Nutritious Diet Research Articles

Knowledge, attitude and practice towards malnutrition and micronutrient deficiency among male and female farmers in Ethiopia

BackgroundDespite a large body of literature on the nexus between knowledge, attitude and practice towards nutrition and gender, this nexus is likely to vary and is not clear in many societies, such as Ethiopia.ObjectivesThe study aimed to analyze the level of gender-based knowledge, attitude, and practice towards malnutrition and micronutrient deficiency using primary data collected from two regional states in Ethiopia.MethodsQualitative and quantitative data collection approaches were used. Qualitative data were analyzed using a narrative and content approach. Quantitative data were analyzed using descriptive statistics.ResultsResults indicate that female are generally more adept than male at identifying the symptoms of malnutrition. However, concerning vitamin A and iodine food types and its deficiency, male respondents had relatively better knowledge and consumption practice than female. Results show that there is very little awareness about biofortified and fortified foods. When we rate respondents, male had a relatively better understanding about fortified foods than their female counterparts.ConclusionFindings can support development agents working to improve nutrition in Ethiopia to focus on improving community knowledge and perception of biofortified and fortified foods to improve diet quality through increased micronutrient intake. The majority of the respondents were aware of the importance of consuming micronutrient rich foods and had a positive attitude towards them. However, there is still a gap in practice. It may therefore require more targeted campaigns to increase the ability of community members to adopt best practices while reducing barriers to consumption of nutritious diet.

How Can Climate Change Impact Human Health via Food Security? A Bibliometric Analysis

Global climate change, induced by anthropogenic causes, has severe consequences for Earth and its inhabitants. With the consequences already visible around the globe, one of them is the impact on food security. The lack of food security has serious impacts on health, especially in vulnerable populations who highly depend on a nutritious diet for a healthy life. The following research aims to assess the current research status of climate change, food security and health. In this context, the interlinkage of the three key concepts is analyzed, as well as the related health consequences. To achieve the aims of this research, a bibliometric analysis was conducted using VOSviewer, (version 1.6.16) including 453 papers. The data were retrieved from the Scopus database on 10 November 2022. Bibliometric analysis can illustrate emerging and key topic areas using keywords and co-occurrence analysis; hence, it is an adequate method to meet the listed research aims. Five different clusters have been derived from the analysis, each representing a different perspective on interlinkage. From the different clusters, the main consequences of climate change on food security could be derived, such as a decrease in crop yields, less availability of fish and livestock, or food contamination through mycotoxins. These can cause serious health implications, predominantly increasing the rate of malnutrition globally. The work showed the importance of action to prevent the consequences of climate change in relation to food security and health nexus. To do so, adaptation strategies are needed that consider the interdisciplinary scope of the problem, building sustainable measures that benefit each concept.

Can ChatGPT provide appropriate meal plans for NCD patients?

ObjectivesDietary habits significantly affect health conditions and are closely related to the onset and progression of non-communicable diseases (NCDs). Consequently, a well-balanced diet plays an important role in lessening the effects of various disorders, including NCDs. Several artificial intelligence recommendation systems have been developed to propose healthy and nutritious diets. Most of these systems use expert knowledge and guidelines to provide tailored diets and encourage healthier eating habits. However, new advances in large language models such as ChatGPT, with their ability to produce human-like responses, have led individuals to search for advice in several tasks, including diet recommendations. This study aimed to determine the ability of ChatGPT models to generate appropriate personalized meal plans for patients with obesity, cardiovascular diseases, and type 2 diabetes. MethodsUsing a state-of-the-art knowledge-based recommendation system as a reference, we assessed the meal plans generated by two large language models in terms of energy intake, nutrient accuracy, and meal variability. ResultsExperimental results with different user profiles revealed the potential of ChatGPT models to provide personalized nutritional advice. ConclusionAdditional supervision and guidance by nutrition experts or knowledge-based systems are required to ensure meal appropriateness for users with NCDs.

Exploring the Interplay Between Lifestyle Medicine and Oral Health: A Bidirectional Relationship.

