Diet-related Outcomes Research Articles

Depression is associated with lower diet quality in both pre- and postmenopausal U.S. women: NHANES 2007-2018

Depression has been associated with adverse diet-related outcomes and women are particularly vulnerable to depression around the menopause transition. Therefore, we hypothesized that depression and post-menopausal status would be associated with lower diet quality, and that depression would be associated with lower diet quality in both pre- and post-menopausal women, but that the association would be stronger in postmenopausal women. Data from 5,634 non-pregnant women age > 20 years from the National Health and Nutrition Examination Survey from 2007-2018 were analyzed. Diet quality was determined using the Healthy Eating Index 2020 (HEI-2020). Multivariable linear regression was used to examine the association between depression and diet quality, menopause and diet quality, and depression and diet quality by menopause status, adjusting for covariates. Mean age was 49.6 ± 0.4; 12% of women were classified as depressed and 46% as postmenopausal. In multivariable-adjusted models, depression was associated with lower HEI-2020 total (β = -3.33, p < 0.001) and adequacy scores (β = -2.41, p < 0.0001) but not moderation scores. Postmenopausal women had higher HEI-2020 total (β = 2.48, p < 0.0001), moderation (β = 1.19, p < 0.0001), and adequacy (β = 0.81, p < 0.01) scores than premenopausal women. In a nationally representative sample of U.S. women, depression was associated with lower diet quality across all women and in both pre- and postmenopause. Further research is needed to better understand the relationship between depression and diet quality throughout the menopause transition, when hormonal changes could make women more vulnerable to depression.

The Potential Effectiveness of Nutrient Declarations and Nutrition and Health Claims for Improving Population Diets.

Nutrition labeling supports healthier diets by aiding purchase decisions and stimulating reformulation. This systematic literature review applied Cochrane methods to synthesize and appraise evidence on the effectiveness of nutrient declarations and nutrition and health claims on diet-related outcomes. The search spanned 11 academic databases, from inception to July 2022. Evidence was synthesized using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) and vote counting. Data were available from 170 studies. Randomized controlled trials (RCTs) suggest that nutrient declarations likely improved consumer understanding of the nutritional quality/content of foods (moderate certainty) and may have improved the healthfulness of choices (low certainty) versus no label. RCT evidence also suggests that claims likely increased consumer perceptions of food healthfulness and increased choice and purchases of labeled foods (both moderate certainty), irrespective of nutritional quality. To improve label understanding and avoid misinterpretation, nutrient declarations may incorporate interpretive elements and claims can apply disqualifying conditions for their usage, on the basis of overall nutritional quality.

The Potential Effectiveness of Front-of-Pack Nutrition Labeling for Improving Population Diets.

Nutrition labeling on the front of food packages can support more healthful purchase decisions and encourage favorable reformulation. This systematic literature review applied Cochrane methods to synthesize and appraise the evidence on the effectiveness of front-of-pack labeling (FOPL) on diet-related outcomes and food reformulation to inform policy recommendations. The search was conducted on 11 academic and gray literature databases, from inception to July 2022. Evidence was synthesized using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation), vote counting, and meta-analyses, where appropriate. Overall, 221 articles were included in the review. The randomized controlled trial evidence suggested that, compared with when no FOPL was present, FOPL likely improved consumer understanding of the nutritional quality/content of foods (moderate certainty of evidence), and the healthfulness of food choices (moderate certainty) and purchases (moderate certainty). Interpretive FOPL had a greater effect on these outcomes compared with noninterpretive systems (moderate certainty). There was inconsistency in the best-performing interpretive FOPL system.

Development of a questionnaire for assessing the impact of children’s food marketing exposure on diet-related outcomes

IntroductionThe Government of Thailand has drafted legislation to protect children from the harmful impact of unhealthy food (including beverages) marketing. Local evidence on Thai children’s exposure to, and the impact...

Testing a conceptual Hierarchy of Effects model of food marketing exposure and associations with children and adolescents' diet-related outcomes.

