To explore government support service access, perceived barriers/enablers to menu planning and menu compliance in long day care (LDC) centres in Victoria, Australia, where the Victorian Government-funded Healthy Eating Advisory Service (HEAS) is available to provide free LDC menu planning support.

This is a cross-sectional study design. Data were collected from online surveys with the option of uploading 2 weeks of menus and recipes. Menu compliance was scored for quantity, quality and variety. Barriers/enablers to menu planning guideline implementation were determined using the Theoretical Domains Framework (TDF). Independent t tests, one-way ANOVA and chi-square tests assessed relationships between characteristics, barriers/enablers and menu scores.

Eighty-nine LDC centres that prepare food onsite.

LDC staff responsible for menu planning (n 89) and menus from eighteen centres.

Fifty-five per cent of centres had accessed HEAS. Of eighteen provided menus, only one menu was compliant with menu planning guidelines. HEAS access was associated with higher average scores in four of seven TDF domains, namely knowledge/awareness, skills/role, reinforcement/influence and optimism/intent. There were no correlations between menu score and barriers/enablers; however, menu quality scores were higher for those accessing HEAS.

Childcare-specific government support services may be an important public health nutrition strategy and may improve menu planning guideline implementation as well as menu quality; however, this does not necessarily translate into menu compliance. Research should confirm these findings in larger studies to ascertain uptake of these services. Public health efforts should focus on exploring barriers and enablers to uptake of government support services to increase reach and acceptability.

To quantify the sector-wide energy and nutritional differences of both adult and children’s restaurant menu items in the UK and the USA in 2018.

Cross-sectional study.

Energy and nutritional information provided on restaurant websites.

Menu items (n 40 902) served by forty-two large UK chains and ninety-six large USA chains.

Mean absolute energy, fat and saturated fat values were higher in USA menu items. For example, the mean adjusted per-item differences of adult menu items between the USA and the UK were 45·6 kcal for energy and 3·2 g for fat. Comparable figures for children’s menu items were 43·7 kcal and 4 g. Compared with UK menu items, USA adult menu items also had higher sugar content (3·2 g, 95 % CI (0·5, 6)), and children’s menu items had higher Na content (181·1 mg, 95 % CI (108·4, 253·7)). Overall, 96·8 % of UK and 95·8 % of USA menu items exceeded recommended levels for at least one of Na, fat, saturated fat or sugars.

Menu items served by large chain restaurants had higher mean absolute levels of energy, fat and saturated fat in the USA compared with the UK. UK adult menu items were also lower in sugars compared with the USA ones and children’s items lower in Na. As more than 95 % of all items were considered to have high levels of at least one nutrient of public health concern in the USA and the UK, improvements in restaurant menu items are needed in both countries.

To report on the prevalence of different types of breast-milk substitutes (BMS) marketing and the compliance of such marketing with the ‘Control of Marketing of Infant and Young Child Food Act 2017’ (The Act) and the ‘International Code of Marketing of Breast-milk Substitutes (WHO Code)’ in Thailand.

Cross-sectional quantitative study, guided by the WHO/UNICEF NetCode Periodic Assessment Protocol.

Health facilities and retail outlets in Bangkok, Thai media.

Mothers of 0–2-year-old children, health professionals, promotions at retail outlets and health facilities, product labels, marketing on television and the internet.

Marketing to mothers was highly prevalent, mostly from electronic or digital media, while BMS companies provided items to health professionals to distribute to mothers. Promotional materials in health facilities displayed company brands or logos. At retail outlets, most promotions were price-related. Approximately two-fifths of labels contained nutrition or health claims. Television marketing was growing-up-milk (GUM) advertisements, while internet promotions were varied from price-related materials to product reviews. Most instances of non-compliant BMS marketing with the Act were advertisements to mothers, and most were infant formula. Most non-compliant BMS marketing with the WHO Code was mainly concerned GUM, which are not covered by the Act and appeared in the media.

