The Dutch Children’s Food Literacy Questionnaire (DCFLQ) was developed and validated to assess food literacy among children aged 8 to 12 years. The DCFLQ is structured around farm-to-fork principles, including questions on food production, distribution, consumption, waste, and sustainability.

After initial item pool creation, the DCFLQ was developed in collaboration with experts and children. The validation process included assessments of reliability and construct validity, as well as a test–retest evaluation in a subgroup of children.

The expert panel consisted of domain-related researchers, a pedagogue, a paediatrician, dietitians, and a primary school teacher. Children were recruited via primary schools and a sports club.

A total of 11 experts and 27 children participated in the development process; 608 children participated in the validation process.

The final questionnaire comprised 29 questions and demonstrated good internal consistency (Cronbach’s α = 0.80) and test-retest reliability (ICC = 0.81). DCFLQ scores positively correlated with age, indicating that food literacy is higher in older children.

The DCFLQ is a valuable tool for assessing the effectiveness of nutrition intervention programs and monitoring Dutch children’s food literacy over time. International expert consensus on developing food literacy instruments is needed, as diversity in assessment tools impedes cross-cultural comparisons.

To describe and evaluate nutrition-related policy, system, and environmental (PSE) change strategies implemented in a rural, volunteer-run Georgia food pantry, exploring facilitators and barriers and changes in clients’ perceptions of food distributed following implementation of nutrition-related PSE changes.

The mixed-methods evaluation used pre-post key informant interviews, client surveys, and program documents to assess implementation and outcomes of a nutrition policy and other PSE changes.

Hancock County, Georgia.

Survey respondents were food pantry clients who completed surveys both in January 2021 and March 2022 (n=155). Key informants were program staff, a local coalition member, and food pantry leadership (n=9).

Nutrition-related PSE changes included a nutrition policy, produce procurement partnerships, and enhanced refrigeration; an awareness campaign and nutrition education were also conducted. Facilitators included the implementation approach (e.g., encouraging small steps, joint policy development), relationship formation, and partnerships. Barriers were modest capacity (e.g., funding, other resources), staffing/volunteers, and limited experience with food policy and procurement processes. Client surveys in 2021-2022 showed canned/dried foods as most commonly received, with significant (p<.05) increases at follow-up in always receiving meat/poultry/seafood and significant decreases in always receiving canned fruits and dry beans/lentils. In both 2021 and 2022, substantial proportions of respondents reported food insecurity (>60%), having obesity (>40%), poor/fair health (>30%), and a household member with hypertension/high blood pressure (>70%).

Nutrition-related PSE changes in rural food pantries to improve the healthfulness of foods distributed require substantial resources, yet if sustained, may increase client access to healthy foods and improve diets.

A Body Shape Index (ABSI) is a validated anthropometric measure describing body shape independently of BMI and height. This study aimed to evaluate the association between ABSI and dietary quality and eating behaviors in a Mediterranean clinical population.

We conducted a cross-sectional study analyzing associations between ABSI and diet/behavior using Pearson correlations and multivariable linear regressions adjusted for age, sex, and BMI.

The study took place at a Mediterranean diet–based nutrition clinic in Rome, Italy.

The sample included 1,640 adult patients attending follow-up visits at the clinic. ABSI z-scores were calculated and standardized by age and sex. Weekly food intake was assessed using 7-day food diaries, and behavioral preferences were collected via structured questionnaires.

The Pearson correlation between BMI and internal zABSI was weak but statistically significant (r = 0.113, p < 0.0001), confirming that ABSI captures body shape independently from BMI. As expected, ABSI strongly correlated with waist circumference (r = 0.78, p < 0.001). Playing a sport was inversely associated with zABSI (β = -0.365, p < 0.001). Nighttime eating (β = 0.237, p = 0.001), snacking between meals (β = 0.133, p = 0.014), and preference for sweet over salty foods (β = 0.025, p = 0.010) were positively associated with higher ABSI values.