Children's exposure to unhealthy food marketing contributes to poor diets by influencing the foods that children like, request, buy and consume. This study aimed to use confirmatory mediational analyses to test a hypothetical model of marketing effects, to better understand the mechanisms behind food marketing's impacts on children. Children responded to a cross-sectional online survey about their attitudes towards, and purchase and consumption behaviours of, ten frequently promoted food/beverage brands and their media use. Structural equation modelling tested a priori potential pathways for the effects of food marketing exposure on children's diets. 10-16-year-old children (n 400). Australia. There was a significant positive correlation between children's commercial screen media use and their attitudes towards brands (related to perceived social norms) and their brand purchasing behaviours, including their own purchases and requests to parents. The use of strategies to avoid advertising in commercial screen media reduced but did not remove the association between media use and brand purchases. Other brand exposures (on clothing, outdoor advertising, sponsorships) had a positive association with children's perceived social norms about brands and their brand purchases and requests. Non-commercial screen media use was not associated with any brand-related outcomes. Commercial screen media use and other brand exposures were strongly positively associated with children's perceptions and purchasing behaviours of frequently marketed food/beverages. Regulations to restrict children's exposures to food marketing on-screen and through other media are required to reduce the effect of marketing exposure on children's food purchasing behaviours.

Which outcome measurement instruments are used to measure core infant feeding outcomes in children up to 1 year of age? A scoping review protocol

Background How, what, and when infants are fed plays a role in the aetiology of childhood obesity. Heterogeneity in how infant feeding outcomes are measured in trials of interventions to prevent childhood obesity limits evidence syntheses and understanding of intervention effectiveness. An infant feeding core outcome set (COS) was previously developed to standardised outcome measurement and reporting. The COS represents what to measure; determining how best to measure these outcomes is the next essential step to improve intervention evaluations. The aim of this scoping review is therefore to identify what outcome measurement instruments have been used in trials, and how they have been used, to measure the core infant feeding outcomes. Methods A scoping review will be conducted. MEDLINE, EMBASE, CINAHL, PsychINFO, the Cochrane Central Register of Controlled Trials, OpenGrey and GreyNet will be searched from inception. Papers are eligible for inclusion if they report trials involving primary data collection that measure and report at least one core infant feeding outcome in infants ≤one year of age. Following searching and screening, eligible studies will be categorised into the following four overarching categories for data extraction, synthesis and write-up: caregiver-related outcomes; diet-related outcomes; feeding environment outcomes; child weight outcomes. Data will be narratively described and presented in tabular format, with findings presented in four separate review papers delineated by the four overarching categories. Discussion This scoping review forms part of the Standardised measurement for Childhood Obesity Prevention (SCOPE) study (www.eiascope.com). Evidence from this scoping review on what measurement instruments are used, and how they are used, represents an essential first step in developing recommendations and guidance about how best to measure core infant feeding outcomes for childhood obesity prevention. This can improve evidence syntheses and understanding of what infant feeding interventions are most effective for childhood obesity prevention.

Community Investments and Diet-Related Outcomes: A Longitudinal Study of Residents of Two Urban Neighborhoods

Investments in historically oppressed neighborhoods through food retail, housing, and commercial development are hypothesized to improve residents' health, nutrition, and perceptions of their neighborhood as a place to live. Although place-based development (e.g., housing, retail, business assistance) is happening in many communities, there is little evidence of the long-term correlates of multiple investments such as health and nutrition among residents. A quasi-experimental longitudinal study was conducted using a cohort of randomly sampled households in two low-income, predominantly African American neighborhoods in Pittsburgh, PA, with surveys assessing residents' food insecurity, perception of their neighborhood as a place to live, perception of access to healthy foods, and dietary outcomes in 2011 and seven years later (2018), with an interim assessment in 2014. Analyses conducted in 2022 compared changes among residents of one neighborhood which had 2.6 times the investments over a 7-year period with changes among residents of a socio-demographically similar neighborhood that received fewer investments. It was found that residents in the neighborhood receiving substantial investments demonstrated statistically significant improvements in neighborhood satisfaction (12.6% improvement compared with a 2.2% decrease) and perceived access to healthy food (52% improvement compared with 18.2% improvement), and marginally significant change in food security (14% compared with 4.8% improvement) compared with residents in the neighborhood receiving fewer investments. Multiple place-based investments in neighborhoods can potentially induce positive change for residents in health and nutrition outcomes.

The interaction between the community food environment and cooking skills in association with diet-related outcomes in Dutch adults.

