We analysed optimal nutrient levels using linear programming (LP) to reveal nutritional shortcomings of Korean dine-out meals and to stress the importance of fruits and dairy products for maintaining a healthy diet.

LP models that minimize deviation from recommended nutrient values were formulated to analyse deficiency or excess of nutrients under the best situation.

Korean dine-out menus and nutritional information were taken from the nutrient composition tables for dine-out menus developed by the Ministry of Food and Drug Safety and the nutrient database from Computerized Analysis Program. Acceptable macronutrient distribution ranges of macronutrients such as carbohydrate, protein and fat, and recommended intake levels for energy, vitamins, minerals and cholesterol, by sex, were based on the Dietary Reference Intake for Koreans aged 30–49 years.

Optimization was performed on selecting the optimal Korean meal combination.

LP optimization models showed that it is unlikely to satisfy all nutrient recommendations with any combination of dine-out menus. Specifically, meal combinations of Korean dine-out menus had high levels of Na and cholesterol and low levels of vitamins and minerals. Four formulations were considered to compare the effects of controlling Na and including fruit and dairy products. The unbalanced diet was resolved with extra consumption of fruits and dairy products.

The best meal combination in dine-out menus, even though the proportion and pairing of menus may be unrealistic, is not healthy, and thus one should consume fruits and dairy products to maintain a balanced diet.

To determine the acceptability, internal consistency and test–retest reliability of self-efficacy, motivation and knowledge scales relating to pre-school children’s nutrition, oral health and physical activity.

An online questionnaire was completed twice with an interval of 7–11d.

Online questionnaires were sent to participants via email from nursery managers. The parent questionnaire was also available on the parenting website www.netmums.com.

Eighty-two parents and sixty-nine nursery staff from Bristol, UK who had and worked with 2–4-year-olds, respectively.

Response rates were 86·3 and 86·0 % and missing data 15·9 and 14·5 % for the second administration of the parent and nursery staff questionnaires, respectively. Weighted κ coefficients for individual items mostly fell under the ‘moderate’ agreement category for the parental (75·0 %) and nursery staff (55·8 %) items. All self-efficacy and motivation scales had acceptable levels of internal consistency (Cronbach’s α coefficients>0·7). The intraclass correlation coefficients for the self-efficacy, motivation and knowledge scales ranged between 0·48 and 0·82. Paired t tests found an increase between test and retest knowledge scores for the Nutrition Motivation (t=−2·91, df=81, P=0·00) and Knowledge (t=−3·22, df=81, P=0·00) scales in the parent questionnaire.

Our findings demonstrate that the items and scales show good acceptability, internal consistency and test–retest reliability.

To verify the previously untested assumption that eating more salad enhances vegetable intake and determine if salad consumption is in fact associated with higher vegetable intake and greater adherence to the Dietary Guidelines for Americans (DGA) recommendations.

Individuals were classified as salad reporters or non-reporters based upon whether they consumed a salad composed primarily of raw vegetables on the intake day. Regression analyses were applied to calculate adjusted estimates of food group intakes and assess the likelihood of meeting Healthy US-Style Food Pattern recommendations by salad reporting status.

Cross-sectional analysis of data collected in 2011–2014 in What We Eat in America, the dietary intake component of the National Health and Nutrition Examination Survey.

US adults (n 9678) aged ≥20 years (excluding pregnant and lactating women).

On the intake day, 23 % of adults ate salad. The proportion of individuals reporting salad varied by sex, age, race, income, education and smoking status (P<0·001). Compared with non-reporters, salad reporters consumed significantly larger quantities of vegetables (total, dark green, red/orange and other), which translated into a two- to threefold greater likelihood of meeting recommendations for these food groups. More modest associations were observed between salad consumption and differences in intake and likelihood of meeting recommendations for protein foods (total and seafood), oils and refined grains.

Study results confirm the DGA message that incorporating more salads in the diet is one effective strategy (among others, such as eating more cooked vegetables) to augment vegetable consumption and adherence to dietary recommendations concerning vegetables.

To assess the reliability and validity of body weight (BW) and body image (BI) perception reported by parents (in children) and by adolescents in a South American population.

