We partner with a secure submission system to handle manuscript submissions.
Please note:
You will need an account for the submission system, which is separate to your Cambridge Core account. For login and submission support, please visit the
submission and support pages.
Please review this journal's author instructions, particularly the
preparing your materials
page, before submitting your manuscript.
Click Proceed to submission system to continue to our partner's website.
To save this undefined to your undefined account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your undefined account.
Find out more about saving content to .
To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
To evaluate the extent of implementation of public policies aimed at creating healthy eating environments in Senegal compared to international best practice and identity priority actions to address the double burden of malnutrition.
Design:
The Healthy Food Environment Policy Index (Food-EPI) was used by a local expert panel to assess the level of implementation of forty-three good practice policy and infrastructure support indicators against international best practices using a Likert scale and identify priority actions to address the double burden of malnutrition in Senegal.
Setting:
Senegal, West Africa.
Participants:
A national group of independent experts from academia, civil society, non-governmental organisations and United Nations bodies (n =15) and a group of government experts from various ministries (n =16) participated in the study.
Results:
Implementation of most indicators aimed at creating healthy eating environments were rated as ‘low’ compared to best practice (31 on 43, or 72 %). The Gwet AC2 inter-rater reliability was good at 0·75 (95 % CI 0·70, 0·80). In a prioritisation workshop, experts identified forty-five actions, prioritising ten as relatively most feasible and important and relatively most effective to reduce the double burden of malnutrition in Senegal (e.g. develop and implement regional school menus based on local products (expand to fourteen regions) and measure the extent of the promotion of unhealthy foods to children).
Conclusions:
Significant efforts remain to be made by Senegal to improve food environments. This project allowed to establish an agenda of priority actions for the government to transform food environments in Senegal to tackle the double burden of malnutrition.
The purpose of the current study was to develop a validated FFQ to evaluate the intake of non-nutritive sweeteners (NNS) in child and adolescent Asian populations.
Design:
Intensive and overall market research was performed to create the applicable NNS-FFQ with thirteen food categories and 305 items. Six intense sweeteners, including acesulfame potassium, aspartame, sucralose, glycyrrhizin, steviol glycosides and sorbitol, were investigated. The validity and reproducibility of the NNS-FFQ were evaluated. The validity was further assessed by examining the consistency of reported NNS intake compared with urinary biomarkers using Cohen’s κ analysis.
Settings:
This work was considered to be relevant in Asian societies.
Participants:
One hundred and two children and adolescents recruited from several clinics were invited to participate in the current study.
Results:
High content validity indices and high content validity ratio levels were revealed for each sweetener and food category. Reproducibility among subjects was satisfactory. Significant moderate correlations between estimated steviol glycoside/sucralose consumption and sensitive urinary biomarker levels were demonstrated (κ values were 0·59 and 0·45 for steviol glycosides and sucralose, respectively), indicating that the NNS-FFQ can be used to assess an individual’s NNS intake. The dietary intense sweetener consumption pattern evaluated in this measurement was similar to those observed in other Asian countries but differed from those observed in Western populations with respect to types and amounts of NNS.
Conclusions:
This validated NNS-FFQ can be an applicable and useful tool to evaluate NNS intake in future epidemiological and clinical studies.
American Indian and Alaska Native peoples (AI/AN) have a disproportionately high rate of obesity, but little is known about the social determinants of obesity among older AI/AN. Thus, our study assessed social determinants of obesity in AI/AN aged ≥ 50 years.
Design:
We conducted a cross-sectional analysis using multivariate generalised linear mixed models to identify social determinants associated with the risk of being classified as obese (BMI ≥ 30·0 kg/m2). Analyses were conducted for the total study population and stratified by median county poverty level.
Setting:
Indian Health Service (IHS) data for AI/AN who used IHS services in FY2013.
Participants:
Totally, 27 696 AI/AN aged ≥ 50 years without diabetes.
Results:
Mean BMI was 29·8 ± 6·6 with 43 % classified as obese. Women were more likely to be obese than men, and younger ages were associated with higher obesity risk. While having Medicaid coverage was associated with lower odds of obesity, private health insurance was associated with higher odds. Living in areas with lower rates of educational attainment and longer drive times to primary care services were associated with higher odds of obesity. Those who lived in a county where a larger percentage of people had low access to a grocery store were significantly less likely to be obese.
