Dietary Behaviors Research Articles

Socioeconomic inequalities in dementia risk among a population-based cohort: Quantifying the role of a broad combination of lifestyle factors.

The complex associations of socioeconomic status (SES) and lifestyle with dementia are unclear. Our objective was to examine whether a broad combination of lifestyle factors mediates the associations of SES with incident dementia and the extent of interaction or joint relations of lifestyles and SES with dementia. A total of 274,871 participants from the UK Biobank were included. SES was assessed using the Townsend Deprivation Index. A lifestyle index was created based on smoking status, alcohol consumption, physical activity, social connections, sleep duration, diet, and sedentary behavior. Cox proportional hazards models were fitted. Mediation and interaction analyses were conducted to explore the relationship between lifestyles and SES in dementia. The HRs (95% CIs) for when participants with low SES were compared with participants of high SES were 1.32 (1.22-1.42) for all-cause dementia, 1.25 (1.11-1.40) for Alzheimer's disease (AD), and 1.61 (1.37-1.90) for vascular dementia (VD). Lifestyles explained ≤ 7.8% of socioeconomic disparities in dementia. Unhealthy lifestyle categories were associated with a higher risk of dementia and its subtypes across all SES levels. The HRs (95% CIs) for all-cause dementia, AD, and VD comparing participants with low SES and the least healthy lifestyle versus those with high SES and the healthiest lifestyle were 1.82 (1.56-2.11), 1.51 (1.20-1.90), and 2.56 (1.81-3.61), respectively. Adhering to a healthy lifestyle may prevent dementia across all socioeconomic groups, but socioeconomic inequalities in dementia cannot be fully addressed by promoting healthy lifestyles alone. The social determinants of dementia need to be better addressed.

Comparison of snack characteristics by diet quality findings from a nationally representative study of Australian adolescents

Snacking is a common dietary behaviour among adolescents contributing to more than one quarter of their total energy intake; however, the relationship between snacks and diet quality remains unclear. Hence, this study aimed to examine the characteristics of snacks among adolescents with different levels of diet quality. Dietary data collected from a nationally representative sample of Australian adolescents (12–18 years old, n = 935) using one 24-hour dietary recall in the National Nutrition and Physical Activity Survey were analysed. Snacks were defined based on participant-identified eating occasions, and diet quality was assessed using the Dietary Guideline Index for Children and Adolescents (DGI-CA). Marginal means and proportion of snack characteristics including snack frequency, snack energy density (ED), and commonly consumed foods at snack from the five food groups and discretionary foods at snack across DGI-CA tertiles (highest tertile indicating high guideline adherence) were estimated for both boys and girls using linear regression and logistic regression. Differences in means were tested using the F-test. The results showed no significant differences in the mean frequency of snacks across tertiles of DGI-CA scores. The mean ED of snacks decreased as DGI-CA scores increased in both boys (lowest tertile = 8.4, 95% CI [7.1, 10.0] kJ/g, highest tertile = 6.3 [5.4, 7.4] kJ/g) and girls (lowest tertile = 9.0 [7.8, 10.3] kJ/g, highest tertile = 5.9 [5.1, 6.9] kJ/g). As diet quality improved, the proportion of adolescents consuming discretionary (i.e., unhealthy) foods and foods from the five food group foods as snacks decreased and increased, respectively. In conclusion, adolescents with higher diet quality consumed snacks with a lower ED while lower proportion of them consume discretionary foods, and higher proportion of them consume from the five food groups. Encouraging the consumption of foods from the five food groups with lower ED as snacks presents an opportunity to enhance adolescent diet quality.

The impact of a positive discipline group intervention on parenting self-efficacy among mothers of young children.

