To evaluate the current state of the Nourish Network (NN) – a healthy food retail network, to inform future planning and improvement opportunities.

A qualitative study was conducted using semi-structured interviews conducted between January and April 2024, open-ended survey questions from six online surveys applied between 2019-2022, and a focus group with the NN Advisory Committee (NNAC) in June 2024. Thematic analysis was applied to interview and survey data. Results from the thematic analysis were presented to the NNAC, which classified them according to the Strengths, Weaknesses, Opportunities and Threats model, resulting in recommendations for future actions.

Australia

NN members (interviews n=9, and survey average response n=30) and NNAC (n=9)

Nine interviews yielded eight codes clustered into three themes: i) NN performance, covering overall performance and management since 2018; ii) members’ engagement with NN activities, addressing current and future involvement; and iii) NN future directions for improvement. The NNAC highlighted strengths in membership diversity and credibility while noting weaknesses in mission clarity and participation. Opportunities for growth include becoming a resource hub through partnerships and national expansion, whereas threats involve limited resources. Recommendations emphasise clear operational tasks, policy alignment, and measurement systems to boost accountability and engagement.

To effectively promote healthy food retail changes, the Network for Nutrition and similar organisations must establish a clear vision and enhance stakeholder engagement. This involves consolidating knowledge dissemination, fostering partnerships, and securing funding. Ongoing efforts from collectives like the Nourish Network can facilitate research in resource-scarce areas.

Food environments can influence dietary behaviours. Promotion of foods high in fats, salt and sugars (HFSS) is a barrier to healthy eating. We explore advertising by deprivation in an English city.

Using a cross-sectional design, we describe the prevalence of outdoor advertising, the types of products advertised and the UK Nutrient Profile Modelling (NPM) scores for advertised foods and non-alcoholic beverages. Differences in outdoor advertising prevalence by area deprivation was assessed using Chi–squared tests.

Six areas in each of 5 deprivation strata were randomly selected from all 482 Leeds neighbourhoods (England) (n = 30 neighbourhoods).

Eligible outdoor advertisement assets (intentionally placed permanent/semi-permanent advertisements visible from the street) were photographed in May-June 2023.

A total of 295 outdoor advertising assets were recorded. The most deprived quintile had the highest number of advertising assets (n = 74). Bus shelters were the most prevalent asset (n = 68). The number of food adverts differed significantly by deprivation level. The 2 most deprived areas had higher than expected exposure while the 2 least deprived areas had lower than expected exposure (p<0.01). Data were insufficient to compare compliance against a hypothetical Healthier Food Advertising Policy (HFAP), however bus shelters were most likely to display HFSS food adverts.

Food advertising in Leeds is unequally distributed with more food adverts in more deprived areas. Similar inequalities may exist in other cities, but data are scarce. Unhealthy adverts are most prevalent on bus shelters, highlighting an important asset for policy focus.

We aimed to analyse the effects of nutrition-sensitive agriculture (NSA) interventions on nutrition, examine the pathways within a project cycle and explore the pathways 3 years after the end of the funding period.

We employed a sequential mixed-methods design using (1) secondary quantitative data and (2) primary qualitative data. The quantitative data were analysed using the Mann–Whitney test, independent sample t test and binary logistic regression. The qualitative data were analysed thematically.

This research used the case of the Integrated Agriculture and Health Based Interventions project.

The quantitative data comprised 4825 households. The qualitative data included forty-six participants (twenty-eight beneficiaries and eighteen implementers) from two focus group discussions (n 15) and thirty-one semi-structured interviews.

NSA interventions reduced child underweight and improved household and women’s dietary diversity scores, breastfeeding practices, handwashing and access to Fe–folic acid during pregnancy. Pregnant and lactating women’s minimum dietary diversity increased, while children’s minimum dietary diversity reduced. Key pathways to nutrition during project implementation were food production, nutrition-related knowledge and strengthening local institutions. Sustainability of knowledge was mostly evident, followed by food production, while the strengthening of local institutions was less evident.

Key pathways to outcomes during the project implementation were food production, nutrition-related knowledge and strengthening local institutions, as these were the main focus of the project. Income and women’s empowerment pathways could be more effective if intentionally integrated. We reiterate the need to enhance children’s dietary diversity, strengthen income–expenditure and women empowerment pathways, sustain livestock production and strengthen local institutions.

This paper explored international experts’ views on what influences the development and implementation of local government (LG) planning policy to support healthy food retail environments; and 2) whether a Rapid Group Model Building (RGMB) can successfully be applied to capture valuable insights.