We examined whether associations between the food environment, frequency of home cooking, diet quality and BMI were modified by the level of cooking skills. Cross-sectional study using linear and modified Poisson regression models adjusted for age, sex, energy intake, education, income, household size and urbanisation. The frequency of home cooking was categorised into <6 and 6-7 d. Diet quality was based on a validated Dutch healthy diet index (0-150 points). Count of restaurants and food stores were determined by their count in a 1000m buffer around home and work. Cooking skills (score 1-5) were assessed using a validated questionnaire and added as interaction term. The Netherlands. 1461 adults aged 18-65 years. Count of restaurants and food stores were not associated with the frequency of home cooking. A 10-unit higher count of food stores was associated with a higher diet quality (β: 0·58 (95 % CI (0·04, 1·12)), and a 10-unit higher count of restaurants was associated with a lower BMI kg/m2 (β: -0·02 (95 % CI (-0·04, -0·004)). Better cooking skills were associated with a higher likelihood of cooking 6-7 d compared with <6 d (risk ratio: 1·24 (95 % CI (1·16, 1·31)) and a higher diet quality (β: 4·45 (95 % CI (3·27, 5·63)) but not with BMI. We observed no interaction between the food environment and cooking skills (P-for-interaction > 0·1). Exposure to food stores was associated with a higher diet quality and exposure to restaurants with a lower BMI. Better cooking skills were associated with a higher frequency of home cooking and better diet quality but did not modify associations with the food environment. Future studies should explore different approaches to understand how individuals interact with their food environment.

Improvements in dietary intake, behaviors, and psychosocial measures in a community-randomized cardiovascular disease risk reduction intervention: Strong Hearts, Healthy Communities 2.0

BackgroundCardiovascular disease (CVD) prevalence has disproportionately risen among midlife and older female adults of rural communities, partly due to poor diet and diet-related behaviors and psychosocial factors that impede healthy eating. ObjectivesThis study aimed to evaluate the impact of Strong Hearts Healthy Communities 2.0 (SHHC-2.0) on secondary diet-related outcomes between intervention and control participants that align with the dietary goal and behavioral aims of the SHHC-2.0, a CVD risk reduction program. MethodsA community-randomized controlled trial was conducted in rural, medically underserved communities. Participants were female adults ≥40 y who were classified as obese or both overweight and sedentary. Communities were randomized to SHHC-2.0 intervention (n = 5 communities; n = 87 participants) or control (with delayed intervention) (n = 6 communities; n = 95 participants). SHHC-2.0 consisted of 24 wk of twice-weekly experiential nutrition education and group-based physical activity classes led by local health educators. Changes between baseline and end point (24 wk) in dietary intake (24-h recalls), dietary behaviors (e.g., Rapid Eating Assessment for Participants-Short Version [REAP-S] scores) and diet-related psychosocial measures (e.g., Three Factor Eating questionnaire) between groups were analyzed using linear mixed-effects multilevel models. ResultsAt 24 wk, participants from the 5 intervention communities, compared with controls, consumed fewer calories (mean difference [MD]= −211 kcal, 95% CI: −412, −110, P = 0.039), improved overall dietary patterns measured by REAP-S scores (MD: 3.9; 95% CI: 2.26, 5.6; P < 0.001), and improved psychosocial measures (healthy eating attitudes, uncontrolled eating, cognitive restraint, and emotional eating). ConclusionsSHHC-2.0 has strong potential to improve diet patterns and diet-related psychosocial wellbeing consistent with improved cardiovascular health.This trial was registered at www.clinicaltrials.gov as NCT03059472.

School-based health and nutrition interventions addressing double burden of malnutrition and educational outcomes of adolescents in low- and middle-income countries: A systematic review.

