Healthy Dietary Behaviors Research Articles

An exploration of perceptions and preferences for healthy eating in Dutch consumers: a qualitative pilot study

BackgroundUnhealthy dietary patterns are highly prevalent in Western countries, and they have been associated with depression, hypertension, heart disease, cancer, type 2 diabetes, and obesity. Many dietary interventions have been developed to promote healthier dietary behavior, yet most do not achieve the intended dietary change. This study aims to provide a better understanding of what Dutch consumers perceive as a healthy diet, how this relates to the current Dutch nutrition guidelines, and their preferences for how to eat more healthily. This is an essential consideration for the development of tailored interventions aimed to help people adopt changes in their dietary behavior.MethodsSeventy-eight participants filled in an online questionnaire containing both open-ended and closed-ended questions. The qualitative data was analyzed using content analysis resulting in a classification scheme. Two students then identified to which category each part of a participant’s answer belonged.ResultsFor both the perception of a healthy diet and how to eat healthily, four major categories and a residual category were identified: dietary patterns, food processing, food products, content/nutrients, and non-food. These major categories consisted of several categories. The results showed that how people perceived a healthy diet was mostly represented at the level of food product (vegetables and fruit) and the content/nutrient level (carbohydrates), whereas how they would like to eat healthily was mostly represented at the level of food processing (preparation), food product (vegetables), and dietary patterns (amount).ConclusionsOur findings are mostly in line with how the Dutch dietary guidelines are communicated (“product level”). However, consumers primarily mention single aspects instead of naming the guidelines as a whole. Health policymakers can use this insight in future communications regarding the guidelines to the general public. A challenge for future (eHealth) diet interventions is how to implement and tailor dietary information that optimally connects with the perceptions of the target population.

A cross-stressor adaptation perspective on challenge stressors, dietary behavior, and exercise of college students

ABSTRACT Previous research has shown much variation in the stress-dietary behavior relationship. To better understand this relationship, we draw on insights from cross-stressor adaptation theory to investigate whether exercise influences the relationship between challenge stressors and dietary behavior of college students. To test our hypothesis, we conducted two studies. In the first study, we examined how much students experience challenge stressors at school and asked how many days per week they exercise and what their dietary choices were like that day. In the second study, we examined how much participants experienced challenge stressors at school and assessed the amount of time they spent exercising per week and their general dietary behaviors. Results from both studies indicate that the relationship between challenge stressors and healthy dietary behaviors is enhanced for students who engage in more exercise. Overall, our findings illustrate yet another mechanism whereby exercise positively influences people’s health.

Dietary behaviour of pregnant women with anaemia in Bangladesh

In pregnancy a healthy dietary behavior is beneficial for the expecting mother and her fetus. Anemia is one of the most common nutritional deficiency disorders that can be prevented through promoting dietary behavior. The aim of this study is to examine the dietary behavior of pregnant woman with anemia in Bangladesh. A descriptive cross-sectional study design was applied. By using G* Power, 135 pregnant women were purposively recruited from MMCH, Dhaka. Data was analyzed by using descriptive statistics and inferential statistics, independent t-test and one way ANOVA. Findings showed the mean age of the participants was 25 (SD=4.96) years. Multi gravida was 55.6% and 68.1% reported their medium healthy condition. The average dietary behavior reported 56.03 (SD=6.15) and 67.4% participants’ hemoglobin concentration were within 10-10.9 g/dl. In bivariate analysis, finding showed that anemia has significantly related with age (F = 12.88, p < 001), level of education (F = 2.92, p = .036), income (r = 0.19, p = .027), gravida (F = 5.63, p = .004) health condition (F = 10.89, p < 001). The result of dietary behaviors showed that anemia has positively correlated (r = 0.21, p = .017) with dietary behavior. Dietary behavior is related with some factors, age, low level education, grand multi and primiparous, poor health condition found less hemoglobin concentration indicate as less dietary intake. Monthly income and dietary behavior impact in increasing Hemoglobin concentration. In this regards, maternal nurses might play a vital role for providing nursing intervention to improve pregnant women’s dietary behavior.
 Asian J. Med. Biol. Res. December 2020, 6(4): 674-682