Instilling healthy behaviors in early childhood is crucial as they can have lifelong impacts. However, many Chinese mothers lack effective parenting strategies, resulting in low self-efficacy. Positive Discipline, a non-punitive and non-indulgent approach, can help enhance maternal parenting self-efficacy and promote healthy lifestyle behaviors in children. This study explores the impact of a Positive Discipline group intervention on the parenting self-efficacy of Chinese mothers and how it can contribute to promoting diet and healthy lifestyle behaviors in early childhood. We randomly selected 70 mothers with low parenting self-efficacy from a kindergarten in China, dividing them into an intervention group (35 participants) and a control group (35 participants). The intervention group received a 6-week Positive Discipline intervention, while the control group received no intervention. The intervention aimed at helping mothers nurture their children in a kind and firm manner. We used paired samples t-tests and independent samples t-tests to compare changes in parenting self-efficacy scores before and after the intervention. Results showed that the intervention group's parenting self-efficacy scores significantly improved after the intervention, from an average score of 25.00 ± 4.08 to 36.29 ± 2.99 (p < 0.05, Cohen's d = 3.156). Significant improvements were observed in areas like "believing their parenting style benefits their child's growth" and "knowing how to effectively parent their children." The control group's average scores showed no significant changes between pre- and post-intervention (pre: 25.07 ± 5.33; post: 24.86 ± 5.75, p > 0.05, Cohen's d = 0.076). Furthermore, 3 months post-intervention, the intervention group's scores remained significantly higher than pre-intervention (p < 0.05), demonstrating the intervention's lasting effect. This study demonstrates that the Positive Discipline group intervention significantly enhances parenting self-efficacy in Chinese mothers, promoting healthy lifestyle behaviors in early childhood. Providing continuous support and guidance to mothers can help solidify their parenting confidence, ensuring long-term intervention success. Future research should explore how group interventions can effectively integrate healthy behaviors into early childhood routines and impact children's diet and lifestyle behaviors.

Associations of takeaway outlets with takeaway food consumption and adiposity: longitudinal analysis of the Fenland cohort.

This study builds on prior findings that link increased availability of takeaway food outlets in home, workplace, and commuting environments to greater takeaway consumption and adiposity. Using longitudinal data, we examine associations of takeaway availability at baseline with changes in consumption and adiposity between baseline and follow-up. We analyzed data from the Fenland Study, with baseline data from 2005 to 2015 and follow-up from 2015 to 2020. Takeaway outlet availability within 1 mile of participants' home and workplace addresses, based on 2011 local authority data, was assessed. Outcomes included takeaway food consumption (from a food frequency questionnaire) and body fat percentage (measured via dual-energy x-ray absorptiometry) at follow-up. Among 7581 participants (mean [SD] age, 49.3 [7.4] years) with a mean follow-up of 6.7 years, no positive association was found between takeaway outlet availability at baseline and changes in consumption or body fat percentage. However, among the 12 associations tested, the highest combined home-workplace availability of takeaway outlets, compared with none, was associated with a 0.68 decrease in body fat percentage (95% CI: 0.24-1.12). Although takeaway outletavailability was linked to greater consumption and adiposity at baseline, it did not predict changes over time, underscoring the complexity of dietary behaviors and their relationship with the neighborhood food environment.

Profiles of cardiometabolic risk and acculturation indicators among South Asians in the US: latent class analysis of the MASALA study.

South Asians (SA) represent the fastest growing US immigrant group, and previous studies have indicated that they face disproportionately high burden of cardiometabolic disease. Cardiometabolic disease manifests as a syndemic or synergistic epidemic encompassing multiple disease clusters influenced by biological, social, and psychological factors stemming from the acculturative process. This process may exacerbate morbidity within immigrant subgroups. Our aim was to identify cardiometabolic risk profiles among SA using indicators of acculturation. We conducted a latent class analysis on data from the Mediators of Atherosclerosis in South Asians Living in America study (N=771). A composite cardiometabolic disease outcome was constructed using prevalent hypertension, type 2 diabetes, and body mass index. Acculturation indicators included years living in the US, English language proficiency, dietary behaviors, preservation of cultural traditions, social and neighborhood support, maintenance of social relationships (i.e., friendships), and experiences of discrimination, along with proxies of acculturative stress (i.e., depressive symptomology, trait anxiety and anger). Social and environmental determinants of health, health behaviors, religiosity and spirituality served as covariates to further assess latent class membership. Four cardiometabolic risk profiles emerged: (1) lowest risk [73.8% of sample] characterized by high integration into both SA and US cultures; (2) the modest risk [13.4% of sample], exhibiting elevated levels of mental health distress and experiences of discrimination, and distancing themselves from both cultures; and the (3) moderate risk [8.9% of sample] and (4) highest risk [3.9% of sample], demonstrating greater assimilation into US culture. Compared to the lowest risk profile: the modest risk profile was associated with low-income and conflicting attitudes about religion/spirituality, while the moderate risk profile was characterized by lower income and educational attainment with positive behaviors and attitudes toward religion/spirituality. Findings expand our understanding of immigrant cardiometabolic health as a syndemic issue wherein multiple co-occurring and interacting processes synergize to produce negative outcomes in already at-risk subpopulations. Furthermore, acculturation emerges as a crucial factor in understanding health disparities among immigrant and refugee groups in the US.