School system is a promising platform for addressing all forms of malnutrition in adolescents. However, little is known about the impact of integrated school health and nutrition programmes on adolescent nutrition and educational outcomes in low- and middle-income countries (LMICs). This systematic review sought to characterize school-based health and nutrition interventions among adolescents in LMICs and analyze their effects on nutritional status and educational outcomes. Four databases were searched for studies evaluating school-based health and nutrition interventions for adolescents in LMICs, reporting changes in either nutritional status or educational outcomes. A narrative synthesis was used to analyze and describe the evidence. Our review included 68 articles evaluating 58 interventions, of which a third had moderate to strong methodological quality. Forty-two studies evaluated single-domain interventions, while 26 evaluated multi-component interventions. A third of all interventions were based on a theoretical framework. Three-fourths of the interventions were shorter than 11 months, which may make identifying their effect difficult. The results of the effectiveness of these interventions were mixed and inconsistent across intervention types. Sixteen out of 21 studies evaluating multi-component interventions and 12 out of 23 studies evaluating nutrition education reported improving nutritional or diet-related outcomes. One out of six studies reported positive effects on educational outcomes. Our review has identified that research needs include: a greater inclusion of theory-based approaches to guide the implementation of interventions; more studies of integrated interventions that involve parents and the wider community in LMICs; and extension of outcomes beyond nutritional status to include educational outcomes.

Abstract P420: The Interaction Between the Community Food Environment and Cooking Skills in Relation to Diet-Related Outcomes

Introduction: What people eat is dependent on their food environment. However, individuals with better cooking skills may be less dependent on what is available in their food environment. Hypothesis: We assessed the hypothesis that the relation of the food environment around home and work with frequency of home cooking, diet quality, and body mass index (BMI) was modified by the level of cooking skills among Dutch adults. Methods: Our study included 1461 Dutch adults aged 18-65 years, who participated in a cross-sectional survey. Availability of restaurants and food stores was determined by their count in a 1000m buffer around home and work. Frequency of home cooking was categorized into &lt;6 days and 6-7 times a week. A validated Dutch healthy diet index (0-150 points) was used to determine dietary quality. BMI was based on self-reported height and weight. Cooking skills (score 1-5) were assessed using a validated questionnaire and added to the models as interaction term. Linear and logistic regression models were adjusted for age, sex, energy intake, education, income, household size, and urbanization. Results: Neither the count of restaurants nor food stores was associated with the frequency of home cooking. A 10-unit higher count of food stores was associated with higher diet quality (β: 0.58 (95% CI: 0.04, 1.13)). This association was not found for count of restaurants (β: 0.04 (95% CI: -0.02, 0.11)). A 10-unit higher count of restaurants was associated with a lower BMI (β: -0.02 (95% CI: -0.04, -0.004) but not with frequency of home cooking (OR: 1.00 (95% CI: 0.99, 1.01) or diet quality (β: 0.04 (95% CI: -0.02, 0.11). Better cooking skills were associated with higher odds of home cooking 6-7 days a week compared to &lt;6 days a week (OR: 1.81 (95% CI 1.55, 2.12) and higher diet quality (β: 4.31 (95% CI: 3.12, 5.49)), but not with BMI (β: 0.06 (95% CI: -0.25, 0.37)). No significant effect modification between the food environment and cooking skills in relation to any of the outcomes was observed (P-for-interaction &gt;0.1). Conclusions: In conclusion, being exposed to food stores was associated with a higher diet quality and being exposed to restaurants was associated with a lower BMI. Better cooking skills were associated with a higher frequency of home cooking and a better diet quality, but did not modify the observed associations with the food environment.

Snacking and anxiety during the coronavirus disease (COVID-19) pandemic: A prospective cohort study

Anxiety and snacking increased during the initial coronavirus disease 2019 (COVID-19) lockdowns, but it remains unknown whether this change in snacking persisted and if it related to anxiety levels. We used prospective data to examine changes in snacking frequency from t1 (eased restrictions in England in May–June 2020) to t2 (national lockdown in December 2020–March 2021), the association of anxiety (assessed by the Generalised Anxiety Disorder-7 questionnaire at t1) with the snacking change, and the mediating and moderating effects of disinhibition and flexible restraint (assessed by the Three Factor Eating Questionnaire in 2016–17). Analyses including 2128 adults (mean age 28.4 y) residing in England from the Avon Longitudinal Study of Parents and Children showed that snacking frequency increased over time (mean change 1.23 (95% CI 0.81, 1.65) snacks/wk). Linear regressions of snacking adjusted for sociodemographic covariates showed that having clinical levels of generalised anxiety at t1, versus not, was associated with 1.22 (95% CI 0.07, 2.37) more snacks/wk at t2. Disinhibition partially mediated the association between Generalised Anxiety Disorder and snacking (βindirect = 0.15, 95% CI 0.01, 0.32), while there was no evidence that flexible restraint moderated the association (β = 0.05, 95% CI -0.57, 0.66). Our longitudinal findings highlight a detrimental anxiety-snacking association partly operating via disinhibition, suggesting future research could target mitigating anxiety and disinhibited eating behaviours to benefit diet-related outcomes following the pandemic.

