Promotion Of Healthy Diet Research Articles

Direito administrativo da alimentação e nudge: alimentação saudável e proporcionalidade

Administrative food law is moving towards a framework that promotes healthy eating, not only in terms of governance, safety and food labelling, but also by introducing behavioural science concepts as interventions to encourage better eating habits. Although nudges arouse the interest of authorities due to their non-coercive nature in influencing consumer behaviour, they bring legal and administrative challenges. This article explores the relationship between administrative food law, nudges and the complexities of their legality. By examining cases of nudges on eating habits, their effectiveness and alignment with administrative regulations, the article seeks to address the question of how to strike a balance between the potential benefits of such interventions in promoting healthier diets and the principle of proportionality. It concludes that nudges for healthy eating should not be purely paternalistic in order to pass the necessity test of the proportionality principle, but are unlikely to be a suitable measure from the point of view of effectiveness.

UnDErstanding consumer food choices & promotion of healthy and sustainable Mediterranean diet and LIfestyle in Children and adolescents through behavIOUral change actionS: the DELICIOUS project

Abstract Over the last decades, the abandonment of traditional dietary patterns and engagement in unhealthy lifestyles (including poor physical activity, prolonged screen time, poor sleep behaviours) in children and adolescents has been considered an important threat for the future health of the younger generations living in the Mediterranean area and the safeguard of the environment. The DELICIOUS project aims to promote healthy lifestyles among children and adolescents by implementing activities and tools to increase the adherence to the Mediterranean diet with an attention to the environmental impacts of dietary habits. The DELICIOUS project as a single-arm, uncontrolled behavioral intervention program providing formal and non-formal education activities, development of new snacks and recipe reformulation, web/mobile app development, and physical activities to school children and adolescents in five European countries. Over 2000 families joined a preliminary survey to investigate potential determinants of adherence to a healthy diet. Children and adolescents recruited from schools in the parterns’ countries are now currently being recruited to participate to the intervention activities. A web application for school canteen and a mobile application for parents have been developed to help both schools and families to track and provide healthy and sustainable meals. The project aims to increase awareness of the nutritional benefits and the sustainability aspects of the Mediterranean Diet and to promote consumers’ empowerment through an online platform for sustainable and healthy meal planning in the school canteen.

Promoting physical activity and healthy diets by modifying the social and/or physical environment at local level: a scoping review of evidence-based policy actions.

Background We aimed to map evidenced-based policy actions proposed by public health institutes or organizations to promote physical activity and healthy diets by modifying the social and/or physical environment at the local level. Methods We conducted a scoping review to identify relevant evidence-based policy actions proposed by public health institutions. We used a two-step strategy to identify government-supported public health institutes or organizations that generate evidence-based recommendations for policy actions. We included policy actions if they 1) aimed at increasing physical activity or improving diet; 2) focused on modifying the physical or social environments; 3) were implemented at the local or community level; 4) were expressed as a concrete action rather than a general aim; and 5) were described explicitly as being based on evidence. Results Starting from 121 public health institutes, we identified 8 relevant organizations and reviewed 63 guidelines or reports that included actions to promote healthy diets and physical activity. Of the 540 proposed actions on diet and 358 on physical activity, 118 met the inclusion criteria. Given that many of the actions were recommended by multiple institutes, we synthesized the information in the infographics to provide recommendations on diet and physical activity in outdoor and indoor settings and schools. Conclusions Public health institutes have generated a wide range of evidence-based recommendations for the promotion of healthy diets and physical activity by modifying the physical and social environment that can be implemented in local settings. Future actions should address barriers to implementing these recommendations and analyze the determinants of local policy decisions.

Utilization of nutrition information on food labels by diabetic mellitus and hypertensive patients attending clinic at Kakamega County Teaching and Referral Hospital, Kenya

