Public Health Nutrition Programs Research Articles

Empowering youth as agents of change: Gaps and opportunities for meaningful youth engagement (MAYE) for sustainable nutrition, climate and public health programmes.

Addressing the intersection of food insecurity, malnutrition and climate change in Sub-Saharan Africa requires meaningful adolescent and youth engagement to drive sustainable change. Drawing on empirical evidence and collective experiences from youth-led initiatives and coalitions, four gaps and opportunities to better involve youth in programmes are discussed, including, the need to: (1) standardise the definition of youth to improve programme design and data harmonisation, (2) provide capacity building and mentorship for youth leadership in health service delivery, (3) foster youth leadership and multisectoral collaboration in food and health systems and (4) enhance capacity development for non-youth actors to support genuine youth participation. This viewpoint underscores the importance of involving African youth in public health nutrition, climate change and food security programmes design and implementation-as drivers of change to addressing hunger and climate crises. By centering youth voices and experiences, programmes and policies can better address African communities' complex challenges, fostering inclusivity, sustainability and resilience in achieving better nutrition and public health programmes and outcomes.

The Relationship between Chronic Energy Deficiency and the Incidence of Anemia in Female Adolescent in Stunting Locus Areas

Background: Adolescent girls are a group that is prone to anemia, so they are at risk of giving birth to stunted children. This study aims to analyze the factors most associated with the incidence of anemia in adolescent girls in the stunting locus area. Subjects and Method: This was a cross sectional study conducted in Patokaan Village, North Minahasa Regency, North Sulawesi. A total of 50 adolescent girls were selected in this study. The dependent variable was anemia. The independent variables were nutritional status, Chronic Energy Deficiency (CED), nutrient intake (Fe, protein, vitamin C), body perception (Body Image), nutritional knowledge, and menstrual patterns based. The variables studied were anemia based on laboratory examination, nutritional status according to BMI/A and CED using anthropometric methods, nutrient intake (Fe, protein, vitamin C) using 24-hour recall, body perception (Body Image), nutritional knowledge, and menstrual patterns based on questionnaire interviews. Fisher's Exact Test was used for bivariate analysis and logistic regression for multivariate analysis. Results: Adolescent girls with CED have a 5.21 times risk of experiencing anemia compared to those without CED, and this result was statistically significant (aOR= 5.21; 95% CI= 1.01 to 26.83; p = 0.048). Conclusion: CED is associate with anemia in adolescent girls in the stunting locus area. This study is expected to be useful for the North Minahasa District Health Office as input for policy makers, planning, and implementing public health nutrition programs. Keywords: anemia, chronic energy deficiency, adolescent girls. Correspondence:Nancy S. H. Malonda. Study Program of Public Health, Faculty of Public Health, University of Sam Ratulangi, Manado, Indonesia. Email: nancymalonda@unsrat.ac.id.

The Impact of the COVID-19 Pandemic on Food Security at the Household Level: Cross-Sectional Survey in Jakarta and Depok, Indonesia

This study aimed to describe when the effects of the pandemic on food security started to be felt by families in Jakarta (urban area) and Depok (semi-urban area). A cross-sectional survey was conducted among 517 respondents. Data were collected using an online questionnaire. The study revealed that effects of economic decline, reduced purchasing power, and increased food prices occurred early during the pandemic. Those living in semi-urban areas were affected earlier than those living in urban areas. However, more semi-urban families perceived that they were prepared to face food shortage during the pandemic. It is recommended to consider these results for public health nutrition program in food security and disaster.

Prevalence and Determinants of Multiple Forms of Malnutrition among Adults with Different Body Mass Index: A Population-Based Survey in the Philippines.