Adaptation of methods from community-based system dynamics in the form of RGMBs.

In person, facilitated workshop at the World Public Health Nutrition Congress (WPHNC) June 2024, London, England.

WPHNC delegates.

Sixty-six participants contributed the RGMB. Factors identified that influence the development and implementation of LG planning to supports healthy food retail environments centred around community, evidence, policy, political leadership/priorities and capitalism. Feedback loops identified in the causal loop diagram showed the potential influence of policies to support healthy food retail environments on public health outcomes. Research evidence and data were key factors in supporting community demand for healthy food policies and raising the profile of health as a priority, which, in turn, could support funding to support healthy food environments. Political will and corporate influence in the system were shown to be highly influential.

International experts identified that data is urgently needed to support demand for healthy food policies and political will to address key nutrition issues. The influence of corporate interests was viewed as highly influential over the current system across the world. RGMB workshop activities and processes described in this paper can be used successfully to capture expert insights into complex problems using interactive technologies.

To examine the impacts of school-based CalFresh Healthy Living (CFHL-California’s SNAP-Ed) interventions post-COVID-19-related school closures and whether student and school characteristics modified intervention impacts on student diet and physical activity (PA).

Quasi-experimental, two-group, pre-post, self-report.

CFHL-eligible public schools (nintervention = 51; ncomparison = 18).

4th/5th grade students (nintervention = 2115; ncomparison = 1102).

CFHL interventions were associated with an increase in consumption frequency of fruit (0·19 times/d (P = 0·015)) and vegetables (0·35 times/d (P = 0·006)). Differences in baseline diet and PA behaviours were observed by student race and gender and by whether the proportion of free and reduced-price meal (FRPM)-eligible students was above the state average. Notably, students in schools with FRPM above the state average reported more frequent consumption of sugar-sweetened beverages (Mean (se): 3·18 (0·10) v. 2·58 (0·11); P = 0·001) and fewer days/week with 60+ min of moderate-to-vigorous PA (MVPA) (Mean (se): 2·8 (0·10) v. 3·21 (0·12); P = 0·020) than those at schools with FRPM at/below the state average. Student gender, school urbanicity and school FRPM modified the relationship between the interventions and certain dietary and/or PA outcomes. Interventions were associated with greater increases in vegetable consumption in more urban schools (β (95 % CI) = 0·67 (0·15, 1·20)), and greater increases in fruit consumption (β (95 % CI) = 0·37 (0·07, 0·66)) and in MVPA in higher FRPM schools (β (95 % CI) = 0·86 (0·33, 1·39)).

Findings reaffirmed effectiveness of school-based CFHL interventions. We identified existing student and school-level disparities and then observed that interventions were associated with greater increases in MVPA in the highest FRPM schools. Findings can inform an equity-centred approach to delivery of school-based interventions that facilitate equal opportunity for all children to achieve lifelong health.

This study outlines the development of a co-designed, co-produced intervention to address the high risk of diet-related noncommunicable diseases (NCDs) among South Asians (SA) in New Zealand. The objectives were to identify: (1) reasons, concerns, and perceptions influencing dietary changes post-migration; (2) preferred formats and delivery modes for the intervention; (3) intervention design features; (4) community volunteers for co-production; and (5) co-produce the intervention components.

Participatory Action Research

SA communities in Auckland and Dunedin, New Zealand.

SA immigrants aged 25-59 years old. Ten telephone or face-to-face interviews were conducted between 2018 and 2019. Following this, one codesign workshop (n = 12) was conducted with the target population and community stakeholders in 2019.

Thematic analysis revealed factors such as children’s preference for boxed cereals and limited time for traditional breakfasts contributed to poor dietary habits. Concerns included meal timing and long-term weight gain, while perceptions such as all home-cooked food is healthy, influenced a lack of concern for long term health. Preferred formats were educational comics and video clips, with digital platforms as the delivery mode. The workshop helped choose comic characters and identify community members to co-produce video content. The final intervention included 11 comics, 8 videos, 12 audio clips, and 18 scientific snippets, organised into five dietary and one physical activity module.

A participatory approach proved feasible for co-designing a culturally tailored lifestyle intervention to address diet-NCD risks in the SA diaspora in New Zealand.

To examine how WIC online food benefit ordering could influence WIC benefit redemptions.