Lifestyle medicine, characterized by its evidence-based approach, recognizes the profound impact of lifestyle choices on overall health. The six pillars of lifestyle medicine encompass nutrition, physical activity, stress management, sleep, avoidance of risky substances, and social connections. While their significance in promoting general health is well-established, their specific influence on oral health is an area of growing interest. A balanced and nutritious diet contributes to strong teeth and healthy gums, while regular physical activity enhances blood circulation and salivary flow, which is vital for maintaining optimal oral health. Effective stress management techniques can mitigate oral health issues related to anxiety and bruxism. Quality sleep supports oral health, allowing for tissue repair and immune system rejuvenation. Avoiding risky substances like tobacco and excessive alcohol consumption reduces the risk of oral diseases such as periodontitis and oral cancer. Lastly, social connections and supportive networks positively influence oral health by promoting positive oral hygiene behaviors and providing access to dental care resources. Understanding the impact of lifestyle medicine's six pillars on oral health offers valuable insights for healthcare professionals and individuals seeking to improve their oral well-being.

A community focused approach toward making healthy and affordable daily diet recommendations.

Maintaining an affordable and nutritious diet can be challenging, especially for those living under the conditions of poverty. To fulfill a healthy diet, consumers must make difficult decisions within a complicated food landscape. Decisions must factor information on health and budget constraints, the food supply and pricing options at local grocery stores, and nutrition and portion guidelines provided by government services. Information to support food choice decisions is often inconsistent and challenging to find, making it difficult for consumers to make informed, optimal decisions. This is especially true for low-income and Supplemental Nutrition Assistance Program (SNAP) households which have additional time and cost constraints that impact their food purchases and ultimately leave them more susceptible to malnutrition and obesity. The goal of this paper is to demonstrate how the integration of data from local grocery stores and federal government databases can be used to assist specific communities in meeting their unique health and budget challenges. We discuss many of the challenges of integrating multiple data sources, such as inconsistent data availability and misleading nutrition labels. We conduct a case study using linear programming to identify a healthy meal plan that stays within a limited SNAP budget and also adheres to the Dietary Guidelines for Americans. Finally, we explore the main drivers of cost of local food products with emphasis on the nutrients determined by the USDA as areas of focus: added sugars, saturated fat, and sodium. Our case study results suggest that such an optimization model can be used to facilitate food purchasing decisions within a given community. By focusing on the community level, our results will inform future work navigating the complex networks of food information to build global recommendation systems.

Digitalisation in the WFP fresh food voucher programme: a pilot study from rural Amhara region, Ethiopia.

Malnutrition continues to pose a major challenge to human well-being around the world. In Ethiopia, 39% of children <5 years are stunted, with peaks in northern regions of the country such as Amhara (54.8%). Very few (2%) children in the region achieve the minimum dietary diversity and only a minority (27%) belong to households that can afford a nutritious diet. To tackle the high stunting rate, diets high in fruits and vegetables are widely recommended to improve dietary diversity. Programmes leveraging fresh food vouchers can be used to support vulnerable groups with malnutrition and limited affordability. Cash-based transfer (CBT) programmes have repeatedly been shown to improve child growth and increase household food security and dietary diversity. This study is part of the World Food Programme (WFP) intervention regarding a stunting reduction rural programme of restricted CBT for improving dietary diversity in households with children under 2 years of age and pregnant and lactating women. A community- based pilot study to assess the itemised foods purchased by beneficiaries was conducted in the four most accessible woredas of the Amhara region of Ethiopia. A total of 556 beneficiaries and 12 active retailers were selected randomly from 10 rural markets in the targeted woredas. A point of sale (POS) system was used to collect the itemised food prices and amounts of food procured by the beneficiaries. Approximately 51, 35, and 15% of the beneficiaries purchased vegetables, fruits, and eggs, respectively. Prices, taste preferences of children, and shelf life determine the purchase of certain food items. The average food expenditure was 49 Ethiopian Birr (ETB; US$ 0.94), representing the 63 and 37% daily and monthly requirements, respectively, for affordability. The higher increase in prices of some food items might be due to their seasonality. Almost half of the Fresh Food Voucher (FFV) beneficiaries were purchasing and consuming vegetables. The finding indicates that the WFP fresh food voucher programme contributes 63% (49 ETB, US$ 0.94) and 37% (837 ETB, US$ 16.1) of the daily and monthly needs of affordability, respectively, for a diversified nutritious diet. The use of Unstructured Supplementary Service Data (USSD) technology in the WFP digital voucher under the Fresh Food Voucher (FFV) project was effective at collecting itemised prices of foods purchased by the beneficiaries. The point of sale (POS) system can be scaled up under the Fresh Food Voucher (FFV) programme so that the digital voucher can contain the itemised food prices. Timely data from the point of sale could be used for timely Social Behaviour Change Communication (SBCC) development to improve dietary diversity.