The aim of food labels is to inform consumers on the food content. The information conveyed on food labels has evolved over time thus the objectives of food labelling have become numerous. Despite the recognized association of food labels utilization and disease management, the current global mortality rate from diabetes mellitus and hypertension remains high. In order for the prevalence rate of diabetes mellitus and hypertension to reduce, population-wide interventions including the promotion of healthy diets through the provision of adequate information on food labels should be done. This study aimed at assessing utilization of nutrition information on food labels by diabetic mellitus and hypertensive patients. This was a cross-sectional study conducted in March and April 2022 at Kakamega County Teaching and Referral hospital, Kenya. Data was collected from respondents using a structured questionnaire administered to 125 randomly selected respondents and the response rate was 80%. Socio- demographic characteristics of the study participants were determined using descriptive statistics for distribution. Association between the study variables was determined using Chi-square test. Statistical significance was set at p<0.05. The analyzed data was presented by use of frequency tables, graphs and pie charts. About 46% of the respondents were aged >60years. About 73% were married and about 40% reported to have completed primary education level. About 39 % were self-employed earning less than Ksh. 5,000 (50 USD) per month. Prevalence of diabetes and hypertension in Kakamega were at 4.6% and 29.4% respectively. Age (p= 0.028), Education (p= 0.001), Job/employment (p=0.0010), Monthly income (p=0.001) and Monthly household food expenditure (p=0.007) significantly influenced utilization of food labels. About 64% (n=64) reported to be knowing what food labels are and about 34% (n=34) reported not knowing what they are. About 46.8% (n=30) of those who reported they read the labels participants reported that they read nutrition information every time they purchased the product, 37.5% (n=24) read the information the first time they purchased the product and 15.7% (n=10) read nutrition information on food labels at other different times. Food prices, nutrition information on the food label, health and nutrition status and fat/sodium/sugar content were among the factors that had a high influence on utilization of food labels. This study recommends nutrition education to the general population on benefits of reading nutrition information on food labels in order to make healthful food choices in order to reduce the prevalence of these chronic diseases. Key words: Food labels, Utilization, Nutrition, Diabetes mellitus, Hypertension, Kakamega

Sensory and consumer science as a valuable tool to the development of quinoa-based food products: More than three decades of scientific evidence

Solutions are needed to address both hunger and the promotion of healthy and sustainable diets. Quinoa, a nutritious and sustainable Andean grain, is a versatile option for creating new foods. Over the years, several technological advancements have been made to include quinoa in various food products. However, there is still a need for solid scientific evidence on the impact of quinoa on the product's acceptance. To address this scientific knowledge gap, this work aims to analyze the scientific literature over the last three decades regarding the sensory and hedonic impact of adding quinoa to food products. To do so, bibliometric methods based on the Scopus and Annual Scientific Production databases were used. After selecting and screening using the PRISMA method, seventy-four articles from 1991 to 2024 were analyzed, identifying relationships between keywords in the analyzed studies, forming a co-occurrence and co-authorship network. Results showed that quinoa has great nutritional potential when added to different food products, but its instrumental and sensory properties are modified. The nine-point hedonic scale was used to measure product acceptability in 47% of the articles. Studies on bakery products have shown that increasing the concentration of quinoa in the product formulation decreases the acceptance of the final product in 67% of cases. It is recommended to include consumer demands from a sensory and hedonic perspective when developing new products. The scientific and industrial community is encouraged to develop new food products catering to a broader consumer range.

Prevalence of Diabetes and Associated Factors Among Government Employees of Mizan-Aman Town and Zonal Sector Office, Bench Sheko Zone, Southwest Ethiopia Region, 2022.

Diabetes mellitus (DM) is a serious non-communicable disease (NCD) that represents a major health and development challenge of the 21st century. Ethiopia is the leading country among the top five high-burden African countries for the number of people with diabetes. To address problems within the population, it is important to assess the prevalence of diabetes and identify the risk factors associated with its diagnosis. The study aims to determine the prevalence of diabetes and identify its associated factors among office workers of Mizan-Aman Town administration and Bench Sheko Zone Sector Office. A sector office-based cross-sectional study was conducted on 559 randomly selected employees of Mizan Aman Town Administration and Zonal Office from June 5 to June 30, 2022. Fasting plasma glucose was tested, and the result ≥126 mg/dL was used to diagnose DM. Data were entered using Epi Data version 4.0.2 and exported to the Statistical Package for the Social Sciences (SPSS version 26) for analysis. Bivariate analyses were included in the multivariable model with p <0.25. Adjusted odds ratios (AOR) with a confidence interval (CI) of 95% are reported, with a significance level of p < 0.05. The overall prevalence of Diabetes was 9.4% with 95%CI(7.1,12.1)). Among the participants,60.8% were men, 58.2% of workers were aged 40 years or older, and the mean age was 39.7 ± 9.9 years. Having hypertension (AOR 3.85, 95% CI (1.7,7.4), family history of diabetes (AOR 4.5, 95% CI (1.2, 15.8), physical inactivity defined as failure to participate in moderate intensity activities at work, sitting ≥180 minutes per day (AOR = 3.57, 95% CI (1.1, 11.0)) and having central obesity AOR: 3.25, 95% CI (1.5, 6.7) independently associated with higher odds of DM. However, those having good knowledge of DM (AOR=0.26, 95% CI: (0.10, 0.6)) and consuming fruits and vegetables greater than five servings per week (AOR=0.32 95% CI (0.1, 0.7)) predicted lower odds of DM. The prevalence of DM among office workers was high and is associated with lifestyle, family history, dietary practices, and knowledge about DM. Therefore, arranging regular screening programs at the workplace and promotion of healthy diet, exercise, and awareness creation are needed to lower the prevalence.