Diet Quality Changes by Educational Level among Adults in Spain from 2017 to 2021

Despite increasing attention on addressing socioeconomic disparities in diet quality, longitudinal studies are scarce. Furthermore, the effects of the COVID-19 pandemic on diet-related outcomes are yet to be fully understood. We examined changes in diet quality by educational level among adults in Madrid, Spain. We used data from recruitment (in 2017) and from 2021. At baseline, our sample included 1358 adults aged 40-75 years who were free of cardiovascular disease and completed a validated diet quality screener. Of them, 931 answered the survey in the follow-up visit in 2021. We used participants' diet quality index scores (range: 18-54; higher scores indicate better diet quality) as the dependent variable. As our independent variable, we assessed participants' educational levels (low, medium, and high). We fitted a multinomial regression using the categories of educational level as the main predictor, adjusting for age, sex, country of origin, and household composition. During the study period, 78.0% of participants sustained their diet quality, 11.6% improved it, and 10.4% moved away from a healthier dietary pattern. In descriptive analyses, we observed an increase in diet quality among less-educated females. Unadjusted multinomial models showed that a lower educational level predicted both increases and decreases in diet quality over the period. Even though the median diet quality scores did not change significantly, we observed heterogeneous changes over the four years. Variability within diet, with some improving and some worsening, seems to have increased among participants with lower educational levels. Future studies should look at the determinants of change in these population subgroups.

A Narrative Review of Dietary Assessment Tools for Preschool-Aged Children in the Home Environment.

Preschool-aged children in the U.S. have suboptimal diets. Interventions to improve child nutrition focus on parents and their role in shaping social and physical home environments, which influence children's eating behaviors. Dietary assessment tools selected to measure intervention objectives, and how results are interpreted in key findings, are essential when examining children's diets. The objectives of this review were to (1) describe dietary assessment tools used in intervention studies in young children focused within the home environment; and (2) examine how the application of these dietary assessment tools addressed intervention objectives. PubMed and Web of Science were searched for English-language nutrition intervention studies that included children aged 2-5 years, had a home environment component, used a dietary assessment tool, and reported on diet-related outcomes. Seventeen studies were included. Intervention objectives focused on overall diet, specific food groups, eating occasions, and obesity prevention/treatment. Concordance of key findings with intervention objectives, type of tool used, and multiple tools within the same study varied with 8 studies aligning in objective and tool, 1 discordant in both, and 8 partially concordant or too broad to determine. This review highlights current challenges in measuring dietary intake in preschoolers and provides recommendations for alternative applications and strategies.

Association Between Parental Feeding Styles and Excess Weight, and Its Mediation by Diet in Costa Rican Adolescents

ObjectivesParental feeding styles (PFS) influence children’s diet and weight; we aimed to evaluate this relationship in adolescents. MethodsCross-sectional study in 686 Costa Rican adolescents (13–18y). Parents responded to a questionnaire from which four validated PFS scores were derived: promotion (verbal encouragement of healthy eating); verbal sanctions/scolding (indirect control of healthy food intake); direct control over diet; instrumental/emotional (food to regulate emotions). Adolescents completed a 3-day food record, from which the validated Traditional Costa Rica Adolescents Diet Score (TCRAD) was defined. Excess weight was dichotomized following standards. Multivariate regression-based mediation analysis estimated the natural direct, indirect, and total effects (NDE/NID/TE) of the following pathway (general/sex-stratified): PFS → TCRAD → excess weight. ResultsExcess weight was present in 33% of adolescents. TCRAD mean was similar between excess weight categories. Each additional point of the direct control PFS score was associated with higher odds of excess weight [(TE-OR: 1.55; 95%CI: 1.04–2.31; p = 0.033), (NDE-OR: 1.52; 95%CI: 1.02–2.27; p = 0.039)]. This association was accentuated in boys vs. girls. A non-significant tendency for lower odds of excess weight was observed for the emotional PFS in boys [(TE-OR: 0.44; 95%CI: 0.19–1.05; p = 0.064), (NDE-OR: 0.43; 95%CI: 0.18–1.02; p = 0.056)] and the promotion PFS in the total sample (TE-OR: 0.74; 95%CI: 0.47–1.17; p = 0.202). TCRAD seemed to have a mediation role between the promotion PFS and excess weight (NID-OR: 0.94; 95%CI: 0.88–1.00; p = 0.056). ConclusionsHealthy eating behaviors encouraged by parents might benefit Costa Rican adolescents’ weight via dietary intake. In contrast, parents directly controlling food access and intake may adversely influence adolescents’ weight, especially in boys. Our work constitutes a first approach studying PFS and obesity among adolescents. Further research is needed to confirm the role of the promotion PFS in obesity prevention and evaluate the contribution of PFS to other diet-related outcomes among adolescents in diverse cultural contexts. Funding SourcesThe Mexican Council of Science and Technology; Fundación México en Harvard; The Costa Rican Ministry of Health; Inciensa Foundation.