Conclusions:
Our findings contribute to the understanding of social determinants of obesity among older AI/AN and highlight the need to investigate AI/AN obesity, including longitudinal studies with a life course perspective to further examine social determinants of obesity in older AI/AN.
Overweight and obesity have been related to a variety of adverse health outcomes. Understanding the overweight and obesity epidemic in Bangladesh, particularly among reproductive-aged women, is critical for monitoring and designing effective control measures. The purpose of this study was to determine the prevalence of overweight and obesity in reproductive-aged women and to identify the risk factors of overweight and obesity.
Design:
A total of 70 651 women were obtained from the five most recent and successive Bangladesh Demographic and Health Surveys (BDHS). The multilevel logistic regression model was used to explore the individual- and community-level factors of overweight and obesity.
Setting:
Five most recent nationally representative household surveys across all regions.
Approximately 35·2 % (95 % CI: 34·9–35·6 %) of women were either overweight or obese in Bangladesh. At the individual- and community-level, higher age (adjusted odds ratio (aOR) = 5·79, 95 % CI: 5·28–6·34), secondary or higher education (aOR = 1·69 [1·60–1·78]), relatively wealthiest households (aOR = 4·41 [4·10–4·74]), electronic media access (aOR = 1·32 [1·26–1·37]) and community high literacy (aOR = 1·10 [1·04–1·15]) of women were significantly positively associated with being overweight or obese. Whereas, rural residents (aOR = 0·79 [0·76–0·82]) from larger-sized households (aOR = 0·80 [0·73–0·87]) and have high community employment (aOR = 0·92 [0·88–0·97]) were negatively associated with the probability of being overweight or obese.
Conclusion:
Individual- and community-level factors influenced the overweight and obesity of Bangladeshi reproductive-aged women. Interventions and a comprehensive public health plan aimed at identifying and addressing the growing burden of overweight and obesity should be a top focus.
The aim of the study is (1) to assess the extent to which omnivores are willing to stop or reduce their consumption of red and processed meat in response to evidence-based information regarding the possible reduction of cancer mortality and incidence achieved by dietary modification; (2) to identify socio-demographic categories associated with higher willingness to change meat consumption and (3) to understand the motives facilitating and hindering such a change.
Design:
During an initial computer-assisted web interview, respondents were presented with scenarios containing the estimates of the absolute risk reduction in overall cancer incidence and mortality tailored to their declared level of red and processed meat consumption. Respondents were asked whether they would stop or reduce their average meat consumption based on the information provided. Their dietary choices were assessed at 6-month follow-up. Additionally, we conducted semi-structured interviews to better understand the rationale for dietary practices and the perception of health information.
Participants:
The study was conducted among students and staff of three universities in Krakow, Poland.
Results:
Most of the 513 respondents were unwilling to change their consumption habits. We found gender to be a significant predictor of the willingness. Finally, we identified four themes reflecting key motives that determined meat consumption preferences: the importance of taste and texture, health consciousness, the habitual nature of cooking and persistence of omnivorous habits.
Conclusions:
When faced with health information about the uncertain reduction in the risk of cancer mortality and incidence, the vast majority of study participants were unwilling to introduce changes in their consumption habits.
To present the process evaluation of a curricular Cross-curricular Unit on Portion Size (CUPS) program that integrates nutrition and mathematics, describing teacher and student perspectives on the intervention.
Design:
Semi-structured interviews and focus groups were conducted following the implementation of the CUPS program during a pilot randomised controlled trial designed to evaluate efficacy for improved portion size estimation. Lessons involved experiential learning using food models and mathematics cubes and focussed on portion size, food groups, volume and capacity. Data were collected immediately post-intervention and analysed using an inductive thematic approach.
Setting:
Primary schools in Newcastle, Australia.
Participants:
Year 3 and/or 4 teachers (n 3) and their students (n 15).