THE RISE OF NON-COMMUNICABLE DISEASES: A GLOBAL HEALTH REVIEW OF CHALLENGES AND PREVENTION STRATEGIES

Non-communicable diseases (NCDs) have emerged as a major global health concern, posing significant challenges to healthcare systems worldwide. This paper provides a succinct overview of the rising prevalence of NCDs, examining the key challenges faced and outlining preventive strategies adopted on a global scale. The escalation of NCDs, including cardiovascular diseases, diabetes, cancer, and respiratory conditions, is intricately linked to lifestyle factors, urbanization, and demographic transitions. This paper explores the multifaceted challenges posed by the growing burden of NCDs, encompassing economic implications, disparities in healthcare access, and the complex interplay of genetic and environmental factors. Addressing NCDs necessitates a comprehensive and multi-sectoral approach. Prevention strategies are crucial components of global health initiatives, encompassing lifestyle modifications, public health interventions, and policy frameworks. This paper outlines successful preventive measures adopted globally, including tobacco control initiatives, promotion of healthy diets and physical activity, and the integration of early screening and detection programs. Despite notable progress, several challenges persist, requiring sustained efforts to curb the NCD epidemic. Issues such as limited resources, inadequate healthcare infrastructure, and the need for cross-sectoral collaboration are explored in this paper. Additionally, the role of education, awareness campaigns, and technological innovations in shaping preventive strategies is emphasized. This paper provides a concise yet comprehensive overview of the global challenges posed by the rise of NCDs and highlights effective prevention strategies. It underscores the urgency for continued collaborative efforts to mitigate the impact of NCDs on global health, with a focus on fostering healthier lifestyles, improving healthcare access, and implementing evidence-based policies.&#x0D; Keywords: Non-communicable Diseases, Global Health, Prevention, Disease, Review, NCD.

Food security and Mediterranean diet in five countries: the DELICIOUS project

Abstract Food security is a universal need assuring access to healthy diet in both developing and developed countries. The aim of this study was to investigate the association between factors related to food security and adherence to the Mediterranean diet in 5 Mediterranean countries (Italy, Spain, Portugal, Egypt, and Lebanon) participating to the EU funded project DELICIOUS (UnDErstanding consumer food choices &amp; promotion of healthy and sustainable Mediterranean diet and LIfestyle in Children and adolescents through behavIOUral change actionS). Data were retrieved from a survey involving 2011 parents of children and adolescents aged 6-17 years old. The KIDMED score was used to assess the level of adherence to the Mediterranean diet. Information regarding easiness to retrieve foods characteristic of the Mediterranean diet, working status, economic allowance, and place of living were collected. The association with adherence to the Mediterranean diet were investigated by performing logistic regressions. The analyses revealed that individuals living in rural areas and reporting difficulty to retrieve all food items explored were less likely to have higher adherence to the Mediterranean diet. Moreover, higher adherence was also associated with household income higher than €3,500. No associations with family status nor working situation were found. There were no evident differences across countries, although there was nearly an inverse trend toward lack of association between economic allowance and higher adherence to the Mediterranean diet in Italy. In conclusion, the progressive abandonment of traditional dietary patterns, such as the Mediterranean diet, may not just depend on a cultural shift toward unhealthier industrial alternatives, but also on family budget and easiness to retrieve food stuff. Key messages • Food security may play a role in adherence to the Mediterranean diet. • The food market may be responsible for changes in cultural culinary habits.