Therapeutic Patient Education and Eating Habits: A Challenge in Caries Disease.

Dietary Factors and Oral Health: Risky dietary behaviors, particularly excessive sugar consumption, significantly contribute to dental caries. Dental practitioners are tasked with detecting and managing these behaviors to effectively treat caries and prevent recurrences. Although dietary assessment tools exist to identify such behaviors, they have limits. Furthermore, traditional methods, focused on information dissemination and advice, often fall short in promoting sustainable changes in patient behavior toward oral health. From our perspective, there is a necessity to integrate educational approaches with therapeutic management for enhancing the ability current and future dental practitioners to effectively care for their patients' oral health needs. Discussion: Specific educational models have been developed for patients with chronic diseases, through Therapeutic Patient Education (TPE), defined as helping patients acquire or maintain the skills they need to best manage their lives with a chronic disease. Future Directions: By incorporating TPE into dental practice, oral health professionals can empower patients to take control of their eating habits and reduce their risk of caries disease. This holistic approach addresses both the carious lesions and underlying causes of tooth decay, leading to better oral health outcomes for patients.

Microbial extracellular electron transfer in the human gastrointestinal tract

Microbial extracellular electron transfer in the human gastrointestinal tract Gratian Ting and Arpita Bose from Washington University in St. Louis discuss the fascinating role that extracellular electron transfer plays within the human gut. The human gut microbiome contains around hundreds of trillions of bacteria, and a great diversity of species. In fact, the number of bacteria in the human gut is similar in number to all the cells in the human body, further signifying the heterogeneity and significance of this microbiota. The habitat filtering of the human gut, defined as the non-random survival of microorganisms in relation to characteristics of the surrounding environment, is influenced by two important factors: host and diet. Disruption of normal host gut processes through various means, could cause cell death and dysbiosis, disrupting host-mediated habitat filtering. However, diet plays a far more common role in this process. Different dietary behaviors exist between individuals from cultural, moral, economic, and other means.

Oral Hygiene Practices and Dietary Behaviours in a Group of Children in Benghazi, Libya

Oral Hygiene Practices and Dietary Behaviours in a Group of Children in Benghazi, Libya

7980 Physical Activity Attenuates the Association of Early Adolescent Adiposity with Later PCOS

Abstract Disclosure: R. Whooten: None. S. Rifas-Shiman: None. W. Perng: None. J. Chavarro: None. E. Oken: None. M. Hivert: None. Purpose: Adiposity is a risk factor for polycystic ovary syndrome (PCOS). Limited knowledge exists regarding modifiable behaviors, such as physical activity, during early-life may mitigate the association of adiposity with PCOS risk. We aimed to assess how moderate-vigorous physical activity (MVPA) may impact the association of adiposity in early adolescence with later report of adolescent PCOS. Methods: Within the Project Viva prospective cohort, we used multivariable logistic regression to assess the association of body mass index z-score (BMIz) at early adolescence (mean age 13.1 years) with mid-late adolescent PCOS (self-reported diagnosis or oligo-anovulation with clinical/biochemical hyperandrogenism at mean age 17.7 years). We stratified our analyses by actigraphy-assessed MVPA during early adolescence (≥30 versus &amp;lt;30 minutes/day). In multivariable models, we adjusted for maternal education and PCOS; and child race and ethnicity, dietary behaviors, actigraphy-assessed sleep duration, and self-reported screentime; and season of actigraphy assessment. Results: Among 341 female adolescents, n=47 (14%) met criteria for PCOS at mid-late adolescence. At early adolescence, mean (SD) BMIz was 0.32 (1.10) units and n=110 (32%) had ≥30 minutes/day MVPA. There was no difference in MVPA ≥30 minutes/day among those with versus without later PCOS (30% vs 33%, p=0.70). In unadjusted analyses, there was an association of early adolescent BMIz with mid-late adolescent PCOS (OR=1.93, 95%CI 1.39, 2.69 per unit increase in BMIz). In stratified analyses, the association of early adolescent adiposity with later PCOS was stronger in those with MVPA &amp;lt;30 minutes/day (OR=2.07, 95%CI 1.37, 3.11) than in those with MVPA ≥30 minutes/day (OR=1.72, 95%CI 0.97, 3.06). These findings persisted after adjusting for all covariates (overall: OR=1.72 95%CI 1.15, 2.56; MVPA &amp;lt;30 min/day: OR=2.01 95%CI 1.17, 3.45; MVPA ≥30 minutes/day: OR=1.36 95%CI 0.64, 2.91), however p-values for interaction terms were non-significant. Conclusion: Our findings suggest that maintaining ≥30 minutes MVPA daily during early adolescence may attenuate the association of adiposity with risk of PCOS by late adolescence. This has implications for the importance of promoting physical activity among at-risk individuals. Presentation: 6/2/2024