Results:
Teachers believed the programme supported the learning of nutrition concepts, with the majority of students enjoying the lessons, cubes and food models. Teachers indicated most students were engaged and became more aware of healthy eating and serve size recommendation. Although teachers enjoyed and valued the lessons, they suggested that the integration of volume and capacity should be further improved in order to address the time barrier for teaching nutrition.
Conclusion:
The process evaluation reports on challenges and successes of implementing an integrative nutrition programme. This teaching approach could be useful and successful when aligned with teacher’ and student’ needs. Based on participant feedback, lessons could be refined to enhance integration of mathematics content and to support student learning.
Describe nutrition and physical activity practices, nutrition self-efficacy and barriers and food programme knowledge within Family Child Care Homes (FCCH) and differences by staffing.
Design:
Baseline, cross-sectional analyses of the Happy Healthy Homes randomised trial (NCT03560050).
Setting:
FCCH in Oklahoma, USA.
Participants:
FCCH providers (n 49, 100 % women, 30·6 % Non-Hispanic Black, 2·0 % Hispanic, 4·1 % American Indian/Alaska Native, 51·0 % Non-Hispanic white, 44·2 ± 14·2 years of age. 53·1 % had additional staff) self-reported nutrition and physical activity practices and policies, nutrition self-efficacy and barriers and food programme knowledge. Differences between providers with and without additional staff were adjusted for multiple comparisons (P < 0·01).
Results:
The prevalence of meeting all nutrition and physical activity best practices ranged from 0·0–43·8 % to 4·1–16·7 %, respectively. Average nutrition and physical activity scores were 3·2 ± 0·3 and 3·0 ± 0·5 (max 4·0), respectively. Sum nutrition and physical activity scores were 137·5 ± 12·6 (max 172·0) and 48·4 ± 7·5 (max 64·0), respectively. Providers reported high nutrition self-efficacy and few barriers. The majority of providers (73·9–84·7 %) felt that they could meet food programme best practices; however, knowledge of food programme best practices was lower than anticipated (median 63–67 % accuracy). More providers with additional staff had higher self-efficacy in family-style meal service than did those who did not (P = 0·006).
Conclusions:
Providers had high self-efficacy in meeting nutrition best practices and reported few barriers. While providers were successfully meeting some individual best practices, few met all. Few differences were observed between FCCH providers with and without additional staff. FCCH providers need additional nutrition training on implementation of best practices.
This study examined parental work hours and household income as determinants of discretionary (energy-dense, nutrient-poor) food and beverage intake in young children, including differences by eating occasion.
Design:
Secondary analysis of cross-sectional data. Three hierarchical regression models were conducted with percentage of energy from discretionary food and beverages across the day, at main meals and at snack times being the outcomes. Dietary intake was assessed by 1 × 24-h recall and 1–2 × 24-h food record(s). Both maternal and paternal work hours were included, along with total household income. Covariates included household, parent and child factors.
Setting:
Data from the NOURISH/South Australian Infants Dietary Intake studies were collected between 2008 and 2013.
Participants:
Participants included 526 mother–child dyads (median (interquartile range) child age 1·99 (1·96, 2·03) years). Forty-one percentage of mothers did not work while 57 % of fathers worked 35–40 h/week. Most (85 %) households had an income of ≥$50 k AUD/year.
Results:
Household income was consistently inversely associated with discretionary energy intake (β = –0·12 to –0·15). Maternal part-time employment (21–35 h/week) predicted child consumption of discretionary energy at main meals (β = 0·10, P = 0·04). Paternal unemployment predicted a lower proportion of discretionary energy at snacks (β = -0·09, P = 0·047).
Conclusions:
This work suggests that household income should be addressed as a key opportunity-related barrier to healthy food provision in families of young children. Strategies to reduce the time burden of healthy main meal provision may be required in families where mothers juggle longer part-time working hours with caregiving and domestic duties. The need to consider the role of fathers and other parents/caregivers in shaping children’s intake was also highlighted.
To understand young adults’ perceptions of online and real-life social influences on their food and activity choices.
Design:
A qualitative study involving 7 focus groups. Thematic analysis using both deductive and inductive techniques were performed.
Setting:
A polytechnic and a university in Singapore.
Participants:
A total of 46 full-time students, 19–24 years of age.