Mediterranean diet in five Mediterranean countries: the DELICIOUS project

Abstract An abandonment of traditional dietary patterns is growingly observed in Mediterranean countries, especially among younger generations. This study aimed to explore determinants of Mediterranean diet (MD) adherence in 5 Mediterranean countries (Italy, Spain, Portugal, Egypt, and Lebanon) within the context of the EU funded project DELICIOUS (UnDErstanding consumer food choices &amp; promotion of healthy and sustainable Mediterranean diet and LIfestyle in Children and adolescents through behavIOUral change actionS). The sample consisted of 2011 parents of children and adolescents aged 6-17 years old. The main background characteristics, including age, sex, education, family situation, weight status, physical activity levels, sleep and screen time duration, were collected. The level of adherence to the MD was assessed using the KIDMED index. Eating habits (i.e., breakfast, place of eating, etc.) were also investigated. Logistic regression analyses were performed to test for likelihood of higher adherence to the MD. The mean KIDMED score in the study sample was 6.1 [standard deviation (SD) 2.0] with significant differences across countries [Lebanon 5.7 (SD 2.0), Italy 5.8 (SD 2.1), Spain 6.3 (SD 2.1), Egypt 6.5 (SD 1.9), and Portugal 6.5 (SD 2.0)]. A total of 865 participants were deemed as highly adherent to the MD [highest tertile, mean KIDMED score = 8.0 (SD 0.9)]. Major determinants of higher adherence to the MD were the following: among background characteristics, younger age group, higher physical activity level and adequate sleep duration; regarding dietary habits, having breakfast, out-of-home eating, eating with family members and at school, and home-cooked meals were associated with higher MD adherence. Parents’ younger age and higher education were also determinants of higher adherence. In conclusion, a cluster of healthy lifestyle behaviors can be observed among Mediterranean children and adolescents as determinant of higher adherence to the MD. Key messages • Lifestyle habits tend to cluster into healthy behaviors. • Differences in Mediterranean diet adherence may occur across countries.

Basic human values drive food choice decision-making in different food environments of Kenya and Tanzania

Increased access to a variety of foods in low-and-middle-income countries (LMICs) has led to greater autonomy in food choice decision-making. Autonomy allows individuals to make decisions through negotiation of considerations in ways that are consistent with basic values. The aim of this study was to identify and describe how basic human values drive food choice in two diverse populations with transitioning food environments living in the neighboring East African countries of Kenya and Tanzania. Secondary data analysis was carried out on focus group discussions conducted with men and women in Kenya (n = 28) and Tanzania (n = 28) as part of prior studies on food choice. A priori coding based on Schwartz's theory of basic human values was conducted, followed by a narrative comparative analysis, which included review by original principal investigators. Values of conservation (security, conformity, tradition), openness to change (self-directed thought and action, stimulation, indulgence), self-enhancement (achievement, power, face), and self-transcendence (benevolence-dependability and -caring) were prominent drivers of food choice in both settings. Participants described how values were negotiated and highlighted existing tensions. For example, the value of tradition was cited as important in both settings but changing food contexts (e.g., new foods, diverse neighborhoods) increased prioritization of values like stimulation, indulgence, and self-directed thought and action. The application of a basic values framework was useful for understanding food choice in both settings. A focused understanding of how values drive food choice decision-making in the context of changing food availability in LMICs is essential for the promotion of sustainable healthy diets.

Point of Decision Design to Address Adolescent Overweight and Obesity.

This study aims to utilize the point of decision design framework to understand how, where, and why adolescents and families make decisions about diet and physical activity and to explore how modifications to the environment can help to promote healthier choices and reduce obesity. Child and adolescent obesity is a critical public health problem. As environmental factors are a primary contributor, understanding the role of design in our surrounding environment highlights an important area of interdisciplinary study. Design strategies have been used successfully to increase stair use and reduce sedentary behavior and can be used to further promote healthier diet and activity choices among adolescents and families. We leveraged the human-centered design-thinking process through (1) qualitative interviews and survey instruments, (2) persona and prompt development, and (3) a design workshop with multidisciplinary stakeholders. Five personas were developed from the qualitative data and used in a design-thinking workshop. During the workshop, participants generated 12 influential factors and nine points of decision which were used to generate 33 solutions spanning the design continuum (from information and policy design to the design of urban, architectural, and interior environments) aimed at improving nutrition and physical activity among adolescents. Additionally, a tool kit was prototyped, which includes interview guides, a persona framework, and a workshop facilitation guide. Our novel process led to the generation of design solutions that can be implemented to expand and improve upon existing interventions for childhood obesity and create environments that encourage positive health outcomes.