Impact of the COVID-19 Pandemic on Lifestyle Behavior and Clinical Care Pathway Management in Type 2 Diabetes: A Retrospective Cross-Sectional Study.

Background and Objectives: In Italy, as in the rest of the world, government restrictions aimed at containing the spread of COVID-19 primarily imposed limitations on social relationships and personal behavior. This situation significantly affected the management of chronic illnesses, including type 2 diabetes (T2D). The objective was to evaluate the perceptions of patients with T2D regarding the quality of care received during the COVID-19 pandemic and the impact on dietary and physical activity behaviors. Materials and Methods: We conducted a retrospective cross-sectional survey. Data were collected from June to July 2023 using the convenience sampling of patients with T2D, and the Patient Assessment of Chronic Illness Care (PACIC) and Medi-Lite questionnaires were administered. Results: During the research period, out of the 130 subjects who met all enrollment criteria, 103 patients were included in this study (79.23%). The results of the administered questionnaires were heterogeneous. The average scores from the PACIC Questionnaire for each question displayed significant variability, indicating a range of experiences in the quality of care. In the Medi-Lite survey, fruit, cereals, and olive oil showed the highest adherence levels, with mean scores ranging from 2.58 (SD ± 1.18) for fruit to 1.89 (SD ± 0.34) for olive oil and 1.97 (SD ± 0.17) for cereals. Patients who reported increased food intake during the lockdown attributed it to having more time to prepare meals. Physical activity levels remained unchanged for 48 patients, decreased for 45 patients, and only 9 patients managed to exercise more during the COVID-19 restrictions. Conclusions: Healthcare systems must prioritize comprehensive care plans for T2D that address not only physical health, but also emotional and social well-being. Post-pandemic, promoting healthier lifestyles and empowering patients to manage their condition is crucial. A multidisciplinary and multidimensional approach could support the care of vulnerable individuals, such as patients with T2D, especially during crises like pandemics or other dramatic events.

Multimedia: Multimodal Mediation Analysis of Microbiome Data.

Mediation analysis has emerged as a versatile tool for answering mechanistic questions in microbiome research because it provides a statistical framework for attributing treatment effects to alternative causal pathways. Using a series of linked regressions, this analysis quantifies how complementary data relate to one another and respond to treatments. Despite these advances, existing software's rigid assumptions often result in users viewing mediation analysis as a black box. We designed the multimedia R package to make advanced mediation analysis techniques accessible, ensuring that statistical components are interpretable and adaptable. The package provides a uniform interface to direct and indirect effect estimation, synthetic null hypothesis testing, bootstrap confidence interval construction, and sensitivity analysis, enabling experimentation with various mediator and outcome models while maintaining a simple overall workflow. The software includes modules for regularized linear, compositional, random forest, hierarchical, and hurdle modeling, making it well-suited to microbiome data. We illustrate the package through two case studies. The first re-analyzes a study of the microbiome and metabolome of Inflammatory Bowel Disease patients, uncovering potential mechanistic interactions between the microbiome and disease-associated metabolites, not found in the original study. The second analyzes new data about the influence of mindfulness practice on the microbiome. The mediation analysis highlights shifts in taxa previously associated with depression that cannot be explained indirectly by diet or sleep behaviors alone. A gallery of examples and further documentation can be found at https://go.wisc.edu/830110.

Co-Creation and Implementation of a Healthy Snacks Policy in Primary Schools: Data from Sintra Grows Healthy.