Associations of diet, physical activity and polycystic ovary syndrome in the Coronary Artery Risk Development in Young Adults Women\u2019s Study

BackgroundCurrent evidence supports the adoption of healthy diet and physical activity (PA) behaviors in patients with polycystic ovary syndrome (PCOS), given the positive effects of those behaviors on physical well-being. An improved understanding of the associations between diet and PA with PCOS is needed to ascertain whether tailored dietary and PA recommendations are needed for this population. Thus, we investigated the associations of diet and PA with PCOS and its isolated features.MethodsCross-sectional study. Of the 748 women who were included in this study from the Coronary Artery Risk Development in Young Adults (CARDIA) Women’s Study, 40 were classified as having PCOS, 104 had isolated hyperandrogenism (HA) and 75 had isolated oligomenorrhea (OA). Dietary intake was measured using the CARDIA diet history questionnaire and diet quality was scored using the Alternative Healthy Eating Index 2010; a higher score indicated a better quality diet. Self-reported PA was measured using a validated interviewer-administered questionnaire. Polytomous logistic regression analyses examined the associations between diet and PA with PCOS, HA, and OA status (outcomes), adjusting for age, race, total energy intake, education, and/or body mass index. The threshold for statistical significance was set at p < 0.05.ResultsMean age of the participants was 25.4 years (SD 3.6) and 46.8% of participants were Black women. There was little to no association of total energy intake, nutrients, diet quality, and PA with PCOS, HA or OA status.ConclusionEnergy intake, nutrient composition, diet quality, and PA were not associated with PCOS, supporting recent PCOS guidelines of using national recommendations for the general population to encourage health-promoting behaviors among women with PCOS. However, longitudinal studies evaluating changes in diet and physical activity in relation to the development and/or the progression of PCOS are needed to establish a causal association.

Correlation between dietary behavior and mental sub-health among Chinese adolescents