The multiple forms of malnutrition, including overnutrition, undernutrition, and diet-related noncommunicable diseases, are emerging crises in Asian countries. Past studies have focused more on malnutrition among overweight/obese individuals; however, limited research has examined chronic energy-deficient adults. Therefore, this study is aimed at investigating the prevalence and determinants of different forms of malnutrition among adults with different body mass index, using the Philippines as an example. Findings from this study will guide the development and implementation of public health nutrition programs and policies. A representative dataset from the 2013 Philippine National Nutrition Survey was used in the study. Adults aged ≥20 years (n = 16,826) were included in the analysis after excluding those with missing values. Six phenotypes of malnutrition were assessed, including three in overweight/obese adults (overweight/obese with metabolic syndrome; those with micronutrient deficiency-anemia, vitamin A deficiency, and iodine insufficiency; and those with both metabolic syndrome and micronutrient deficiency) and three in chronic energy-deficient (CED) adults (CED with either metabolic syndrome or micronutrient deficiency and with both metabolic syndrome and micronutrient deficiency). Sociodemographic and lifestyle factors were examined as the determinants of different forms of malnutrition, and multinomial logistic regression analyses were performed. The prevalence of the six phenotypes of malnutrition ranged from 0.4% to 10.2%, where overweight/obese with metabolic syndrome was the most predominant type. The multinomial logistic regression models indicated that older age was the major risk factor across all phenotypes. Sex was associated with the outcomes in the overweight/obesity group, whereas employment status was correlated with CED adults. Furthermore, higher educational levels, being married, living in affluent households, and not smoking were protective factors for conditions related to CED but not overweight/obese individuals. Malnutrition in all its forms is a significant public health concern that must be understood and addressed. Policymakers should implement appropriate intervention programs to control these nutritional problems considering the specific risk factors for the adult population.

Perspective: Human Milk Composition and Related Data for National Health and Nutrition Monitoring and Related Research.

National health and nutrition monitoring is an important federal effort in the United States and Canada, and the basis for many of their nutrition and health policies. Understanding of child exposures through human milk (HM) remains out of reach due to lack of current and representative data on HM's composition and intake volume. This article provides an overview of the current national health and nutrition monitoring activities for HM-fed children, HM composition (HMC) and volume data used for exposure assessment, categories of potential measures in HM, and associated variability factors. In this Perspective, we advocate for a framework for collection and reporting of HMC data for national health and nutrition monitoring and programmatic needs, including a shared vision for a publicly available Human Milk Composition Data Repository (HMCD-R) to include essential metadata associated with HMC. HMCD-R can provide a central, integrated platform for researchers and public health officials for compiling, evaluating, and sharing HMC data. The compiled compositional and metadata in HMCD-R would provide pertinent measures of central tendency and variability and allow use of modeling techniques to approximate compositional profiles for subgroups, providing more accurate exposure assessments for purposes of monitoring and surveillance. HMC and related metadata could facilitate understanding the complexity and variability of HM composition, provide crucial data for assessment of infant and maternal nutritional needs, and inform public health policies, food and nutrition programs, and clinical practice guidelines.

Peer-reviewed Nutrition-Affiliated Journals from Sub-Saharan Africa: A Regional Snapshot.

Sub-Saharan African (SSA) countries face the multipart burden of nutrition-related disease characterized by a high incidence of undernutrition, overweight, obesity, and associated non-communicable disease. Local and regional research to support a robust public health response is necessary. No evaluation of the availability and scope of nutrition-related journals within SSA has been published. An electronic search for peer-reviewed journals was conducted using seven publicly accessible databases. Ten journals were identified including journals from Kenya (4 journals), Nigeria (3 journals), South Africa (2 journals), and Ghana (1 journal) with eight journals in active production. All actively publishing journals are available only as English publications. An increased focus on evidence-based research through local and regional journal publications is necessary to develop and maintain public health nutrition programs. Active journals related to nutrition and food sciences are very limited in this comparatively large area and require more support at local, regional, and legislative levels.

Successful Community Nutrition Incentive Program Data Collection during the COVID-19 Pandemic: A Case Study