Policy interventions in the school food environment can improve dietary behaviors. However, the literature describing its development and implementation is scarce. This manuscript aims to describe the process of co-creation, implementation, monitoring, and evaluation of a Healthy Snacks Policy, in the scope of Sintra Grows Healthy intervention. Through a community-based participatory research methodology, the co-creation of the Healthy Snacks Policy comprises six stages: snacks evaluation, feedback sessions, class assemblies, school community assemblies, school cluster policy approval, and process evaluation. Within one school year, a Healthy Snacks Policy was co-created, approved, incorporated in the school regulations, implemented, continuously monitored, and evaluated. Regarding snacks evaluation, 1900 snacks were evaluated at the beginning of the school year and 1079 at the end of the school year. There were three feedback sessions, twenty-two class assemblies, and three school community assemblies. Most teachers perceived that children began to consume healthier snacks (72%); 66% of the children were considered to have started eating healthier; and most families said "yes or sometimes" when asked whether their children started requesting healthier snacks (70%), trying new foods (63%), and noticing improvements in their eating habits (74%). The co-creation of a Healthy Snacks Policy establishes an approach to effectively implement existing guidelines for school food supplies, complying with national priority implementation recommendations.

Adherence to the Mediterranean Diet in Association with Self-Perception of Dietary Behavior (Discrepancy between Self-Perceived and Actual Diet Quality): A Cross-Sectional Study among Spanish University Students of Both Genders.

Background/Objectives: The Mediterranean diet (MD) is one of the most studied dietary patterns to date and is associated with multiple benefits for health and sustainability. However, paradoxically, adherence to the MD (AMD) has been gradually decreasing in native regions. It is necessary to identify the factors that influence AMD to reverse this trend and to mitigate the negative outcomes (for health and the environment) associated with westernized diets. The objective of this study was to assess how self-perception of dietary behavior influences AMD. Methods: During the 28-day repeated measurement cross-sectional study, participants' dietary information was obtained from an initial form which established the self-perception of dietary behavior and the e12HR application to establish actual food consumption by individuals. Using the dietary information from both sources, the AMD index was calculated (specifically, the Mediterranean diet Serving Score (MDSS) index). Two categories of self-perception of dietary behavior were defined: Normal/underestimation: difference (MDSS index from initial form-MDSS index from e12HR application) ≤0; and Overestimation: difference >0 (with three subcategories: low (difference = 1-5), moderate (difference = 6-10), high (difference = 11-15)). Results: 139 (111, women; 28, men) Spanish university students were studied, with 98.6% (99.1%, women; 96.4%, men) falling into the overestimation category (they overestimated their dietary behavior); these students had significantly lower MDSS indexes, mean = 6.7, than students in the normal/underestimation category, mean = 12.0. Within the overestimation category, there were significant differences in the MDSS index: low (mean = 8.1), moderate (mean = 6.7), and high (mean = 4.9) subcategories and also differences that were significant in women but not in men. Conclusions: Overestimation of dietary behavior could be associated with lower AMD in all Spanish university students and women.

Unhealthy Eating Habits and Determinants of Diet Quality in Primary Healthcare Professionals in Poland: A Cross-Sectional Study

Background/Objectives: The aim of this work was to understand the factors influencing the prevalence of dietary behaviors, as well as determinants of unhealthy eating and diet quality among primary care physicians and nurses in Poland. Methods: A cross-sectional study involving 161 doctors and 331 nurses was conducted in the years 2020–2022 in primary healthcare settings. Results: Unhealthy eating habits affected GPs aged 40–54 years (42.9%), females (64.3%), those of normal body weight (67.9%), representing private medical practice (67.9%), who had over 20 years of work experience (42.8%). Similarly, among the group of nurses, unhealthy eating habits were reported in subjects aged 40–54 (46.5%), individuals with normal body weights (49.5%), those with one chronic disease (38.4%), representing public medical practice (63.6%), with over 20 years of work experience (40.4%), seeing ≤100 patients during the work week (84.8%). The univariable logistic regression analyses for unhealthy dietary habits showed that overweight GPs had lower odds of unhealthy eating habits (OR = 0.35; 95% CI: 0.11–1.08; p &lt; 0.05). Among the nurses, the odds of unhealthy eating habits increased with the number of years of work. Nurses with 10–20 years of work experience had 1.23 times greater odds of unhealthy eating habits, while people working for more than 20 years had 1.81 times greater odds of unhealthy eating habits than individuals working for a period shorter than ten years (OR = 1.23; 95% CI: 0.68–2.23; p &gt; 0.05 vs. OR = 1.81; 95% CI: p &lt; 0.05). The multivariable logistic regression analysis did not show statistically significant results. Conclusions: These issues should be addressed when planning educational activities aimed at supporting healthcare professionals in implementing lifestyle changes.

