Daily Consumption Of Vegetables Research Articles

Development and validation of the Health Activation Scale for Children (HAS-C): an important intermediate outcome measure for health promotion initiatives

BackgroundValid and reliable measures for assessing health activation in school-aged children are currently lacking. This study aimed to develop a scale to measure health activation and evaluate its psychometric properties among English-speaking primary school children in Singapore.MethodsThe development of the Health Activation Scale for Children (HAS-C) involved an extensive literature review, expert consultations, cognitive interviews with primary school children, and thorough discussions for dimension and item refinement. A cross-sectional study was conducted with 597 children aged 8 to 12 years, recruited from four mainstream primary schools, comprising 50.1% boys and 64.8% Chinese students. The potential scale, along with other measures, was independently completed by the children. Descriptive statistics were provided for individual scale items. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to assess factorial validity. Convergent validity was examined by correlating the scale scores with scores of health confidence and self-efficacy measures. Hypothesis-testing validity was evaluated by assessing the scale’s correlation with self-reported health behaviours, including daily consumption of vegetables and fruits, time spent on sedentary activities and physical activities. Internal consistency reliability was measured using Cronbach’s alpha.ResultsEFA suggested a three-factor structure for the 12-item HAS-C, which was subsequently confirmed by CFA with a good model fit. All three HAS-C dimension scores demonstrated moderate correlations (rho = 0.34–0.52) with health confidence and self-efficacy measures, indicating good convergent validity. They were positively correlated with more vegetable and fruit intakes, more time spent on exercises, and negatively correlated with time spent on sedentary activities, supporting hypothesis-testing validity. Internal consistency reliability for individual HAS-C dimensions was generally acceptable, with Cronbach’s alpha values of 0.70 or above.ConclusionThe 12-item multi-dimensional HAS-C exhibited good validity and reliability, making it a valuable tool for assessing health activation in primary school-aged children.

Knowledge and practices of vegetable consumption in Accra and greater Lomé: nutritional, health and environmental sustainability

In Accra and Greater Lomé, research into the harmful effects of food transitions focuses scarcely on the levels of knowledge and good practices (LKGP) of vegetable consumers. However, these foods play a key role in the nutritional, health, socio-economic and ecological sustainability of cities. This research aims to assess the health, nutritional, ecological and socio-economic sustainability of LKGP linked to vegetable consumption in these conurbations. A quantified multi-criteria evaluation approach was adopted. The respondents (394), selected via judgmental sampling, were equally distributed between the two cities. Data were collected using a Food Frequency Questionnaire administered by Kobocollect. The overall average rate of good vegetable consumption knowledge and practices in Accra and Greater Lomé is low (37.43%). This result stems from the low LKGP for daily vegetable consumption (24.62%), their inclusion in the main daily meals (33.50%) and consideration of their nutritional composition (30.86%). The target population is unaware of the health, nutritional and ecological drawbacks of poorly preserved vegetables (66.93%) and adopts inappropriate waste management practices when handling them (65.91%). The average proportions of access to vegetable procurement technology (47.08%) and sustainable food education (11.29%) were also low. The research results, unfavorable to the achievement of the SDGs in Accra and Greater Lomé, call for an inclusive, integrated and continuous sustainable food education program.

Application of soil amendments to reduce the transfer of trace metal elements from contaminated soils of Lubumbashi (Democratic Republic of the Congo) to vegetables

The extraction of copper and cobalt from mines has led to the contamination of agricultural soils by trace metal elements (TMEs) (e.g. Cu: 204 to 1355 mg/kg). The mining industry is one of the sources of metal discharges into the environment, contributing to water, soil, and air contamination and causing metabolic disorders in the inhabitants of the city of Lubumbashi (R.D. Congo). This study assessed the effectiveness of organocalcareous soil improvers applied to TME-contaminated soils to reduce their transfer to plants. Following a factorial design, increasing doses of organic soil improvers (chicken droppings and sawdust) and agricultural lime were applied to the soils of three market gardens (high, medium, and low Cu contamination). The experiment was monitored for 60 days. Soil physicochemical properties (pH, TOC, and total and available copper, cobalt, lead, cadmium, and zinc (mg/kg)) were determined for the three gardens and in the vegetable biomass. The daily consumption index of the vegetables was determined based on total TME content. The results show that organocalcareous soil improvers did not promote plant growth and survival on soils with high and medium levels of copper contamination. However, on soils with low copper content, organocalcareous soil improvers improved germination and plant survival and reduced the transfer of metals from the soil to the plants. The best germination and plant survival rates were obtained with the lightly contaminated market garden. In addition, the organo-limestone amendments applied to the soils slightly increased the soil pH from acidic to slightly acidic, with pH values ranging from (5.43 ± 0.07 to 7.26 ± 0.33). The daily vegetable consumption index obtained for cobalt in the low-contaminated garden ranged from (0.029 to 0.465 mg/60 kg/day), i.e. from 0.5 to 8.45 times higher than the FAO/WHO limit, unlike the other trace metals (Cd, Cu and Pb) for which the daily consumption index found was lower than the FAO/WHO limit. Organocalcareous soil improvers can only be applied to soils with low levels of TME contamination, but for soils with medium to high levels of metal contamination, new soilless production techniques such as hydroponics or bioponics are needed.