BackgroundThe coronavirus 2019 (COVID-19) pandemic has complicated rigorous evaluation of public health nutrition programs. The USDA Gus Schumacher Nutrition Incentive Program (USDA GusNIP) funds nutrition incentive programs to improve fruit and vegetable purchasing and intake by incentivizing Supplemental Nutrition Assistance Program (SNAP) participants at the point of sale. GusNIP grantees are required to collect survey data (e.g., fruit and vegetable intake and food insecurity status) on a subset of participants. However, due to COVID-19, most GusNIP grantees faced formidable barriers to data collection. The Hunger Task Force Mobile Market (HTFMM), a Wisconsin-based 2019 GusNIP grantee, used particularly innovative methods to successfully collect these data (n > 500 surveys). ObjectivesThe aim was to explore HTFMM’s successful participant-level data-collection evaluation during COVID-19. MethodsA single case study methodological approach framed this study. The case is the HTFMM in Milwaukee, WI, USA. Participants included HTFMM leadership (n = 3), evaluators (n = 2), staff (n = 3), volunteers (n = 3), and customers (n = 10). These teleconference interviews were recorded and transcribed verbatim. Transcripts were coded using thematic qualitative analysis methods with 2 independent coders. ResultsFour salient themes emerged: 1) there were multiple key players with unique roles and responsibilities who contributed to personalized, proactive, and time-intensive, telephone-based proctored survey collection methods; 2) the importance of resources dedicated to comprehensive evaluation; 3) longstanding relationships rooted in trust and community-based service are key to successful program delivery, engagement, and evaluation; and 4) the COVID-19 data-collection protocol also serves to mitigate nonpandemic challenges to in-person survey collection. ConclusionsThese findings provide guidance on how alternative methods for data collection during COVID-19 can be used and applied to other situations that may affect the ability to collect participant-level data. These findings contribute to a growing body of literature as to best practices and approaches to collecting participant-level data to evaluate public health nutrition programs.

Double burden of malnutrition in ethnic minority school-aged children living in mountainous areas of Vietnam and its association with nutritional behavior.

BACKGROUND/OBJECTIVESAlthough children of ethnic minority groups are experiencing a transition from a predominance of undernutrition to overnutrition, there is little evidence of a dual-malnutrition burden. Therefore, this study examined the double burden of malnutrition among school-aged ethnic minority children living in mountainous areas and its association with their diets.SUBJECTS/METHODSA cross-sectional study was conducted from September 2019 to March 2020 in 3 mountainous areas of Northern Vietnam among 1,556 ethnic minority school-aged children. The prevalence of under-nutrition (stunting and thinness) and over-nutrition (overweight and obesity) were measured using the WHO 2006 child growth standards (height-for-age and BMI-for-age Z-score). Nutritional practices were evaluated by the frequency of food consumption based on a 4-level scale.RESULTSThe percentage of children with stunting and thinness were 14.0% and 5.4%, respectively, while the figure for overweight/obesity was 9.4%. The factors positively associated with stunting were living in a family with more than 2 children or being Muong/other ethnicities compared to the Tay ethnicity. Children who consumed fish/shrimps/crabs or milk weekly/daily were less likely to be undernourished compared to those who never consumed these foods. By contrast, children who never consumed foods rich in vitamin A precursors and vitamin A and fruit or consumed daily snacks/junk food were more likely to be overweight/obese.CONCLUSIONSUndernutrition remains a common issue among school-aged children and adolescents of ethnic minority groups, while over-nutrition exists simultaneously. Public health nutrition programs promoting adequate diets and positive lifestyle changes related to nutrition are essential to tackle the double burden of malnutrition among ethnic minority children.

A Traditional Costa Rican Adolescents' Diet Score Is a Valid Tool to Capture Diet Quality and Identify Sociodemographic Groups With Suboptimal Diet.

Traditional diet indices may capture diet quality according to local food culture. Higher adherence to traditional diet scores may help prevent disease, yet evidence in adolescents is limited. This cross-sectional study aimed to develop and validate a Traditional Costa Rica Adolescents Diet Score (TCRAD) and determine its association with sociodemographic characteristics, under the hypothesis that girls, adolescents from rural areas, and with low socioeconomic status, have a more traditional healthy diet. A total of 804 urban and rural adolescents (13–18 years old) participated in the study. The TCRAD showed adequate internal validity as shown by significant associations with intake of 14 traditional foods and nutrients (legumes, vegetables, fruits, oils, dairy, and corn tortilla scored as healthy; and white rice, red/processed meat, solid fats, desserts/pastries, sugar-sweetened beverages, snacks, fast food, and bread and cookies scored as unhealthy). A high TCRAD score, indicative of a healthier and more traditional diet, was observed among adolescents in the low socioeconomic group vs. medium or high socioeconomic categories (42.9, 41.2, and 38.2%, respectively, p < 0.05), adolescents living in rural areas vs. urban (47.6 vs. 34.2%, p < 0.05), and among boys vs. girls (46.9 vs. 37.5%, p < 0.05). The TCRAD score is a valid tool to capture diet quality of adolescents in Costa Rica and could be used to measure association of diet with disease outcomes in this and similar populations. Public health nutrition programs in Costa Rica should focus on improving intake of foods and nutrients, and prioritize girls, adolescents in urban areas, and adolescents with high socioeconomic status.