Results:
Participants revealed that social media meets multiple needs, contributing to its ubiquitous use and facilitating content spread between social networks. Food-related content shared on social media were mostly commercial posts, marketing foods and eateries showcasing price promotions, emphasising sensory properties of foods or creating narratives that activated trends. Subsequently, real-life social activities frequently revolve around marketed foods that were not necessarily healthy. In contrast, physical activity posts were rarely being followed up in real life. Portrayals describing a toxic gym culture could contribute to negative perceptions of peers’ physical activity posts and a disinclination towards sharing such posts. Participants expressed that close, supportive social networks in real life strongly influenced initiating and maintaining healthy lifestyles. However, in a society that highly values academic achievements, participants prioritised studying and socialising over healthy eating and physical activity.
Conclusions:
Overall, our findings reveal that virtual and real-life social influences have complex interactions affecting Asian young adults’ behavioural choices and should be considered when designing interventions for this group. Regulations related to the digital marketing of unhealthy food, and improving the availability, accessibility and affordability of healthier food options, particularly in the foodservice sector, would be of value to consider.
This study aimed to examine the intrapersonal, interpersonal, environmental and macrosystem influences on dietary behaviours among primary school children in Singapore.
Design:
A qualitative interpretive approach was used in this study. Focus group discussions guided by the socio-ecological model (sem), of which transcripts were analysed deductively using the sem and inductively using thematic analysis to identify themes at each sem level.
Setting:
Two co-educational public primary schools in Singapore.
Participants:
A total of 48 children (n 26 girls) took part in the semi-structured focus group discussions. Their mean age was 10·8 years (sd = 0·9, range 9–12 years), and the majority of the children were Chinese (n 36), along with some Indians (n 8) and Malays (n 4).
Results:
Children’s knowledge of healthy eating did not necessarily translate into healthy dietary practices and concern for health was a low priority. Instead, food and taste preferences were pivotal influences in their food choices. Parents had a large influence on children with regards to their accessibility to food, their attitudes and values towards food. Parental food restriction led to some children eating in secrecy. Peer influence was not frequently reported by children. Competitions in school incentivised children to consume fruits and vegetables, but reinforcements from teachers were inconsistent. The proximity of fast-food chains in the neighbourhood provided children easy access to less healthy foods. Health advertisements on social media rather than posters worked better in drawing children’s attention.
Conclusions:
Findings highlighted important factors that should be considered in future nutrition interventions targeting children.
Previous studies of sociodemographic and lifestyle correlates of dietary patterns among young adults have primarily focused on physical activity and smoking, with inconclusive results. This study aims to examine the associations between a broader range of lifestyles of young adults and their patterns of food consumption.
Design:
Cross-sectional.
Setting:
Brisbane, Australia.
Participants:
The data set are from a long running birth cohort study which commenced in 1981. Details of dietary intake and sociodemographic and lifestyle factors were from the 21-year follow-up of the Mater-University of Queensland Study of Pregnancy (MUSP) birth cohort. The effective cohort (n 2665, 57 % women) is of young adult offspring. Usual dietary intake was assessed using a Food Frequency Questionnaire (FFQ). Data on sociodemographic and lifestyle variables were obtained from self-reports.
Results:
Western and prudent dietary patterns were identified for the combined cohort of women and men using principal components analysis. Multivariable linear regression models were used to examine the associations between lifestyle variables and dietary patterns adjusting for potential confounders. Results from multivariable adjusted models showed that physical activity, watching TV and smoking were strongly associated with each dietary pattern; alcohol consumption and BMI showed weaker associations (P < 0·05 for all).
Conclusions:
Our study describes a clustering of unhealthy lifestyles in young adults. Young adults with unhealthy lifestyles less often adhere to a healthy prudent dietary pattern and more often an unhealthy Western pattern. Dietary preferences are enmeshed in a lifestyle matrix which includes physical activity, sedentary activity, smoking and alcohol consumption of young adults.
Linear growth is controlled by several factors, malnutrition is one of the leading causes of stunted child growth. The objective of this study was to determine the dietary intakes associated with stunting among pre-school children in rural Upper Egypt.