Cross-sectional study. BW perception was evaluated by the question, ‘Do you think you/your child are/is: severely wasted, wasted, normal weight, overweight, obese?’ BI perception was evaluated using the Gardner scale. To evaluate reliability, BW and BI perceptions were reported twice, two weeks apart. To evaluate validity, the BW and BI perceptions were compared with WHO BMI Z-scores. Kappa and Kendall’s tau-c coefficients were obtained.

Public and private schools and high schools from six countries of South America (Argentina, Peru, Colombia, Uruguay, Chile, Brazil).

Children aged 3–10 years (n 635) and adolescents aged 11–17 years (n 400).

Reliability of BW perception was fair in children’s parents (κ=0·337) and substantial in adolescents (κ=0·709). Validity of BW perception was slight in children’s parents (κ=0·176) and fair in adolescents (κ=0·268). When evaluating BI, most children were perceived by parents as having lower weight. Reliability of BI perception was slight in children’s parents (κ=0·124) and moderate in adolescents (κ=0·599). Validity of BI perception was poor in children’s parents (κ=−0·018) and slight in adolescents (κ=0·023).

Reliability of BW and BI perceptions was higher in adolescents than in children’s parents. Validity of BW perception was good among the parents of the children and adolescents with underweight and normal weight.

To examine associations between maternal parenting style and pre-school children’s dietary intake and to test whether perceived maternal time pressures, parenting arrangements and employment status influence these relationships.

This cross-sectional study examined mothers’ reports of their child’s frequency of consumption of eight food and drink groups, including sugar-sweetened beverages (SSB), unhealthy snacks, takeaway foods, fruit and vegetables. Parenting styles were classified as authoritative, authoritarian, permissive or disengaged using two parenting dimensions (warmth and control). The moderating roles of parenting arrangements, indexed by number of parents in the home and maternal employment status, were assessed. Associations were examined using multinomial regression.

Data were from the infant and child cohorts in the Longitudinal Study of Australian Children.

Children aged 4–5 years from both cohorts (infant: n 3607; child: n 4661) were included.

Compared with children of disengaged mothers, children of authoritative mothers consumed most unhealthy foods less frequently, and fruit and vegetables more frequently. Results suggested parenting arrangements and mothers’ working status may moderate associations between parenting styles and SSB, takeaway foods, takeaway snacks and fruit consumption.

These findings suggest that authoritative parenting style is associated with a higher consumption of fruit and vegetables and a lower consumption of unhealthy foods among children. However, parenting arrangements and the mothers’ working status may influence these relationships. Further research is required to examine the influence of other potential moderators of parenting style/food consumption relationships such as household time and resource limitations.

To assess interdependent effects of autonomous motivation to limit sugar-sweetened beverage (SSB) consumption in relation to SSB and healthy beverage (HB) intake in mother–adolescent and father–adolescent dyads.

Adopting a dyadic cross-sectional design, the actor–partner interdependence modelling (APIM) approach was used to construct and analyse two APIM for mother–adolescent and father–adolescent dyads. The first model assessed actor effects (individual’s autonomous motivation associated with his/her own beverage intake) and partner effects (individual’s autonomous motivation associated with another family member’s beverage consumption) of autonomous motivation on SSB consumption. The second model assessed actor and partner effects of autonomous motivation on HB intake.

Two Internet-based surveys were completed in participant households.

Data from a demographically representative US sample of parent–adolescent dyads (1225 mother–adolescent dyads, 424 father–adolescent dyads) were used.

In the first model (autonomous motivation on SSB consumption), actor effects were significant for adolescents, but not for parents. Partner effects were significant for mother–adolescent, but not father–adolescent dyads. In the second model (autonomous motivation on HB intake), actor effects were significant for adolescents and parents in all dyadic combinations. Regarding partner effects, adolescent autonomous motivation had a significant effect on HB intake for mothers and fathers. In addition, maternal autonomous motivation had a significant effect on adolescent HB intake. No partner effects for HB were identified for fathers.

We found significant interdependent effects of autonomous motivation in relation to SSB and HB intake in mother–adolescent and father–adolescent dyads for eleven out of sixteen pathways modelled.