The WIC Infant and Toddler Feeding Practices Study-2 (WIC ITFPS-2) Through Age 5: What We’ve Learned, What Questions Remain, and How You Can Use This Longitudinal Dataset

Abstract Objectives By the end of the session, attendees will be able to: (1) Articulate the methodology of and notable findings from the USDA WIC Infant and Toddler Feeding Practices Study-2 (WIC ITFPS-2); and (2) Summarize the major domains of data available through age 5 in the WIC ITFPS-2 public use dataset. Methods The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is the premier public health nutrition program for low-income, nutritionally at-risk pregnant and post-partum women, infants, and children up to age five. To better understand how WIC participation is associated with the health and nutrition outcomes of young children, USDA funded the WIC Infant and Toddler Feeding Practices Study-2 (ITFPS-2) in 2011. WIC ITFPS-2 is a national, longitudinal study of 3775 mother-child dyads who enrolled in WIC either during the mother's pregnancy or shortly after the child was born. The study interviews participants every 2 to 6 months through the child's fifth birthday, with two additional follow-ups at ages 6 and 9 years. The study captures information on children's health and nutrition status, including 24 hour dietary recall data; mothers’ feeding practices and beliefs; household food security; and WIC participation patterns. Data are weighted to produce national estimates. As of June 2021, data through children's fifth birthday (i.e., all years during which children were categorically eligible for WIC) are publicly available. Results Using descriptive, univariate, and multivariate techniques, analyses across the first 6 study reports have demonstrated positive associations between WIC and diet outcomes among young children. After controlling for other factors, longer WIC participation was associated with higher Health Eating Index-2015 scores at various time points, with lower daily energy intake, and with meeting the Dietary Guidelines recommendation to limit added sugar. Conclusions Across children's first five years of life, WIC participation has been associated with improved dietary intake and better diet quality, among other positive outcomes. The WIC ITFPS-2 dataset is publicly available and should be leveraged by researchers to further explore the health and nutrition status of low-income children during the early years of life. Funding Sources WIC ITFPS-2 is funded by USDA contract number AG-3198-B-11–0020 with Westat.

Impact of Early Nutrition, Physical Activity and Sleep on the Fetal Programming of Disease in the Pregnancy: A Narrative Review.

Early programming is the adaptation process by which nutrition and environmental factors alter development pathways during prenatal growth, inducing changes in postnatal metabolism and diseases. The aim of this narrative review, is evaluating the current knowledge in the scientific literature on the effects of nutrition, environmental factors, physical activity and sleep on development pathways. If in utero adaptations were incorrect, this would cause a mismatch between prenatal programming and adulthood. Adequate caloric intake, protein, mineral, vitamin, and long-chain fatty acids, have been noted for their relevance in the offspring brain functions and behavior. Fetus undernutrition/malnutrition causes a delay in growth and have detrimental effects on the development and subsequent functioning of the organs. Pregnancy is a particularly vulnerable period for the development of food preferences and for modifications in the emotional response. Maternal obesity increases the risk of developing perinatal complications and delivery by cesarean section and has long-term implications in the development of metabolic diseases. Physical exercise during pregnancy contributes to overall improved health post-partum. It is also interesting to highlight the relevance of sleep problems during pregnancy, which influence adequate growth and fetal development. Taking into account these considerations, we conclude that nutrition and metabolic factors during early life play a key role of health promotion and public health nutrition programs worldwide to improve the health of the offspring and the health costs of hospitalization.

La Niña weather impacts dietary patterns and dietary diversity among children in the Peruvian Amazon.

