Related Non-communicable Diseases Research Articles

Knowledge and Uptake of Community-Based Healthcare Financing in Management of Non-Communicable Diseases among Community Members in Anambra State, Nigeria

Background: Catastrophic health expenditure is one of the challenges people living with non-communicable disease face, especially in Nigeria. This has led to the emergence of community-based health insurance as a means to achieve universal health coverage and reduce out-of-pocket payments. However, lack of knowledge about the insurance scheme and how it helps to manage non-communicable diseases seems to affect utilization. Aim: The study assessed the knowledge and uptake of community based healthcare financing in the management of non-communicable diseases among community members in Anambra State. Materials and Methods: A descriptive cross-sectional survey design was adopted for the study, sample size was 444 and a multistage sampling technique was used. The instrument for data collection was a self structured questionnaire and data obtained were analyzed using Microsoft excel, descriptive statistics, inferential statistics for hypothesis testing and IBM statistical package for social Sciences (SPSS) version 29. Results: 64.1% had a good knowledge of community based healthcare financing; 51.4% managed their health condition through hospital visits under CBHI. There was a significant relationship between the level of education of respondents and their level of knowledge of community based health insurance (p-value 0.001 < 0.05). Conclusion: Majority had a good knowledge; those suffering pregnancy related non-communicable diseases used the insurance more although half of the respondents still pay through their pocket. The following recommendations were made: increase access to community-based healthcare financing information, encourage those in the informal sector to enroll and plan benefit packages to have wide illness coverage.

Assessing the impact of a personalised application-based nutrition intervention on carbohydrate intake in rural Benin

BackgroundThis study aims to assess the effect of a personalised nutrition intervention on nutrient intake in rural Benin as a tool to tackle the double burden of malnutrition. The personalised recommender system uses information from the eating behaviour of all household members combined to provide tailored advice on adjusting the consumption of up to three food items to tackle malnutrition and obesity in the household. Many developing countries nowadays experience the double burden of malnutrition, the coexistence of undernutrition alongside overweight and obesity, as well as other related non-communicable diseases. Personalised nutrition was very effective in European studies in improving nutrition and tackling obesity, which is why this study aims to translate personalised nutrition to a developing country context.ResultsA study was conducted in rural areas of Benin where 720 households were randomly selected. Due to high attrition, we used propensity score matching and looked into average treatment effects. We found that the recommendation to eat less carbohydrates resulted in a reduction in carbohydrate consumption with a significant effect for both the average treatment effect (ATE) of the whole population as well as the average treatment effect of the treated (ATET). We found that households that received the treatment to consume less food items with a high carbohydrate intake have followed this advice and have consumed on average lower levels of carbohydrates than their control counterparts.ConclusionsRising obesity is a worldwide problem that poses a severe challenge for policymakers. Especially in developing countries the change from too little, to too much is seamless. For the increasing obese population, the recommender system could be a useful tool. The idea of personalised nutrition has the potential to be one of the necessary steps in the ongoing battle against obesity and unhealthy diets. The personalised application-based recommender system used in this study has the ability to be a strong and effective tool for policymakers in the ongoing battle of food security vs. obesity in Benin and other countries. We propose that future research focuses more on personalised nutrition in the context of a developing country.

Determinants of Eating Habits and Body Mass Index in transition; A Comparative Cross-Sectional Study of Public and Private Schools of Lahore