The Interaction between the Community Food Environment and Cooking Skills in Relation to Diet-Related Outcomes

ObjectivesEvidence shows that diet-related outcomes are influenced by the food environment. However, individuals with better cooking skills may be less dependent on what is available in their food environment. We examined whether the relation between the food environment around home and work and frequency of home cooking, diet quality and body mass index were modified by the level of cooking skills among Dutch adults.MethodsOur study included 1782 Dutch adults aged 18–65 years, who participated in a cross-sectional survey. We measured the number of food retailers in a 1000m buffer around home and work and distinguished between counts of restaurants and food stores. These counts were summed and divided into quartiles. Participants reported their frequency of home cooking per week (≤ 5 days and 6–7 days) and completed a validated food frequency questionnaire, assessing adherence to the Dutch Healthy Diet score (0–150 points). Body mass index, based on reported length and weight, was categorized into < 25 kg/m2 and ≥25 kg/m2. Cooking skills score (1–5) was assessed using a validated questionnaire and added as interaction term to the linear and logistic regression models. We adjusted for age, sex, energy intake, education, income, household size, and urbanization.ResultsNo significant effect modification was found between the food environment and cooking skills in relation to any of the outcomes (P-interaction >0.1). After adjustment for confounders, neither the count of restaurants or food stores was consistently associated with the frequency of home cooking. In adjusted models, participants having the most food stores around their home and work (>27 stores per 1000 square meter, quartile 4) had a 3.29 higher diet score (95%CI:0.20–6.39), compared to those in quartile 1. Furthermore, participants having the most food stores (>27/1000 square meter, quartile 4) and restaurants (>125/1000 square meter, quartile 4) had lower odds of being overweight, compared with those in quartile one: OR = 0.53 (95%CI:0.36–0.80) and OR = 0.63 (95%CI:0.42–0.94).ConclusionsBeing exposed to many supermarkets and restaurants was associated with a better diet score and lower odds of being overweight, but not modified by the level of cooking skills.Funding SourcesThe Eet & Leef study was funded by an NWO VENI grant on “Making the healthy choice easier–role of the local food environment”.

Association between Parental Feeding Styles and Excess Weight, and Its Mediation by Diet, in Costa Rican Adolescents.

Background. Whereas parental feeding styles (PFS) influence children’s diet, less is known about this relationship in adolescents. Methods. A cross-sectional study in 686 Costa Rican adolescents (13–18 years) evaluated 4 validated PFS scores: healthy eating verbal encouragement; scolding; directly controlling diet; instrumental/emotional. Diet was evaluated through 3-day food records, deriving a Traditional Costa Rica Adolescents Diet Score (TCRAD). Excess weight (EW) measured by BMI was dichotomized following standards. Regression-based mediation analysis estimated the overall and sex-stratified odds ratios of EW for natural direct (NDE), natural indirect (NIE), and total effects (TE) of the pathway PFS→TCRAD→EW. Results. A one-unit increase in the direct control PFS score was associated with higher EW odds overall [(TE: 1.55; 95% CI: 1.04–2.31; p-value = 0.033), (NDE: 1.52; 95% CI: 1.02–2.27; p-value = 0.039)], and in boys [(TE: 2.13; 95% CI: 1.04–4.38; p-value = 0.039), (NDE: 2.10; 95% CI: 1.03–4.31; p-value = 0.042)]. Non-significant mediation by TCRAD was observed for the healthy eating verbal encouragement PFS overall (p-value = 0.06). Associations for the instrumental/emotional and scolding PFS were not significant. Conclusions. Direct diet control from parents may contribute to adolescents’ excess weight, particularly among boys. Parents encouraging healthy eating might support adolescents’ healthy weight through a healthy diet. Longitudinal research should clarify the association between PFS and diet-related outcomes among diverse adolescents.