Design:
Community-based cross-sectional study
Setting:
Data were collected by interviewing the children’s caregivers in the rural household setting.
Participants:
The study included 497 pre-school children aged 2–5 years in rural Upper Egypt. Food intake data were estimated using 24-h recall method. Anthropometric measurements of children were taken and then converted to z-scores for weight-for-age Z-score, height-for-age Z-score and weight-for-height Z-score.
Results:
The study included 497 children of which 19·1 % were stunted, 76·3 % did not meet recommended energetic intake and 13·7 % did not meet recommended protein intake and this was significantly higher than non-stunted children. Children who were stunted significantly consumed poultry, eggs and fruits less often than non-stunted children, by regression; male sex (adjusted odds ratio (aOR) = 1·91), mother’s age (0·93), lower socio-economic status (SES); and not meeting recommended protein intake (aOR = 2·26) were found to be associated with stunting.
Conclusion:
Male sex, younger mothers, lower SES and not meeting recommended energy and protein were statistically associated with stunting. Nutrition education messages encouraging adequate and healthy eating are recommended.
This study aimed to examine the impact of different dietary patterns on stroke outcomes among type 2 diabetes mellitus (T2DM) patients in China.
Design:
Participants were enrolled by a stratified random cluster sampling method in the study. After collecting dietary data using a quantified FFQ, latent class analysis was used to identify dietary patterns, and propensity score matching was used to reduce confounding effects between different dietary patterns. Binary logistic regression and conditional logistic regression were used to analyse the relationship between dietary patterns and stroke in patients with T2DM.
Setting:
A cross-sectional survey available from December 2013 to January 2014.
Participants:
A total of 13 731 Chinese residents aged 18 years or over.
Results:
Two dietary patterns were identified: 61·2 % of T2DM patients were categorised in the high-fat dietary pattern while 38·8 % of patients were characterised by the balanced dietary pattern. Compared with the high-fat dietary pattern, the balanced dietary pattern was associated with reduced stroke risk (OR = 0·63, 95 %CI 0·52, 0·76, P < 0·001) after adjusting for confounding factors. The protective effect of the balanced model did not differ significantly (interaction P > 0·05).
Conclusions:
This study provides sufficient evidence to support the dietary intervention strategies to prevent stroke effectively. Maintaining a balanced dietary pattern, especially with moderate consumption of foods rich in quality protein and fresh vegetables in T2DM patients, might decrease the risk of stroke in China.
The present work was performed to analyse the association of dietary patterns with glycaemic control (Hb A1c < 7 %) in a large group of Chinese adults aged between 45 and 59 years.
Design:
Habitual dietary intakes in the preceding 12 months were assessed by well-trained interviewers using a validated semi-quantitative FFQ. Factor analysis with principal component method was used to obtain the dietary patterns, and the associations between dietary patterns and glycaemic control were determined using multivariable logistic regression models. Poor glycaemic control was defined as HbA1c ≥ 7·0.
Setting:
Despite decades of research, data on the relationship between dietary patterns and glycaemic control (HbA1c < 7 %) in China are sparse.
Participants:
A total of 1739 participants aged 45–59 years from Hangzhou were included in the final analysis.
Results:
Three dietary patterns were ascertained and labelled as traditional southern Chinese, Western and grains-vegetables patterns. After controlling of the possible confounders, participants in the highest quartile of Western pattern scores had greater OR for HbA1c ≥ 7·0 (OR = 1·05; (95 % CI 1·000, 1·095); P = 0·048) than did those in the lowest quartile. Compared with those in the lowest quartile of grains-vegetables pattern, participants in the highest quartile had lower OR for HbA1c ≥ 7·0 (OR = 0·82; (95 % CI 0·720, 0·949); P = 0·038). Besides, no significant relationship between the traditional southern Chinese pattern and HbA1c ≥ 7·0 was observed (P > 0·05).
Conclusions:
This study indicated that the Western pattern was associated with a higher risk, and the grains-vegetables pattern was associated with a lower risk for HbA1c ≥ 7·0. Future prospective studies are needed to confirm our findings.
To investigate the influence of parental physical activity on offspring’s nutritional status in the 1993 Pelotas (Brazil) birth cohort.