BMS marketing does not fully comply with the Act or the WHO Code. The Thai government should conduct regular monitoring and enforcement activities, educate health professionals, and strengthen the Act’s provisions on the media and GUM to fully align with the WHO Code.

The mother–child breastfeeding dyad is a powerful force for achieving healthy, secure and sustainable food systems. However, food system reports exclude breastfeeding and mother’s milk. To help correct this omission and give breastfeeding women greater visibility in food systems dialogue and action, we illustrate how to estimate mother’s milk production and incorporate this into food surveillance systems, drawing on the pioneering experience of Norway to show the potential value of such analysis.

The estimates use data on the proportion of children who are breastfed at each month of age (0–24 months), annual number of live births and assumptions on daily human milk intake at each month. New indicators for temporal and cross-country comparisons are considered.

It is assumed that a breastfeeding mother on average produces 306 l of milk during 24 months of lactation.

The annual number of live births is from Statistics Norway. Data for any breastfeeding at each month of age, between 0 and 24 months, are from official surveys in 1993, 1998–1999, 2006–2007, 2013 and 2018–2019.

Estimated total milk production by Norwegian mothers increased from 8·2 to 10·1 million l per year between 1993 and 2018–2019. Annual per capita production increased from 69 to 91 l per child aged 0–24 months.

This study shows it is feasible and useful to include human milk production in food surveillance systems as an indicator of infant and young child food security and dietary quality. It also demonstrates significant potential for greater milk production.

The purpose of the current study was to cross-culturally adapt and validate an online questionnaire to assess eating habits and physical activity of university students under confinement due to coronavirus disease (COVID-19).

Generation of a cross-sectional online survey to university students conducted during confinement due to COVID-19. The study was divided into two phases.

Students, Chile.

Phase 1 considered the process of translation and back translation, expert panel, cultural adaptation and the generation of a pilot to validate a preliminary format of the questionnaire. In Phase 2, information from the instrument was collected from two hundred and sixty-eight university students, ages 16 to 30 years old, with a mean age of 21·6 (3·3) The major proportion of participants were female (82 %).

The adapted questionnaire was statistically validated in three dimensions: (A) eating habits and behaviours during quarantine, (B) perception of risk and (C) physical activity changes during the quarantine. The reliability of Cronbach’s α for dimensions A, B and C was 0·59, 0·85 and 0·97, respectively. The complete questionnaire obtained 0·61 in internal consistency and 0·61 (0·58–0·67) ICC reliability. A statistically significant positive correlation matrix was observed.

This questionnaire is a practical tool to obtain accurate information about the relation of COVID-19 confinement on people’s eating habits and physical activity. Therefore, it could contribute to establishing appropriate strategies to prevent negative effects on people’s health.

To validate a Food Diversity Questionnaire (CDA, for its name in Spanish) that identifies the prevalence of the risk of deficiency in the intake of eleven micronutrients.

The CDA paper form, an online application for data entry and handling, was designed and compared with the 24-h recall (24HR) as a reference method. All data were processed in Personal Computer Software for Intake Distribution Estimation (PC-SIDE) v1 software. A descriptive analysis and comparisons between prevalence, concordance and reproducibility analyses were performed.

Medellín, Colombia.

Women of childbearing age between 19 and 50 years (n 186) who worked for the Buen Comienzo programme in 2019.

When comparing the adjusted 24HR technique and the CDA, there was no significant difference in population-level data at risk of deficiency in any micronutrient intake. However, based on individual-level data of the best linear unbiased predictor, the concordance analyses were weak, and although agreements were high according to the diagnostic performance tests, a good ability to detect deficiency was only observed in a few nutrients: vitamin A 100·0 %, Ca 98·7 %, Fe 92·8 %, folates 91·6 %, and pyridoxine 81·8 %.

The CDA validated in this study is useful and faster at evaluating population-level data at risk of deficiency in the intake of Ca, Fe, Zn, thiamine, riboflavin, niacin, pyridoxine, folates, vitamin B12, vitamin C and vitamin A. Based on individual-level data, a good ability to detect deficiencies was observed in the intake of vitamin A, Ca, Fe, folates and pyridoxine.

