The current study explored changes in trend of anaemia and BMI among currently pregnant nullipara adolescent women against socio-economic determinants in India from 2005 through 2015. The association between anaemia in currently pregnant nullipara adolescent women v. currently pregnant nullipara older women of reproductive age was also explored.

We used the 2005 and the 2015 nationally representative Indian Demographic and Health Surveys (DHS). The outcomes of interest, anaemia and BMI, were measured based on the DHS methodology following WHO standards and indicators. Place of residence, educational attainment and wealth quintiles were used as determinants in the analysis.

India.

In total, 696 adolescent girls from the India 2005 DHS and 3041 adolescent girls from the India 2015 DHS.

The 10-year transition from 2005 to 2015 showed differences between the least and most wealthy sections of society, with heaviest gains in anaemia reduction over time among the latter (from 50·0 to < 40·0 %). The odds of anaemia were significantly higher among the adolescent population when compared with adult women both in 2005 and in 2015 (OR = 1·2).

Despite an overall improvement in the prevalence of both BMI < 18·5 and anaemia among adolescents nullipara in India, the adjusted risk of anaemia in the latter category was still significantly higher as compared with their adult counterparts. Since the inequalities evidenced during the first round of DHS remained unchanged in 2015, more investments in universal health care are needed in India.

To examine socio-economic inequalities in decreases in household sugar purchasing in Great Britain (GB).

Longitudinal, population-based study.

Data were obtained from the GB Kantar Fast-Moving Consumer Goods (FMCG) panel (2014–2017), a nationally representative panel study of food and beverages bought and brought into the home. We estimated changes in daily sugar purchases by occupational social grade from twenty-three food groups, using generalised estimating equations (household-level clustering).

British households who regularly reported food and beverages to the GB Kantar FMCG (n 28 033).

We found that lower social grades obtained a lower proportion of sugar from healthier foods and a greater proportion of sugar from less healthy foods and beverages. In 2014, differences in daily sugar purchased between the lowest and the highest social grades were 3·9 g/capita/d (95 % CI 2·9, 4·8) for table sugar, 2·4 g (95 % CI 1·8, 3·1) for sugar-sweetened beverages, 2·2 g (95 % CI 1·5, 2·8) for chocolate and confectionery and 1·0 g (95 % CI 0·7, 1·3) for biscuits. Conversely, the lowest social grade purchased less sugar from fruits (2·1 g (95 % CI 1·5, 2·8)) and vegetables (0·7 g (95 % CI 0·5, 0·8)) than the highest social grade. We found little evidence of change in social grade differences between 2014 and 2017. These results suggest that recent overall declines in sugar purchases are largely equally distributed across socio-economic groups.

This suggests that recent population-level policy activity to reduce sugar consumption in GB does not appear to exacerbate or reduce existing socio-economic inequalities in sugar purchasing. Low agency, population-level policies may be the best solution to improving population diet without increasing inequalities.

To assess trends in relative availability, sugar content and serve size of ready-to-drink non-alcoholic beverages available for sale in supermarkets from 2013 to 2019.

Repeat cross-sectional surveys. Data on single-serve beverages to be consumed in one sitting were obtained from an updated brand-specific food composition database. Trends in beverages availability and proportions with serve size ≤ 250 ml were assessed by χ2 tests. Sugar content trends were examined using linear regressions. The proportion of beverages exceeding the sugar threshold of the United Kingdom Soft Drinks Industry Levy (SDIL) was assessed.

New Zealand.

From 2013 to 2019, there was (i) an increase in the availability of sugar-free/low-sugar beverages (n 25 (8·4 %) to n 75 (19·1 %); P < 0·001) and craft sugar-sweetened soft drinks (n 11 (3·7 %) to n 36 (9·2 %); P < 0·001), and a decrease in availability of fruit/vegetable juices/drinks (n 94 (31·8 %) to n 75 (19·4 %); P < 0·001); (ii) small decreases in sugar content (mean g/100 ml) of sugar-sweetened soft drinks (3·03; 95 % CI 3·77, 2·29); fruit/vegetable juices/drinks (1·08; 95 % CI 2·14, 0·01) and energy drinks (0·98; 95 % CI 1·63, 0·32) and (iii) slight reduction in the proportion of beverages with serve size ≤ 250 ml (21·6 to 18·9 %; P < 0·001). In 2019, most beverages were sugar-sweetened or had naturally occurring sugars (79·1 %) and serve size > 250 ml (81·1 %) and most sugar-sweetened beverages exceeded the SDIL lower benchmark (72·9 %).