THE RELATIONSHIP BETWEEN ANEMIA INCIDENCE IN PREGNANT MOTHERS AND LOW BIRTH WEIGHT BABY DELIVERY

Anemia is a condition in which the number of red blood cells (erythrocytes) is less than it should be even though red blood cells contain hemoglobin which is responsible for distributing nutrients and oxygen throughout the body Anemia in pregnancy can cause miscarriage, premature birth, low birth weight, bleeding before and after childbirth can even cause death of mother and child. The purpose of this study was to determine the relationship between the incidence of anemia in pregnant women and LBW births at UPT Puskesmas Kaliorang in 2023. This research is a type of analytic observational research with a retrospective approach. The population in this study were pregnant women at UPT Puskesmas Kaliorang. The number in this study was 15 people, the sampling technique used was total sampling. The instruments in this study were observation sheets, medical records, laboratory results sheets. Data analysis using chi-square. The results of statistical tests using the Chi-square test on the variable anemia with LBW incidence showed that the p-value = 0.001 and the Odds Ratio value (OR = 27.500). There is a relationship between the incidence of anemia in pregnant women and LBW births with a risk level of 27 times greater. Anemia can be prevented by consuming a balanced nutritious diet with sufficient intake of iron to meet the body's needs. Iron can be obtained by consuming meat (especially red meat) such as beef.

Automated Menu Planning Algorithm for Children: Food Recommendation by Dietary Management System using SVM, RF, DT for Indian Food Database

In recent years, childhood obesity and related health issues have become a major concern worldwide. Proper nutrition is crucial for children's growth and development, making it essential to ensure they have a balanced and nutritious diet. This study presents an innovative approach to address this issue through an Automated Menu Planning Algorithm for Children (AMPAC). AMPAC utilizes a Dietary Management System powered by the SVM, RF, DT (Iterative Dichotomiser 3) decision tree algorithm, specifically designed for the Indian food context. The proposed system leverages a comprehensive Indian Food Database, encompassing diverse and culturally relevant food items. By integrating the SVM, RF, DT algorithm, AMPAC can analyze the nutritional content of various foods and recommend suitable meal plans based on specific dietary requirements. The system considers essential factors such as age, gender, body mass index (BMI), and any existing health conditions to create personalized and balanced menus. To validate the effectiveness of AMPAC, extensive testing and evaluation have been conducted using a diverse group of participants, including children, parents, and nutrition experts. The results demonstrate the system's accuracy, efficiency, and user satisfaction, highlighting its potential to revolutionize menu planning for children and promote healthier eating habits. This research contributes to the fields of nutrition, computer science, and public health by offering an innovative solution to address the critical issue of childhood nutrition. AMPAC's user-friendly interface and intelligent algorithm empower users to make informed food choices, ultimately fostering a healthier and happier future generation. Key Words : Automated Menu Planning, Food Recommendation, SVM, RF, DT Algorithm, Indian Food Database, Childhood Nutrition, Nutritional Requirements, Personalized Diet.

Healthy brain aging and delayed dementia in Texas rural elderly.

Healthy aging is the process of preserving and enhancing one's independence, physical and mental well-being, and overall quality of life. It involves the mental, emotional, and cognitive wellness. Although biological and genetic factors have a significant influence on the process of aging gracefully, other adjustable factors also play a crucial role. Adopting positive behaviors such as maintaining a nutritious and balanced diet, engaging in regular physical activity, effectively managing stress and anxiety, ensuring sufficient sleep, nurturing spiritual coping mechanisms, and prioritizing overall well-being from an early stage can collectively influence both lifespan and the quality of health during advanced years. We aim to explore the potential impacts of biological, psychosocial, and environmental factors on the process of healthy cognitive aging in individuals who exhibit healthy aging. Additionally, we plan to present initial findings that demonstrate how maintaining good cognitive health during aging could potentially postpone the emergence of neurodegenerative disorders. We hypothesize that there will be strong associations between biological, environmental, and social factors that cause some elderly to be superior in cognitive health than others. For preliminary data collection, we recruited 25 cognitively healthy individuals and 5 individuals with MCI/AD between the ages of 60-90 years. We conducted anthropometric measurements, and blood biomarker testing, administered surveys, and obtained structural brain magnetic resonance imaging (MRI) scans. The Montreal Cognitive Assessment (MoCA) scores and sub-scores for the healthy group were also reported. We found that at baseline, individuals exhibiting healthy cognitive aging, and those with MCI/AD had comparable measures of anthropometrics and blood biomarkers. The healthy group exhibited lower signs of brain volume loss and the ones observed were age-related. Moreover, within the healthy group, there was a significant correlation (p=0.003) between age and MoCA scores. Conversely, within the individuals with MCI/AD, the MRI scans showed disease signs of grey and white matter and loss of cerebral volume. Healthy brain aging is a scientific area that remains under-explored. Our current study findings support our hypothesis. Future studies are required in diverse populations to determine the various biological, psychological, environmental, lifestyle, and social factors that contribute to it.