A cross-sectional study. We compare the average redemption rates between online ordering early adopters and non-adopters among WIC customers before and after implementing WIC online ordering. A propensity score-weighted difference-in-difference (DiD) model was used to estimate the coefficients.

The Oklahoma WIC program and a grocery store chain in Oklahoma.

12,743 Oklahoma WIC households that had redeemed their food benefits at the grocery store chain in 2020.

WIC online ordering significantly positively affected redemption rates for eight of the fifteen food categories. For example, the DiD coefficients (P–values) of these food categories were: cheese or tofu (0.077, < .01), yogurt (0.092, < .01), whole milk (0.082, .022), low-fat milk (0.060, < .01), eggs (0.049, .033), breakfast cereal (0.085, < .01), and infant formula (0.073, .039). Two food categories with significantly negative DiD coefficients had relatively lower redemption rates overall: canned fish (Coefficient = –0.209, P < .01) and infant cereal (Coefficient = –0.138, P = .015). There were no significant changes in the redemption of fruits and vegetables (Coefficient = 0.031, P = 0.121).

Adopting WIC online ordering was positively associated with benefit redemption rates among most food benefit categories. Our findings provide preliminary but important evidence regarding online food benefit redemption among low-income consumers.

To assess the nutritional quality of foods and beverages (F&B) advertised to adolescents and analyse marketing techniques and persuasive appeals used by celebrities and influencers on Instagram.

A content analysis study was conducted using the WHO’s CLICK Monitoring Framework and Nutrient Profile Model.

Instagram, a popular social media platform among adolescents with frequent F&B advertisements by celebrities and influencers.

The top forty-eight Instagram accounts of celebrities and influencers posting F&B advertisements were selected based on follower count and engagement metrics. Nutrient profiling of advertised F&B (n 344) and content analysis of posts featuring F&B (n 326) between January 2021 and May 2023 were performed. Data collected included characteristics of celebrities and influencers, marketing techniques, online engagement and persuasive appeals in the posts.

Carbonated beverages and flavored waters (28·5 %), energy drinks (20·6 %) and ready-made foods (15·4 %) were most frequently advertised, with the majority (89·2 %) of products not permitted for advertisement to adolescents, according to WHO. Common marketing techniques included tagging brand (96·9 %) and using brand logo (94·2 %). The most frequently used persuasive appeals were taste (20·9 %), energy (10·7 %), link to sports events (10·7 %), new product (9·5 %) and fun (7·4 %).

Most F&B advertised on Instagram by celebrities and influencers are prohibited from being advertised to adolescents by the WHO. This highlights the need for stricter regulation of user-generated content and for users and parents to be better educated about persuasive techniques used on social media to make them less vulnerable to the influence of marketing.

To explore the development of the Nutrition Society of Australia’s (NSA) mentoring program for Registered Nutritionists and evaluate the experience of the nutrition professionals participating in the mentoring program.

Case study evaluation utilising a focus group, individual semi-structured interviews, open-ended survey responses, and document analysis, via an interpretivist lens.

Australia

Three members of the NSA’s inaugural Mentoring Program Committee participated in a focus group. Eleven program mentees and ten mentors from three consecutive cohorts of the NSA Mentoring program for Registered Nutritionists (paired in 2021-2022) agreed to participate.

Data were analysed from survey responses, document analysis, in addition to focus group and in-depth interviews with twelve program participants. Mentoring was seen as a pathway beyond tertiary training to negotiate challenges associated with career development; mentors were seen as facilitators of growth through “real world” skill-set acquisition. Successful partnerships were facilitated by program flexibility and the perception of professional compatibility. Participation in the NSA’s mentoring program was perceived to value-add to society membership, strengthening the society and professional practice, promoting networking within the nutrition community and public health field.

Mentoring programs may provide access to diverse skillsets required in a non-vocational profession, promoting greater confidence and a stronger professional identity. These skills are essential for fostering a resilient nutrition workforce that can help combat the burden of non-communicable disease.

To estimate the potential health benefits from the reduction in consumption of salt and sugar following the introduction of a proposed tax on salt and sugar in the United Kingdom (UK).

Epidemiological modelling study. Life-table modelling was used to estimate the expected population health benefits from the reduction in consumption of salt and sugar for four scenarios, each reflecting different manufacturer and consumer responses the proposed tax. Relative risks for 24 disease-risk pairs were applied, exploring different pathways between salt and sugar consumption, and mortality and morbidity.

UK.

Population of the UK.