In 2011-2012, severe El Niño Southern Oscillation (ENSO) conditions (La Niña) led to massive flooding and temporarily displacement in the Peruvian Amazon. Our aims were to examine the impact of this ENSO exposure on child diets, in particular: (1) frequency of food consumption patterns, (2) the amount of food consumed (g/d), (3) dietary diversity (DD), (4) consumption of donated foods, among children aged 9-36 months living in the outskirts of City of Iquitos in the Amazonian Peru. This was a longitudinal study that used quantitative 24-h recall dietary data collection from children aged 9-36 months from 2010 to 2014 as part of the MAL-ED birth cohort study. Iquitos, Loreto, Peru. Two hundred and fifty-two mother-child dyads. The frequency of grains, rice, dairy and sugar in meals reduced by 5-7 %, while the frequency of plantain in meals increased by 24 % after adjusting for covariates. ENSO exposure reduced girl's intake of plantains and sugar. Despite seasonal fluctuations in the availability of fruits, vegetables and fish, DD remained constant across seasons and as children aged. However, DD was significantly reduced under moderate La Niña conditions by 0·32 (P < 0·05) food groups. Adaptive social strategies such as consumption of donated foods were significantly higher among households with girls. This is the first empirical study to show differential effect of the ENSO on the dietary patterns of children, highlighting differences by gender. Public health nutrition programmes should be climate- and gender-sensitive in their efforts to safeguard the diets of vulnerable populations.

Food Insecurity And Nutritional Status Among Women in Palm-Plantation Area of Kutai Kertanegara East Kalimantan

Inability of individuals and household in providing adequate, nutritious and safe food will continue in conditions of food insecurity, which have an impact on malnutrition. Women play an important role in maintaining household food security while they are also vulnerable to food insecurity. This study aim to examine correlation between food insecurity and women nutritional status. This was a cross sectional study, with sample consist of 128 women in reproductive age who lived in palm plantation area in Kutai Kertanegara. The sampling technique was purposive. Food insecurity was assessed by the Radimer/ Cornell Hunger and Food Insecurity Instrument Questionnaire. The nutritional status of women measured by Body Mass Index and upper arm circumference. Bivariate Analysis was performed by Chi Square test. Household food insecurity was reported in 27.3% women, individual food insecurity was found in 29.7% women, and 8.6% child hunger. Bivariate analysis showed there is no significant correlation between food insecurity with nutritional status based on BMI or upper arm circumference. It should be made a comprehensive public health nutrition program to address food insecurity in remote area. Future studies would need more adequate study design and larger sample size to examine women nutritional status and food insecurity.&#x0D; Keywords : Food insecurity, nutritional status, palm-plantation

Grandmothers as Change Agents: Developing a Culturally Appropriate Program to Improve Maternal and Child Nutrition in Sierra Leone.

ABSTRACTBackgroundGlobal recommendations on optimal maternal and child nutrition (MCN) practices are clear; however, there is limited literature 1) exploring how roles of family members influence those practices and on 2) designing programs accordingly. Researchers using a family-systems approach in the Global South find that grandmothers often play a vital role in MCN, yet most nutrition programs narrowly target mothers, thereby potentially limiting effectiveness.ObjectivesThis article reports on the results of qualitative research exploring the roles and influence of family members on MCN in southern Sierra Leone, the local MCN beliefs and practices, and how those findings informed the design of a culturally appropriate program.MethodsFocus group discussions (FGDs) were conducted with mothers, fathers, and grandmothers in 9 communities in Bonthe District, Sierra Leone. We used participatory tools to explore family members’ roles and local MCN beliefs and practices. Interviews were recorded by notetakers and coded and analyzed using a content analysis approach.ResultsA total of 88 mothers, 125 grandmothers, and 79 fathers participated in the FGDs. All groups indicated that 1) grandmothers are the culturally designated advisors and supervisors of women on MCN issues and 2) mothers are not autonomous decision makers and are greatly influenced by grandmothers. The research identified both beneficial MCN practices and gaps between optimal and existing MCN practices—particularly related to maternal diet during pregnancy and exclusive breastfeeding for 6 mo. Research findings were used to design a grandmother-inclusive program.ConclusionsOur research showed that mothers are embedded in a family system of caring and supervision where grandmothers have primary influence on MCN practices, clearly supporting the need for grandmothers to have a central role in community MCN programs. It also points to the need for increased use of a family-systems approach in designing public health nutrition programs.