Objective To determine the relationship between mental sub-health and dietary behavior among Chinese adolescents, and to provide a scientific basis for improving adolescent mental sub-health through healthy dietary behavior. Methods A total of 16 545 adolescents aged 13 to 22 years were sampled by random cluster sampling method in six administrative regions of China. A questionnaire survey was conducted to investigate adolescents’ dietary behaviors and mental sub-health status. Results The proportion of boys consuming breakfast, snacks, carbonated drinks, vegetables, fish and dairy products was 76.2%, 20.2%, 19.0%, 78.4%, 52.4% and 59.2%, respectively, while the proportion of girls was 79.2%, 28.6%, 12.6%, 78.3%, 43.2% and 54.9%, respectively. Except for the “vegetable” option, dietary behaviors showed significant sex differences ( χ 2 = 20.79, 320.10, 229.06, 150.27, 32.21, P <0.01). In terms of mental sub-health, the detection rates of male adolescents’ mental sub-health status, behavioral sub-health and social sub-health were 20.7%, 26.0% and 17.2%, respectively, while those of female adolescents were 18.6%, 24.1% and 14.8%, respectively. The differences between boys and girls were statistically significant (χ 2 = 17.32, 7.66, 17.46, P <0.01). Controlling for age and gender, breakfast “normally eating” and “occasionally eat”, vegetables “normally eating” and “occasionally eat”, fish “normally eating” and “occasionally eat”, milk, dairy products “normally drink” and “occasional drink”, was negatively associated with teenagers’ psychological sub-health ( OR = 0.60, 0.73; 0.50, 0.65; 0.74, 0.77; 0.73, 0.69, P < 0.05). Conclusion Healthy dietary behavior could be protective to avoid adolescent mental sub-health. Nutritional lectures and guideline books are needed among students and their parents. Nutritionists are encouraged to provide healthy nutritional advice to school canteen. 【摘要】 目的 了解中国青少年心理亚健康与饮食行为的相关性, 为改善青少年心理亚健康提供科学依据。 方法 2015—2017 年在中国六大行政区采用分层随机整群抽样方法抽取 16 545 名 13~22 岁青少年, 采用青少年亚健康多维评定 问卷 (Multidimensional Sub-health Questionnaire of Adolescents, MSQA) 的心理问卷进行心理亚健康测试, 同时进行饮食行为 调査。 结果 男生在早餐、零食、碳酸饮料、蔬菜、鱼肉以及乳制品方面 “基本都吃/喝” 的比例分别为 76. 2%, 20. 2%, 19. 0%, 78. 4%, 52. 4%, 59. 2%, 女生分别为 79.2%, 28, 6%, 12. 6%, 78, 3%, 43. 2%, 54, 9%, 除 “蔬菜” 选项外, 其他各项在性 别间分布差异均有统计学意义 (χ 2 值分别为 20. 79, 320. 10, 229. 06, 150. 27, 32. 21, P 值均<0. 01)。心理亚健康方面, 男生 心理亚健康状态、品行亚健康和社会适应亚健康检出率分别为 20. 7%, 26. 0%, 17. 2%, 女生分别为 18. 6%, 24. 1%, 14. 8%, 差异均有统计学意义 (χ 2 值分别为 17.32, 7.66, 17.46, P 值均<0.01)。控制年龄和性别后, 多因素Logistic回归分析显示, 早餐 “基本都吃” 和 “偶尔吃” 、蔬菜 “基本都吃” 和 “偶尔吃” 、鱼肉 “基本都吃” 和 “偶尔吃” 、牛奶、乳制品 “基本都喝” 和 “偶 尔喝” 与心理亚健康状态的发生均呈负相关 ( OR 值分别为 0. 60, 0. 73; 0. 50, 0. 65; 0.74, 0. 77; 0, 73, 0. 69, P 值均<0.05)。 结论 健康的饮食行为是避免青少年产生心理亚健康的保护因素。建议学校针对家长及学生定期开展膳食营养讲座及发 放膳食营养指导手册, 学校食堂配备公共营养师指导日常配餐等。

Intergenerational Technology Transfer: Enhancing African American Older Adults' Self-Efficacy for Diabetes Self-Management.

African American older adults are twice as likely to have diabetes than White older adults. Little is understood of African American older adults' self-efficacy in using technology to support recommended chronic disease self-management. Our objective was to describe the feasibility of using a community-based health education session that used intergenerational technology transfer to promote use of technology to support self-management. The team designed a health and technology education session then measured its impact on African American older adults' self-efficacy for using technology to support self-management. The community-based participatory research approach informed the study design which duplicated the sessions at the two study sites, in Detroit and Flint. We conducted a health education seminar in which older adults with diabetes shared insights on living with diabetes with younger adults they selected from their personal networks. The younger adults showed older adults how to access health information on smartphones. The sample included African American older adults (aged ≥50 years; n = 39) and younger adults (aged 18-49 years; n = 26). All participants showed improvements in self-efficacy for following recommendations for diet (i.e., preparing healthy meals [p = 0.0179]) and healthy diet behavior [p = 0.0044]) and physical activity (i.e., decrease in effort to exercise [p = 0.0185]), and for six of seven items, which measured confidence in using technology for self-management (e.g., using technology for health [p = 0.0002]). Findings provide foundational observations to inform evidence-based healthy aging interventions that use technology. Future research should explore the efficacy of community-based health education sessions with intergenerational technology transfer designed to support self-management.

Beverage Consumption of Children and Adolescents Aged 6-17 Years - China, 2016-2017.