To assess the nutritional suitability of commercially produced complementary foods (CPCF) marketed in three South-East Asian contexts.

Based on label information declared on the products, nutrient composition and content of CPCF were assessed against the WHO Europe nutrient profile model (NPM). The proportion of CPCF that would require a ‘high sugar’ warning was also determined.

Khsach Kandal district, Cambodia; Bandung City, Indonesia; and National Capital Region, Philippines.

CPCF products purchased in Cambodia (n 68) and Philippines (n 211) in 2020, and Indonesia (n 211) in 2017.

Only 4·4 % of products in Cambodia, 10·0 % of products in Indonesia and 37·0 % of products in the Philippines fully complied with relevant WHO Europe NPM nutrient composition requirements. Sixteen per cent of CPCF in Cambodia, 27·0 % in Indonesia and 58·8 % in the Philippines contained total sugar content levels that would require a ‘high sugar’ warning.

Most of the analysed CPCF were not nutritionally suitable to be promoted for older infants and young children based on their nutrient profiles, with many containing high levels of sugar and sodium. Therefore, it is crucial to introduce new policies, regulations and standards to limit the promotion of inappropriate CPCF in the South-East Asia region.

To determine the relative validity and reproducibility of the Eetscore FFQ, a short screener for assessing diet quality, in patients with (severe) obesity before and after bariatric surgery (BS).

The Eetscore FFQ was evaluated against 3-d food records (3d-FR) before (T0) and 6 months after BS (T6) by comparing index scores of the Dutch Healthy Diet index 2015 (DHD2015-index). Relative validity was assessed using paired t tests, Kendall’s tau-b correlation coefficients (τb), cross-classification by tertiles, weighted kappa values (kw) and Bland–Altman plots. Reproducibility of the Eetscore FFQ was assessed using intraclass correlation coefficients (ICC).

Regional hospital, the Netherlands.

Hundred and forty participants with obesity who were scheduled for BS.

At T0, mean total DHD2015-index score derived from the Eetscore FFQ was 10·2 points higher than the food record-derived score (P < 0·001) and showed an acceptable correlation (τb = 0·42, 95 % CI: 0·27, 0·55). There was a fair agreement with a correct classification of 50 % (kw = 0·37, 95 % CI: 0·25, 0·49). Correlation coefficients of the individual DHD components varied from 0·01–0·54. Similar results were observed at T6 (τb = 0·31, 95 % CI: 0·12, 0·48, correct classification of 43·7 %; kw = 0·25, 95 % CI: 0·11, 0·40). Reproducibility of the Eetscore FFQ was good (ICC = 0·78, 95 % CI: 0·69, 0·84).

The Eetscore FFQ showed to be acceptably correlated with the DHD2015-index derived from 3d-FR, but absolute agreement was poor. Considering the need for dietary assessment methods that reduce the burden for patients, practitioners and researchers, the Eetscore FFQ can be used for ranking according to diet quality and for monitoring changes over time.

Most previous research on the antecedents of healthy food choice has not investigated the links between these antecedents and has focused on specific food choice rather than on an overall diet. In the present study, we tested the plausibility of an integrated theoretical model aiming to explain the role of different psychosocial factors in increasing the intention to adhere to the Mediterranean Diet (MeDiet).

An online survey measured participants’ attitude and perceived behavioural control (i.e. rational antecedents), subjective norm (i.e. social antecedent), positive and negative anticipated emotions (i.e. emotional antecedents), food choice health and mood motives (i.e. motivational antecedents), past adherence to the MeDiet (i.e. behavioural antecedent), and intention to adhere to the MeDiet.

Italy.

1940 adults: 1086 females; 854 males; mean age = 35·65; sd = 14·75; age range = 18–84.