Insight into the Interaction Mechanism of Vitamin D against Metabolic Syndrome: A Meta-Analysis and In Silico Study.

As a dietary supplement or functional food additive, vitamin D (VD) deficiency may impact extra-skeletal functions associated with metabolic syndrome (MetS) risk factors. However, the precise effects and mechanisms of VD supplementation on dyslipidemia and insulin resistance in MetS subjects remain controversial. Here, we investigate potential therapeutic targets, pathways and mechanisms of VD against MetS through a comprehensive strategy including meta-analysis, network pharmacology analysis, molecular docking, dynamics simulations, and quantum chemical calculations. Our results reveal that VD supplementation significantly reduces triglyceride levels, fasting glucose, and insulin concentrations in subjects, thereby improving insulin homeostasis to some extent. We theoretically identify 14 core MetS-associated targets. Notably, VD exhibits substantial interactions with three targets (PPARγ, FABP4, and HMGCR) in the PPAR signaling pathway, indicating that VD can modulate this pathway. Van der Waals forces predominantly stabilize the complexes formed between VD and the three targets. Nonetheless, to provide valuable insights for personalized MetS management, further research is necessary to confirm our findings, emphasizing the importance of exploring genetic variability in VD response. In conclusion, our study contributes insights into the mechanisms of VD in preventing and treating MetS through dietary supplementation, promoting the development of VD-based functional foods or nutritious diets.

Optimizing Polycystic Ovarian Disorder (PCOD) Treatment with Personalized Lifestyle and Nutrition Strategies

Introduction: Polycystic Ovarian Disorder (PCOD) is a prevalent endocrine illness in women of reproductive age. It has hormonal abnormalities, irregular menstrual cycles and tiny ovarian cysts. Lifestyle and food affect PCOD development and maintenance, coupled with medical therapies. Lifestyle, diet and PCOD are interconnected in this thorough assessment. Methodology: The evaluation comprises PCOD, lifestyle, diet, exercise, stress management and nutrition research published between January 1, 2000 and May 1, 2023. Result: PCOS management requires lifestyle changes including frequent exercise, a healthy weight, nutritious diet and no cigarettes. While lifestyle modifications cannot substitute medical care, they improve well-being. Low-GI, ketogenic and omega-3 fatty acid diets may reduce insulin resistance and PCOS symptoms. Eating no Saturated Fats (SFAs) is also important. Exercise improves insulin sensitivity, but high-intensity sessions improve cardiorespiratory fitness, insulin resistance and body composition more. We propose intense aerobic and strength training. PCOS might worsen insulin resistance due to sleep disruptions. Getting enough sleep is important for metabolism. PCOS sufferers may have reduced melatonin, which regulates the body’s 24-hour schedule, underlining the significance of sleep. Vitamin D, inositol, folate, B-group vitamins, vitamin K and vitamin E may improve insulin sensitivity and hormonal balance. Vitamins including bioflavonoids, carnitine and alpha-lipoic acid and minerals like chromium picolinate, calcium, magnesium, selenium and zinc may also help PCOS sufferers. More study is required to prove their effectiveness. Conclusion: PCOD is complicated and needs comprehensive treatment. Lifestyle, food and medical therapies should be combined for best outcomes. Healthcare practitioners and PCOD patients must collaborate to create tailored lifestyle, diet and supplement recommendations. Improve these remedies for the PCOD community with further study.