To assess the extent of error present in self-reported weight data in the Women’s Health Initiative, variables that may be associated with error, and to develop methods to reduce any identified error.

Prospective cohort study.

Forty clinical centres in the USA.

Women (n 75 336) participating in the Women’s Health Initiative Observational Study (WHI-OS) and women (n 6236) participating in the WHI Long Life Study (LLS) with self-reported and measured weight collected about 20 years later (2013–2014).

The correlation between self-reported and measured weights was 0·97. On average, women under-reported their weight by about 2 lb (0·91 kg). The discrepancies varied by age, race/ethnicity, education and BMI. Compared with normal-weight women, underweight women over-reported their weight by 3·86 lb (1·75 kg) and obese women under-reported their weight by 4·18 lb (1·90 kg) on average. The higher the degree of excess weight, the greater the under-reporting of weight. Adjusting self-reported weight for an individual’s age, race/ethnicity and education yielded an identical average weight to that measured.

Correlations between self-reported and measured weights in the WHI are high. Discrepancies varied by different sociodemographic characteristics, especially an individual’s BMI. Correction of self-reported weight for individual characteristics could improve the accuracy of assessment of obesity status in postmenopausal women.

Breakfast skipping is regarded as a public health issue among adults worldwide. Nutrition knowledge has been reported to be one of predictors of dietary behaviour. Therefore, the aim of the present study was to examine the association between nutrition knowledge and breakfast skipping.

Data regarding nutrition knowledge were obtained by using a validated, self-administered general nutrition knowledge questionnaire for Japanese adults (JGNKQ). Participants were classified into three nutrition knowledge level groups according to total JGNKQ score: Low, Middle and High. In addition, participants reported the frequency of meal consumption per week and rated the difficulty in finding time to eat breakfast, lunch and dinner in the lifestyle questionnaire. The differences in frequency of breakfast, lunch and dinner consumption among Low, Middle and High nutrition knowledge groups were determined by using ANCOVA adjusted for potential confounding factors.

Kanto region, Japan.

Japanese adults aged 18–64 years (n 1165, 57·3% women).

Mean age of the participants was 43·8 (sd 8·9) years. There were no significant differences found in the proportion of respondents reporting difficulty in finding time to eat each meal among the three groups. However, the frequency of breakfast consumption was significantly different among Low, Middle and High groups, while lunch and dinner frequency did not differ among the three groups.

The present study suggests that nutrition knowledge level is related to breakfast skipping among Japanese adults.

To explore the associations of absolute and relative measures of exposure to food retailers with dietary patterns, using simpler and more complex measures.

Cross-sectional survey.

Urban regions in Belgium, France, Hungary, the Netherlands and the UK.

European adults (n 4942). Supermarkets and local food shops were classified as ‘food retailers providing healthier options’; fast-food/takeaway restaurants, cafés/bars and convenience/liquor stores as ‘food retailers providing less healthy options’. Simpler exposure measures used were density of healthy and density of less healthy food retailers. More complex exposure measures used were: spatial access (combination of density and proximity) to healthy and less healthy food retailers; density of healthier food retailers relative to all food retailers; and a ratio of spatial access scores to healthier and less healthy food retailers. Outcome measures were a healthy or less healthy dietary pattern derived from a principal component analysis (based on consumption of fruits, vegetables, fish, fast foods, sweets and sweetened beverages).

Only the highest density of less healthy food retailers was significantly associated with the less healthy dietary pattern (β = −129·6; 95 % CI −224·3, −34·8). None of the other absolute density measures nor any of the relative measures of exposures were associated with dietary patterns.

More complex measures of exposure to food retailers did not produce stronger associations with dietary patterns. We had some indication that absolute and relative measures of exposure assess different aspects of the food environment. However, given the lack of significant findings, this needs to be further explored.

To explore the direct and indirect associations of dietary patterns with hypertension using structural equation modelling (SEM).

Factor analysis with varimax rotation was used to classify different dietary patterns and SEM was employed to investigate the associations of dietary patterns with hypertension. Total cholesterol to HDL-cholesterol (TC:HDL-C) ratio and LDL-cholesterol to HDL-cholesterol (LDL-C:HDL-C) ratio were used as observed indicator variables of the lipid latent variable. Waist circumference, body fat percentage and BMI, which were associated with hypertension, were used as observed indicator variables of the obesity latent variable.