In this Mediterranean clinical sample, ABSI identified behavioral and dietary correlates of body shape–related risk. Promoting physical activity and addressing nighttime eating may help improve anthropometric profiles linked to abdominal fat distribution.

The current study examined perceptions of and experiences with Flint Families Cook, a virtual cooking and nutrition program for youth and families.

Families were invited to participate in virtual focus groups after completing the five-week Flint Families Cook program. The research study was guided by Social Cognitive Theory. Researchers used thematic analysis to examine the transcribed focus groups, identify patterns across transcripts, and develop emerging themes.

Families living in Flint and surrounding Genesee County, Michigan, USA engaged in virtual focus groups via Zoom.

Youth (n=32; 59% female, 53% African American) and adult caregivers (n=31; 90% female, 39% African American) participated in focus groups between October 2020 and February 2022.

Five themes were generated from the focus group discussions: (i) general cooking challenges; (ii) class format; (iii) family support; (iv) provision of food; and (v) instruction and learning.

In addition to perceived positive impacts on cooking skills and nutrition education, many participants shared that Flint Families Cook encouraged family cohesion and support. Most caregivers felt the program, which included instruction by a chef and dietitian as well as ingredient box delivery, had important impacts on emotional health of youth and family resilience. Flint Families Cook, and similar virtual scalable programs, could broadly reach children and families to support physical and psychosocial health, especially in low-resource communities where such interventions may be most beneficial.

Aspects of the school food environment can influence food purchasing and consumption among adolescents, particularly those without access to a school meal program. Our objective was to describe and compare food vendors of junior high schools in Ghana.

We conducted structured observations of food vendors within a 0.25-km radius of 8 junior high schools. We compared foods sold and hygiene practices by vendor and community characteristics, such as on vs off campus location, urban vs rural, and predominant income generating activity of the community. We also assessed the relationship between adolescent diet quality (food group diversity, all-5, NCD-protect, and NCD-risk scores) and procurement method for foods consumed during the school day.

Cape Coast and Elmina, Ghana

200 randomly selected students.

Of 265 identified vendors, 25.3% sold foods on-campus. On-campus vendors were less likely to sell branded snacks (19.4% vs. 33.8%, p=0.001), and beverages (17.9% vs. 35.4%, p=0.008) and more likely to sell prepared dishes (53.7% vs. 31.8%, p=0.001) than off-campus vendors. Vendors practiced an average of 38.8% of applicable food hygiene practices, which did not differ by on- or off- campus location. In the previous month, 59.4% of students most often purchased food on campus. There were no significant relationships between method of food procurement and diet quality.

Many adolescents purchased food at school and there were differences in foods sold by on- and off campus vendors. School policies may be a promising avenue to alter food environments for adolescents.

This study aimed to evaluate adult women’s cooking and food preparation skills and their nutrition literacy levels, and to examine the relationship between these two concepts.

Data were collected via face-to-face interviews using a personal information form, the Cooking and Food Skills Scale, and the Evaluation Instrument of Nutrition Literacy on Adults. Data were analyzed with SPSS, with p<0.05 considered significant.

Female adults aged 20–64 who participated in family support courses in Tepebaşı, Eskişehir, Turkey.

The study sample consisted of 330 female individuals between the ages of 20-64 who agreed to participate in the survey.

Nutrition literacy was generally adequate (91.8%), though gaps were identified in portion knowledge (54.2%) and food label reading (44.2%, borderline). Higher literacy levels were associated with being younger, more educated, and employed (p<0.05). Cooking and food preparation skills were higher among married women and those with children. Cooking frequency and enjoyment significantly influenced these skills (p<0.05). Those who cooked more often had higher scores in food label reading and basic math (p<0.001), and higher total scores (p=0.049). Participants who enjoyed cooking had better reading comprehension (p=0.030). A weak but significant correlation was found between food preparation skills and general nutrition knowledge, but no strong relationship was observed between overall cooking skills and total nutrition literacy.

Although no strong link was found between nutrition literacy and cooking skills, these skills appear to support healthier eating behaviors. Promoting cooking and food preparation through nutrition education may help improve public health.