What is already known on this topic?Beverage consumption has become a problematic dietary behavior in children and adolescents. Excessive drinking of beverages, especially sugary beverages, can increase the risk of chronic diseases such as obesity, dental cavities, and diabetes.What is added by this report?This report revealed the beverage consumption rate was higher in males, in urban areas, and adolescents aged 12–17 years. The top three beverages by consumption rate were carbonated beverages (33.2%), milk-containing beverages (25.0%), and non-100% fruit and vegetable beverages (23.5%). Children and adolescents in China consumed beverages at a primary frequency rate of 1–3 times/week. Among children and adolescents aged 6–17 years who consumed beverages, the average amount was 193.8 g/d, and was higher in males (210.6 g/d), those in urban areas (204.7 g/d), and adolescents aged 12–17 years (259.0 g/d).What are the implications for public health practice?Children and adolescents are key periods of life to develop healthy dietary behaviors for individuals. The consumption of beverages by Chinese children and adolescents has shown to increase year over year. Parents, schools, and governments need to prioritize promoting health consumption of beverasges.

Motivation Mediates the Influence of the Knowledge of Nutrients’ Function on Diet

Unhealthful diets are strongly linked to health problems, including obesity, cancer, heart disease, and diabetes. Past efforts to improve population diet centered on conveying the importance of nutrition and nutrition knowledge. This study examines if the effect of the knowledge of specific nutrient’s function on dietary behavior is mediated by motivation towards better health. Survey data used in this study was obtained via a web-panel survey that was conducted by Ipsos-Observer. We employed the mediation analysis method that is established in the literature. We find that motivation mediates the influence of the knowledge of nutrients’ function on dietary behaviors. Individuals with high health-motivation and higher levels of the knowledge of nutrients’ dietary functions exhibit healthier dietary behaviors than individuals with low-health motivation but high levels of nutrients’ functional knowledge. Furthermore, individuals with health problems exhibited higher motivation to maintain healthy diet. A key implication is that efforts to promote healthy dietary behaviors should consider motivation in addition to providing tools, such as nutrients’ functional knowledge and nutrition labels. Simply conveying the importance of nutrition itself may not be enough to motivate people to affect diet changes. Educating about the specific role of nutrients’ in human health might motivate more individuals to modify diet.

Personal and Family and Friends but not the Medical Team are the Sources of Support in Management of Type 2 Diabetes

Aim: To examine sources of support, based on the socio-ecologic model, for a better lifestyle parameter, health perceptions, and self-reported health status in people with type 2 diabetes. Methods: A telephone survey was conducted among a sample of 552 registered patients with type 2 diabetes, aged 45-70 using The-Brief-Chronic-Illness-Resources-Survey to assess sources of support to health behaviors. Logistic regression analysis adjusted for age, sex, body-mass-index, and smoking status was used. Results: No association was found between support from the medical team and health behaviors. The personal resource subscale was associated with visiting a dietitian [OR=1.3, 95%CI (1.1-1.5)], engaging in physical activity [(OR=1.3, 95%CI (1.1-1.7)], consuming a healthy diet (OR=1.6 95%CI (1.3-2.0), and having a better health perception [OR=1.31, 95%CI (1.06-1.62)]. The family and friends’ resource were associated with dietitian consultation [OR=1.3, 95%CI (1.1-1.6)] and with physical activity [OR = 2.0, 95%CI (1.6-2.6)]. Conclusion: Personal support and support of the family and friends but not medical team support subscales were the most associated with healthy diet and physical activity behaviors in people with type 2 diabetes. The medical team should emphasize the importance of lifestyle to lead changes among people with type 2 diabetes and to assess these sources of support during medical interviews.

Perceptions of the social and physical environment of adolescents’ dietary behaviour in neighbourhoods of different socioeconomic position