The Interplay of Psycho-Social Determinants on Quality of Life and Health Behaviors Among Hispanic, Non-Hispanic Black Cancer Survivors

ObjectivesThis study aimed to explore psycho-social factors (i.e., socio-demographics, health insurance, stress) associated with Quality of life (QOL) and the degree to which self-reported access to healthcare and health behaviors (i.e., fruit and vegetable consumption, physical activity) mediate the effects of psycho-social factors on QOL among Hispanic, non-Hispanic Black (NHB), and other non-White cancer survivors. MethodsThe descriptive cross-sectional study enrolled a total of 74 Hispanic (n = 26), NHB (n = 42), and other non-White (n = 6) people affected by cancer. QOL, physical activity, diet, stress, and survivorship care data were collected prospectively between June 2022-September 2023. ResultsThe mean scores of QOL were moderate for global health (59.4 ± 21.4) and functional status (64.8 ± 22.2) and low for symptom experience (33.6 ± 19.4). Of the participants, 35.1% (n = 24) reported at least one challenge in accessing healthcare. The average daily consumption of fruits and vegetables was 2.44 ± 0.61 cup equivalents. Most participants had insufficient (37.8%) or minimal (47.3%) engagement in physical activity. Men and those with higher stress levels reported lower global health status. Higher stress level was associated with an increased likelihood of lower physical activity. Private insurance and some college education were associated with an increased likelihood of consuming more fruit and vegetables. Self-reported access to healthcare did not mediate the association between any of the variables and the global health score of QOL. ConclusionsHispanic, NHB and other non-White cancer survivors had moderate global health and functional status with lower symptom burden. Further research with a large sample is needed to explore the associations between health behaviors, access to care challenges, and other factors that may better explain determinants of QOL among non-White cancer survivors. Implications for Nursing PracticeFindings suggest that tailored interventions should consider the interplay of psychosocial determinants to optimize health behaviors and QOL.

An Assessment of Behavioral Risk Factors in Oncology Patients.

An evaluation of the behavioral risk factors that contribute to the incidence and evolution of cancer in oncology patients was conducted through a cross-sectional study using a questionnaire completed by 206 patients (101 men and 105 women) diagnosed with various types of cancer. These patients were selected from different oncology centers in Romania, located in Bucharest and Constanta. Among the respondents, 91 are of normal weight, 12 are underweight, 62 are overweight, and 41 are obese, with overweight individuals predominating (p = 0.799). Regarding the presence of behavioral risk factors that can aggravate oncological pathology, it is found that 10 respondents consume alcohol daily, 36 consume it weekly with varying frequencies (p = 0.012), 26 respondents smoke excessively daily, and 12 respondents smoke 1-2 cigarettes daily (p = 0.438). Additionally, 40 respondents rarely engage in physical activity, and 71 respondents do not engage in physical activity at all as they do not typically participate in sports (p = 0.041). Thus, respondents with colon cancer tend to consume sweets, pastries and even fast food or fried foods more often, while the daily consumption of vegetables and fruits is insufficient, according to the recommendations of nutrition guidelines (a minimum of four portions per day). The analysis found that smoking and excessive alcohol consumption were associated with an increased incidence of lung and liver cancer. The lack of regular physical activity was identified as a risk factor for breast and colon cancer. An unhealthy diet, characterized by a low consumption of fruits and vegetables and high intake of processed foods, was correlated with a higher incidence of colorectal cancer. Additionally, non-adherence to medical advice was associated with poorer clinical outcomes and faster disease progression. The majority of respondents who declared that they did not feel an improvement in their state of health in the last period were among those who stated that they did not fully comply with the oncologist's recommendations. Identifying and modifying behavioral risk factors can play a crucial role in cancer prevention and in improving the prognosis and quality of life of cancer patients.