Abstract 53: Real-Life Effects of Nudging and Pricing Strategies in the Supermarket to Promote Healthy Diets and Cardiometabolic Health: The Supreme Nudge Parallel Cluster-Randomized Controlled Trial

Introduction: Unhealthy food intake is a major risk factor for cardiometabolic diseases. Individual-level efforts to promote heathy diets (e.g., nutrition education) have limited effect on the long term. Designing the choice context in such a way that it facilitates healthy food choices may contribute to sustainable prevention of cardiometabolic diseases. We evaluated the real-life effects of nudging and pricing strategies in supermarkets. Hypothesis: Exposure to store-level nudging and pricing will improve dietary guideline adherence, healthy food purchasing and customer satisfaction, and reduce cardiometabolic risk among Dutch adults after 12 months compared to no intervention. Methods: In this parallel cluster-randomized controlled trial, we randomized 12 Dutch supermarkets in socially disadvantaged neighborhoods to a control (n=6 supermarkets) or intervention group (n=6). Intervention supermarkets received healthy food nudges (across 13 food groups on circa 9% of supermarket products) and pricing strategies (price decreases on healthy products and increases on unhealthy products; on circa 3% of products). Eligible participants were aged 30-80 years and regular shoppers at participating supermarkets. The primary outcome was dietary guideline adherence measured via a validated index score (scale 0-150), at baseline and after 3, 6 and 12 months. Secondary outcomes included the percentage of healthy food purchases, parameters of cardiometabolic health (HbA1c (mmol/L), lipid profile (mmol/L), and waist circumference (cm)), and supermarket customer satisfaction (very unsatisfied (1) to very satisfied (7)). Implementation fidelity was regularly monitored (no implementation (1) to optimal implementation (5)). Results: Of the 361 participants included (162 intervention, 199 control), 73% were female, 42% were highly educated and the average age (sd) was 58 (11) years. Linear mixed models showed no effectiveness of the intervention compared to control on dietary guideline adherence (β -1.1, 95%CI: -3.8; 1.7), the total percentage of healthy purchases (β 0.4, 95%CI: -3.0; 3.7), HbA1c (β 0.6, 95%CI: -0.1; 1.3), lipid profile (LDL β -0.0, 95%CI: -0.2; 0.1, HDL β -0.0, 95%CI: -0.1; 0.0), and waist circumference (females β 0.7 (95%CI: -0.8; 2.2), males β 0.5, 95%CI: -2.4; 3.5) over the 12-month intervention period. Participants in the intervention clusters scored 0.3 points (95%CI: 0.1; 0.5) higher on overall customer satisfaction, compared to control clusters. Median implementation fidelity over time was 3.6 (range 2.9-4.1). Conclusions: Nudging and pricing strategies implemented in a real-life purchasing setting were not effective in promoting healthier diets and purchasing patterns nor in improving cardiometabolic health on an individual level. Sub-optimal intervention exposure due to practical implementation barriers may have contributed to these null results.

The Paleolithic Diet.

The promotion of healthy diets is likely one of the most cost-effective strategies for preventing a wide range of disorders, including cardiovascular disease, obesity, hypertension, and type 2 diabetes. The majority of present non-communicable chronic diseases are attributed to civilization, an abundance of food, and a lack of physical activity. According to the purported lifestyles of early humans, the paleolithic diet (PD) encourages the intake of wild animal and plant foods. In recent decades, the paleolithic diet has grown in popularity, particularly among younger populations and those with cardiometabolic syndrome and other chronic diseases. Due to the nutrition profile of the paleolithic diet, historical studies have postulated that hunter-gatherers (HGs) have slender physiques and were physically fit and devoid of chronic ailments such as cardiovascular diseases (CVDs). This review highlights the composition/constituentof the paleolithic diet along with an emphasis on current studies and evidence on the effectiveness of the paleolithic diet in mitigating chronic diseases.