Diet quality and risk of SARS-CoV-2 infection or COVID-19 disease: a systematic review

Abstract Background The COVID-19 disease pandemic highlighted the importance of healthy diets in the management of SARS-CoV-2 infection and COVID-19 disease. Evidence suggests the influence of the diet and dietary patterns during post-COVID-19 disease, and the impact of the COVID-19 disease pandemic on dietary habits and quality. However, limited evidence exists on the association between a healthy diet, and risk of SARS-CoV-2 infection and COVID-19 disease. Methods 5072 research articles from Scopus, EMBASE, PubMed and MEDLINE databases were identified for eligibility. Only studies that had prospective and cross-sectional study designs were included. Eight studies were extracted and were included in the current systematic review that explored Mediterranean diet and dietary components as dietary exposures, and SARS-CoV2 infection and COVID-19 disease as study outcomes. Results Amongst cross-sectional studies, a higher adherence to Mediterranean diet lowered the odds of COVID-19 disease between 12% (OR: 0.88; 95% CI: 0.81-0.97) and 84% (OR: 0.16; 95% CI: 0.08-0.32). Amongst prospective studies, a higher diet quality and adherence to a Mediterranean diet was associated with lower hazard ratio of 9% (HR: 0.91; 95% CI: 0.88-0.94), and the odds of COVID-19 diseases by 36% (OR: 0.64, 95% CI: 0.42-0.98) to 50% (OR: 0.50, 95% CI: 0.34-0.73), respectively. Conclusions Overall findings of the studies in this review support the concept that Mediterranean diet and other nutritious diets might lower the risk of COVID-19 disease. Awareness could be created by promoting nutrition education programmes. Finally, this review highlights the limited evidence, and requirement of further studies to explore the longitudinal associations between diet, and SARS-CoV2 infection and COVID-19 disease in order to make the findings more generalisable. Key messages • A nutritious diet is associated with lower risk of COVID-19 disease. • Longitudinal studies and nutritional awareness is required to promote the importance of diet quality to cautiously prevent the risk of SARS-CoV2 infection and COVID-19 disease.

A Mediterranean-Style Diet Improves the Parameters for the Management and Prevention of Type 2 Diabetes Mellitus.

Background and Objectives: Type 2 diabetes mellitus (T2DM) is a chronic condition recognized as the inability to maintain glucose homeostasis, typically presenting with insulin resistance and systemic inflammation. With the prevalence of T2DM and major risk factors, such as prediabetes and obesity, increasing each year, the need to address risk factor reduction strategies is crucial. Materials and Methods: Twenty-two men and women, overweight-to-obese adults (BMI mean: 26.1-31.6) (age range mean: 44.6-51.8) with T2DM, indicators of prediabetes, or who were metabolically healthy, participated in Cal Poly's Nutrition and Exercise in Type 2 Diabetes (CPNET) study. There were no significant differences in terms of age, BMI, or sex distribution among the groups at the baseline. This study's protocol included following a Mediterranean-style diet, the daily consumption of a high-quality whey protein supplement, and physical activity recommendations for 16 weeks. Body composition data, via dual-energy X-ray absorptiometry (DXA), and fasting blood samples were collected at the baseline and following the intervention. Due to restrictions associated with the outbreak of the COVID-19 pandemic, only 13 of the 22 participants who started this study were able to return for the second data collection to complete this study following the 16-week intervention. Results: The prediabetic and T2DM groups exhibited reductions in their fasting plasma glucose (12.0 mg/dL reduction in the prediabetic group; 19.6 mg/dL reduction in the T2DM group) to that of normal and prediabetic levels, respectively, while the T2DM group also demonstrated improvement in their hemoglobin A1c (reduced from 6.8% to 6.0%) to prediabetic levels. Additionally, the metabolically healthy, overweight group exhibited significant improvements in adiposity, while the obese prediabetic and T2DM groups showed non-significant improvements in all the measured metrics of body composition. No significant changes were observed in the inflammatory biomarkers (p-values ranged from 0.395 to 0.877). Conclusions: Collectively, our results suggest that adherence to a well-balanced, nutritious diet and activity may improve the parameters of glycemic control and provide benefits to body composition that help to manage and prevent the development of T2DM. Our study was able to yield significant findings signifying that the effects of a Mediterranean-style diet are observed even for a more conservative sample size.

Non-Traditional Starches, Their Properties, and Applications.