Structural Equation Modelling (sem) analyses confirmed the plausibility of the proposed model. Perceived behavioural control was the strongest rational antecedent of intention, followed by the emotional (i.e. anticipated emotions) and the social (i.e. subjective norm) antecedents. Mediation analysis showed that motivational antecedents had only an indirect impact on intention via emotional antecedents. Finally, multigroup sem analysis highlighted that past adherence to the MeDiet moderated the hypothesised paths among all the study variables.

The above findings advance our comprehension of which antecedents public communication might leverage to promote an increase in the adherence to the MeDiet.

This study aimed to investigate the mediating role of food parenting practices (FPP), including home availability of different types of foods and drinks, parental modelling of fruit intake, permissiveness and the use of food as a reward in the relationship between parental education and dietary intake in European children.

Single mediation analyses were conducted to explore whether FPP explain associations between parents’ educational level and children’s dietary intake measured by a parent-reported FFQ.

Six European countries.

Parent–child dyads (n 6705, 50·7 % girls, 88·8 % mothers) from the Feel4Diabetes-study.

Children aged 8·15 ± 0·96 years were included. Parental education was associated with children’s higher intake of water, fruits and vegetables and lower intake of sugar-rich foods and savoury snacks. All FPP explained the associations between parental education and dietary intake to a greater or lesser extent. Specifically, home availability of soft drinks explained 59·3 % of the association between parental education and sugar-rich food intake. Home availability of fruits and vegetables was the strongest mediators in the association between parental education and fruit and vegetable consumption (77·3 % and 51·5 %, respectively). Regarding savoury snacks, home availability of salty snacks and soft drinks was the strongest mediators (27·6 % and 20·8 %, respectively).

FPP mediate the associations between parental education and children’s dietary intake. This study highlights the importance of addressing FPP in future interventions targeting low-educated populations.

To quantify perceptions of tap water among low-income mothers with young children residing in Michigan and examine associations between perceptions of tap water, mothers’ and young children’s beverage intake, and mothers’ infant feeding practices.

Cross-sectional study.

Online survey.

Medicaid-insured individuals who had given birth at a large Midwestern US hospital between fall 2016 and fall 2020 were invited by email to complete a survey in winter 2020 (N 3881); 15·6 % (N 606) completed eligibility screening, 550 (90·8 %) were eligible to participate, and 500 (90·9 %) provided valid survey data regarding perceptions of tap water, self and child beverage intake, and infant feeding practices.

Two-thirds (66·2 %) of mothers reported that their home tap water was safe to drink without a filter, while 21·6 % were unsure about the safety of their home tap water. Mothers’ perceptions of their home tap water were associated with their own tap and bottled water intake and their young children’s tap water and bottled water intake. Mothers with more negative perceptions of tap water in general, independent of their perceptions about their home tap water, consumed more bottled water and sugar-sweetened beverages, and their young children drank bottled water and fruit drinks more frequently. Few associations were observed between mothers’ perceptions of tap water and infant feeding practices.

Uncertainty about tap water safety and negative perceptions of tap water are common among low-income Michigan mothers. These beliefs may contribute to less healthful and more costly beverage intake among mothers and their young children.

The study explores whether type 2 diabetes (T2D) diagnosis affects food consumption patterns in line with the dietary recommendations provided to individuals in relation to a diagnosis.

Based on detailed food purchase data, we explore which dietary changes are most common following a T2D diagnosis. Changes are investigated for several energy-adjusted nutrients and food groups and overall adherence to dietary guidelines.

We use data on diagnosis of T2D and hospitalisation in relation to T2D for a sample of adult Danes registered in the official patient register. This is combined with detailed scanner data on food purchases, which are used as a proxy for dietary intake.

We included 274 individuals in Denmark who are diagnosed during their participation in a consumer panel where they report their food purchases and 16 395 individuals who are not diagnosed.