International Chronic Disease Cohort (ICDC) that began in 2005 with the purpose of describing the frequency and determinants of chronic diseases in Jilin Province, China.

A total of 1492 adults (40–79 years) were enrolled in the baseline study from August 2010 to August 2011.

Hypertension prevalence in our study population was 34·9 %. It was found that the wine pattern, condiment pattern, obesity latent variable, lipid latent variable, glucose, age and family history of hypertension were factors that had an association with hypertension via SEM, and the corresponding coefficients were 0·056, 0·011, 0·230, 0·281, 0·098, 0·232 and 0·116, respectively.

The wine pattern and lipid latent variable had positive direct associations with hypertension. The condiment pattern had a positive indirect association with hypertension via the obesity latent variable. The vegetables pattern, modern pattern and snack pattern were not associated with hypertension.

Retention of participants has been an issue in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). It has been suggested that the perceived value of WIC may affect whether participants remain in the programme. The present study aimed to explore this phenomenon.

Using a constructivist approach, thirty-one individual in-depth interviews were conducted. Transcripts were analysed using constant comparative analysis. Social, cultural and environmental factors that contribute to the value of WIC were explored as the phenomenon of interest.

Eight WIC clinics across the State of Illinois, USA.

Thirty-one caregivers of children enrolled in WIC for at least 6 months.

Several factors influenced perceived value of WIC at the interpersonal (level of social support), clinic (value of WIC services v. programme administration issues), vendor (shopping difficulties), community and systems levels (other programme use, stigma and restrictions on food choice). Other themes existed along continua, which overlapped several levels (continuum of perceived need and perceived value of infant formula).

Many caregivers value WIC, especially before their child turns 1 year old. Improvements are needed at the clinic, during shopping and within the food packages themselves in order to increase perceived value of WIC.

To identify demographic risk factors associated with high stress and examine the relationships between levels of stress, demographics and dietary fat, fruit and vegetable intakes in low-income pregnant women with overweight or obesity.

A cross-sectional study.

Participants were recruited from the Special Supplemental Nutrition Program for Women, Infants, and Children in Michigan, USA.

Participants (n 353) were non-Hispanic Black (black) or White (white).

Women aged 35 years or older (OR=4·09; 95% CI 1·45, 11·51) and who had high school or less education (OR=1·88; 95% CI 1·22, 2·89) or were unemployed (OR=1·89; 95% CI 1·15, 3·12) were significantly more likely to report high stress than women who were younger, had at least some college education or were employed/homemakers. However, race and smoking status were not associated with level of stress. Women with high stress reported significantly lower fruit and vegetable intakes but not fat intake than women with low stress. Women aged 35 years or older reported significantly higher vegetable but not fat or fruit intake than women who were 18–24 years old. Black women reported significantly higher fat but not fruit or vegetable intake than white women. Education, employment and smoking status were not significantly associated with dietary intake of fat, fruits and vegetables.

Nutrition counselling on reducing fat and increasing fruit and vegetable intakes may consider targeting women who are black or younger or who report high stress, respectively.

To examine consumers’ perceptions of their food environments, their food consumption patterns and preferences, and to better understand the attributes of foods that are available within food environments in Myanmar.

An exploratory mixed-methods study using a combination of focus group discussions, market and consumer surveys.

Four study settings in Myanmar were included: an upper-income township of Yangon; a lower-income township of Yangon; a middle-income township in the southern Myanmar town of Dawei; and a lower-income village in the country’s dry zone of Magway.

Thirty-two women participated in the focus groups discussions, twenty market surveys were conducted and 362 consumers (both men and women) completed food consumption surveys.

Focus group participants indicated that the availability of a diverse range of foods had increased over time, while the quality of foods had decreased. Health was seen primarily through the lens of food safety and there was an overall lack of knowledge about which foods were more or less healthy. Consumers preferred fruits, vegetables and red meat compared with highly processed snack foods/beverages. Although consumers reported low intakes of highly processed snack foods, Burmese street food was consumed in high quantities. The market surveys suggested that fresh, minimally processed and highly processed foods were available at all markets across the study settings.