Most single-serve beverages available for sale in 2019 were sugary drinks with high sugar content and large serve sizes; therefore, changes made across the years were not meaningful for population’s health.

This study aimed to validate a nutrition knowledge questionnaire appropriate for use in Australia.

Nutrition knowledge is essential in establishing and maintaining strategies that reduce the burden of disease and promote wellbeing. The General Nutrition Knowledge Questionnaire (GNKQ) was developed in the United Kingdom in 1999 and validated for Australia in 2008. Changes in national nutrition recommendations and food availability prompted the redevelopment and revalidation of the UK questionnaire in 2016. However, the Australian questionnaire had not been subsequently updated.

Australia.

Content validity was determined using a sample of academic dietitians in Australia (n 8). Face validity was undertaken with retail employees (n 11) whose highest level of education was secondary school. Ninety-three undergraduate nutrition and engineering students at Queensland University of Technology completed the questionnaire for construct validity, and nineteen students were contacted a week later for test–retest reliability.

In the 117-scored questionnaire, nutrition students scored consistently higher in each of the four sections and overall (87 %, M 102, IQR 95, 107) compared with engineering students (77 %, M 82, IQR 76, 87·25, P < 0·01). Internal reliability of the questionnaire was high (α = 0·92) as was test–retest reliability (rs = 0·96, ICC2,1 = 0·99). AUS-R NKQ determined significant differences between individuals with known higher levels of nutrition knowledge and obtained high validity, reliability and consistency within an Australian sample.

AUS-R NKQ refined through this research is valid and would be an appropriate questionnaire for assessing the effectiveness of nutrition knowledge-based interventions for public health programmes, clinicians and researchers.

This study aimed to identify and rank the different aspects of households’ vulnerability to food insecurity.

The data were collected by a standard online questionnaire. The Household Food Insecurity Access Scale was used to assess food insecurity levels, and first-order structural equation modelling was applied to determine factors that affect food insecurity. Seven dimensions of vulnerability were measured: economic, social, cultural, human, physical, psychology and information, using thirty-seven items extracted from the related literature review.

This study was implemented in Tehran province in Iran.

The sample included 392 families residing in Tehran province which was determined using random sampling.

About 61 % of the total sample faced food insecurity, at marginal, moderate and severe levels. Economic, psychological and human aspects of vulnerability had the highest effect on food insecurity during the initial COVID-19 lockdown.

Authorities and policymakers must provide economic and financial support to vulnerable households. Abolition of US economic and financial sanctions imposed on Iran must be implemented to battle with COVID-19 in this country.

To determine whether food security, diet diversity and diet quality are associated with anthropometric measurements and body composition among women of reproductive age. The association between food security and anaemia prevalence was also tested.

Secondary analysis of cross-sectional data from the Healthy Life Trajectories Initiative (HeLTI) study. Food security and dietary data were collected by an interviewer-administered questionnaire. Hb levels were measured using a HemoCue, and anaemia was classified as an altitude-adjusted haemoglobin level < 12·5 g/dl. Body size and composition were assessed using anthropometry and dual-energy x-ray absorptiometry.

The urban township of Soweto, Johannesburg, South Africa.

Non-pregnant women aged 18–25 years (n 1534).

Almost half of the women were overweight or obese (44 %), and 9 % were underweight. Almost a third of women were anaemic (30 %). The prevalence rates of anaemia and food insecurity were similar across BMI categories. Food insecure women had the least diverse diets, and food security was negatively associated with diet quality (food security category v. diet quality score: B = –0·35, 95 % CI –0·70, –0·01, P = 0·049). Significant univariate associations were observed between food security and total lean mass. However, there were no associations between food security and body size or composition variables in multivariate models.

Our data indicate that food security is an important determinant of diet quality in this urban-poor, highly transitioned setting. Interventions to improve maternal and child nutrition should recognise both food security and the food environment as critical elements within their developmental phases.

A suboptimal diet and nutritional deficiencies can have important influences on health with significant impact among older adults. This study aims to assess the presence of suboptimal dietary intake among older Americans and identify risk and protective factors influencing diet quality.

Cross-sectional secondary analysis.

USA.