This review paper focuses on the recent advancements in the large-scale and laboratory-scale isolation, modification, and characterization of novel starches from accessible botanical sources and food wastes. When creating a new starch product, one should consider the different physicochemical changes that may occur. These changes include the course of gelatinization, the formation of starch-lipids and starch-protein complexes, and the origin of resistant starch (RS). This paper informs about the properties of individual starches, including their chemical structure, the size and crystallinity of starch granules, their thermal and pasting properties, their swelling power, and their digestibility; in particular, small starch granules showed unique properties. They can be utilized as fat substitutes in frozen desserts or mayonnaises, in custard due to their smooth texture, in non-food applications in biodegradable plastics, or as adsorbents. The low onset temperature of gelatinization (detected by DSC in acorn starch) is associated with the costs of the industrial processes in terms of energy and time. Starch plays a crucial role in the food industry as a thickening agent. Starches obtained from ulluco, winter squash, bean, pumpkin, quinoa, and sweet potato demonstrate a high peak viscosity (PV), while waxy rice and ginger starches have a low PV. The other analytical methods in the paper include laser diffraction, X-ray diffraction, FTIR, Raman, and NMR spectroscopies. Native, "clean-label" starches from new sources could replace chemically modified starches due to their properties being similar to common commercially modified ones. Human populations, especially in developed countries, suffer from obesity and civilization diseases, a reduction in which would be possible with the help of low-digestible starches. Starch with a high RS content was discovered in gelatinized lily (>50%) and unripe plantains (>25%), while cooked lily starch retained low levels of rapidly digestible starch (20%). Starch from gorgon nut processed at high temperatures has a high proportion of slowly digestible starch. Therefore, one can include these types of starches in a nutritious diet. Interesting industrial materials based on non-traditional starches include biodegradable composites, edible films, and nanomaterials.

Effect of microbial plant biostimulants on fruit and vegetable quality: current research lines and future perspectives.

Fruit and vegetables hold a prominent place in dietary guidance worldwide and, following the increasing awareness of the importance of their consumption for health, their demand has been on the rise. Fruit and vegetable production needs to be reconsidered so that it can be productive and, meantime, sustainable, resilient, and can deliver healthy and nutritious diets. Microbial plant biostimulants (PBs) are a possible approach to pursuing global food security and agricultural sustainability, and their application emerged as a promising alternative or substitute to the use of agrochemicals (e.g., more efficient use of mineral and organic fertilizers or less demand and more efficient use of pesticides in integrated production systems) and as a new frontier of investigation. To the best of our knowledge, no comprehensive reviews are currently available on the effects that microbial plant biostimulants' application can have specifically on each horticultural crop. This study thus aimed to provide a state-of-the-art overview of the effects that PBs can have on the morpho-anatomical, biochemical, physiological, and functional traits of the most studied crops. It emerged that most experiments occurred under greenhouse conditions; only a few field trials were carried out. Tomato, lettuce, and basil crops have been primarily treated with Arbuscular Mycorrhizal Fungi (AMF), while plant grow-promoting rhizobacteria (PGPR) metabolites were used for crops, such as strawberries and cucumbers. The literature review also pointed out that crop response to PBs is never univocal. Complex mechanisms related to the PB type, the strain, and the crop botanical family, occur.

Evaluation of self-measured blood pressure monitoring in a southern rural West Virginia health system.