Supermarket Opening in an Urban, Low-Income Community Was Not Found to Be Associated With Improvements in Dietary Outcomes for Most Residents in the First Year

BackgroundLimited access to healthy foods in low-income, racial and ethnic minority communities has been proposed as a critical factor contributing to health disparities. One policy option for improving access is to introduce supermarkets in low-income communities, but evidence increasingly points to null effects. ObjectiveThe aim of this study was to examine whether the introduction of a new supermarket in a public housing community, and proximity to it, were associated with improvements in residents’ dietary outcomes. It also explored whether these associations may be moderated by access and cost barriers to eating healthy at baseline. DesignA cohort of public housing residents were recruited from Jordan Downs, where the new supermarket was introduced, and from 2 comparison sites. Longitudinal data on outcomes and exposures were collected at baseline (2018-2019) and follow-up (2020-2021). Quasi-experimental variation in residents’ distance to the new supermarket was used to examine whether proximity to the supermarket was associated with dietary improvements. Participants/settingParticipants included 557 adult residents from 3 public housing sites in Watts, Los Angeles, CA. InterventionThe intervention is the opening of a new supermarket in the Jordan Downs community. The primary exposure measure is an indicator for whether residents lived in Jordan Downs vs in the comparison sites. The secondary exposure measure is residents’ driving distance to the new supermarket. Main outcome measuresSelf-reports of daily consumption of whole grains, dairy, fruits and vegetables, added sugar, red meat, processed meat, and overall healthiness of diet were obtained from surveys administered at baseline and follow-up. Statistical analyses performedDescriptive analyses examined households’ grocery shopping patterns after the new supermarket’s introduction. Analysis of covariance linear regressions models estimated the association between residents’ dietary outcomes at follow-up and the exposure measures, conditional on dietary outcomes at baseline and other covariates. ResultsProximity to the new supermarket was associated with a significantly higher probability of shopping there, particularly for households that reported an access or cost barrier at baseline. Overall, there were no statistically significant or practically meaningful differences observed in dietary outcomes between Jordan Downs residents and those in comparison sites, or between residents who lived at varying distances from the supermarket. Exploratory moderation analyses suggested some meaningful dietary benefits for those who had a frequent access barrier at baseline, but not for those without such a barrier, but there was mostly no evidence of moderation by price barrier at baseline. ConclusionsSupermarket opening in an urban, low-income, and racial and ethnic minority community was not found to be associated with improvements in dietary outcomes for most residents in the first year after its opening. Improving dietary outcomes in such communities may require a broader and nuanced approach that addresses varied barriers faced by residents.

Incidence and Risk Factors of Perianal Pathology during Pregnancy and Postpartum Period: A Prospective Cohort Study.

We aimed to identify the incidence and risk factors of perianal pathology during pregnancy and the postpartum period. A prospective cohort study was conducted in three institutions in Lithuania. A total of 190 patients were examined and interviewed three times (<12, 18-20 weeks of gestation, and during the first 2 months after delivery). They completed a questionnaire including demographic, obstetric, coloproctological, and birth data. A total of 73 (34.59%) women developed hemorrhoidal disease after delivery, and 120 (56.87%) developed perianal pathology. Multivariate analysis identified a neonatal birth weight ≥3380 g (OR 4.22; 95% CI 1.83-9.71, p < 0.001) and consumption of eggs (OR 3.10; 95% CI 1.13-8.53, p = 0.028) or cereals (OR 2.87; 95% CI 1.32-6.25, p = 0.008) several times per week as significant risk factors for hemorrhoidal disease. Neonatal birth weight ≥3380 g (OR 3.95; 95% CI 1.47-10.59, p = 0.006), maternal BMI ≥ 21.48 (OR 3.58; 95% CI 1.51-8.47, p = 0.004), the duration of the second labor period ≥38 min (OR 2.81; 95% CI 1.09-7.23, p = 0.032), and consumption of flour products several times per week (OR 2.77; 95% CI 1.10-6.98, p = 0.030) were associated with a higher risk of perianal pathology. Daily consumption of fruits and vegetables (OR 0.35; 95% CI 0.15-0.81, p = 0.014) and less frequent consumption of eggs were protective factors (OR 0.18; 95% CI 0.06-0.56, p = 0.003). Perianal diseases, especially hemorrhoidal disease, are common during pregnancy and the postpartum period. A neonatal birth weight ≥ 3380 g, a maternal BMI of ≥21.48, duration of the second labor period of ≥38 min, and consumption of flour products and cereals several times a week are risk factors for developing these diseases.