A higher proportion of adolescents from families in a lower socioeconomic position (SEP) tends to have more unhealthy dietary behaviours, and overweight and obesity, than their counterparts in higher SEPs. More research is needed to understand the causes of these differences, in particular the influence of the neighbourhood environment, which has been explored less. The presented qualitative study explores how adolescents and their parents from higher and lower SEP neighbourhoods perceive the social and physical environment influencing adolescents’ dietary behaviours. We conducted 6 semi-structured focus groups with 35 13–14 year olds and 8 interviews with some of their parents. The interviewees were recruited from one higher and two lower SEP neighbourhoods in Oslo, Norway. Theme-based inductive coding was used for analysis, and the results discussed in light of an ecological framework.The results indicate that all the adolescents experience several barriers to healthy dietary behaviours. For adolescents in the lower SEP neighbourhood, one or both parents desired their cultural cuisine served at home, whereas the adolescents wanted and often consumed western dishes. Fast-food restaurants or hanging out at the mall was perceived as the preferred social arena, often due to lack of involvement in either leisure-time physical activities or youth clubs as a safe, engaging option. The adolescents in the higher SEP neighbourhood perceived social norms which accentuated healthy dietary choices. When more possibilities for activities were present and the adolescents expressed being highly engaged in leisure-time physical activity, this also seemed to facilitate healthier dietary behaviours. These findings indicate how several factors simultaneously can influence dietary behaviour. Use of a multi-layered approach when exploring the environmental influences could increase knowledge about tackling social inequalities in dietary behaviours among adolescents.

The Association of Early-Morning Eating Habits With High Nutrient Intake by Older Japanese Adults Living Alone

The consumption of essential nutrition is fundamental to maintain the health of older adults. Conventional studies report that community dwelling older adults who live alone have the tendency to skip meals and result in low nutrition intake. However, the details regarding the dietary behavior and its association with the status of nutrition intake remain unclear. In this study, a cross-sectional analysis was conducted to explore the association between the time of meals and nutrition balance. In October 2019, questionnaire surveys were distributed to 184 participants of a lunch event dedicated to older adults living alone (Kashiwa, Japan). The time of meals, number of meals per day, consumption status of 10 food groups, and self-rated health were used for the analysis (N=165). As a result, older adults who usually ate their first meal between 5 to 8 A.M. ate three meals/day, while those who ate their first meal after 8 A.M. ate two meals/day. Those who ate their meal between 5 to 8 A.M., frequently consumed meat, fish and seafood, milk, and green and yellow vegetables compared to those who ate after 8 A.M. Self-rated health score was also high. The consumption of early-morning meals was associated with good dietary behaviors. The importance of eating breakfast has been emphasized, however, the time of the breakfast could vary among individuals. This study proposed the importance of considering the time of the meal. Development of intervention programs which encourage early-morning meal consumption might be helpful to form healthy dietary behaviors of older adults.

Codevelopment of Healthy and Unhealthy Dietary Behaviors: A Dyadic Examination of Parenting Practices and Adolescent Characteristics

ObjectiveTo identify the pathways through which external, parental, and adolescent factors influence adolescents’ motivation to adopt healthy dietary behaviors. MethodsA total of 28 ethnically and socioeconomically diverse (25% White) families were interviewed in which adolescents (mean age = 12.7 years; 50% girls) and parents (mean age = 43.3 years; 68% mothers) were interviewed separately. Data were first analyzed thematically, and family summaries, supplemented with diagrams, were then used to identify the processes through which factors influenced adolescents’ dietary behaviors. ResultsThe analyses identified 3 main motivational pathways (intrinsic motivation, extrinsic motivation, and amotivation), wherein variability and inconsistencies were observed across and within pathways. The unique combination of external factors, parenting profiles, as well as adolescents’ willingness to be socialized by family members, differentiated these pathways from each other. Conclusions and ImplicationsHealth interventions need to target the overall approaches that parents use to socialize their adolescent to make healthy food choices instead of targeting specific parenting practices.

Does Flourishing Reduce Engagement in Unhealthy and Risky Lifestyle Behaviours in Emerging Adults?