Overweight and obesity have become a global public health concern, with prevalence rising sharply in low- and middle-income countries. This study analyzed temporal trends in overweight and obesity among schoolchildren in the largest capital city of Brazil, from 2006 to 2024.

Repeated cross-sectional.

Schoolchildren aged 6 to 19 from Porto Velho, Rondônia, Brazil.

A total of 12,646 participants were evaluated. To assess the body mass index z-score, standardized body mass and height measurements were used, stratified by sex (male and female) and age group (6-10 and 11-19 years). Temporal trends were assessed using joinpoint regression analysis.

Overall, 17.8% of participants were classified with overweight, and 8.6% were classified with obesity. The study also found that obesity prevalence was consistently higher among younger age groups compared to adolescents. The results revealed a significant increase in obesity prevalence among girls (annual percentage change [APC] = 5.81%; 95% confidence interval [95%CI] = 1.03-10.81; p-value = 0.021) and children aged 6 to 10 years (APC = 5.20%; 95%CI = 1.17-9.39; p-value = 0.017), while no significant trends were observed for overweight or for male adolescents or adolescents aged 11 to 19 years.

Our findings indicate rising obesity among girls and children aged 6–10 and support the need for urgency. We recommend targeted action, including implementing mandatory quality physical education and school nutrition standards, enforcing restrictions on marketing to children, and prioritizing municipal policies that increase access to healthy foods.

This study assessed iron-rich food consumption and its factors among children aged 6–23 months in South and Southeast Asia.

A cross-sectional study from the Standard Demographic and Health Survey (2015-2022).

South and Southeast Asian countries.

Data collected from 95,515 children aged 6 to 23 months, including information from their parents or caregivers.

The overall proportion of children, aged 6 to 23 months, consuming iron-rich foods in the region was 29.87% (95% CI: 29.58, 30.16). Higher odds of iron-rich food consumption were observed among children aged 12–23 months (AOR = 3.59; 95% CI: 3.45–3.76), had history of exclusive breastfeeding (AOR = 1.17; 95% CI: 1.12–1.23), born to teenage motherhood (AOR = 1.09; 95% CI: 1.02–1.17), born in health institution (AOR = 1.10; 95% CI: 1.02–1.19), and had pregnant mother at the time of the survey (AOR = 1.60; 95% CI: 1.50–1.72). Children of birth order 2–4 (AOR = 1.26; 95% CI: 1.20–1.32) and 5+ (AOR = 1.29; 95% CI: 1.18–1.43), from female-headed households (AOR = 1.06; 95% CI: 1.01–1.12), and those with household mass media exposure (AOR = 1.27; 95% CI: 1.19–1.36) also had significantly higher odds of iron-rich food consumption. Additionally, higher odds ratios (AOR > 1) of iron-rich food consumption were observed in Cambodia, Bangladesh, Indonesia, Myanmar, Maldives, Philippines, Pakistan, and Timor-Leste.

Across countries, only about 30% of children consumed iron-rich foods, with significant variation. Targeted public health efforts are essential to address maternal, child, and household factors that influence intake.

The present study examined the association of body mass index (BMI), screen and sleep time, physical fitness and eating behaviour with Mediterranean diet (MD) adherence in a sample of pre-schoolers from Granada, Spain.

A cross-sectional, non-randomised design was employed. A multilinear regression model with backward elimination was used for analysis.

Variables included age, BMI, screen time, hours of nightly sleep, physical fitness, food approach and food avoidance. The developed model met assumptions of multiple regression in terms of linearity, homoscedasticity, normality, independence and non-multicollinearity.

Data were collected from 653 of the 2250 three-to-six-year-old children attending the 18 schools invited to take part in the present study.

Better sleep time and lower screen time and food avoidance were found to be predictive of MD adherence. These variables explained 15% of the variance in pre-schoolers MD adherence.