Application of Fermentation as a Strategy for the Transformation and Valorization of Vegetable Matrices

This review paper addresses vegetable fermentation from a microbiological and technological point of view, with particular emphasis on the potential of lactic acid bacteria to carry out these transformations. This review paper also covers the spectrum of traditional and emerging fermented plant foods. Fermentation with lactic acid bacteria represents an accessible and appropriate strategy to increase the daily consumption of legumes and vegetables. Often, lactic fermentation is carried out spontaneously following protocols firmly rooted in the culture and traditions of different countries worldwide. Fermented plant products are microbiologically safe, nutritious, and have pleasant sensory characteristics, and some of them can be stored for long periods without refrigeration. Controlled fermentation with selected lactic acid bacteria is a promising alternative to guarantee high-quality products from a nutritional and organoleptic point of view and with benefits for the consumer’s health. Recent advances in genomics and molecular microbial ecology predict a bright future for its application in plant fermentation. However, it is necessary to promote molecular approaches to study the microbiota composition, select starters aimed at different legumes and vegetables, generate products with nutritional properties superior to those currently available, and incorporate non-traditional vegetables.

Income and education level trajectories and changes in the daily consumption of vegetables after thirteen years of follow-up: the Pró-Saúde Study.

This study aimed to examine whether education level and income trajectories influence vegetable consumption changes over 13 years among civil servants at different campuses of a university in the state of Rio de Janeiro, Brazil. Vegetable intake frequency (daily and non-daily consumption), income (per capita), and education level (maintenance of low schooling/ upward mobility/maintenance of high schooling) were assessed at baseline (1999) and in the fourth wave (2011-12) of the Pró-Saúde (Pro-Health) cohort study. A total of 2,381 participants were analyzed. The association between educational and income trajectories and variation in vegetable consumption was assessed via crude and age-adjusted generalized linear models, stratified by sex. Men in upward educational mobility showed a 0.5% increase in vegetable consumption (p=0.01), while women in this group demonstrated a 2.5% increase (p=0.05). Adjusted models showed that women who reduced their income had a lower likelihood of consuming vegetables (odds ratio [OR] 0.93; 95% confidence interval [CI] 0.89-0.97). The findings highlight the influence of social inequalities on vegetable consumption in adults.

Trends in Fruit and Vegetable Intake Among the Labor Force Population - China, 2010-2018.

This research investigates trends pertaining to the prevalence of low fruit and vegetable consumption among the labor force population in China. The study considered data derived from four nationally representative cross-sectional surveys. The data under review for this study was derived from the China Chronic Disease and Risk Factor Surveillance (CCDRFS) carried out in 2010, 2013, 2015, and 2018, correspondingly. We utilized a food frequency questionnaire to evaluate the quantity and frequency of fruit and vegetable consumption. The estimated prevalence of low fruit and vegetable consumption was calculated for each survey, while considering factors such as sex, age, location, and socioeconomic status (SES). Participants' SES was ascertained via latent class analysis, serving to identify distinct classes based on criteria such as education, occupation, and household income per capita. Logistic regression was deployed to determine the statistical significance of trends. From 2010 to 2018, there was a notable increase in the average daily consumption of vegetables and fruits among the working population, rising from 418.6 g/day to 491.8 g/day (P<0.01 for trend). During the same period, the prevalence of low fruit and vegetable intake declined from 51.1% to 43.5% [P<0.001 for trend; -1.6% average annual percent change (AAPC)]. This downward trend was prevalent across genders, however, certain subgroups of adults (e.g., those living in rural areas or those of low SES) saw stable consumption levels throughout this period (P>0.05 for trend). Over the past nine years, there has been a notable decline in the prevalence of low fruit and vegetable consumption among the labor force population in China. Moreover, the comparatively deficient intake of fruits and vegetables evident among individuals of lower SES warrants further attention.