The results show that life expectancy in the UK could be increased by 1.7 (0.3-3.6) to 4.9 (1.0-9.4) months, depending on the degree of industry and consumer response to the tax. The tax could also lead to up to nearly 2 (0.4-3.6) million fewer cases of preventable chronic diseases and an increase of as much as 3.5 (0.8-6.4) million years of life gained. The largest health benefits would accrue from reduced mortality and morbidity from cardiovascular diseases.

Significant benefits to population health could be expected from extending the current tax on sugar sweetened beverages to other sugary foods and from adding a tax on foods high in salt. The proposed dietary changes are likely to be insufficient to reach national public health targets; hence, additional measures to reduce the burden of chronic disease in the UK will be equally critical to consider.

To examine differences in fruit and vegetable intake and food insecurity between Black African and Caribbean and South Asian (Indian, Pakistani and Bangladeshi) ethnic minority groups with a White (British) reference population in the UK. This study was part of the TANGERINE project (nuTritional heAlth aNd aGeing in oldER ethnIc miNoritiEs).

Longitudinal analysis using multilevel logistic regression from Understanding Society, and a cross-sectional comparison with UK Biobank.

Understanding Society waves 2 (2010-2012), 5 (2013-2015), 7 (2015-2017), 9 (2017-2019) 11 (2019-2021), and 13 (2021-2023).

UK Biobank baseline data (2006-2010).

Understanding Society: adults aged 16 years and above (approximately 44,000 households).

UK Biobank: participants aged 37-73 years (n=502,412).

At wave 2, African, Caribbean, Pakistani, and Bangladeshi participants in Understanding Society had lower odds of daily vegetable intake than White British/Irish participants, with Pakistanis showing the lowest intake. These disparities persisted after adjusting for socioeconomic position (SEP) at individual and area level, particularly for Caribbean and Pakistani groups. Indians consistently had higher odds of vegetable intake. Ethnic differences in fruit intake were smaller and largely attenuated by SEP adjustment. Food insecurity was more prevalent in all ethnic minority groups (except Indians) and associated with lower vegetable and fruit intake, though SEP explains more of the ethnic difference.

Ethnic differences in fruit and vegetable intake are at least partially explained by SEP, with persistent vegetable consumption disparities after adjustment. Culturally tailored interventions addressing affordability, accessibility, and SEP disparities are needed to improve dietary behaviours among minority ethnic groups.

With the re-emerging homelessness issue in Hong Kong given its least affordable housing, securing food to meet the basic physiological needs is of priority concern in the homeless. This study aims to examine the situation and determinants of food insecurity in the homeless of Hong Kong.

Cross-sectional survey on food insecurity level, sociodemographic characteristics, homeless experiences, and health status and behaviours.

360 community hot spots of homeless people identified by NGOs and experienced social workers in different districts of Hong Kong in 2021.

711 individuals experiencing homelessness.

The observed prevalence of low, medium, and high food insecurity levels were 37.4%, 20.4%, and 42.2%, respectively. Results from multivariable ordinal logistic regression showed that older, female, non-Chinese, and non-married respondents were inversely associated with food insecurity, whereas having sufficient savings for more proper housing was the primary determinant among socioeconomic indicators. In addition to reasons for homelessness, risk factors of food insecurity included living in guesthouses/hotels and difficulties due to government measures on homeless control. Except for disability, both self-rated physical and mental health statuses showed dose-response relationships with food insecurity level.

The substantial individual variations in sociodemographic statuses, homeless experiences, and health deficits shaped the differential risks of food insecurity within the homeless community in Hong Kong. Targeted homeless programmes should go beyond the conventionally vulnerable groups but consider the multifaceted nature of homeless experiences in relation to food access, and integrate health assessments to holistically support the homeless.

Little is known about food insecurity in Asian Americans (AAs). We examined age/ethnic subgroup differences in food insecurity among AAs in California.

We examined associations between food insecurity and sociodemographic characteristics among AAs (Chinese, Filipino, Korean, Vietnamese) using the Chi-square test. Rolling averages were calculated to examine food insecurity trends.

California

We used data from the California Health Interview Survey (2011-2018) for AAs categorized by age (18-39, 40-59, 60+ years).

Food insecurity prevalence varied by subgroup, with the highest observed in older adult (aged 60+) Vietnamese (26%). Between 2011-14 and 2015-18, food insecurity prevalence increased 20-45% across older adults, but showed a decreasing trend among younger adults. Being foreign born and speaking a language other than English at home were associated with increased food insecurity.

Community-engaged research to develop culturally appropriate strategies for mitigating food insecurity among older AAs is warranted.