A nationally representative sample of 5614 community-dwelling older adults over age 54 in the Health and Retirement Study – Health Care and Nutrition Survey.

Overall, only 10·7 % of respondents had a good quality diet (Healthy Eating Index score 81 and above); the majority had diets considered poor or needing improvement. Less than 50 % of respondents met dietary guidelines and nutritional goals for most individual food groups and nutrients. Respondents with low socio-economic status, fewer psychosocial resources and those who had limited access to healthy food outlets were more likely to have a diet of suboptimal quality.

Efforts to remove identified barriers that put older adults at risk for poor nutrition and to provide resources that increase access to healthy food should be made to encourage healthy eating and enhance diet quality.

To evaluate weight misperception among adolescents and determine associations between self-perceived weight and socio-demographic characteristics, BMI, screen time, self-rated food quantity and diet quality, weekly frequency of breakfast and the consumption of healthy and unhealthy foods.

A cross-sectional, two-stage, probabilistic population-based study was conducted in Campinas, Brazil. Multinomial logistic regressions were run to estimate weight self-perception.

Data from the Campinas Health Survey (ISACamp) and Campinas Food Consumption Survey (ISACamp-Nutri).

A total of 911 adolescents aged 10–19 years.

Nearly half (47·7 %) of the adolescents with overweight/obesity did not evaluate their weight properly. Weight self-perception as thin and excess weight was associated with the female gender, overweight/obesity, self-rated diet quality as poor/very poor and eating snacks ≥3 times/week. Adolescents who did not consume breakfast daily were less likely to perceive themselves as thin. Adolescents who ate excessively were more likely and those who consumed cookies/crackers ≥3 times/week were less likely to perceive themselves as having excess weight.

Greater weight misperception was found in overweight/obese adolescents. Gender, BMI, self-rated food quantity/diet quality, weekly frequency of breakfast and some unhealthy foods were associated with self-perceived weight. The present findings could contribute to health promotion strategies targeting adolescents.

The aim of the study was to identify components of the COM-B (capability, opportunity, motivation and behaviour) model that influences behaviour to modify dietary patterns in 40–55-year-olds living in the UK, in order to influence the risk of cognitive decline in later life.

This is a qualitative study using the COM-B model and theoretical domains framework (TDF) to explore beliefs to adopting the Mediterranean-DASH Intervention for Neurodegenerative delay (MIND) diet.

Northern Ireland.

Twenty-five participants were recruited onto the study to take part in either a focus group or an interview. Participants were men and women aged between 40 and 55 years. Participants were recruited via email, Facebook and face to face.

Content analysis revealed that the main perceived barriers to the adoption of the MIND diet were time, work environment, taste preference and convenience. The main perceived facilitators reported were improved health, memory, planning and organisation, and access to good quality food.

This study provides insight into the personal, social and environmental factors that participants report as barriers and facilitators to the adoption of the MIND diet among middle-aged adults living in the UK. More barriers to healthy dietary change were found than facilitators. Future interventions that increase capability, opportunity and motivation may be beneficial. The results from this study will be used to design a behaviour change intervention using the subsequent steps from the Behaviour Change Wheel.

To examine whether bedtime is associated with usual sleep duration and eating behaviour among adolescents, emerging adults and young adults.

Cross-sectional multivariable regression models, stratified by developmental stage, to examine: (1) association between bedtime and sleep duration and (2) associations between bedtime and specific eating behaviours at each developmental period, controlling for sleep duration. All models adjusted for sociodemographic characteristics, depressive symptoms and screen time behaviours.

National Longitudinal Study of Adolescent to Adult Health, waves I–IV, USA.

A national probability sample surveyed in adolescence (aged 12–18 years, wave I: 1994–1995, n 13 048 and wave II: 1996, n 9438), emerging adulthood (aged 18–24 years, wave III: 2001–2002, n 9424) and young adulthood (aged 24–34 years, wave IV: 2008, n 10 410).

Later bedtime was associated with shorter sleep duration in all developmental stages, such that a 1-h delay in bedtime was associated with 14–33 fewer minutes of sleep per night (Ps < 0·001). Later bedtime was also associated with lower odds of consuming healthier foods (i.e. fruits, vegetables; range of adjusted OR (AOR), 0·82–0·93, Ps < 0·05) and higher odds of consuming less healthy foods and beverages (i.e. soda, pizza, desserts and sweets; range of AOR, 1·07–1·09, Ps < 0·05). Later bedtime was also associated with more frequent fast-food consumption and higher sugar-sweetened beverage consumption (Ps < 0·05).