Study on the correlation between dietary structure and sleep in patients with insomnia disorder.

Insomnia disorder (ID) is a persistent difficulty sleeping, often accompanied by anxiety and depression, which seriously reduces a person's quality of life. Dietary changes in insomnia patients have been a concern. To explore the rationality of diet in patients with ID and its correlation with insomnia in ID patients. This study included 216 patients diagnosed with ID and 197 individuals as the healthy control (HC) group who attended the neurology outpatient clinic or sleep clinic at Henan Provincial People's Hospital between September 2018 and November 2019. Through the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HAMD), sleep and mental conditions were assessed in the ID and HC groups. The dietary intake structure of both groups was observed using the food frequency table. Meanwhile, the relationship between dietary intake and sleep quality was analyzed based on the logistics regression. Individuals in the ID group had significantly higher age, weight, and body mass index compared to the HC group (p<0.01). Individuals within the ID category demonstrated a heightened daily consumption of carbohydrates, grains, tubers, and legumes relative to the healthy control group. In contrast, the intake levels of vegetables, fruits, and nuts were diminished compared to the HC group, with this difference being statistically significant (p<0.01). A positive correlation was observed between the daily consumption of grains, tubers, and legumes and PSQI scores. Conversely, a negative association was found between daily consumption of vegetables and fruits. ID patients exhibit an elevated intake of carbohydrates, whereas the consumption of vegetables, fruits, and nuts is deficient in comparison to the healthy cohort, implying that a distorted dietary structure might be a contributing factor to ID onset. Sensible and scientific dietary guidance is of considerable significance in preventing the onset of ID and facilitating its management. However, the derived conclusions warrant further extensive research.

Capturing youth voices to improve food policy: applying CO-CREATE’s Dialogue Forum Tool in Ireland

Abstract Background The percentage of children eating fruit and vegetables and consuming milk in Europe is low The EU School Fruit, Vegetable, and Milk Scheme (SFVMS) is funded by the European Commission to promote the daily consumption of fruit, vegetables and milk. In 2023, the Commission plan to revise the scheme and are interested in hearing the views of young people. The aim of this research is to capture the voices of European Youth on the SFVMS from a collaboration of 4 countries. The present study provides initial findings from 11 and 12 year olds living in Ireland using the novel CO-CREATE Dialogue Forum Tool (DFT). Methods Two primary schools were recruited from a list of schools participating in the EU school, fruit, vegetables and milk scheme. The schools were from a high and a low socioeconomic status area. In each school, 6 pupils were invited to participate in the forum with consent from their parents. The DFT was applied to capture youth voices. The tool involved a moderated structured discussion about a prewritten SFVMS policy idea. The moderator guided the participants through the discussion with a series of activities on a physical canvas. Results The participants felt the policy idea was important to improve health. They discussed the obstacles and opportunities to the policy idea, including the quality of the school food products and their preferences. They proposed actions for improvement, including raising awareness of the quality and creating an advertising campaign. The participants enjoyed taking part in the dialogue forum and felt it was important to have their voices heard. Conclusions The CO-CREATE DFT was useful to discuss a policy idea for the EU SFVMS. The implementation of the tool by other countries will provide a wider European perspective of the policy idea. Key messages • Participants engaged well with The CO-CREATE dialogue forum tool. • Youth voices can be readily captured to co-create food related policies.

VEGETABLE CONSUMPTION AND COOKING SKILLS AMONG UNIVERSITY STUDENTS

A high vegetable diet has proved to offer health benefits that can lower blood pressure, reduce the risk of heart disease and stroke, prevent some types of cancer, lower the risk of eye and digestive problems, and have a positive effect on blood sugar, which can help control appetite. However, the prevalence of vegetable consumption below the recommended daily intake is worrying. Nearly 95% of Malaysian adults, including university students, have not met the recommended daily amount of vegetables. Sociodemographic factors and a lack of cooking skills may contribute to inadequate vegetable consumption. A study was carried out to determine the relationship between sociodemographic characteristics and cooking skills with vegetable consumption among Malaysian university students. By utilizing a random sample, a cross-sectional study was conducted to evaluate the frequency of vegetable consumption and cooking skill among university students aged 18 and older. The data was obtained via online survey using the Food Frequency Questionnaire (FFQ) and the Cooking Skills Questionnaire validated and tested by previous researchers. Vegetable consumption was divided into daily and non-daily consumption and a chi-square test was performed to analyze the association followed by the Bonferroni posthoc test. The association between sociodemographic and five dimensions of cooking skills with daily vegetable consumption was subject to logistic regression and an adjusted odds ratio was applied. Results demonstrated that only 24% of students (20% of males and 52% of females) consumed vegetables regularly, while the rest did not. There is a positive association between cooking skills dimensions (availability and accessibility of fruits and vegetables; produce consumption self-efficacy and knowledge of cooking terms and techniques) with daily vegetable consumption. Students who were 25 years old and older, male, lived alone, with friends, or with children, understand how to cook, ordered outside during lunchtime, and dined at the cafeteria for lunch were significantly associated with daily vegetable consumption.