This study aimed to investigate the association between moderate thinness (MT) and muscle strength among children aged 5-7 years old in Ethiopia.

A school-based comparative cross-sectional study was conducted between June to July 2022. Their nutritional status (MT versus well-nourished (WN) was identified using BMI-for-age-and-sex; hand grip was measured using a digital grip strength dynamometer, and biceps, quadriceps, and gastrocnemius strength were measured with Digital (Handheld) Dynamometry. Independent predictors of muscle strength were identified using a multivariable linear regression model.

The study was conducted in Kindergarten and primary schools of Jimma Town, located in Southwest Ethiopia

Children 5-7 years old (n=388) with moderate thinness (MT=194) and well-nourished peers (WN=194).

Children with MT (n=198) had significantly lower grip strength, biceps, quadriceps, and gastrocnemius muscle groups than WN children (n=198) (p< 0.001). The mean and standard deviation of grip strength were 4.15 ± (2.56) kilograms (kg) for MT and 5.6 ± (2.04) kg for WN children. Biceps strength was 34.3 ± (7.34) Newton (N) for MT and 48 (11.69) N for WN children. Gastrocnemius strength was 30.1 (6.9) N for MT and 45.1 ± (9.7) N for WN children. After adjusting for background characteristics, WN children had 1.38 times higher grip strength (β=1.38, p <0.001), 11.22 times higher biceps strength (β=11.22, p<0.001), 16.70 times higher quadriceps strength (β=16.70, p<0.001), and 12.75 times higher gastrocnemius strength (β=12.75, p<0.001) than MT children.

Children with MT had significantly lower muscle strength than their WN counterparts. This highlights the negative functional effect of wasting.

To identify the dietary patterns of ultra-processed food (UPF) consumption in the UK adults, and to explore their nutritional characteristics and associated demographic and socioeconomic factors.

UPF-based dietary patterns were identified using weighted principal component analysis and k-means cluster analysis on UPFs intakes (identified using Nova classification) from the cross-sectional NDNS data (2008-2019). Weighted multivariable logistic regression models were employed to identify the demographic and socioeconomic factors associated with the patterns.

United Kingdom.

8,347 adults (≥ 18y).

UPFs accounted for 54% of total energy intake in the UK adult diet. Three distinct UPF-clusters were identified, labelled as “Sweet Foods,” “Fast Foods,” and “Traditional Foods” based on their predominant food intakes. Older participants (>68 years) were more likely to adhere to the “Sweet Foods” pattern (OR: 2.39; 95% CI: 1.99-2.87) and less likely to be part of the “Fast Foods” pattern (OR: 0.47; 95% CI: 0.40-0.55) compared to younger individuals (< 29). Participants in lower occupations were less likely to adhere to the “Fast Foods” pattern than participants in the higher occupations (OR: 0.82; 95% CI: 0.72-0.94) while being more likely to adhere to the “Traditional Foods” pattern (OR: 1.23; 95% CI: 1.06-1.43).

The UK diet was dominated by UPF products. Our analysis identified three distinct UPF dietary patterns with varying nutritional quality, influenced by key demographic and social factors. These findings provide valuable insights into the determinants of UPF consumption and highlight which population groups are more likely to consume certain types of UPFs.

To characterize the dietary patterns of Marshallese mothers of young children in Northwest Arkansas, informing the cultural adaptation of nutrition education curricula.

An exploratory cross-sectional study was conducted, in which Marshallese women with children under 12 months completed 3 telephone-administered 24-hour dietary recalls with a trained bilingual Marshallese interviewer. Diet quality was characterized using the Healthy Eating Index (HEI)-2020. A food-level analysis identified top food groupings contributing to total energy and HEI-2020 components.

Northwest Arkansas.

Marshallese mothers with children <12 months.

29 women were recruited, 20 completed 2 or 3 dietary recalls. Median age was 25.5 years. Diet quality by HEI-2020 was 46.4 (max score 100). White rice was the top contributor to total energy; high seafood/plant protein and fatty acid diet quality component scores were influenced by high fish intakes.

Diet quality was low. Key adaptations include reducing rice portion sizes, while emphasizing lean proteins and fruits/vegetables. Cultural adaptation of nutrition education is essential to improve diet quality among communities with varying dietary practices.

To assess the association between coffee consumption and life expectancy among the US adults.

Prospective cohort.

National representative survey in the United States, 2001–2018.