Results suggest some changes in dietary composition following diagnosis, as measured by a Healthy Eating Index and for specific food groups and nutrients, although the long-term effects are limited. Socio-economic characteristics are poor predictors of dietary changes following diagnosis. Change in diet following diagnosis vary with the pre-diagnosis consumption patterns, where individuals with relatively unhealthy overall diets prior to diagnosis improve overall healthiness more compared to individuals with relatively healthy diets prior to diagnosis.

Adherence to dietary advice is low, on average, but there is large variation in behavioural change between the diagnosed individuals. Our results stress the difficulty for diagnosed individuals to shift dietary habits, particularly in the long term.

This study aimed to verify the association between socio-economic and demographic characteristics and dietary patterns (DP) of children assisted by the Conditional Cash Transfer Program, Bolsa Família Program (BFP).

This is a cross-sectional study. DP were defined using a principal component analysis. The association of the predictive variables and DP was modelled using multilevel linear regression analysis.

This study was conducted in six municipalities from the State of Alagoas, Brazil.

The participants were children aged 6–24 months who were assisted by the BFP.

A total of 1604 children were evaluated. Four DP were identified (DP1, DP2, DP3 and DP4). DP1 is composed of traditional Brazilian food. DP2 is formed mostly from ultra-processed foods (UPF). DP3 consists of milk (non-breast) with added sugar, while DP4 consists of fresh and minimally processed foods. Caregivers with higher age and education (β = −0·008; (95 % CI −0·017, −0·000); β = −0·037; (95 % CI −0·056, −0·018), respectively) were negatively associated with DP2. We observed a negative association between households with food insecurity (β = −0·204; (95 % CI −0·331, −0·078)) and DP4 and a positive association between caregivers with higher age and education (β = 0·011; (95 % CI (0·003; 0·019); β = 0·043; (95 % CI 0·025, 0·061), respectively) and DP4.

This study identified the association between socio-economic inequities and DP early in life, with an early introduction of UPF, in children assisted by BFP in the State of Alagoas.

To determine the level of adherence and to assess the association between higher adherence to the South African food based dietary guidelines (SAFBDG) and breast cancer risk.

Population-based, case–control study (the South African Breast Cancer study) matched on age and demographic settings. Validated questionnaires were used to collect dietary and epidemiological data. To assess adherence to the SAFBDG, a nine-point adherence score (out of eleven guidelines) was developed, using suggested adherence cut-points for scoring each recommendation (0 and 1). When the association between higher adherence to the SAFBDG and breast cancer risk was assessed, data-driven tertiles among controls were used as cut-points for scoring each recommendation (0, 0·5 and 1). OR and 95 % CI were estimated using multivariate logistic regression models.

Soweto, South Africa.

Black urban women, 396 breast cancer cases and 396 controls.

After adjusting for potential confounders, higher adherence (>5·0) to the SAFBDG v. lower adherence (<3·5) was statistically significantly inversely associated with breast cancer risk overall (OR = 0·56, 95 % CI 0·38, 0·85), among postmenopausal women (OR = 0·64, 95 % CI 0·40, 0·97) as well as for oestrogen-positive breast cancers (OR = 0·51, 95 % CI 0·32, 0·89). Only 32·3 % of cases and 39·1 % of controls adhered to at least half (a score >4·5) of the SAFBDG.

Higher adherence to the SAFBDG may reduce breast cancer risk in this population. The concerning low levels of adherence to the SAFBDG emphasise the need for education campaigns and to create healthy food environments in South Africa to increase adherence to the SAFBDG.

To identify factors associated with breast-feeding initiation and continuation in Canadian-born and non-Canadian-born women.

Prospective cohort of mothers and infants born from 2008 to 2012: the Canadian Healthy Infant Longitudinal Development (CHILD) Cohort Study.

General community setting in four Canadian provinces.

In total, 3455 pregnant women from Vancouver, Edmonton, Winnipeg and Toronto between 2008 and 2012.