Anemia in female adolescents at Karanganyar regency: A cross-sectional study associated with polymorphism of duodenal cytochrome B gene and daily consumptions of fruits and vegetables.

The prevalence of anemia in female adolescents increases every year. A duodenal Cytochrome B (CYBRD1) enzyme is involved in the regulation of iron metabolism. G797A gene polymorphism of the CYBRD1 reduces nonheme iron transport into the enterocytes, which was mediated by the divalent metal transporter 1 protein. Daily consumption of fruits and vegetables has been recommended for the prevention of non- communicable diseases, including anemia. This study aimed to analyze the association of CYBRD1 polymorphism and daily consumption of fruits and vegetables with anemia in female adolescents in the Karanganyar regency. This cross-sectional study recruited 233 female students in 6 senior and vocational high schools in Karanganyar regency, which were selected using purposive sampling. Data on fruit and vegetable consumption were collected using Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ). Polymorphism of the G797A CYBRD1 gene was determined using the amplification refractory mutation system polymerase chain reaction. All collected data were analyzed using chi-square and multiple logistic regression tests with p < 0.05. Anemia was found in 13.73% of female students. Inadequate intakes of fruits and vegetables were found in 63.09 and 51.07% of female students, respectively. The AA genotype (OR = 5.779; 95%CI: 0.974-34.289; p = 0.053), inadequate fruit consumption (OR = 1.497; 95%CI: 0.603-3.718; p = 0.133), and inadequate vegetable consumption (OR = 11.99; 95%CI: 3.457-41.586; p < 0.001) increased higher risk of anemia, compared with their counterparts. G797A CYBRD1 gene polymorphism and daily consumption of vegetables increase the risk of anemia but not for daily consumption of fruits in female adolescents in the Karanganyar regency.

Development and Validation of Protocol Based on Brazilian Dietary Guidelines for Adults with Diabetes Mellitus Who Attended Primary Health Care.

To date, there is no protocol providing dietary guidelines to assist health care professionals in counseling Brazilian individuals with Diabetes Mellitus (DM) assisted in primary health care (PHC) according to the Dietary Guidelines for the Brazilian Population (DGBP). Therefore, this study aimed to develop and validate a protocol based on the DGBP for health care, non-nutritionist professionals in counseling adults with DM in PHC. We systematized the recommendations published in the DGBP, the Diabetes Brazilian Society guidelines, and the scientific literature regarding food and nutrition needs of adults with DM. The clarity and relevance were validated by an expert panel (n = 19) and the understanding and applicability were validated by PHC professionals (n = 12). The degree of agreement of the experts was assessed using a Content Validity Index (CVI). Items receiving CVI > 0.8 were considered appropriate. The protocol consisted of six dietary recommendations that encouraged the daily consumption of beans, vegetables, and fruits, advised the avoidance of sugar-sweetened beverages and ultra-processed foods, stimulated eating in appropriate environments, and gave additional guidance addressed to the particularities of DM. The protocol clarity, relevance, and applicability were successfully validated. The protocol supports health care, non-nutritionist professionals in the guidance of dietary recommendations and promoting adequate and healthy eating habits for adults with DM in PHC.