The influence of unhealthy food and beverage marketing through social media and advergaming on diet-related outcomes in children-A systematic review.

SummaryChildren are increasingly exposed to food and beverage marketing, but little is known about the specific effects of marketing through media most used by children. This study aims to systematically review the influence of unhealthy food and beverage marketing through social media and advergaming on diet‐related outcomes in children. Seven databases were systematically searched for English peer‐reviewed quantitative and qualitative scientific studies on the effects of marketing of unhealthy products through social media or advergaming on a range of diet‐related outcomes in children. Risk of bias was assessed with tools specific for the different study designs. Twenty‐six studies were included, of which 20 examined the effect of food and beverage marketing through advergaming and six through social media. Most studies had a high risk of bias. The results suggested that unhealthy food and beverage marketing through social media and advergaming has a significant effect on pester behaviors, food choice, and food intake of children. The studies demonstrate that unhealthy food and beverage marketing through media popular with children significantly impacts different diet‐related outcomes. Combined with existing evidence on this effect in other settings, this review provides clear evidence of the need for policies targeting screen‐based marketing.

The Use of Portion Control Plates to Promote Healthy Eating and Diet-Related Outcomes: A Scoping Review.

The role of portion control plates in achieving healthy diets is unclear. The aim of this scoping review was to systematically map findings from peer reviewed and grey literature to provide evidence for the use of portion control plates to promote healthy eating and nutrition-related knowledge in children and adults. A secondary aim was to review the design characteristics of portion control plates. The search was conducted in four databases, including Medline, CINAHL, Embase, and PsycInfo, and grey literature sources following the PRISMA scoping review guidelines. A total of 22 articles comprising 23 intervention studies and 8 from grey literature were included. It was found that the various two-dimensional and three-dimensional portion control plates examined were effective tools for better portion size selection in healthy children and adults. Most portion control plates dedicated half the plate to vegetables, a quarter to protein, and a quarter to carbohydrates. The use of portion control plates in nutrition interventions appears to promote weight loss among those with overweight and obesity and/or type 2 diabetes. However, portion control plates were mostly used as part of multicomponent interventions and the effectiveness of the portion control plate as a stand-alone educational resource or portion control tool alone was uncertain. Further interventional research is indicated to investigate portion plates as tools to improve dietary behaviours and food consumption at the population level.

Investigating Web-Based Nutrition Education Interventions for Promoting Sustainable and Healthy Diets in Young Adults: A Systematic Literature Review.

Background: Our current rapidly growing food systems are imposing a heavy burden on both environmental sustainability and human health. Sustainable and healthy diets aim to promote optimal health and have a minimal environmental impact. This study aimed to critically review and synthesise the evidence on the effectiveness of web-based nutrition education interventions aiming to promote sustainable and healthy diets among young adults. Methods: A systematic search of four databases (Medline, PsycINFO, Scopus, and Embase) was conducted in March 2021. Studies were included if they used an online platform to deliver the intervention to young adults and measured at least one aspect of sustainable and healthy diets, such as plant-based food intake, food waste, and local and seasonal produce. Of the 2991 studies, a total of 221 full-text articles were assessed for eligibility of which 22 were included in the final review. Results: A majority of the studies (82%) targeted fruit and vegetable consumption, and close to a quarter of studies (23%) targeted other aspects of a sustainable and healthy diet, such as red meat intake. Only one study included multiple aspects of a sustainable and healthy diet. Program delivery outcomes reported overall positive feedback and engagement. Conclusion: This review suggests that web-based interventions may be effective in promoting some sustainable diet-related outcomes in young adults. However, there is a need for developing and evaluating future programs to promote sustainable diets more comprehensively in order to help young adults make healthy and sustainable food choices.