Of 3010 participants included in the current study, the majority were Canadian-born (75·5 %). Breast-feeding initiation rates were high in both non-Canadian-born (95·5 %) and Canadian-born participants (92·7 %). The median breast-feeding duration was 10 months in Canadian-born participants and 11 months in non-Canadian-born participants. Among Canadian-born participants, factors associated with breast-feeding initiation and continuation were older maternal age, higher maternal education, living with their partner and recruitment site. Rooming-in during the hospital stay was also associated with higher rates of breast-feeding initiation, but not continuation at 6-month postpartum. Factors associated with non-initiation of breast-feeding and cessation at 6-month postpartum were maternal smoking, living with a current smoker, caesarean birth and early-term birth. Among non-Canadian-born participants, maternal smoking during pregnancy was associated with lower odds of breast-feeding initiation and lower odds of breast-feeding continuation at 6 months, and older maternal age and recruitment site were associated with breast-feeding continuation at 6 months.

Although Canadian-born and non-Canadian-born women in the CHILD cohort have similar breast-feeding initiation rates, breast-feeding initiation and continuation are more strongly associated with socio-demographic characteristics in Canadian-born participants. Recruitment site was strongly associated with breast-feeding continuation in both groups and may indicate geographic disparities in breast-feeding rates nationally.

To investigate nutrition knowledge (NK) in university students, potential factors affecting knowledge and predictors of good NK.

A cross-sectional study was conducted in 2017–2018. The revised General Nutrition Knowledge Questionnaire was administered online to assess overall NK and subsections of knowledge (dietary recommendations, nutrient sources of foods, healthy food choices and diet–disease relationships). The Kruskal–Wallis test was used to compare overall NK scores according to sex, age, ethnicity, field of study, studying status, living arrangement, being on a special diet and perceived health. Logistic regression was performed to identify which of these factors were associated with a good level of NK (defined as having an overall NK score above the median score of the sample population).

Two London-based universities.

One hundred and ninety students from various academic disciplines.

The highest NK scores were found in the healthy food choices (10 out of 13 points) and the lowest in the nutrient sources of foods section (25 out of 36 points). Overall NK score was 64 out of 88 points, with 46·8 % students reaching a good level of knowledge. Knowledge scores significantly differed according to age, field of study, ethnicity and perceived health. Having good NK was positively associated with age (OR = 1·05, (95 % CI 1·00, 1·1), P < 0·05), White ethnicity (OR = 3·27, (95 % CI 1·68, 6·35), P < 0·001) and health rating as very good or excellent (OR = 4·71, (95 % CI 1·95, 11·4), P < 0·05).

Future health-promoting interventions should focus on increasing knowledge of specific nutrition areas and consider the personal and academic factors affecting NK in university students.

To explore the influence of socio-economic position (SEP) on habitual dietary intake in Colombian cities.

We conducted a cross-sectional, population-based study in five Colombian cities. Dietary intake was assessed with a 157-item semi-quantitative FFQ previously developed for the Colombian population. Nutrient analysis was performed using national and international food composition tables. SEP was assessed with two indicators: a government-defined, asset-based, household-level index called socio-economic stratum (SES) and, among adults, highest educational level attained.

The five main urban centers of Colombia: Bogotá, Medellin, Barranquilla, Cali and Bucaramanga.

Probabilistic, multi-stage sample of 1865 participants (n 1491 for analyses on education).

For both sexes, increasing SES was associated with a lower consumption of energy (P-trend <0·001 in both sexes), carbohydrates (P-trend <0·001 in both sexes), Na (P-trend = 0·005 in males, <0·001 in females), SFA (P-trend <0·001 in both sexes) and among females, cholesterol (P-trend = 0·002). More educated men consumed significantly less energy and carbohydrates (P-trend = 0·036 and <0·001, respectively). Among men, intake of trans fats increased monotonically with educational level, being 21 % higher among college graduates relative to those with only elementary education (P-trend = 0·023). Among women, higher educational level was associated with higher MUFA intake (P-trend = 0·027).