Mobile Phone Apps for Low-Income Participants in a Public Health Nutrition Program for Women, Infants, and Children (WIC): Review and Analysis of Features.

BackgroundSince 1972, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) has been proven to improve the health of participating low-income women and children in the United States. Despite positive nutritional outcomes associated with WIC, the program needs updated tools to help future generations. Improving technology in federal nutrition programs is crucial for keeping nutrition resources accessible and easy for low-income families to use.ObjectiveThis review aimed to analyze the main features of publicly available mobile phone apps for WIC participants.MethodsKeyword searches were performed in the app stores for the 2 most commonly used mobile phone operating systems between December 2017 and June 2018. Apps were included if they were relevant to WIC and excluded if the target users were not WIC participants. App features were reviewed and classified according to type and function. User reviews from the app stores were examined, including ratings and categorization of user review comments.ResultsA total of 17 apps met selection criteria. Most apps (n=12) contained features that required verified access available only to WIC participants. Apps features were classified into categories: (1) shopping management (eg, finding and redeeming food benefits), (2) clinic appointment management (eg, appointment reminders and scheduling), (3) informational resources (eg, recipes, general food list, tips about how to use WIC, links to other resources), (4) WIC-required nutrition education modules, and (5) other user input. Positive user reviews indicated that apps with shopping management features were very useful.ConclusionsWIC apps are becoming increasingly prevalent, especially in states that have implemented electronic benefits transfer for WIC. This review offers new contributions to the literature and practice, as practitioners, software developers, and health researchers seek to improve and expand technology in the program.

Strengthening integration of clinical and public health systems to prevent maternal-child obesity in the First 1,000 Days: A Collective Impact approach

IntroductionObesity interventions may be most effective if they begin in the earliest stages of life, support changes across family, clinical, and public health systems, and address socio-contextual factors. MethodsThe First 1000Days is a systematic program starting in early pregnancy lasting through the first 24months of infancy to prevent obesity among low-income mother-infant pairs in three community health centers in Massachusetts. The program uses a Collective Impact approach to create the infrastructure for sustained, system-wide changes for obesity prevention across early life clinical and public health services, including Obstetrics, Pediatrics, Adult Medicine, Behavioral Health, Nutrition, Community Health, the Women, Infants and Children (WIC) program, and the Maternal, Infant and Childhood Home Visiting program. Program components include 1) staff and provider training; 2) enhanced gestational weight gain and infant overweight tracking; 3) universal screening of adverse health behaviors and socio-contextual factors; 4) universal patient navigation to support individual behavior change and social needs, while strengthening integration of clinical and public health services; 5) individualized health coaching for mother-infant pairs at high risk of obesity; and 6) educational materials to support behavior change. ResultsA quasi-experimental evaluation design will examine changes, between 2015 and 2019, in gestational weight gain and prevalence of infant overweight from 0 to 24months of age. ConclusionsThe First 1000Days program will examine the effectiveness of an early life obesity prevention program for mother-infant pairs. If successful, the program could provide a model for chronic disease prevention and health promotion among vulnerable families starting in early life.

Spatial, temporal, and health associations of eating alone: A cross-cultural analysis of young adults in urban Australia and Japan

Eating alone is driven by social and cultural factors, not solely by individual preferences. In academic research, eating alone is often simply treated as an alternative to social, commensal eating, and little is known about the practice of eating alone itself. This study employs a cross-cultural analysis to explore social and cultural associations of eating alone. The analysis is based on 1) cultural domain data, derived from principal component analysis of freelist responses, a set of words or phrases related to the topic of eating alone; and 2) in-depth interviews with 72 young adults aged 20–40 in urban Australia and Japan. Many Australian and Japanese young adult participants associated eating alone with both pleasure and stress of being isolated from others. However, the comparison of principal components between Australian and Japanese groups and gender subgroups showed cross-cultural variations and complexity in the context of eating alone including: locations and timings of eating alone, and associations with healthy/unhealthy eating. Analyses of interviews are included to deepen understandings of cultural domains. These key associations are influenced by a range of social and cultural environments such as fast food cultures, work and life environments, and the scope of public health nutrition programs. The association between eating alone and healthy eating among young adults indicates that individualistic understandings of food intake in current public health nutrition programs are more favorable to eating alone and foster a gap between ideas of healthy eating and commensal eating as a cultural ideal.