Background Pakistan is facing a double burden of disease. Nutrition has an impact on nutritionally related non-communicable diseases. Malnutrition in adolescent age continues in adulthood so interventions in this stage can help us fight this emerging problem. Objective: To determine the nutritional status of school-going adolescents and their eating patterns and then compare them between public and private secondary schools of Lahore. Methods This analytical cross-sectional study was done on 372 school-going adolescents from 01.03.2023 to 20.06.2023 (3.5 months). A self-structured questionnaire was filled with interviews by convenience sampling. Weight and height were measured and BMI was plotted on WHO z charts to determine the nutritional status. Data were entered and analyzed by SPSS Version 21. The chi-square test was used to compare BMI and its determinants. Factors found significant were subjected to Binary logistic regression. P-value ≤ 0.05 was taken as significant. Results Out of the 372 school-going adolescent participants had a mean age of 14.86 years SD ± 1.75 (164 males and 208 females). 76(20.43%) were underweight, 201 (54.03%) had normal weight, 66(17.74%) were overweight and 29(7.8%) were obese. Public Schools had higher odds of undernutrition AOR 1.49 and lower odds of overweight and obesity AOR 0.38. Males had a reduced chance of undernutrition AOR 0.59 while the increased odds of overweight/ Obesity AOR 1.81. Age groups 11 to 15 years had reduced odds of undernutrition as compared to 16 to 19 years AOR 0.53 and increased odds of overweight/ obesity as compared to 16 to 19 years AOR 2 .00. Conclusion There is a significant difference in the nutritional status and eating habits of adolescents between public and private schools. Undernutrition is higher in public schools, among females and age 16 to 19 years. Nutritional interventions should be strengthened in school health services

POTENTIAL EFFECTS OF KETOGENIC DIETS, A NARRATIVE REVIEW

Background: Ketogenic diets have a long history of therapeutic use and have recently attracted significant attention due to their promising effects on a variety of disorders. However, no definitive links have been identified. This review aims to highlight the possible impacts of ketogenic diets as well as the mechanisms involved in metabolic processes and related non-communicable metabolic diseases. Methods: For our analysis, a bibliographic review of articles about ketogenic diets and their therapeutic effect on chronic pathologies was carried out, retrieved from the scientific literature. Results and discussion: These studies found both positive and negative outcomes for the effects and implications of ketogenic diets on metabolism. Significant differences in metabolic markers such as weight, glycemia, serum lipids and lipoproteins, anthropometric measures, and hormones such as insulin, leptin, and adiponectin have been reported. In addition to changes in the microbiome that have modest to moderate concurrent effects, changes in metabolism indicate the significance of dietary changes in treating and preventing chronic non-communicable diseases. Conclusions: In this review, we present the available scientific evidence on the effects of the ketogenic diet, and thus ketone bodies, on metabolism and related chronic diseases.

Developmentally programmed obesity: Is there a role for anti-inflammatory nutritional strategies?

Pregnancy represents a period of immense maternal physiological adaptation, with progressive increases in lipid storage potential and insulin resistance to support fetal/placental growth. This requires significant change in the adipose tissue. Women living with obesity/overweight are more susceptible to these changes causing complications such as gestational diabetes. This is particularly worrying as up to 60% of European women are living with overweight/obesity at the onset of pregnancy. Furthermore, less than 1% meet all nutrition guidelines. There is now evidence that these deep metabolic changes can result in a predisposition to metabolic disease in both the mother and child in later life. Health and nutrition status during this period therefore represents a window to future health. This period offers a valuable opportunity for intervention to prevent the negative consequences of poor in utero environments and increases the long-term quality of life for mother and offspring. This review will examine a range of in utero factors which determine adipose tissue development, the impact of these factors on later-life obesity and metabolic health and the therapeutic value of dietary anti-inflammatory nutritional interventions during pregnancy and early life. When it comes to early life nutrition, a 'one size fits all' approach is not always appropriate. Understanding the mechanisms of adipose tissue development in response to differing nutritional strategies may be important in the context of complicated or adverse in utero environments and represents a substantial step towards a more personalised nutritional approach for the prevention of obesity, metabolic syndrome and related non-communicable diseases in future generations.