A total of 43 114 participants aged 20 years or older with complete coffee consumption data were included from National Health and Nutrition Examination Survey 2001–2018.

Over a median follow-up of 8·7 years, 6234 total deaths occurred, encompassing 1929 deaths from CVD and 1411 deaths from cancer. Based on the nationally representative survey, we found that coffee consumption is associated with longer life expectancy. The estimated life expectancy at age 50 was 30·06 years (95 % CI, 29·68, 30·44), 30·82 years (30·12, 31·57), 32·08 years (31·52, 32·70), 31·24 years (30·29, 32·19), and 31·45 years (30·39, 32·60) in participants consuming 0, ≤ 1, 1 to ≤ 2, 2 to ≤ 3, and > 3 cups of coffee per day, respectively. Consequently, compared with non-coffee drinkers, participants who consumed 1 to ≤ 2 cups/day had a gain of 2·02 years (1·17, 2·85) in life expectancy on average, attributable to a 0·61-year (29·72 %) reduction in CVD deaths. Similar benefits were found in both males and females.

Our findings suggest that moderate coffee consumption (approximately 2 cups per day) could be recommended as a valuable component of a healthy diet and may be an adjustable effective intervention measure to increase life expectancy.

To compare the association of participation in Supplemental Nutrition Assistance Program (SNAP) alone v. in combination with Head Start (HS), Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) or both on household dietary environment (HDE) indicators: food security, nutrition security, healthfulness choice, dietary choice, perceived food store availability, utilisation barriers and healthy food access barriers in families with young children.

This study, part of SNAP-Ed Nebraska’s Needs and Assets Assessment ‘Healthy People, Healthy State’, utilised a cross-sectional design. HDE indicator means were compared across the federal assistance program (FAP) participation groups using multivariate ANCOVA, controlling for significant demographics, with Benjamini–Hochberg-adjusted P values compared with α = 0·05.

Nebraska’s low-income households.

Households (n 821) with at least one child aged 2–6 years participating in SNAP-only (n 257), SNAP + HS (n 349), SNAP + WIC (n 132) and SNAP + WIC + HS (n 83).

Compared with other groups, SNAP + HS reported comparatively higher levels of household food security, whereas SNAP + HS + WIC reported lower levels (P < 0·01). SNAP + HS also showed higher levels of nutrition security, dietary choices, perceived availability of healthy foods in stores, fewer healthy food access and utilisation barriers (P < 0·05).

The findings support recent joint policy changes by Administration for Children and Families and Food and Nutrition Service, facilitating SNAP households’ access to HS. HS performance standards for nutrition and family engagement can serve as a model for creating healthy HDE. Future research should employ quasi-experimental or longitudinal designs to establish causal relationships between FAP participation and HDE outcomes.

To compare the international BMI standard/references of the International Obesity Task Force (IOTF), MULT and the WHO and to analyse the association between changes in BMI growth channelling (BMI-GC) during childhood and the risk of being overweight in early adolescence.

Participant data from the Millennium Cohort Study (MCS), young lives (YL) and Generation XXI (G21) cohorts were obtained at three time points. Lin’s concordance correlation coefficient (CCC) and the weighted Kappa coefficient were used to assess the agreement among the BMI standard/references. The relative risk (RR) of being overweight at 9·5–13·5 years, based on an increase in BMI-GC (amplitude ≥ 0·67) between 3·5–6 years and 6·5–9 years, was calculated, with estimates adjusted for sex, ethnicity and socio-economic status.

Ethiopia, India, Portugal, Vietnam and United Kingdom.

Totally, 12 624 participants from the MCS, YL and G21 studies.

The prevalence of overweight across the three ages groups was higher when using the WHO standard/reference (12·8–25·9 %) compared with the MULT (17·1–22·9 %) and IOTF (13·0–19·3 %) references. However, substantial agreement (0·95 < CCC ≤ 0·99) was found among these standard/references. Children who increased their BMI-GC by ≥ 0·67 and < 0·86 were more likely to be overweight at 9·5–13·5 years (MULT-RR = 2·49, 95 % CI: 2·00, 3·09/ WHO-RR = 2·47, 95 % CI: 1·96, 3·12/ IOTF-RR = 2·31, 95 % CI: 1·82, 2·93), compared with those who have stayed in their BMI-GC.

A change in the BMI-GC among normal-weight children during childhood was associated with a significantly higher risk of being overweight at 9·5–13·5 years. These findings suggest that monitoring BMI-GC in children could be a tool to intervene and to prevent overweight in early adolescence.