Higher vegetable consumption is related to a lower risk of cardiometabolic risk cluster among children and adolescents: A national cross-sectional study in China

Background and aimsEvidence about the association between vegetable consumption and cardiometabolic risk factors (CMRFs) cluster among children and adolescents was inconsistent. We aimed to investigate the prevalence of CMRFs and CMRFs cluster, and to evaluate their associations with vegetable consumption. Methods and resultsA total of 14,061 participants aged 6–19 years were recruited from 7 provinces of China. A standard physical examination, including height, weight and blood pressure, was conducted. Information regarding CMRFs was obtained through anthropometric measurements and blood sample testing, while weekly frequency and daily servings of vegetable consumption data collected by questionnaires. Logistic regression models were used to analyze the odds ratios (OR) for associations between CMRFs, CMRFs cluster and vegetable consumption. The prevalence of no CMRFs cluster among children and adolescents was 26.4%. Participants whose daily vegetable consumption was 0.75–1.5 and ≥1.5 servings showed a lower risk of high blood pressure (HBP), high total cholesterol (TC), high triglyceride (TG), and high low-density lipoprotein cholesterol (LDL-C) compared to those with daily vegetable consumption of <0.75 servings. Besides, higher average daily vegetable consumption was strongly associated with lower risks of CMRFs cluster. Stratified analyses showed that the protective effects of more vegetable intake on CMRFs cluster were profounder in boys and young adolescents. ConclusionMore vegetable intake was associated with lower risks of CMRFs cluster in Chinese children and adolescents aged 6–19 years, which further highlighted the significance of vegetable consumption to improve the cardiometabolic risk status.

Offering vegetables to children at breakfast time in nursery and kindergarten settings: the Veggie Brek feasibility and acceptability cluster randomised controlled trial

BackgroundIn many Westernised countries, children do not consume a sufficient amount of vegetables for optimal health and development. Child-feeding guidelines have been produced to address this, but often only promote offering vegetables at midday/evening meals and snack times. With guidance having limited success in increasing children’s vegetable intake at a population level, novel approaches to address this must be developed. Offering vegetables to children at breakfast time in nursery/kindergarten settings has the potential to increase children’s overall daily vegetable consumption as children typically attend nursery/kindergarten and many routinely eat breakfast there. However, the feasibility and acceptability of this intervention (Veggie Brek) to children and nursery staff has not been investigated.MethodsA feasibility and acceptability cluster randomised controlled trial (RCT) was undertaken in eight UK nurseries. All nurseries engaged in one-week baseline and follow-up phases before and after an intervention/control period. Staff in intervention nurseries offered three raw carrot batons and three cucumber sticks alongside children’s main breakfast food each day for three weeks. Control nurseries offered children their usual breakfast. Feasibility was assessed by recruitment data and nursery staff's ability to follow the trial protocol. Acceptability was assessed by children’s willingness to eat the vegetables at breakfast time. All primary outcomes were assessed against traffic-light progression criteria. Staff preference for collecting data via photographs versus using paper was also assessed. Further views about the intervention were obtained through semi-structured interviews with nursery staff.ResultsThe recruitment of parents/caregivers willing to provide consent for eligible children was acceptable at 67.8% (within the amber stop–go criterion) with 351 children taking part across eight nurseries. Both the feasibility and acceptability of the intervention to nursery staff and the willingness of children to consume the vegetables met the green stop–go criteria, with children eating some part of the vegetables in 62.4% (745/1194) of instances where vegetables were offered. Additionally, staff preferred reporting data using paper compared to taking photographs.ConclusionsOffering vegetables to children at breakfast time in nursery/kindergarten settings is feasible and acceptable to children and nursery staff. A full intervention evaluation should be explored via a definitive RCT.Trial registrationNCT05217550.

Aspectos psicossociais relacionados ao consumo de frutas e hortaliças em adolescentes

This study aimed at assessing the association between psychosocial aspects and fruit and vegetable consumption in adolescents. Cross-sectional study developed with 327 adolescents from a public school in Brazil. A questionnaire developed for adolescents was applied to assess the influence of self-efficacy, family, peers, and body image on the consumption of fruits and vegetables. Specific questions assessed the intake frequency of fruits and vegetables, and the mean consumption was estimated using two 24-hour recalls. Scores related to psychosocial aspects were described as mean and median and the weight status was classified based on the body mass index. The average daily consumption of fruits and vegetables was 36.2 g and 45.4 g, respectively. Self-efficacy and the influence of peers were associated with an increase in the amount and frequency of fruits and vegetables consumption. Adolescents with higher scores of self-efficacy had greater average consumption of fruits and vegetables when compared to those with lower scores. The same was observed for the influence of peers. Self-efficacy and the influence of peers were the factors that most influenced the consumption of fruits and vegetables in adolescents.