Later bedtime was associated with shorter sleep duration and less healthy eating behaviours. Bedtime may be a novel behaviour to address in interventions aiming to improve sleep duration and dietary intake.

The current study aimed to analyse the prospective association between perceived work demand and changes in eating behaviours in schoolteachers.

This was a prospective cohort study with self-reported information obtained on the Demand Control Support Questionnaire and eating behaviours at baseline and after a 2-year follow-up. The analyses were performed using mixed-effects models adjusted for the main confounders.

The setting consisted of elementary and secondary schools located in a large city in southern Brazil.

The participants were 502 schoolteachers (65·9 % females, median age of 42·7 years [interquartile range 34·2, 49·4]).

A total of 39·2 % of the schoolteachers were classified at baseline with job strain, 28·9 % with passive job, 12·2 % with active job and 19·7 % with low-strain job. In the fully adjusted models, compared with teachers who reported low-strain job, those with higher levels of job strain were more likely to reduce (coefficient = 0·064; 95 % CI 0·018, 0·109) and less likely to increase (coefficient = −0·066; 95 % CI −0·115, −0·016) their frequency of fruit consumption regardless of sociodemographic, lifestyle, health conditions and social support at work.

Job strain plays a relevant role in the frequency of fruit consumption over time in schoolteachers. The balance between demand and control at work must be considered in strategies for promoting healthy eating despite perceived social support.

To examine: (1) diet quality of older adults, using the Healthy Eating Index 2010 (HEI-2010) and self-rated diet quality, (2) characteristics associated with reported awareness and use of nutrition information and (3) factors associated with HEI score and self-rated diet quality.

Cross-sectional study. Based on Day 1 and/or Day 2 dietary recalls, the Per-Person method was used to estimate HEI-2010 component and total scores. T-tests and ANOVA were used to compare means. Logistic and linear regressions were used to test for associations with diet quality, controlling for potential confounders.

National Health and Nutrition Examination Survey, 2009–2014.

Three thousand and fifty-six adults, aged 60 years and older, who completed at least one 24-h recall and answered questions on awareness and use of nutrition information.

Mean HEI score for men was significantly lower than for women (56·4 ± 0·6 v. 60·2 ± 0·6, P < 0·0001). Compared with men, more women were aware of (44·8 % v. 33·7 %, P < 0·05) and used (13·7 % v. 5·9 %, P < 0·05) nutrition information. In multivariable analyses, awareness and use of nutrition information were significant predictors of both HEI and self-rated diet quality for both women and men. Groups with lower nutrition awareness included men, non-Whites, participants in nutrition assistance programmes and those with lower education and socio-economic status.

Nutrition awareness and use of nutrition information are associated with diet quality in adults 60 years and older. Gaps in awareness of dietary guidelines in certain segments of the older adult population suggest that targeted education may improve diet quality for these groups.

To assess the consumption of ultra-processed foods and its association with the overall dietary content of nutrients related to non-communicable diseases (NCD) in the Chilean diet and to estimate the population attributable fraction of ultra-processed food consumption on the unhealthy nutrient content.

Cross-sectional analysis of dietary data collected through a national survey (2010).

Chile.

Chilean population aged ≥2 years (n 4920).

In Chile, ultra-processed foods represented 28·6 % of the total energy intake. A significant positive association was found between the dietary share of ultra-processed foods and NCD-promoting nutrients such as dietary energy density (standardised regression coefficient (β) = 0·22), content of free sugars (β = 0·45), total fats (β = 0·26), saturated fats (β = 0·19), trans fats (β = 0·09) and Na:K ratio (β = 0·04), while a significant negative association was found with the content of NCD-protective nutrients such as K (β = –0·19) and fibre (β = –0·31). The content of Na (β = 0·02) presented no significant association. Except for Na, the prevalence of inadequate intake of all nutrients (WHO recommendations) increased across quintiles of the dietary share of ultra-processed foods. With the reduction of ultra-processed foods consumption to the level seen among the 20 % lowest consumers (3·8 % (0–9·3 %) of the total energy from ultra-processed foods), the prevalence of nutrient inadequacy would be reduced in almost three-fourths for trans fats; in half for energy density (foods); in around one-third for saturated fats, energy density (beverages), free sugars and total fats; in near 20 % for fibre and Na:K ratio and in 13 % for K.