Design:
Birth cohort study.
Setting:
The main outcomes were overweight and obesity status of children. The main exposure was parental physical activity over time, measured during the 11, 15 and 18 years of age follow-ups. The exposure was operationalised as cumulative, and the most recent measure before the birth of child. We adjusted Poisson regression models with robust variance to evaluate crude and adjusted associations between parental physical activity and offspring’s nutritional status. All analyses were stratified according to the sex of the parent.
Participants:
A total of 874 members from the 1993 Pelotas (Brazil) birth cohort followed-up at 22 years of age with their first-born child were analysed.
Results:
Children were, on average, 3·1 years old. Crude analyses showed that the mother’s cumulative physical activity measure had an indirect association with the prevalence of children’s obesity. The most recent maternal physical activity measure before the birth of the child was associated with 41 % lower prevalence of obesity in children, even after adjustment for confounders.
Conclusions:
The most recent maternal physical activity measure was indirectly associated with the prevalence of obesity in children. No associations were found for fathers, reinforcing the hypothesis of a biological effect of maternal physical activity on offspring’s nutritional status.
To explore the relationships between dental problems and underweight status among rural women in Burkina Faso by using nationally representative data.
Design:
This was a cross-sectional secondary study of primary data obtained by the 2013 WHO Stepwise Approach to Surveillance survey conducted in Burkina Faso. Descriptive and analytical analyses were performed using Student’s t test, ANOVA, the χ2 test, Fisher’s exact test and logistic regression.
Setting:
All thirteen Burkinabè regions were categorised using quartiles of urbanisation rates.
Participants:
The participants were 1730 rural women aged 25–64 years.
Results:
The prevalence of underweight was 16·0 %, and 24·1 % of participants experienced dental problems during the 12-month period. The women with dental problems were more frequently underweight (19·9 % and 14·7 %; P < 0·05) and had a lower mean BMI (21·1 ± 3·2 and 21·6 ± 3·7 kg/m2, P < 0·01) than those without dental problems. More risk factors for underweight were observed in less urbanised regions among elderly individuals (> 49 years old) and smokeless tobacco users. Age > 49 years, professions with inconsistent income, a lack of education, smokeless tobacco use and low BMI were factors that were significantly associated with dental problems, while residency in a low-urbanisation area was a protective factor.
Conclusion:
The prevalence of underweight in rural Burkinabè women is among the highest in sub-Saharan Africa, and women with dental problems are more frequently affected than those without dental problems. Public health measures for the prevention of these disorders should specifically target women aged over 49 years and smokeless tobacco users.
The Global Burden of Disease (GBD) Study provides estimates of death and disability from eighty-seven risk factors, including some micronutrient deficiencies.
Objectives:
To review methodological changes that led to large differences in the disease burden estimates for vitamin A and Zn deficiencies between the GBD 2017 and 2019 Studies.
Methods:
GBD publications were reviewed; additional information was provided by GBD researchers.
Results:
Vitamin A deficiency prevalence is based on plasma retinol concentration, whereas the estimate for Zn deficiency prevalence uses dietary adequacy as a proxy. The estimated global prevalence of vitamin A deficiency for children aged 1–4 years in the year 2017 decreased from 0·20 (95 % CI 0·17, 0·24) in GBD 2017 to 0·16 (95 % CI 0·15, 0·19) in GBD 2019, while the global prevalence of Zn deficiency did not change between the two studies (0·09 (95 % CI 0·04, 0·17) and 0·09 (95 % CI 0·03, 0·18)). New to 2019 was that meta-analyses were performed using Meta Regression – Bayesian, Regularized, Trimmed, a method developed for GBD. Due to this and multiple other methodological changes, the estimated number of deaths due to vitamin A deficiency dropped from 233 000 (179 000–294 000) to 24 000 (3000–50 000) from GBD 2017 to 2019, and for Zn deficiency from 29 000 (1000–77 000) to 2800 (700–6500), respectively.
Conclusion:
The changes in the estimated disease burdens due to vitamin A and Zn deficiencies in the GBD reports from 2017 to 2019 are due primarily to changes in the analytical methods employed, so may not represent true changes in disease burden. Additional effort is needed to validate these results.