Gender-specific determinants of overweight and obesity among older adults in India: evidence from a cross-sectional survey, 2017-18

BackgroundA major societal trend of the twenty-first century is the rapidly ageing population as a consequence of the decline in fertility and increase in life expectancy. Along with the rise in ageing population, the burden of obesity and related non-communicable diseases is also equally rising. In this study, we aimed to investigate the potential gender-specific determinants of overweight and obesity among older adults in India.Subjects and methodsThe present study used data from the Longitudinal Ageing Study in India (LASI) wave 1 (2017–18). A total sample of 25,952 older adults (≥ 60 years) was selected for the study. Descriptive statistics, bivariate chi-square test, and logistic regression estimation were applied to accomplish the study objectives. Body mass index (BMI) has been classified in this study according to the WHO criteria.ResultsThe prevalence of overweight was higher among women (18.15% in rural areas and 46.62% in urban areas) compared to men (12.9% in rural areas and 30.61% in urban areas). Similarly, obesity was higher among women than men who were residing in urban areas (17.07% vs. 5.37%), had secondary or above education (32.38% vs. 6.1%) belonged to richest strata (16.37% vs. 4.50%), or had mobility impairment (9.2% vs. 2.8%). Despite adjustment for several confounders, women were more likely to be overweight (OR: 2.18; CI: 1.86, 2.55) and obese (OR: 3.79; CI: 2.86, 5.03) than men. However, among both the elderly men and women, those who were highly educated were 2.29 times (OR: 2.29; CI: 1.80, 4.11) and 2.71 times (OR: 2.71; CI: 1.78, 4.11), respectively more likely to be overweight than their illiterate counterparts. Older adults living in urban areas were more likely to suffer from obesity compared to rural men (OR: 1.47; CI: 1.07, 2.02) and women (OR: 2.58; CI: 1.85, 3.60). Both men and women, who were highly educated were 2.64 times (OR: 2.64; CI: 1.71, 4.09) and 2.94 times (OR: 2.94; CI: 1.40, 6.20), respectively, more likely to be obese than their illiterate counterparts. Older men and women who were richest (OR: 1.60; CI: 1.19, 2.14 & OR: 2.12; CI: 1.63,2.76), or had mobility impairment (OR: 1.33; CI: 1.09,1.61 & OR: 1.72; CI: 1.42,2.08) were more likely to be overweight than their counterparts who were poorest or did not have any mobility limitation, respectively.ConclusionsThis study found increased vulnerability of overweight and obesity among older women than men irrespective of their socioeconomic, demographic, and health status. The present study suggests that introducing preventative measures such as campaigns to encourage physical activity, and community awareness may help reduce the high burden of overweight and obesity. Finally, the findings are important for better functioning of any public health programme and suitable intervention techniques to maintain a healthy body in order to lower the prevalence and risk factors of non-communicable diseases in later life.

Front-of-Pack Nutrition Labelling: are Health Policy Decisions Reconcilable with the WTO Disciplines?

Over the past decade, States have increasingly used various forms of front-of-pack nutrition labelling to prevent the proliferation of obesity and related non-communicable chronic diseases. Some forms of front-of-pack nutrition labelling highlight increased amounts of certain nutrients in foods and are mandatory for compliance. The growing popularity of such measures raises serious concerns amongst the Members of the World Trade Organization, since, to date, no position has been formed on the conformity of such labelling with the core disciplines of the WTO. This article attempts to reach that understanding and to suggest how national legislators may adjust their labelling initiatives so as to bring them in line with the WTO Agreement on Technical Barriers to Trade (TBT Agreement). Section 1 the paper analyses Art. 2.1 of the TBT Agreement (principle of non-discrimination) and concludes that the legislator should take into account all dietary options in order to avoid discriminati on against certain types of foods. Unpackaged goods should also be covered by regulatory interventions, since by nutritional composition they are similar to pre-packaged foods. Section 2 looks at Art. 2.2 of the TBT Agreement (principle of necessity) and summarises that the adopting Member has to be cautious when setting the goals of the labelling measure, since demonstration of its necessity would further require to separately establish what contribution to any of the stated objectives the measure makes. Moreover, the WTO Member must determine how labelling schemes discourage consumption of various nutrients. Otherwise, there may be a problem in demonstrating the expected regulatory results. The anticipated contribution of front-of-pack labelling could be enhanced by creating a supporting environment of regulatory interventions. Section 3 focuses on Arts. 2.4 and 2.5 of the TBT Agreement (harmonisation principle) and concludes that current international standards recognize the relevance and authority of regional studies, including those examining dietary patterns of locals. Nonetheless, this does not exempt the WTO Members from the need to provide a scientific justification for how the measure relates to the consumption of particular foods and nutrients.