SES and educational level are strong correlates of the usual diet of urban Colombians. Economically deprived and less educated segments of society display dietary habits that make them vulnerable to chronic diseases and should be the primary target of public health nutrition policies.

According to the WHO, anaemia is a severe public health problem when the prevalence is ≥ 40 %. In 2019, in Peru, 40·1 % of children (aged 6 to 35 months) are diagnosed as anaemic. This is a concern since, despite the efforts of the governments to reduce the prevalence, the problem has stagnated since 2011. The treatment applied to deal with anaemia is Fe supplementation. Although Fe is essential for cell function, an excess can produce adverse responses, such as gut inflammation affecting microbiota and resulting in diarrhoeic episodes.

To determine the association between diarrhoea and Fe supplementation in children with and without anaemia, controlling for different socio-demographic variables.

We conducted via logistic regression to obtain diarrhoea prevalence ratios (PR), adjusted by age, sex, geographic region, water and sanitation service, and rurality. The survey asked for recent episodes of diarrhoea during the last 7 d; similarly, after the consumption of Fe supplements during the last 12 months before the survey.

Peru.

The Demographic and Family Health Survey (DHS) is conducted annually at home among 14 202 children on average (2009–2019).

Fe supplementation in the last 7 d (PR = 1·09) or the last 12 months (PR = 1·19) (P < 0·0001) was associated with an increased risk of diarrhoea. The same association was observed between Fe supplementation and the presence of anaemia.

Fe supplementation is associated with diarrhoea and overuse in children should be avoided.

To investigate the relationship of a healthy eating score with depression in Chilean older adults.

Cross-sectional study.

Older adults from the Chilean National Health Survey 2016–2017. Associations were analysed using complex samples multivariable logistic regressions adjusted for age, sex, socio-demographic, lifestyles (physical activity, smoking, alcohol consumption and sleep duration), BMI and clinical conditions (hypertension, diabetes, hypercholesterolaemia and cardiovascular diseases).

The number of participants was 2031 (≥ 60 years). The Composite International Diagnostic Interview-Short Form was applied to establish the diagnosis of major depressive episode. Six healthy eating habits were considered to produce the healthy eating score (range: 0–12): consumption of seafood, whole grain, dairy, fruits, vegetables and legumes. Participants were categorised according to their final scores as healthy (≥ 9), average (5–8) and unhealthy (≤ 4).

Participants with a healthy score had a higher educational level, physical activity and regular sleep hours than participants with an average and unhealthiest healthy eating score. Participants classified in the healthiest healthy eating score had an inverse association with depression (OR: 0·28, (95 % CI 0·10, 0·74)). Food items that contributed the most to this association were legumes (15·2 %) and seafood (12·7 %).

Older adults classified in the healthiest healthy eating score, characterised by a high consumption of legumes and seafood, showed a lower risk for depression in a representative sample of Chilean population.

To quantify the mediating role of childhood diets in the relationship between maternal diets prior to pregnancy and childhood behavioural disorders.

The Healthy Eating Index score was constructed using a semi-quantitative and validated 101-item FFQ. We assessed childhood behavioural disorders using the Strengths and Difficulties Questionnaire. Three dietary patterns were identified using principal component analysis to explore childhood dietary patterns (high fats and sugar; prudent diets; and diary). A causal inference framework for mediation analysis was used to quantify the mediating role of childhood diets in the association between pre-pregnancy diets and the risk of offspring behavioural problems.

This is a national representative population-based survey which covers all Australian citizens and permanent residents in Australia.

We included 1448 mother–child pairs from the Australian Longitudinal Study on Women’s Health and its sub-study mothers and their children’s health.

We found a 20 % of the total effect of the poor adherence to pre-pregnancy diet quality on the risk of offspring behavioural problems was mediated through childhood high consumptions of fats and sugar. No clear mediating effect through prudent and diary childhood diets was observed.

This study suggests that childhood high fats and sugar consumption may contribute to the total effects of the pre-pregnancy diets on the risk of childhood behavioural problems.