Emerging adulthood is a transitional life stage with increased probability of risky and unhealthy lifestyle behaviours that are known to have strong links with premature mortality and morbidity. Wellbeing, as a positive subjective experience, is identified as a factor that encourages self-care and may steer individuals away from risky lifestyle behaviours. Investigating wellbeing–behaviour links in the emerging adult population may increase understanding of the factors that lead to, and ways to prevent, engagement in risky behaviours. This study examines the association between flourishing, that is, the experience of both high hedonic and eudaimonic wellbeing, and a broad range of risky and unhealthy lifestyle behaviours among emerging adults in Australia. A cross-sectional survey of 1155 emerging adults aged 18–25 years measured wellbeing, socio-demographics, and six groups of lifestyle behaviours surrounding substance use, physical activity, diet, sex, sun protection, and driving. Bivariate and multivariate statistics were used to analyse the data. The findings revealed that flourishing was negatively associated with more dangerous types of risk behaviours, such as driving under the influence of drugs, and positively associated with self-care behaviours, such as healthier dietary behaviour and sun protection. If enabling emerging adults to flourish can contribute to reduced engagement in risky/unhealthy lifestyle behaviours, then promoting it is an important goal for health promotion efforts not only because flourishing is desirable in its own right, but also to bring about sustainable change in behaviour. Further research is needed to inform the designs of such interventions.

The Role of Children\u2019s Dietary Pattern and Physical Activity in the Association Between Breastfeeding and BMI at Age 5: The GECKO Drenthe Cohort

ObjectivesBreastfeeding is protective against childhood obesity, but the role of childhood lifestyle in this association is unclear. We investigated whether physical activity and dietary pattern at age 5 differed between breastfed and non-breastfed children, and how they relate to Body Mass Index (BMI) Z-scores.Methods1477 children of the Dutch GECKO Drenthe birth cohort were included. At one month, children were categorized as breastfed (receiving breast milk exclusively or in combination with formula milk) or non-breastfed (receiving formula milk exclusively). At age 5, height and weight were objectively measured, physical activity was measured by ActiGraph GT3x and dietary patterns were assessed with a parent-reported food pattern questionnaire, assessing the consumption frequency of selected food items at seven occasions over the day.ResultsNon-breastfed children had higher BMI Z-scores (0.36 ± 0.90 vs. 0.20 ± 0.80 SD, p = 0.002), more frequently consumed sugar-sweetened beverages (25.0 ± 10.5 vs. 22.5 ± 9.71 times per week, p < 0.001), and consumed relatively less whole-wheat or brown bread (p = 0.007). Differences in sugar-sweetened beverage consumption were most pronounced during main meals. Total fruit consumption, sedentary time and moderate-to-vigorous physical activity levels did not differ between the groups. Multivariable adjusted linear regression analyses showed that the differences in BMI-z score between non-breastfed and breastfed children were not explained by the differences in sugar-sweetened beverages or type of bread consumed.ConclusionsInfant breastfeeding itself is indicative of healthy dietary behaviors in early life, and is also more likely to be followed by a favorable dietary pattern at toddler age. However, the differences in dietary habits between breastfed and non-breastfed children did not explain the difference in BMI Z-score at the age of 5.

La nutrition au Zimbabwe contemporain: une analyse situationnelle

Background: Malnutrition in all its forms continues to be a global public health challenge affecting mostly women and children in Africa. The socioeconomic consequences of poor nutrition are far-reaching and cross-generational. Objective: To provide an update on the nutrition situation in Zimbabwe in the context of the United Nations 2030 sustainable development agenda. Key findings: In Zimbabwe, the leading nutrition problems include high levels of childhood stunting, micronutrient deficiencies (Vitamin A, Iron, Zinc, and Selenium) affecting mostly children younger than 5 years and women aged 15-49 years. This paper presents evidence on the emergence of obesity and associated complications like diabetes, hypertension, and several cancers in addition to the traditional problem of undernutrition burden “multiple burden of malnutrition”. These nutrition challenges can be attributed to poor breastfeeding and infant and young child feeding (IYCF) practices, the low dietary diversity affecting mostly rural households and nutrition transition. Cultural and religious beliefs are barriers to the adoption of appropriate breastfeeding and IYCF practices. Conclusion: The multiple burden of malnutrition exists in Zimbabwe. Although there is political, commitment and multisectoral initiatives to address malnutrition and food insecurity, the declining socio-economic situation and the COVID-19 associated restrictions are worsening the situation and poor households are getting more vulnerable. Considering that Zimbabwe’s economy is agriculture-based there is a need to put emphasis on promoting nutrition-sensitive agriculture initiatives and urgently implement the Food-Based Dietary Guidelines (FBDGs) to propel the adoption of healthy lifestyles and dietary behaviors. Keywords: Stunting, Breastfeeding, IYCF, Micronutrient deficiency, SDGs, COVID-19, Zimbabwe.