Association of lifestyle-related risk factors with incidence and mortality rates of colorectal cancer among adolescents and young adults (AYA) in the United States.

80 Background: Incidence of colorectal cancer (CRC) among adolescents and young adults (AYA) is increasing. A significant proportion of adolescents and young adults (AYA) with colorectal cancer (CRC) lack traceable genetic risk factors. We sought to study the impact of lifestyle-related risk factors on the incidence and mortality of CRC in these patients. Methods: We extracted data on crude incidence and mortality rates of CRC (reported per 100,000 population) for ages 15-39 years in all 50 U.S. states and District of Columbia from the Center for Disease Control (CDC) WONDER database (1999-2018). Data on risk factors such as obesity, physical activity, alcohol and tobacco abuse and nutrition were obtained from the Behavioral Risk Factor Surveillance System (BRFSS, 2020). Correlations were analyzed using Pearson’s co-efficient. p &lt; 0.05 was considered statistically significant. Statistical analysis was performed using VassarStats. Results: Median crude incidence and mortality rates of CRC in AYA in the US from 1999-2018 were 3.8 (IQR 3.2, 4.4) and 0.7 (IQR 0.5,0.9) per 100,000 population respectively. States with higher age-adjusted prevalence of obesity per 100,000 had higher incidence (r = 0.36, p = 0.01) and mortality rates (r = 0.49, p = 0.0002) of CRC in AYA population. States with a higher age-adjusted prevalence of adherence to recommended weekly aerobic activity had lower incidence (r = -0.4515, p = 0.001) and mortality (r = -0.569, p &lt; 0.0001) rates. While states with higher age-adjusted prevalence of tobacco abuse had higher incidence rate of CRC (r = 0.33, p = 0.02), there was no correlation with mortality rates (r = 0.24, p = 0.09). Higher prevalence of alcohol consumption was associated with decreased mortality rate (r = -0.44, p = 0.001), with no impact on incidence rate (r = -0.16, p = 0.26). States with lower daily consumption of fruits had higher incidence (r = 0.37, p = 0.01) and mortality rates (r = 0.59, p &lt; 0.0001). No correlation of daily consumption of vegetables with incidence (r = -0.1516, p = 0.29) and mortality (r = 0.18, p = 0.22) rates was noted. Conclusions: In the current analysis, higher prevalence of obesity, lower rates of aerobic activity and lower daily consumption of fruits were strongly associated with increased incidence and mortality rates. The impact of tobacco abuse and alcohol consumption was more variable. Apart from improving access to genetic testing and counseling, efforts aimed at mitigating the rise of CRC incidence among AYA should also focus on traditional lifestyle-related risk factors.

Nutrition knowledge and influence on diet in the carer-client relationship in residential care settings for people with intellectual disabilities.

People with intellectual disabilities generally have poorer health outcomes compared with those who do not, including outcomes related to nutrition-related non-communicable diseases. Carers support people with intellectual disabilities in many aspects including habitual shopping and preparation of food, but their own nutrition knowledge and the influence this may have on dietary intakes of clients is unknown. We explored the nutrition knowledge of carers of people with intellectual disabilities in residential care settings, their dietary habits and their influence on clients' food shopping and preparation and therefore the diet consumed by their clients. Ninety-seven carers belonging to a large independent care sector organisation specialising in the care of people with an intellectual disability completed a validated general nutrition knowledge and behaviour questionnaire. Seventeen carers from the residential care settings were interviewed to contextualise practice. Knowledge about key dietary recommendations scored highly. Carers who had more work experience were found to have higher scores in 'making everyday food choices' (p=0.034). Daily consumption of fruit and vegetables (at least one portion per day) was observed (for fruit by 46% of the carers and for vegetables by 60% of the carers), whilst most carers reported avoiding consuming full-fat dairy products, sugary foods and fried foods. The concept of a healthy diet; typical dietary habits of clients; role in food acquisition; and training in nutrition emerged as themes from the interviews. Carers discussed various topics including the importance of a balanced diet, cooking fresh foods and control of food portion sizes for clients relative to the care philosophy of a client-centred approach, which encapsulates client autonomy. Gaps in knowledge around specific nutrients, making healthy choices and cooking skills remain. Carers have an influence on clients' dietary choices; they are able to provide healthy meals and share good dietary habits with clients. Further training in nutrition is recommended for impact on clients' health.