Ultra-Processed Food vs. Fruit and Vegetable Consumption before and during the COVID-19 Pandemic among Greek and Swedish Students.

The COVID-19 pandemic has impacted children's lifestyles, including dietary behaviors. Of particular concern among these behaviors is the heightened prevalence of ultra-processed food (UPF) consumption, which has been linked to the development of obesity and related non-communicable diseases. The present study examines the changes in (1) UPF and (2) vegetable and/or fruit consumption among school-aged children in Greece and Sweden before and during the COVID-19 pandemic. The analyzed dataset consisted of main meal pictures (breakfast, lunch, and dinner) captured by 226 Greek students (94 before the pandemic and 132 during the pandemic) and 421 Swedish students (293 before and 128 during the pandemic), aged 9-18, who voluntarily reported their meals using a mobile application. The meal pictures were collected over four-month periods over two consecutive years; namely, between the 20th of August and the 20th of December in 2019 (before the COVID-19 outbreak) and the same period in 2020 (during the COVID-19 outbreak). The collected pictures were annotated manually by a trained nutritionist. A chi-square test was performed to evaluate the differences in proportions before versus during the pandemic. In total, 10,770 pictures were collected, including 6474 pictures from before the pandemic and 4296 pictures collected during the pandemic. Out of those, 86 pictures were excluded due to poor image quality, and 10,684 pictures were included in the final analyses (4267 pictures from Greece and 6417 pictures from Sweden). The proportion of UPF significantly decreased during vs. before the pandemic in both populations (50% vs. 46%, p = 0.010 in Greece, and 71% vs. 66%, p < 0.001 in Sweden), while the proportion of vegetables and/or fruits significantly increased in both cases (28% vs. 35%, p < 0.001 in Greece, and 38% vs. 42%, p = 0.019 in Sweden). There was a proportional increase in meal pictures containing UPF among boys in both countries. In Greece, both genders showed an increase in vegetables and/or fruits, whereas, in Sweden, the increase in fruit and/or vegetable consumption was solely observed among boys. The proportion of UPF in the Greek and Swedish students' main meals decreased during the COVID-19 pandemic vs. before the pandemic, while the proportion of main meals with vegetables and/or fruits increased.

Dietary intake and quality for young adolescents in sub‐Saharan Africa: Status and influencing factors

Adolescents face the risk of the triple burden of malnutrition-the co-existence of micronutrient deficiencies, underweight and overweight and obesityand related noncommunicable diseases. Poor-quality diets are a modifiable risk factor for all forms of malnutrition in adolescents. However, there is limited knowledge about diet quality for African adolescents. We analyzed data from 4609 school-going adolescents aged 10-15 years in Burkina Faso, Ethiopia, Sudanand Tanzania. Dietary intake was assessed using food frequency questionnaires, and diet quality computed using the Global Diet Quality Score (GDQS). Generalized estimating equations linear regression models were used to evaluate factors associated with adolescent diet quality. Mean adolescent age was 12.4 (±1.4) years and 54% of adolescents were female. Adolescents reported physical activity on 1.5 (±1.7) days/week. The mean GDQS (±SD) was 20.6 (±4.0) (maximum 40). Adolescent consumption of vegetables, fruit, nuts and seeds, eggs, fish and poultry was low, and refined grain consumption was relatively high. Boys consumed unhealthy foods less frequently but consumed fewer cruciferous vegetables and deep orange tubers. Older adolescents had higher fish and lower red meat consumption. Having an unemployed mother versus farmer (estimate -2.60, 95%confidence interval [CI]: -4.81, -0.39), and having 3-4 days of physical activity per week versus none (estimate 0.64, 95%CI: 0.11, 1.17) were associated with GDQS. We found evidence of poor-quality adolescent diets and gender and age differences in the consumption of healthy diets. Programs to address poor-quality diets should consider tailoring interventions for adolescent girls and boys of different ages and also consider the role of physical activity in these contexts.