La nutrition au Zimbabwe contemporain: une analyse situationnelle

Background: Malnutrition in all its forms continues to be a global public health challenge affecting mostly women and children in Africa. The socioeconomic consequences of poor nutrition are far-reaching and cross-generational. Objective: To provide an update on the nutrition situation in Zimbabwe in the context of the United Nations 2030 sustainable development agenda. Key findings: In Zimbabwe, the leading nutrition problems include high levels of childhood stunting, micronutrient deficiencies (Vitamin A, Iron, Zinc, and Selenium) affecting mostly children younger than 5 years and women aged 15-49 years. This paper presents evidence on the emergence of obesity and associated complications like diabetes, hypertension, and several cancers in addition to the traditional problem of undernutrition burden “multiple burden of malnutrition”. These nutrition challenges can be attributed to poor breastfeeding and infant and young child feeding (IYCF) practices, the low dietary diversity affecting mostly rural households and nutrition transition. Cultural and religious beliefs are barriers to the adoption of appropriate breastfeeding and IYCF practices. Conclusion: The multiple burden of malnutrition exists in Zimbabwe. Although there is political, commitment and multisectoral initiatives to address malnutrition and food insecurity, the declining socio-economic situation and the COVID-19 associated restrictions are worsening the situation and poor households are getting more vulnerable. Considering that Zimbabwe’s economy is agriculture-based there is a need to put emphasis on promoting nutrition-sensitive agriculture initiatives and urgently implement the Food-Based Dietary Guidelines (FBDGs) to propel the adoption of healthy lifestyles and dietary behaviors. Keywords: Stunting, Breastfeeding, IYCF, Micronutrient deficiency, SDGs, COVID-19, Zimbabwe.

MINISTOP 2.0: a smartphone app integrated in primary child health care to promote healthy diet and physical activity behaviours and prevent obesity in preschool-aged children: protocol for a hybrid design effectiveness-implementation study

BackgroundChildhood obesity is still a major health problem in many countries, including Sweden. Childhood obesity and obesity-related behaviours in childhood, such as low physical activity and unhealthy eating habits, tend to track into adulthood, which highlights the need for early prevention. Our aims are to evaluate whether a parent-oriented mobile health app (the MINISTOP 2.0 app) integrated into primary child health care can improve diet and physical activity behaviours and reduce the prevalence of overweight and obesity in preschool-aged children as well as to evaluate the implementation among child health care nurses and parents.MethodsThis trial uses a hybrid type 1 effectiveness-implementation design. Families (n = 500) who attend a routine visit to one of 15–20 primary child health care centres throughout Sweden, when their child is 2.5 years, are offered participation in a randomised controlled trial (effectiveness evaluation). After acceptance, families will be randomised (1:1) to control or intervention groups. The intervention group receives a 6-month parent-oriented smartphone intervention aimed at improving the dietary and activity behaviours of their child (the MINISTOP 2.0 app) and the control group receives routine child health care. Dietary habits, physical activity and screen time (primary outcomes), body weight and height in children, and parental self-efficacy (secondary outcomes) are measured at baseline and at 6 months post randomisation. Implementation outcomes (i.e. perceived acceptability, appropriateness, and feasibility) of the intervention will be assessed among primary child health care nurses and parents in the trial through questionnaires and qualitative interviews.DiscussionThis trial will evaluate whether the MINISTOP 2.0 app can be used in primary child health care to improve diet and physical activity behaviours, and prevent overweight and obesity, in preschool-aged children. If effectiveness is proven, and the MINISTOP 2.0 app is considered acceptable, appropriate and feasible, it can be implemented nationally as part of the preventive strategies to combat childhood obesity provided by routine child health care.Trial registrationThe trial was registered at the Clinicaltrials.gov register platform (ID NCT04147039) on 31 October 2019.