Dietary habit and lifestyle of postpartum women in South China: a mixed methods research

ObjectiveTo investigate the dietary and hygiene behaviours and influencing factors of women during the puerperium in South China.DesignA cross-sectional study.SettingThree tertiary hospitals in Guangdong Province, ChinaParticipantsFrom November 2022 to March...

Difference in Dietary Behaviors Between Children with and Without Neurodevelopmental Disabilities: Results from the 2022 National Survey of Children’s Health

Difference in Dietary Behaviors Between Children with and Without Neurodevelopmental Disabilities: Results from the 2022 National Survey of Children’s Health

Evaluating Experiences in a Digital Nutrition Education Program for People With Multiple Sclerosis: A Qualitative Study.

Multiple sclerosis (MS) is a complex immune-mediated disease with no currently known cure. There is growing evidence to support the role of diet in reducing some of the symptoms and disease progression in MS, and we previously developed and tested the feasibility of a digital nutrition education program for people with MS. The aim of this study was to explore factors that influenced engagement in the digital nutrition education program, including features influencing capability, opportunity and motivation to change their dietary behaviours. Semi-structured interviews were conducted with people who had MS, and who completed some or all of the program until data saturation was reached. Interviews were analysed inductively using thematic analysis. Themes were deductively mapped against the COM-B (Capability, Opportunity, Motivation, Behaviour) behaviour change model. Sixteen interviews were conducted with participants who completed all (n = 10) or some of the program (n = 6). Four themes emerged: (1) acquiring and validating nutrition knowledge; (2) influence of time and social support; (3) getting in early to improve health and (4) accounting for food literacy experiences. This is the first online nutrition program with suitable behavioural supports for people with MS. It highlights the importance of disease-specific and evidence-based nutrition education to support people with MS to make dietary changes. Acquiring nutrition knowledge, coupled with practical support mechanisms, such as recipe booklets and goal setting, emerged as crucial for facilitating engagement with the program. When designing education programs for people with MS and other neurological conditions, healthcare professionals and program designers should consider flexible delivery and building peer support to address the needs and challenges faced by participants. Members of the MS Nutrition Research Program Stakeholder Reference Group, which includes people with MS and MS health professionals, provided input during the development of the nutrition education program and study design stages.

Moderators and mediators of the association between the obesogenicity of neighbourhoods and weight status in Dutch adults

This study aimed to assess sociodemographic, personality, and psychological moderators, and lifestyle behavioural mediators, of the association between obesogenicity of neighbourhoods and weight status in Dutch adults. This cross-sectional study used baseline data of 150,506 adult participants of the Lifelines study. To quantify obesogenicity of Dutch neighbourhoods, the Obesogenic Built Environment CharacterisTics (OBCT) index was used, calculated for 1000 m circular buffers around participant's residencies. Z-scores of components across food and physical activity (PA) environments were averaged, and rescaled from 0 to 100. Weight status was operationalised as objectively measured waist circumference. Stratified linear regression analyses by (self-reported) sociodemographic factors, perceived stress, impulsivity, self-discipline, and deliberation were conducted when interaction terms were significant (P < .01). Mediation by adherence to the Dutch PA guidelines and dietary behaviour was examined using the difference-in-coefficients approach. Every 10% increase in OBCT index was associated with a 0.65 (P < .001, 95%CI [0.59, 0.71]) centimetre larger waist circumference. The association was largest for respondents who were younger, had the lowest income, the highest educational level, the least self-discipline, the highest impulsivity scores and the most perceived stress. Adherence to PA guidelines and dietary behaviour mediated 13.3% of this association; however, the difference in coefficients was not statistically significant. Our findings enable to better target lifestyle interventions to individuals most vulnerable to obesogenic environments. Furthermore, they provide guidance for policymakers and urban planners in promoting health-enhancing environments.

Scoping Review of Nutrition Education Programs for Middle Schoolers to Improve Nutrition Knowledge and Dietary Behavior

Scoping Review of Nutrition Education Programs for Middle Schoolers to Improve Nutrition Knowledge and Dietary Behavior

Analysis of factors associated with public attitudes towards salt reduction: a multicountry cross-sectional survey

ObjectiveThis paper provides an in-depth examination of public attitudes towards salt reduction across seven culturally diverse countries: the USA, the UK, France, Japan, Indonesia, Thailand, and Brazil.DesignCross-sectional regression analysis with...