Consumers are exposed to a variety of foods, of varying quality, within their food environments in Myanmar. Interventions aimed at increasing consumer knowledge regarding healthy diets and improving food safety are needed.

To evaluate the impact of multiannual, seasonal unconditional cash transfers (UCT) provided within the Moderate Acute Malnutrition Out (MAM’Out) research project on households’ food security and children’s and caregivers’ dietary diversity.

A two-arm cluster-randomized controlled trial with sixteen villages in the intervention group and sixteen others in the control group. A monthly allowance of 10 000 XOF was transferred to caregivers of eligible children via a personal mobile phone account from July to November 2013 and 2014.

Tapoa province in the eastern region of Burkina Faso.

Data on household food access (monthly adequate household food provisioning (MAHFP); household food insecurity access scale (HFIAS)) and maternal and child dietary diversity were analysed for 1143 households, 1219 caregivers of reproductive age (15–49 years) and 1247 under-5 children from both intervention and control groups.

The mean women dietary diversity score in intervention caregivers and the mean dietary diversity score (DDS) in intervention children with inadequate minimum DDS at baseline were respectively 7 % (95 % CI 2, 11 %; P = 0·002) and 17 % (95 % CI 11, 23 %; P <0·001) higher compared with the control group. However, no difference was found in the intervention effect on household food security measured with HFIAS (relative risk = 1·03; 95 % CI 0·92, 1·15; P = 0·565) and MAHFP (relative risk = 0·98; 95 % CI 0·96, 1·01; P = 0·426).

Multiannual, seasonalUCT increased dietary diversity in children and their caregivers. They can be recommended in actions aiming to improve maternal and child diet diversity.

Evaluate the feasibility, fidelity and preliminary efficacy of Camp NERF to prevent unhealthy weight gain and promote healthy behaviours in children during the summer.

Camp NERF was an 8-week, multicomponent, theory-based programme coupled with the US Department of Agriculture’s Summer Food Service Program. Twelve eligible elementary-school sites were randomized to one of three treatment groups: (i) Active Control (non-nutrition, -physical activity (PA), -mental health); (ii) Standard Care (nutrition and PA); or (iii) Enhanced Care (nutrition and PA, plus cognitive behavioural techniques) programming. Efficacy was determined by assessing mean change by group in child outcomes using hierarchical linear regression models.

Low-income, urban neighbourhoods in Columbus, OH, USA.

Economically disadvantaged, racial minority children of elementary school age (kindergarten–5th grade).

Eighty-seven child–caregiver dyads consented; eighty-one completed pre- and post-intervention assessments resulting in a 93·10 % retention rate. Delivery of the intended lesson occurred 79–90 % of the time. Of the children, 56·98 % (n 49) were female; 89·53 % (n 77) were Black. Overall mean change in BMI Z-score from baseline to post-intervention was −0·03 (se 0·05); change in BMI Z-score did not differ significantly between treatment group. Change in nutrition, PA, mental health or psychosocial outcomes did not differ between groups.

Results from the current study demonstrate feasibility and fidelity, yet no intervention effect of Camp NERF. Instead, findings suggest that participation in structured programming of any type (health behaviour-related or not) may prevent unhealthy summer weight gain. Additional studies are needed to confirm findings. Results have implications for child nutrition policy addressing the issue of summer health.

In the light of Chile’s comprehensive new restriction on unhealthy food marketing, we analyse food advertising on Chilean television prior to the first and final phases of implementation of the restriction.

Content analysis of marketing strategies of 6976 advertisements, based on products’ nutritional quality. Statistical analysis of total and child audience reached using television ratings data.

Advertising from television aired between 06.00 and 00.00 hours during two random composite weeks across April–May 2016 from the four broadcast and four cable channels with the largest youth audiences.

Food ads represented 16 % of all advertising; 34 % of food ads featured a product high in energy, saturated fats, sugars and/or salt (HEFSS), as defined by the initial regulation. HEFSS ads were seen by more children and contained more child-directed marketing strategies than ads without HEFSS foods. If HEFSS advertising was restricted only in programmes where 20 % are children aged 4–12 years, 31 % of children’s and 8 % of the general audience’s HEFSS advertising exposure would be reduced. The newest 06.00–22.00 hours restriction captures 80 % of all audience exposure.