Healthy Dietary Intake Behavior Potentially Modifies the Negative Effect of COVID-19 Lockdown on Depression: A Hospital and Health Center Survey.

Background: The COVID-19 pandemic causes a huge burden for affected countries. Several public health interventions were applied to contain the infection. However, the pandemic itself and the lockdown measure negatively influence people's lifestyles and psychological health.Purpose: To explore determinants of healthy dietary intake and depression, and examine the interaction between healthy dietary intake and COVID-19 lockdown on depression.Methods: A cross-sectional study was conducted at 18 hospitals and health centers from February 14 to May 31, 2020. Data of 8,291 outpatients were collected including patients' characteristics, clinical parameters, health literacy, healthy dietary intake (using the healthy eating score, HES), other health-related behaviors, and depression (using the patient health questionnaire, PHQ). Depression was defined as PHQ score ≥ 10.Results: Protective factors of healthy dietary intake and depression were higher education, better medication payment ability, higher social status, more physical activity, and higher health literacy, whereas older age, ever married, own business or other types of occupation, lockdown, suspected COVID-19 symptoms, and comorbidity were associated with lower HES scores and a higher depression likelihood. Besides, overweight/obesity and alcohol drinking were associated with lower HES scores. As compared with patients not under lockdown and with lowest HES score, those who were under lockdown and with lowest HES score had 10.6 times higher depression likelihood (odds ratio, OR, 10.60; 95% CI 6.88, 16.32; p < 0.001), whereas people with higher HES score had 15% lower depression likelihood (OR 0.85; 95% CI 0.82, 0.89; p < 0.001).Conclusions: Healthy dietary intake and depression were determined by several sociodemographic, clinical, and behavioral factors. Lockdown measure affects people's dietary intake behavior and depression. Importantly, healthy dietary intake potentially modifies the negative effect of lockdown on depression.

Diet and lifestyle factors associated with cognitive performance in college students

Objective Engaging in a healthy diet and positive lifestyle behaviors have been shown to improve cognitive functioning in children and older adults, however, few have examined these factors in college-aged students. Participants: A diverse sample of 115 college students were recruited on two university campuses. Method: Completed computerized cognitive testing and an online survey about diet and lifestyle behaviors. Results: All analyses were conducted with Pearson’s correlations. Higher fruit consumption was correlated with better visual memory scores. Higher seafood consumption was correlated with better learning performance. Increased fast food consumption was correlated with poorer executive functioning in resident students and poorer visual memory performance in commuter students. Increased fluid intake on testing day was correlated with better visual memory and better verbal memory performance. Conclusions: Behavioral changes such as increasing hydration, eating more fruit and fish, and eating less fast food may improve cognitive performance in college students.

African-American Views of Food Choices and Use of Traditional Foods.

Objectives: In this study, we describe dietary intakes and examine variation among African-American adults in the Southwest, and identify barriers to engaging in healthy dietary behaviors, and use of traditional African-American foods, including pulses. Methods: Using mixed-methods parallel analysis, 97 African Americans aged 25-60 years completed surveys on lifestyle and dietary habits prior to focus group discussions in 3 geographic regions of Arizona. We identified themes in the qualitative transcripts using an inductive approach informed by Grounded Theory. Survey data were compared by sex, and age cohort via chi-square and ANOVA. Results: Qualitative knowledge of healthy choices was high for most participants, but survey dietary in-takes were below recommendations for fruit, vegetables, fiber, and pulses. Greens, fried chicken and fish, barbequed meats, okra-corn-tomato mix, grits, and sweet potatoes were eaten at least twice a month by 30%-50%. Statistically significant food consumption differences were observed by sex, age, and income. Healthy eating barriers included cost, access, convenience or time to prepare, accessibility, and cultural preferences and traditions. Interest in food preparation education was a common theme. Conclusions: Arizona African Americans retain elements of traditional foods in their diet. Health education should offer practical solutions for the cited barriers, be culturally relevant, and build on existing knowledge.