economic status (SES) on the link between child stunting and overweight mothers in two periods 2000–2005 v. 2010–2014. We hypothesised that SES would be a primary factor associated with this phenomenon.

We included 14 988 children under the age of 5 years, among non-pregnant mothers aged 15–49 years of age and conducted analysis on a subsample of 1572 children with overweight mothers.

Nationally representative household survey across all regions.

SES factors, specifically household wealth and maternal employment in service or manual occupations (in 2010–2014), are the main drivers of stunting among children of overweight mothers. Children with overweight mothers in the poorest households are more than twice as likely to be stunted than in the richest in both periods (2000–2005: adjusted OR (aOR) = 2·53, 95 % CI: 1·25, 5·13; 2010–2014: aOR = 2·61, 95 % CI: 1·43, 4·77), adjusting for other SES factors, indicating that despite decreasing income inequality, the poorest continue to bear excess risk of a double burden of malnutrition. Maternal short stature also doubled the likelihood of child stunting in both periods, which suggests intergenerational transmission of adversity and physical underdevelopment.

Socio-economic inequalities should be addressed to reduce disparities in the household-level double burden of malnutrition.

To assess the prevalence and to identify the associated factors of malnutrition among elderly Chinese with physical functional dependency.

Face-to-face interviews using standardised questionnaires were conducted to collect demographic information, health-related issues and psychosocial status. Physical function was measured by the Barthel Index (BI), and nutrition status was assessed by the Mini Nutritional Assessment–Short Form. Multivariate binary logistic regression was used to assess associated factors of malnutrition.

China.

A total of 2323 participants (aged ≥ 60 years) with physical functional dependency in five provinces in China were enrolled using a multistage cluster sampling scheme.

The prevalence of malnutrition was 17·9 % (95 % CI 16·3, 19·4). Multivariable binary logistic regression revealed the independent risk factors of poor nutrition status were being female, older age, lower educational status, poor hearing, poor physical functional status, lack of hobbies, low religious participation, poor social support, lack of social participation and changes in social participation. The study found that the most significant independent risk factor for malnutrition was complete physical functional dependence (OR 4·46, 95 % CI 2·92, 6·82).

The findings of the study confirm that malnutrition and the risk of malnutrition are prevalent in Chinese older adults with physical functional dependency. In addition to demographic and physical health-related factors, psychosocial factors, which are often overlooked, are independently associated with nutrition status in Chinese older adults with physical functional dependency. A holistic approach should be adopted to screen for malnutrition and develop health promotion interventions in this vulnerable population.

Population reductions in Na intake could prevent hypertension, and current guidelines recommend that clinicians advise patients to reduce intake. This study aimed to estimate the prevalence of taking action and receiving advice from a health professional to reduce Na intake in ten US jurisdictions, including the first-ever data in New York state and Guam.

Weighted prevalence and 95 % CI overall and by location, demographic group, health status and receipt of provider advice using self-reported data from the 2017 Behavioral Risk Factor Surveillance System optional Na module.

Seven states, the District of Columbia, Puerto Rico and Guam.

Adults aged ≥ 18 years.

Overall, 53·6 % (95 % CI 52·7, 54·5) of adults reported taking action to reduce Na intake, including 54·8 % (95 % CI 52·8, 56·7) in New York and 61·2 % (95 % CI 57·6, 64·7) in Guam. Prevalence varied by demographic and health characteristic and was higher among adults who reported having hypertension (72·5 %; 95 % CI 71·2, 73·7) v. those who did not report having hypertension (43·9 %; 95 % CI 42·7, 45·0). Among those who reported receiving Na reduction advice from a health professional, 82·6 % (95 % CI 81·3, 83·9) reported action v. 44·4 % (95 % CI 43·4, 45·5) among those who did not receive advice. However, only 24·0 % (95 % CI 23·3, 24·7) of adults reported receiving advice from a health professional to reduce Na intake.

The majority of adults report taking action to reduce Na intake. Results highlight an opportunity to increase Na reduction advice from health professionals during clinical visits to better align with existing guidelines.

To estimate the total energy and micronutrient intakes of children 9–24 months of age and evaluate the probability of adequacy (PA) of the diet in seven MAL-ED sites.

Cohort study. Food intake was registered monthly using 24-h recalls beginning at 9 months. We estimated PA for thirteen nutrients and overall mean PA (MPA) by site and 3-month periods considering estimated breast milk intake.

Seven sites in Asia, Africa and Latin America.

1669 children followed from birth to 24 months of age.

Median estimated %energy from breast milk ranged from 4 to 70 % at 9–12 months, and declined to 0–39 % at 21–24 months. Iron bioavailability was low for all sites, but many diets were of moderate bioavailability for zinc. PA was optimal for most nutrients in Brazil and South Africa, except for iron and vitamin E (both), calcium and zinc (South Africa). PA for zinc increased only for children consuming a diet with moderate bioavailability. MPA increased 12–24 months as the quantity of complementary foods increased; however, PA for vitamin A remained low in Bangladesh and Tanzania. PA for vitamins D and E and iron was low for most sites and age groups.

MPA increased from 12 to 24 months as children consumed higher quantities of food, while nutrient density remained constant for most nutrients. Ways to increase the consumption of foods containing vitamins D, E and A, and calcium are needed, as are ways to increase the bioavailability of iron and zinc.

We aimed to investigate whether dietary patterns were associated with the risk of type 2 diabetes mellitus (T2DM) or pre-diabetes in adults of rural area in Henan.

Cross-sectional study. Principal component analysis was used to identify dietary patterns, while multivariate logistic regression analysis and restricted cubic spline regression models were used to analyse the association between dietary patterns and both pre-diabetes and T2DM.

Rural area of Henan province, China.

A total of 38 779 adults aged 18–79 years were recruited from the Henan rural cohort study as the subjects.

The prevalence of pre-diabetes and T2DM in rural Henan was 6·8 % and 9·4 %, respectively. A total of three dietary patterns were assessed in the present study. Dietary pattern I with a high intake of red meat and white meat; dietary pattern II with a high intake of grains, nuts, milk and eggs and dietary pattern III with a high intake of vegetables, staple food and fruits. The highest quintile (Q5) of pattern III could reduce 32·7 % risk of pre-diabetes. The Q5 of pattern II showed a 15·5 % decreased risk of T2DM, in a U-shaped dose–response manner; meanwhile, the Q5 of pattern III was significantly associated with reduced risks of T2DM (OR: 0·582, 95 % CI (0·497, 0·682)).

Pattern III is beneficial for reducing risk of pre-diabetes or T2DM. Though a higher consumption of ‘grains-nuts-egg’ may associate with a reduced risk of T2DM, excessive intakes should be avoided. This study may provide a reference for the prevention of diabetes on dietary precautions.