To identify factors influencing Black immigrant mothers’ perceptions and concerns about child weight and to compare children’s diet quality according to these perceptions and concerns.
Design:
Mothers’ perceptions and concerns about child weight were assessed with sex-specific figure rating scales and the Child Feeding Questionnaire, respectively. Participants’ weights and heights were measured and characterised using WHO references. Children’s dietary intakes were estimated using a 24-h dietary recall. Children’s diet quality was evaluated using the relative proportion of their energy intake provided by ultra-processed products, which were identified with the NOVA classification. χ2 tests, multivariate logistic regressions and t tests were performed.
Setting:
Ottawa, Ontario, Canada.
Participants:
Black immigrant mothers of Sub-Saharan African and Caribbean origin (n 186) and their 6–12-year-old children.
Results:
Among mothers, 32·4 % perceived their child as having overweight while 48·4 % expressed concerns about child weight. Girls and children with overweight or obesity were significantly more likely to be perceived as having overweight by their mothers than boys and normal-weight children, respectively. Mothers of children living with obesity, but not overweight, were significantly more likely to be concerned about their child’s weight than mothers of normal-weight children. Children’s diet quality did not differ according to mothers’ perceptions and concerns.
Conclusions:
Children’s gender and weight status were major determinants of perceptions and concerns about child weight among Black immigrant mothers. Including knowledge about mothers’ perceptions and concerns about child weight will help nutrition professionals develop interventions tailored to specific family needs within the context of their cultural backgrounds.
To investigate the advertising patterns on the posts of a fast-food chain in Brazil on three social media platforms in 2019.
Design:
An exploratory cross-sectional study.
Setting:
Advertising strategies on the posts of a major fast-food chain on their official Facebook, Instagram and YouTube accounts. The strategies were investigated according to the INFORMAS protocol for food promotion monitoring. Principal component analysis (PCA) was employed to identify advertising patterns in each platform.
Participants:
305 advertisements
Results:
Four advertising patterns were identified in the PCA of Facebook and Instagram. In both platforms, the components for kids and product exaltation were similar. On Facebook, a pattern corresponding to economic appeal was identified as price and discount, while on Instagram, this pattern also included a practical approach. On Facebook, the fourth component was named celebrity, while on Instagram it was celebrity/innovation since on this second social media the component also included the ‘new brand development’ variable. On YouTube, three advertising patterns were identified in PCA. Similar to the other platforms, the first and the second patterns were called for kids and price and discount, and the third component referred to both celebrity and commemorative dates.
Conclusions:
The advertising patterns of the fast-food chain on three social media platforms were commonly directed to children and addressed price, discounts and the celebrities’ universe. The findings of this study corroborate other data in the literature regarding unhealthy food advertising on social media. This study discusses the urgency of regulating food advertising content on this medium.
Breast-feeding rates are unsatisfactory in Lebanon. Social media groups could play an important role in promoting breast-feeding in normal conditions and post crisis. The aim of this study is to identify breast-feeding challenges, facilitators and assets and to describe how community assets via social media could build community resilience to pandemic’s and disaster’s effects.
Design:
A two-phase qualitative content analysis was performed on posts and comments collected from a Facebook breast-feeding support group. Data were categorised into themes, categories and subcategories.
Setting:
Posts and comments retrieved from a Facebook breast-feeding support group in Lebanon during the month of August 2020.
Participants:
Group members: mothers who breastfed, breast-feeding mothers and group admins that are lactation consultants.
Results:
In phase one, breast-feeding ‘Challenges’ identified were lack of support from peers and family, lack of supportive policies, lack of knowledge and maternal stress related to political instability, COVID-19 and economic crisis. ‘Assets and facilitators’ included community support and donations. In phase two, analysis revealed how assets were being used on social media platform to build community resilience post crisis, through access to social support in challenging times, community engagement, material resources and transformative potential.
Conclusion:
Challenges faced during breast-feeding were diminished due to the support and assets received on a Facebook breast-feeding support group, and social media has been shown to be an important community asset implicated in empowering women to breastfeed and to build community resilience in moments of crisis.