At the time of the 2021 Behavioral Risk Factor Surveillance System survey, an estimated 32.3% of adults in the US and nearly half (43.4%, 776 000) of adults in West Virginia (WV) had hypertension. Further, the Interactive Atlas of Heart Disease and Stroke estimates an increase in the percentage of adults with hypertension in the US from 32.3% to 47.0%, with hypertension rates in WV rising as high as 58.7%, indicating a significant public health concern in the community. Hypertension increases the risk of several negative health outcomes, including heart disease and stroke, and leads to increased economic and chronic disease burden. Although certain unmodifiable factors (sex, age, race, ethnicity, and family history) increase the risk of developing hypertension, a healthy lifestyle - including a nutritious diet, maintaining a healthy weight, avoiding nicotine products, and participating in regular moderate physical activity - can decrease the risk of developing hypertension. Self-measured blood pressure (SMBP) monitoring, or home BP monitoring, when integrated with a provider's clinical management approach, is linked to improvements in BP management and control. This study represents a mid-point assessment of a remote SMBP monitoring program implemented by Cabin Creek Health Systems (CCHS), a federally qualified health center, and its impact on BP control. CCHS implemented SMBP programming in March 2020 as one element of a developing comprehensive program aimed at reducing uncontrolled hypertension, and therefore chronic disease burden, in its service area and patient population. The project, funded by the Health Resources and Services Administration, continued to February 2023. This report represents a mid-point analysis and was based on the retrospective analysis of de-identified data collected for 234 patients to June 2022, who were assessed for changes in BP between the date of enrollment and the most recently available BP measurement. Patients were enrolled in the SMBP program if they exhibited current or previous indicators of uncontrolled hypertension (systolic &ge;140 mmHg and/or diastolic &ge;90 mmHg), at the discretion of their provider, and were equipped with an iBloodPressure cellular connected home BP monitoring system, manufactured by Smart Meter. Their BP readings were documented in the integration software TimeDoc Health and electronic health record athenahealth. At the time of enrollment, 201 (86.0%) patients had uncontrolled hypertension, with 116 (49.6%) patients having both uncontrolled systolic (&ge;140 mmHg) and diastolic (&ge;90 mmHg) values. At follow-up, the number of patients with uncontrolled hypertension decreased from 201 to 98 (41.9%), with only 36 (15.4%) patients having both uncontrolled systolic and diastolic values. Additionally, 26 (11.1%) patients were in hypertensive crisis at the time of enrollment, and no patients remained in crisis at the time of follow-up. The number of patients with BP values in the controlled range (systolic <140 mmHg and diastolic <90 mmHg) increased from 33 (14.1%) at enrollment to 136 (58.1%) at follow-up. Overall, there was a 44.0% increase in the number of patients with BP values in the controlled range at follow-up, and a concomitant 44.1% decrease in the number of patients in the uncontrolled range. These observations were consistent across multiple demographic indicators, including clinic location, three-digit zip code, and patient sex. Systematic implementation of remote BP monitoring, when integrated into clinician workflows, was associated with a substantial reduction in the number of patients with uncontrolled hypertension in this rural federally qualified health center. Further, CCHS was successful in implementing a remote SMBP monitoring program in a community challenged with transportation insecurity, and poor cellular and broadband access, of which lessons learned are applicable to other health systems interested in pursuing comparable efforts.

Food oppression in the United Kingdom: A study of structural race and income-based food access inequalities

In 2007, Freeman pioneered the phrase “food oppression” to capture the state’s perpetuation of socioeconomic and racial disparities in nutrient consumption and diet-related diseases in the United States. Amid an increasing awareness of the impact of intersecting identities in all facets of life, particularly in light of the COVID-19 pandemic and the Black Lives Matter movement, this article argues that food oppression is an equally applicable, and necessary, characterization of the unequal enjoyment of the right to food in the United Kingdom. Patterns of food insecurity—chiefly, the overrepresentation of Black households among food bank users—are tied back to the austerity measures enacted by the Conservative–Liberal Democrat Coalition Government in response to the 2007/2008 financial crisis. These findings illuminate the race- and class-based barriers to access to adequate food in the United Kingdom that predate the pandemic as a manifestation of racial capitalism yet have increased in prominence. The article concludes that the adoption of a rights-based approach to household food security by the state is necessary to formulate policies that target the commodification of food and ensure a nutritious diet is available to all without discrimination.

Implementing Nutritional Strategies in the Workplace

The lifestyle of a health professional is mired with long hours, undue stress, shift work, poor sleep, inactivity, and unhealthy eating, despite their knowledge and expertise in what habits promote or preserve health. Healthcare workplaces are largely environments with underfunding, poor infrastructure, overcrowding, and limited or no access to health and well-being resources. The British Medical Association published a charter for minimum standards for facilities and preventing fatigue which has recommendations for access to freshly prepared food, extended hours for canteens and healthier options. 1 Most health professionals report high levels of stress and burnout. Burnout is believed to be directly associated with poor patient outcomes and compromised safety. 2 While better rota design, managed workloads, improved infrastructure, physical activity, psychological safety, and dignity at work are important determinants of employee health and well-being – access to a nutritious diet, water and education on healthy habits is a crucial component. Organisations including the National Health Service have a social responsibility to encourage healthier habits provide access to healthy eating within their premises and even offer incentives, not only to the patients they serve but also to their staff. This article explores the simple interventions that have been shown to be effective- and links to their evidence.