The present study suggests that sleep and screen time and food avoidance are important components to consider when targeting improvements in MD adherence in pre-schoolers. Future research should explore the way in which parental health behaviours influence their children’s health habits in order to better understand outcomes.

To evaluate the nutritional status of adults with beta thalassemia major in Vietnam by analysing body composition parameters and assessing the adequacy of energy, macronutrient, and micronutrient intake.

A cross-sectional study was conducted among adult patients with beta thalassemia major. Nutritional status was assessed using three components: body mass index (BMI), body composition, and dietary intake.

Department of Thalassemia, The National Institute of Hematology and Blood Transfusion in Vietnam

317 adult patients with beta thalassemia major (54.2% females, median age 32)

Nearly half (49.5%) of the patients had a normal BMI, while 18.3% were severely underweight and 32.2% were underweight. Severe underweight patients exhibited lower body fat, bone mineral content, and visceral fat. Average daily energy intake (1,449.9 kcal) was significantly below the estimated requirement (2,079.5 kcal), with 81.4% of patients consuming less than 85% of their energy needs. Severely underweight patients consumed 12.06 g/day less fat (95% CI: 6.85–17.26) and 10.42 g/day less protein (95% CI: 4.42–16.42) than normal weight patients. Severe deficiencies in calcium, magnesium, iron, and B-complex vitamins were prevalent, with the lowest mean probability of adequacy for minerals and vitamins observed in severely underweight patients.

This study provides the first comprehensive assessment of the nutritional status of beta thalassemia major patients in Vietnam, revealing critical gaps in energy and nutrient intake. Evidence-based strategies, including dietary education and interventions tailored to the unique needs of this population, are urgently needed to improve nutritional outcomes and overall health.

Governments are seeking to regulate food environments to promote health by restricting sales and marketing of processed foods high in fat, sugar and sodium. We aimed to evaluate whether the legal instruments in Member States of the Western Pacific Region (WPR) mandate the declaration of nutrient composition for nutrients of concern in relation to Codex Alimentarius and Non-Communicable Disease (NCD) prevention.

We undertook content analysis of legal instruments governing food quality and safety, documenting mandates for nutrient declarations in the WPR. Legal instruments were purposefully sourced through a systematic search of regional legal databases and Google. We performed qualitative and quantitative analysis, using an adapted version of Reeve and Magnusson’s Framework for Analyzing and Improving the Performance of Regulatory Instruments.

Legal instruments governing food quality and safety in 28 Member States of the WPR.

There was substantial variation in the nutrient declaration mandates within legal instruments, with only 3 out of 28 countries mandated nutrient declarations in full alignment with Codex recommendations (energy, protein, available carbohydrate, fat, saturated fat, sodium and total sugars). Just 4 countries mandated the display of sodium, sugar, saturated fat and trans-fats, in line with NCD prevention recommendations. Sodium labelling was mandated in 10 countries, sugar in 7, and saturated fat in 6.

There is scope for countries to strengthen legal instruments for nutrient declarations to better support diet-related NCD prevention efforts. Regional support agencies can play a key role in promoting greater policy coherence and alignment with international best practice.

To evaluate eligibility and participation in nutrition assistance programs (Supplemental Nutrition Assistance Program [SNAP] and Woman, Infants, and Children [WIC]) among transgender and gender diverse (TGD) adults in the United States (U.S.) and to capture their experiences when accessing food benefits.

This was a cross-sectional analysis of the U.S. Transgender Survey (USTS) dataset– the largest survey of TGD adults in the U.S. SNAP and WIC participation and experiences when visiting the public assistance office were reported using descriptive statistics; stratified analyses were conducted based on race using multivariate logistic regression modeling.

The USTS was completed electronically in the United States.

27,715 TGD adults.

Approximately 40.9% of the full sample were SNAP eligible, yet only 30.6% of those eligible were receiving the benefit; 0.45% of the sample reported receiving WIC. TGD adults avoided the public assistance office because they feared being mistreated (3.2%), were identified as transgender (46.2%), were denied equal treatment (6.5%), or were verbally harassed (5.2%). People of color were more likely to be denied equal treatment and verbally harassed at the public benefits office than white peers. The impact of age, education level, employment status, relationship status, and census region varied within each racial group.