Satisfying America's Fruit Gap: Summary of an Expert Roundtable on the Role of 100% Fruit Juice.

The 2015 to 2020 Dietary Guidelines for Americans (DGAs) recognize the role of 100% fruit juice in health and in helping people meet daily fruit recommendations and state that 100% fruit juice is a nutrient-dense beverage that should be a primary choice, along with water and low-fat/fat-free milk. The DGAs note that children are consuming 100% fruit juice within recommendations (that is, 120 to 180 mL/d for children aged 1 to 6 y and 236 to 355 mL/d for children aged 7 to 18 y). Evidence shows that compared to nonconsumers, those who consume 100% fruit juice come closer to meeting daily fruit needs and have better diet quality. In children, 100% fruit juice is associated with increased intakes of nutrients such as vitamin C, folate, and potassium. When consumed within the DGA recommendations, 100% fruit juice is not associated with overweight/obesity or childhood dental caries and does not compromise fiber intake. Preliminary data suggest that polyphenols in some 100% fruit juices may inhibit absorption of naturally occurring sugars. Given its role in promoting health and in helping people meet fruit needs, experts participating in a roundtable discussion agreed that there is no science-based reason to restrict access to 100% fruit juice in public health nutrition policy and programs such as the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Reducing or eliminating 100% fruit juice could lead to unintended consequences such as reduced daily fruit intake and increased consumption of less nutritious beverages (for example, sugar-sweetened beverages).

Effectiveness of Australian cooking skill interventions

PurposeThe purpose of this paper is to assess the effectiveness of cooking skill interventions (CSIs) targeting adults to improve dietary intakes in public health nutrition settings.Design/methodology/approachA scoping review of the literature was used to identify and assess the quality and effectiveness of Australian single-strategy CSIs and multi-strategy programmes that included cooking for independent healthy people older than 16 years from 1992 to 2015.FindingsThere were only 15 interventions (n=15) identified for review and included CSIs as single strategies (n=8) or as part of multi-strategy programmes (n=7) over 23 years. The majority of the interventions were rated as weak in quality (66 per cent) due to their study design, lack of control groups, lack of validated evaluation measures and small sample sizes. Just over half (53 per cent) of the CSIs reviewed described some measurement related to improved dietary behaviours.Research limitations/implicationsThere is inconclusive evidence that CSIs are effective in changing dietary behaviours in Australia. However, they are valued by policymakers and practitioners and used in public health nutrition programmes, particularly for indigenous groups.Originality/valueThis is the first time that CSIs have been reviewed in an Australian context and they provide evidence of the critical need to improve the quality CSIs to positively influence dietary behaviour change in Australia.

Cardiovascular disease and nutrition: The use of food-based dietary guidelines for prevention in Africa

There is no doubt that morbidity and mortality from cardiovascular disease (CVD) are increasing in many African countries. Research and implementation of public health nutrition programmes in the developed world have shown that CVD can be prevented by dietary interventions. The objectives of this paper are to (i) review the relationships between diet and CVD; (ii) review the possible contribution of the nutrition transition, which is associated with economic development and “modernisation” to CVD in Africa; (iii) identify barriers and challenges plus assessing the opportunities available to steer the nutrition transition into a more positive direction; and (iv) show how ideal nutrient intakes can be translated into appropriate food based dietary guidelines (FBDGs) and how to apply these for prevention and management of CVDs. This should result in appropriate recommendations for diets that will be country-specific, affordable, culturally acceptable and based on available, traditional and indigenous foods. It is concluded that all health professionals should be sensitised, informed, trained and/or educated to apply FBDGs in a way that will motivate the public or patients to follow healthier diets for primary, secondary and tertiary prevention and treatment of CVD.