In Chile, decreasing the consumption of ultra-processed foods is a potentially effective way to achieve the WHO nutrient goals for the prevention of diet-related NCD.

The purpose of the study was to examine the association between dietary lutein and zeaxanthin (L + Z) intake and immediate word recall (IWR) and delayed word recall (DWR), and to identify the major contributors to dietary L + Z intake in a recent and representative sample of the older US population.

In this cross-sectional analysis, multivariate path analytic models estimated the association between L + Z consumption and cognitive performance while adjusting for covariates.

Observations were drawn from the 2014 Health and Retirement Study, a nationally representative panel study of older US adults, and the 2013 Health Care and Nutrition Study, which assessed dietary intake via FFQ in a subsample of respondents.

The analytic sample included 6390 respondents aged ≥50 years.

L + Z intake was 2·44 ± 2·32 mg/d on average, and L + Z intake differed significantly across quartiles (P < 0·001). For example, average L + Z intake in Q1 was 0·74 ± 0·23 mg/d and in Q4 was 5·46 ± 2·88 mg/d. In covariate adjusted models, older adults in the highest quartiles of L + Z intake had significantly greater IWR and DWR scores than those in the lowest quartile. Leafy vegetables, cruciferous vegetables, dark yellow vegetables, fish and seafood, legumes, eggs and fruit were significant and meaningful predictors of dietary L + Z intake.

A high consumption of vegetables, fish and seafood, legumes, eggs and fruit is associated with a higher intake of L + Z and greater word recall among older adults.

The current study aimed to evaluate the association of major dietary patterns with anxiety in middle-aged adults in eastern China.

Dietary intake was assessed using a semi-quantitative FFQ. Binary logistic regression analysis was used to estimate OR and 95 % CI for anxiety according to quartiles of each dietary pattern score.

Evidence regarding the relationship between dietary patterns and anxiety in the Chinese population is scarce.

The study participants were 1360 Chinese adults aged 45–59 years, who participated in a health survey at the time of periodic check-up in the city of Linyi, Shandong Province, China.

Four major dietary patterns were identified by factor analysis: traditional Chinese, western, grains–vegetables and high-salt diets. After adjusting for potential confounders, participants in the highest quartile of the western pattern had greater odds for anxiety, compared with those in the lowest quartile (OR 1·35, 95 % CI 1·000, 3·086, P < 0·05). In contrast, participants in the highest quartile of the grains–vegetables pattern had lower odds for anxiety than did those in the lowest quartile (OR 0·78, 95 % CI 0·574, 1·000, P < 0·05). Moreover, no significant associations were observed between the traditional Chinese and high-salt patterns and the risk of anxiety.

Our findings indicate that the western pattern is associated with an increased risk, and the grains–vegetables pattern is associated with a decreased risk of anxiety.

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.

Existing research suggests walnut intake may be associated with better cognitive function in older adults, yet few studies utilise longitudinal data from observational studies of ageing populations. Our objective was to estimate the association between whole walnut intake and cognitive change in a representative sample of older Americans.

Secondary analysis of the Health and Retirement Study and Health Care and Nutrition Study. Walnut consumption was defined as a categorical measure (none, low intake (0·01–0·08 1 oz. servings per day) and moderate intake (>0·08 1 oz. servings per day)) and cognitive function was measured using the Telephone Interview for Cognitive Status. Latent growth modelling estimated the association between walnut consumption and trajectories of cognitive status over a 4-year observational period. Sensitivity analyses assessing non-random dropout and Monte Carlo power analyses were conducted to contextualise results.

The USA.

A sample of 3632 US adults aged 65 years and older.

Those reporting any walnut consumption had greater cognitive scores at baseline than those not consuming walnuts (low walnut consumption, b = 1·53, se = 0·21, P < 0·001; moderate walnut consumption, b = 2·22, se = 0·27, P < 0·001), but walnut consumption was not associated with cognitive change. Walnut consumption was positively associated with socioeconomic status and health behaviours as well as intake of nutrients identified to have neuroprotective benefits.

We identified an association between walnut consumption and cognitive function in older adults, although we did not find that walnut consumption was protective against age-related cognitive decline.