Far more TGD adults need food assistance compared to the general population, yet fewer are receiving the benefit. Culturally informed interventions are urgently needed to resolve the root causes of food insecurity, increase SNAP participation and address the negative experiences of TGD adults when accessing food benefits.

To assess frequency and correlates of meal-kit use across five countries using population-level data.

Online surveys conducted in 2022 assessed past week meal-kit use. Binary logistic regression models examined sociodemographic and nutrition-related correlates of meal-kit use, including self-reported home meal preparation and cooking skills, commercially prepared meal consumption, and healthy eating, weight change, and sustainability efforts.

Canada, Australia, United Kingdom, United States (US), and Mexico.

20,401 adults aged 18-100 years.

Overall, 14% of participants reported using meal-kits in the past week. Use was highest in the US (18%) and lowest in Canada (9%). Meal-kit use was greater among individuals who were younger, male, minority ethnicity, had high educational attainment, higher income adequacy, or children living in the household (p<0.01 for all). Use was greater for those who participated in any food shopping (vs. none), those who prepared food sometimes (3-4 days/week or less vs. never), and those who reported ‘fair’ or better cooking skills (vs. poor; p<0.05 for all). Consuming any ‘ready-to-eat’ food (vs. none) and visiting restaurants more recently (vs >6 months ago; p<0.001 for all) was associated with greater meal-kit use. Eating fruits/vegetables more than 2-times/day and engaging in diet modification efforts were also associated with increased meal-kit use, as was engaging in weight change or sustainability efforts (p<0.001 for all).

Meal-kits tend to be used by individuals who make efforts to support their health and sustainability, potentially valuing ‘convenient’ alternatives to traditional home meal preparation; however, use is concentrated amongst those with higher income adequacy.

This study assessed the suitability of nutritional composition data from a commercial dataset for policy evaluation in Brazil.

We compared the proportions of packaged foods and beverages, classified according to the Nova food classification and the nutritional composition of matched products using data from a commercial database of food labels (Mintel-Global New Products Database (GNPD)) and the Brazilian Food Labels Database (BFLD), collected in 2017 as a ‘gold standard.’ We evaluated the agreement between the two datasets using paired t tests, Wilcoxon–Mann-Whitney test and the Intraclass Correlation Coefficient (ICC) for energy, carbohydrates, total sugars, proteins, total fats, saturated fats, trans-fats, sodium and fiber.

Brazil.

Totally, 11 434 packaged foods and beverages collected in 2017 provided by BFLD and 67 042 packaged foods and beverages launched from 2001 to 2017 provided by Mintel-GNPD.

The proportions of ultra-processed foods (UPF) were similar in both datasets. Paired products exhibited an excellent correlation (ICC > 0·80), with no statistically significant difference in the mean values (P ≥ 0·05) of most nutrients analysed. Discrepancies in fibre and fat content were noted in some UPF subcategories, including sweet biscuits, ice cream, candies, dairy beverages, sauces and condiments.

The Mintel-GNPD dataset closely aligns with the BFLD in UPF distribution and shows a similar nutritional composition to a sample of matched foods available for purchase in stores, indicating its potential contribution to monitoring and evaluating food labelling policies in Brazil and in studies of food and beverages composition in food retail through the verification of policy compliance.

This study is the first study in Middle Eastern population that aimed to investigate the association between global diet quality Score(GDQS) and risk of hypertension(HTN) in Iranian adults.

This population-based cohort study was conducted on 5,718 individuals aged≥18 years from the third and fourth TLGS surveys, who were followed until the sixth survey(mean follow-up:7.8 years). Dietary data were collected using a validated food frequency questionnaire to calculate GDQS as a novel food-based metric designed to assess diet quality across diverse populations. It evaluates the adequacy of healthy food groups(e.g., fruits, vegetables, whole grains) while monitoring the moderation of unhealthy or excessive intake(e.g., refined grains, processed meats, sugary foods).