Healthy diet promotion among adolescents

Healthy diet promotion among adolescents

The application of electrostatic field technology for the preservation of perishable foods

With the global promotion of healthy diet, people's demand for freshness of food has risen, so extending the shelf life of food has become a hot topic now. Electrostatic field is widely concerned because it has the advantages of simple equipment, low cost, low maintenance, low energy consumption, one investment can be used for a long time, flexible operation, no drug pollution, no secondary pollution to the environment, and can better retain the original quality and flavor of food. As a non-thermal physical preservation technology, electrostatic field preservation can produce ozone and electric ions to kill bacteria inside and outside the food and reduce the enzyme activity, so as to play the effect of preservation. In this paper, based on the introduction of the working principle and mechanism of action of electrostatic field processing technology, the research progress of the application of this technology in different perishable food sterilization and preservation is described, and the limitations of electrostatic field technology are proposed, in order to provide a theoretical basis for the processing application of electrostatic field in perishable food and to provide guidance for the industrial production of electrostatic field.

Real-life effects of nudging and pricing strategies in the supermarket to promote healthy diets

Abstract Background Unhealthy dietary patterns pose a major public health challenge. Individual-level efforts to promote heathy diets (e.g. nutrition education) have limited effect on the long term. Context-specific interventions focussing on point-of-purchase may create opportunities for sustainable dietary changes. We evaluated real-life effects of nudging and pricing strategies in supermarkets on dietary intake. Methods In this parallel cluster-randomised controlled trial, we randomized 12 Dutch supermarkets in socially deprived neighbourhoods to a control group (n = 6), or intervention group (n = 6). Healthy food nudges were implemented in intervention stores across 13 food groups, combined with healthy product price decreases and unhealthy product price increases. Eligible participants were aged 30-80 years and regular shoppers at participating stores. The primary outcome was dietary guideline adherence measured via an index score (0-150), at baseline and after 3, 6 and 12 months. Secondary outcomes included parameters of cardiometabolic health (HbA1c, lipid profile, and waist circumference), the percentage of healthy food purchases in the supermarket, socio-cognitive factors, and supermarket customer satisfaction. Effects were analysed with linear mixed models. Results This study included 173 participants from intervention clusters and 220 from control clusters. Preliminary evaluation of the 3-month follow-up data revealed no effectiveness of the nudging and pricing strategies compared to the control supermarkets in terms of dietary guideline adherence (β -0.8, 95%CI -4.2; 2.7). Results on all outcomes will be available at time of the conference. Conclusions This novel supermarket trial is the first to evaluate real-life long-term effects of nudging and pricing strategies based on a comprehensive set of study outcomes and using a strong methodological design. Findings can direct future design of context-specific interventions focussing on the promotion of healthy diets. Key messages • Context-specific interventions focussing on point-of-purchase may create opportunities for sustainable dietary changes. • Findings from this supermarket trial testing real-life and long-term effects of nudging and pricing strategies can direct future design of context-specific interventions focussing on healthy diets.

Sustainable dietetic models: strategies for communication and promotion

Abstract Global Burden of Disease identifies the makeup of diets as a significant risk factor for mortality and morbidity, with 11 million deaths and 255 million disability-adjusted life years attributable to dietary risk factors. 690 million people lack sufficient food and economic projections suggest that COVID-19 pandemic may add an additional 83 to 132 million people to the ranks of the undernourished, as the outbreak has exacerbated the global food flaws and insufficiencies, impacting the most vulnerable populations. Diets and related food systems also contribute to significant environmental degradation and climate change. Demand for animal-source foods is also increasing, particularly in emerging economies, which entails risks for the environment. 1.3 billion tons of food are wasted globally yearly, utilizing 38% of total energy consumption in the global food system. The real cost of acquiring enough nutrient-rich food to meet national dietary guidelines for a healthy diet exceeds available income for ∼38% of the world's population. A balanced diet that meets food-based dietary guidelines calls for even larger quantities of more costly food groups than would be needed just for nutrient adequacy, owing to their many functional attributes beyond just the essential nutrients that they contain. Faced with this scenario, there is urgent need for an appropriate strategy to increase people's awareness of the relationship between specific food choices and health and to facilitate the educational environment on this issue. Actual examples of current strategies for communication and promotion of healthy and sustainable diets will be discussed. With awareness and knowledge, clear and precise information, a supportive social environment, available and accessible healthy and sustainable food items, and the implementation of related policies, individuals have a great potential to achieve healthiness and environmental sustainability by choosing healthier and more sustainable foods.

The Effects of Food Taxes and Subsidies on Promoting Healthier Diets in Iranian Households.