The trends and effects of food price inflation on the cost and affordability of nutritionally adequate diets in Malawi

Background Global challenges of hunger, food insecurity, and malnutrition persist, with nearly one in three people lacking sufficient food access. The COVID-19 pandemic exacerbated these issues, particularly in Africa, where 59.6% of the population grapples with food insecurity. Malawi faces high stunting and anaemia rates in children, driven by poverty, inadequate health services, and improper diet. Despite progress, the prevalence remains above regional averages. Research reveals imbalanced diets in Malawi, primarily reliant on maize, risking micronutrient deficiencies. This study examines diet affordability in the context of rising costs and low incomes, aiming to influence policy in addressing undernutrition in Malawi and highlighting the overlooked role of affordability in nutrition access. Objectives This assessment aimed to estimate the minimum cost of a nutritious diet using locally available and culturally acceptable food items in Malawi. The objective was to explore how economic constraints affect Malawian households, particularly the poor and ultra-poor, in accessing such diets. Additionally, it sought answers to questions about cost changes over 12 months and affordability among different wealth groups in the country. Methods This study involved secondary data analysis by employing the Cost of the Diet (CotD) research method and software. The World Food Programme’s Minimum Expenditure Basket (MEB) provided monthly food prices for 28 items from April 2021 to March 2022. Comparing the cost of a nutritious diet with per capita income from the Malawi Poverty Report, we estimated the affordability gap. Food price data was from 77 markets in 25 districts, ensuring national representation. Results The annual cost of a culturally acceptable nutritious diet for a five-person household from April 2021 to March 2022 was MWK 84,658/month (≈$103). The diet’s cost increased by 25% during the period, from MWK 2,519 to MWK 3,140 per day. Only average urban households had sufficient income to afford the diet, with a 9.7% surplus. Ultra-poor, poor, rural, and average Malawian households faced affordability gaps of 139.5%, 61.4%, 48.5%, and 32%, respectively. Closing the affordability gap would require additional monthly income of 29,134 kwacha (≈$35.5) for an average Malawian household, 37,481 kwacha for a typical rural household, 42,452 kwacha for a poor household, and 58,885 kwacha for an ultra-poor household. Conclusion The CotD assessment revealed a significant increase in the cost of a nutritious diet over the past 12 months. Most of the population cannot afford the cheapest nutritious diet. The recent currency devaluation may worsen the situation. Cash, voucher or food distribution could help close the affordability gap for poor and ultra-poor households. Regular monitoring and ongoing updates of the CotD results are necessary for informed decision-making.

Dietary trends among young adults during the COVID-19 lockdown: socioeconomic and gender disparities

BackgroundHealthy eating is vital to well-being and during the COVID-19 pandemic, it was especially important for boosting immunity and protecting against viral infections. Yet, by many accounts, keeping a nutritious diet was a casualty of the pandemic rather than a means to fight it. Young adults experienced disproportionate pandemic-related disruptions during a formative stage of development while little is still known about dietary outcomes.MethodsWe employed a cross-sectional design to examine dietary disparities targeting young adults (ages 18–28) during the COVID-19 lockdown period. Participants (N = 254) responded to a 15–20-min online survey with questions related to food composition and sources of food, perceptions of healthy eating, weight change, physical activity, and food insecurity. Comparisons were made by household income and gender. Multiple regression analyses were conducted to investigate factors that predicted perceptions of healthy eating behaviors while controlling for other sociodemographic factors.ResultsA clear overall trend toward unhealthy behaviors was found while positive changes were also identified. Consumption of junk food significantly increased (+ 3%), 40% gained weight, a third were less active, and 5–8% were food insecure on a regular basis. Meanwhile, eating food from restaurants declined and, for some, home-based cooking increased. Lower income participants were overly represented in unhealthy changes and higher income participants were disproportionately represented in healthy changes. Males reported more changes in dietary composition while females reported more fluctuation in weight. Reduced activity, weight gain, and food insecurity predicted unhealthy eating behaviors. Living with friend(s)/roommate(s) predicted healthier eating, but only among lower income participants.ConclusionsIt is recommended that pandemic minded public health interventions account for negative dietary trends with particular attention to low-income young adults. Solutions should be geared toward reshaping fiscal, social and physical environments, rather than relying solely on behavioral interventions.