Tehran Lipid and Glucose Study.

Iranian men and women.

Participants had a mean±SD age of 37.7±12.8 years, BMI of 26.6±4.7 kg/m2, and GDQS of 25.3±4.4. During the 7.8-year follow-up, 1302(18%) new cases of HTN were identified. Higher GDQS and its healthy components were associated with reduced HTN risk(HR:0.83;95%CI:0.70-0.98;Ptrend=0.034 and HR:0.78;95%CI:0.65-0.92;Ptrend=0.005, respectively), while unhealthy components of GDQS showed no association with HTN risk (HR:1.14;95%CI:0.98-1.33;Ptrend=0.059). These protective associations were observed across all weight categories and both genders, with stronger effects among obese individuals(for GDQS:HR:0.75;95%CI:0.58-0.98;P=0.041; for healthy components:HR:0.75;95%CI:0.57-0.99;P=0.044) and females(for GDQS:HR:0.77;95%CI:0.62-0.97;P=0.028; for healthy components:HR:0.76;95%CI:0.60-0.96;P=0.023).

A higher GDQS was associated with a reduced risk of incident HTN among Iranian adults. Adherence to a high-quality diet, particularly focusing on the healthy dietary components of GDQS, may serve as an effective strategy for preventing HTN, especially among obese individuals and women.

To assess the prevalence and identify sociodemographic predictors of regular fast-food consumption (R-FFC) among UAE adults to inform public health nutrition responses to growing diet-related ill-health in the region.

A descriptive cross-sectional study using purposive, convenience sampling. Data was collected using an online survey adapted from two validated surveys and distributed via social media platforms. R-FFC was defined as visiting a fast-food restaurant to eat ≥2 times/week. Pearson chi-squared tests and multiple binary logistic regression models were used to investigate prevalence and predictors of R-FFC. All statistical significance was considered at p-value <0.05.

Community, adults living in the UAE.

UAE residents, ≥18 years, who consumed fast-food ≥once during the previous month.

320 respondents met the inclusion criteria (age [mean± SD] = 23.7± 7.7 years). The prevalence of R-FFC was 46.6%. Based on results from the regression model, predictors of R-FFC were (AOR; 95% CI) being female (2.47; 1.06- 5.79), married (3.11; 1.25-7.77), BMI ≥25.0 (2.09; 1.10-4.00) and residing outside Abu Dhabi (32.79; 12.06-89.16). None of the remaining variables reached statistical significance. Taste was the most common reason for FFC (56.9%), followed by convenience (21.6%). Regular fast food consumers were more likely to “super-size” meals (p=0.011), eat alone (p=0.009), and not have regular meal patterns (p=0.004).

The study revealed a high prevalence of R-FFC among UAE adults, and novel cultural predictors and characteristics of FFC in this context, highlighting the importance of socially and culturally informed research and public health strategies in this region.

Vegetables are a key aspect of a healthy diet, but they are under-consumed throughout West Africa, where there is a lack of evidence on food environments. This study aimed to understand the physical availability of vegetables around schools in urban areas of Benin and Mali, as well as describe other aspects of the food environment.

The study used neighbourhood surveys of food outlets around schools in marginalised areas in five cities of Benin and Mali.

Food outlets within a 1 km radius of the main public primary schools.

Owners/managers/vendors of food outlets.

Vegetables are in general highly available around schools in representative urban areas of both Mali and Benin, with more outlets and more outlet diversity in general in the Benin contexts but a greater proportion of outlets selling vegetables in the Mali contexts. There is nuance, however, in which vegetables are sold (global or traditional vegetables) and what they are sold alongside that provides healthier or unhealthier options for consumers. Quality, convenience, source, cost and promotion were variable across sites.

The detailed findings in this study on outlet types, vegetable characteristics and the characteristics of vending are a significant contribution to understanding physical food environments in urban neighbourhoods that can inform policy responses in West Africa and beyond.