Background and AimPrice, as a key driver of food purchasing, has an important role in determining the consumer demand. This study is aimed to estimate the effect of food taxes and subsidies on purchasing patterns of Iranian households (HHs).MethodsThis study was performed in two phases. In phase one, a two-round Delphi study was conducted to determine and prioritize food-related fiscal policies; and in the second phase, using the Iranian Household Income and Expenditure Survey (HIES), we estimated an almost ideal demand system (AIDS) and simulated changes in purchases, nutrient intake, and consumer welfare under six different policy scenarios: (1) 20% subsidy on vegetables, (2) 20% subsidy on fruits, (3) 30% subsidy on legumes, (4) 25% tax on sugar and sweets, (5) 30% tax on sweetened beverages, and (6) 30% tax on hydrogenated oil and animal fats.ResultsThe highest calorie reduction was detected in sugar and sweets tax, which has resulted in 949.67, 971.68, and 1,148.03 kilocalories decrease in energy intake per Adult Male Equivalent (AME) in all HHs, low-income HHs, and high-income HHs, respectively. In terms of welfare changes, high-income HHs will experience a lower change in welfare (−0.81 to 0.11%) relative to their income when compared with low-income HHs (−0.88 to 0.28%) due to fiscal policies.ConclusionFiscal policies in Iran can be a potential way to improve dietary choices. The findings provide essential information for decision makers for the implementation of food-related fiscal policies.

Neglected listeria infection in pregnancy in China: 93 cases

Objective Listeriosis is a foodborne disease that occurs in immunocompromised patients. Pregnant women are a high-risk group for the disease. Listeria infection during pregnancy is uncommon in China because of dietary habits, with little clinician attention and minimal therapeutic options due to its population-specific nature.This article studies the clinical characteristics of Listeria infection in pregnant women and the improvement of treatment methods. Subjects This study collected clinical data from 16 cases of pregnant patients with laboratory-confirmed Listeria monocytogenes infections at the Women and Children's Hospital of Jiaxing University. These data were combined with 77 cases that were reported in the literature for a total of 93 cases of Listeria monocytogenes infection in pregnancy that occurred in China over a 15-year interval. Methods We collected the clinical data of 16 pregnant patients with listeriosis diagnosed in the laboratory of the Women and Children's Hospital of Jiaxing University from May 2013 to December 2020, and combined it with 77 cases of Listeria monocytogenes during pregnancy in China obtained from a literature search. We summarized the clinical features of listeriosis in pregnancy infection and investigated its treatment methods and prevention. Results Ninety-three cases of Listeria monocytogenes infection in pregnancy occurred in early, middle and late pregnancy in 31, 27, and 35 patients, respectively. The initial clinical presentation was fever in 90 patients, intermittent lower abdominal pain in 50 patients, and abnormal fetal movement and/or abnormal fetal heartbeat in 27 cases. Specimens with a positive bacterial culture included the following: 6 amniotic fluid cultures, 35 blood cultures, 37 maternal placenta and uterine secretion cultures, and 15 neonatal blood cultures. Fifty-seven cases of placental pathology, all showing of neutrophil infiltration, were 100% consistent with acute chorioamnionitis. Fifty-eight patients were initially treated with cephalosporin antibiotics, and only 24 cases were initially treated with broad-spectrum penicillins to cover the pathogenic bacteria. Drug sensitivity tests revealed resistant strains, 15 penicillin G-resistant, 14 oxacillin-resistant, and 13 ampicillin-resistant strains. After penicillin failure, vancomycin or meropenem was given. Maternal outcomes included the following: 20 cases of sepsis, 3 cases of pneumonia, 6 cases of acute pyelonephritis, 28 cases of intrauterine infection, 2 cases of multiple organ dysfunction syndromes, and 1 case of septic shock. The fetal and neonatal outcomes were as follows: 16 cases of abortion, 16 cases of intrauterine fetal death, 22 cases of death after birth, and 39 cases of cure. Conclusion In our study and reported cases, Listeria monocytogenes in pregnancy is associated with fever as the primary manifestation, a high incidence of adverse pregnancy outcomes, and a significant increase in fetal and neonatal mortality. The low coverage of practical use of antimicrobial drugs and the emergence of drug-resistant strains in recent years have increased the difficulty of treatment, suggesting the need for clinicians to raise awareness of the disease and strengthen healthy diet promotion for women in pregnancy.

Socio-economic inequalities in child growth: Identifying orientation and forward-looking layout

Socio-economic inequalities in child growth: Identifying orientation and forward-looking layout