Higher quality dietary patterns such as healthy/prudent and Mediterranean dietary patterns have been protectively associated with depression. This study examined whether healthy Japanese dietary patterns, which differ from dietary patterns derived from Western areas, are associated with depressive symptoms among Japanese women.

A cross-sectional study (the Nagano Nutrition and Health Study). Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. Dietary patterns were derived with a principal component analysis of the consumption of fifty-six food and beverage items, which were assessed by a validated brief diet history questionnaire.

Nagano, Japan.

Japanese women (n 1337) aged 20–72 years.

We identified three dietary patterns: ‘healthy Japanese’, ‘sweets-fat’ and ‘seafood–alcohol’. The highest quality dietary pattern was ‘healthy Japanese’. It is characterised by a high intake of vegetables, mushrooms, seaweed, soyabean products, potatoes, fish/shellfish and fruit. The age- and multivariate-adjusted OR (95 % CI) of depressive symptoms for the highest quartiles of the ‘healthy Japanese’ pattern score were 0·58 (95 % CI 0·41, 0·82) and 0·69 (95 % CI 0·45, 1·06), respectively. Meanwhile, no associations were observed for ‘sweets-fat’ and ‘seafood–alcohol’ patterns.

The ‘healthy Japanese’ pattern may be inversely associated with depressive symptoms with an exposure-response association. The specific Japanese food groups in the ‘healthy Japanese’ pattern included mushrooms, seaweed, soyabean products and potatoes, as well as vegetables, fish/shellfish and fruit. These seem to create an anti-inflammation-prone dietary pattern, and this factor might be associated with better mental health.

This review summarises and synthesises the existing literature on the relationship between food insecurity (FS) and mental health conditions among adult individuals experiencing homelessness.

Scoping review. Papers published between 1 January 2008 and 2 November 2018, searched in PubMed, Web of Science, Scopus, PsycINFO, Cochrane Library and CINAHL, using homelessness, food security and mental health keywords.

Global evidence.

Homeless adults aged 18 years or more.

Nine articles (eight cross-sectional and one longitudinal) were included in the present review. FS was measured using the Household Food Insecurity Access Scale, the United States Department of Agriculture Household Food Security Survey Module, as well as single-item or constructed measures. Depression and depressive symptoms were the most common mental health conditions studied. Other mental health conditions assessed included alcohol and substance use, emotional disorders, mental health problems symptoms severity and psychiatric hospitalisations. Composite measures such as axis I and II categories and a cluster of severe mental conditions and mental health-related functioning status were also analysed. FS and mental health-related problems were considered as both exposure and outcome variables. The existing evidence suggests a potential association between FS and several mental health conditions, particularly depression, mental health symptoms severity and poor mental health status scores.

This review suggests the potential association between some mental health conditions and FS among homeless adults. However, there is a need for more longitudinal- and interventional-based studies, in order to understand the nature and directionality of the links between FS and mental health in this population group.

To assess dairy Ca intake and investigate its relationship with insomnia and other common co-morbidities including anxiety, depression and musculoskeletal pain (MSP) among university students.

Cross-sectional study.

University, Irbid, Jordan.

Male and female individuals (n 1000), aged 20·87 ± 2·69 years.

Low dairy Ca intake (<1000 mg/d) was reported by 96·5 % of participants, and moderate to severe insomnia reported by 15·6 % of participants. Abnormal anxiety and depression scores were reported by 26·2 and 18·0 % of participants, respectively. MSP was reported by 42·9 % of participants. Participants with moderate to severe insomnia had lower dairy Ca, higher anxiety and depression scores and higher measures of MSP compared to participants with no insomnia (P-values < 0·05). Dairy Ca was weakly inversely correlated with Insomnia Severity Index (ISI) score, depression score and measures of MSP (P-values < 0·05). Regression analysis indicated that insomnia was predicted by low dairy Ca, anxiety, depression, MSP and smoking (P-values < 0·05). Both anxiety and depression were predicted by increased ISI score (P-values < 0·05), while depression alone was predicted by low dairy Ca (P-value < 0·01). MSP was predicted by increased ISI and anxiety scores (P-values < 0·05).

Low dairy Ca was highly prevalent and associated with insomnia and depression among university students. Individuals should be advised to increase dietary Ca intake to achieve the recommended daily amount. Further research is required to investigate a potential causal relationship between low Ca and both insomnia and its related co-morbidities.