HEFSS advertising was seen by a large proportion of children before Chile’s regulation. Chile’s first implementation based on audience composition should reduce a third of this exposure and its second restriction across the television day should eliminate most of the exposure. The current study is a crucial first step in evaluating how Chile’s regulation efforts will impact children’s diets and obesity prevalence.

The present commentary introduces a Health Evidence Network (HEN) report that synthesises evidence of front-of-pack food labelling (FOPL) policy development and implementation across the European Region.

Countries were identified as having policies on interpretive FOPL from the WHO databases of Member State policies and online repositories of global food policies. For each identified country, evidence published from 1 January 1980 to 31 March 2018 was retrieved from peer-reviewed and grey literature. Extracted data were cross-checked with in-country representatives to ensure completeness and accuracy.

WHO European Region, spanning fifty-three countries.

Fifteen countries had a government-endorsed policy on interpretive FOPL. Thirteen of these countries had introduced endorsement logos, while only three labelling systems provided an indicator for unhealthfulness. Common steps were identified in FOPL policy development, including: establishing FOPL as a nutrition policy priority; engaging stakeholders and the public; and collecting formative evidence on which to base the labelling system. Few countries had outlined formal provisions for evaluation of FOPL systems. The HEN report describes seven considerations for the adoption/review of FOPL policies to ensure these achieve the population nutrition aims of FOPL. These considerations relate to supporting consumer use and understanding of the labelling, policy feasibility and credibility, and ensuring policy implementation and accountability.

The HEN report encourages countries to consider FOPL policy that is applied widely across all products and provides negative evaluative judgements, possibly combined with positive indicators. Implementation provisions should drive widespread uptake of the system and allow for formal evaluation of impact.

Dietary guidelines for food groups, types and portion sizes are common practice at the national level. As the relationship between nutrition and disease and the influence of cultural identity on individual behaviour become clearer, dietary guidelines necessarily evolve. Today, the Arabic-speaking region is experiencing a dual burden of undernutrition and increasing rates of overweight and obesity. Cultural congruency among dietary guidelines in the Arabic-speaking region and how they affect health education, health promotion, and nutrition programme planning or individual dietary behaviours have yet to be examined. The present work provides dietitians and public health professionals a narrative review of proposed food guidelines for the Arabic-speaking region.

The current review examined five established dietary guidelines within the Arabic-speaking region, namely the Arab Food Dome (Arab Gulf states), the Healthy Food Palm (Saudi Arabia), the Lebanese Dietary Guidelines, the Omani Guide to Healthy Eating and the Qatar Dietary Guidelines, and compared findings with the regional Eastern Mediterranean guidelines developed by the WHO. Individual guideline recommendations are tabled for comparative review.

The Arabic-speaking region.

Respective Arabic-speaking populations.

Health educators, community health practitioners and nutrition professionals can benefit from the cultural contexts associated with dietary guidelines in this region.

Community-level policy and individual behaviour change will benefit from cultural sensitivity; health communication and behaviour change programming require cultural competence provided in the present review; and programme evaluation efforts (prior to and after implementation) should include a detailed understanding of how culture shapes regional policy and individual nutrition behaviours.

The present study reviewed the literature on iodine status among women of childbearing age and pregnant women in the UK. Particular attention was given to study quality and methods used to assess iodine status.

A systematic review was conducted to examine the literature and critically evaluate study design.

Studies were identified in PubMed, Web of Science, Scopus and Ovid MEDLINE databases, as well as from secondary references.

Women of childbearing age or pregnant, living in the UK.

Fifty-seven articles were identified and twelve articles were selected, including a total of 5283 women. Nine studies conducted urinary iodine assessments, three studies conducted dietary assessments only, and seven studies classified their target population as iodine deficient according to WHO criteria.

No single study from the selected articles could produce nationally representative results regarding the prevalence of iodine deficiency among the female population in the UK. Consideration of the evidence as a whole suggests that women of childbearing age and pregnant women in the UK are generally iodine insufficient. Further large-scale research is required for more accurate and reliable evidence on iodine status in the UK.