Patient trust and positive attitudes maximize non-communicable diseases management in rural Tanzania.

The objectives of this study were to identify difficulties and their related contexts non-communicable disease (NCD) patients in rural Tanzania experienced, examine how patients managed the situation by seeking better treatment of the diseases, and propose a realistic approach for optimizing disease management with long-term perspectives in resource-limited settings, based on views of patients (PTs), health-care providers (HPs), and health volunteers (HVs). Nine focus group discussions were performed with 56 participants of PTs, HPs, and HVs in three district hospitals in the Dodoma region. Their views and self-care practices were extracted, and the verbatim data were analyzed to derive codes and categories. The types of NCDs reported by the PTs were hypertension (HT), diabetes mellitus (DM), and HT/DM comorbidity. Reported barriers to disease management included discontinuation of treatment due to various factors and a lack of positive messages regarding disease management in NCD care. The following points were addressed in relation to the improved management of NCDs: (i) positive attitudes and coping skills, (ii) support from family members, (iii) good communication between PTs and HPs, and (iv) trustworthy relationships with HVs. The findings suggest that to gain the trust of PTs in optimizing disease control in overstretched health-care systems, patient support systems should be strengthened by empowering positive attitudes.

WCN23-0776 BARRIERS TO ACCESSING ESSENTIAL MEDICINES IN NEPHROLOGY AND RELATED NON-COMMUNICABLE DISEASES: A SCOPING REVIEW

WCN23-0776 BARRIERS TO ACCESSING ESSENTIAL MEDICINES IN NEPHROLOGY AND RELATED NON-COMMUNICABLE DISEASES: A SCOPING REVIEW

Prevalence of non-communicable diseases and its association with tobacco smoking cessation intention among current smokers in Shanghai, China.

Smoking remains one of the biggest public health challenges worldwide, quitting tobacco smoking can lead to substantial health gains, even later in life. Previous studies indicate that illness can be a powerful motivation to quit and physicians' advice on smoking cessation has been shown to improve quit rates, but evidence on the role of non-communicable diseases in smoking cessation is limited. This cross-sectional study aims to evaluate the prevalence of non-communicable diseases and to explore its role in smoking cessation intention in smokers in Shanghai. From January to June 2021, 1104 current smokers were recruited in the Songjiang and Fengxian districts of Shanghai. We used an Android assisted electronic questionnaire for data collection, and implemented logistic regression for odds ratio (OR) and 95% confidence interval (CI) calculation to explore how smoking cessation intention would be influenced by non-communicable diseases comorbidity among smokers. The 1104 current smokers included 914 males (82.8%), with an average age of 43.6 years. Approximately 22% of smokers had at least 1 type of non-communicable disease, with 17.8% for non-respiratory system related non-communicable diseases and 6.6% for respiratory system related non-communicable diseases. The prevalence of non-communicable diseases comorbidity ranged from 0.5% to 13.9%, and was higher in male smokers; 41.8% of current smokers had intention to quit smoking in a recent year, and the percentage of smoking cessation intention was higher in smokers with non-communicable diseases. Logistic regression indicated that smokers with non-communicable diseases had 1.3 (95% CI: 1.0-1.8) times higher smoking cessation intention than those without non-communicable disease. The findings were consistent in respiratory system related and non-respiratory system related non-communicable diseases. The prevalence of non-communicable diseases was high among current smokers in Shanghai, and their smoking cessation intention was associated with non-communicable diseases comorbidity. Physicians should treat illness as a powerful motivation and provide professional cessation service to tobacco users to reverse the severe tobacco epidemic.

Nutritional and non-nutritional dietary factors affecting obesity and chronic related disorders

Abstract There is convincing evidence that diet quality represents one of the most important public health targets to prevent non-communicable diseases. Dietary risks alone have been estimated to be responsible for about 10 million deaths due to cardiovascular diseases, metabolic disorders, and certain cancers worldwide, with trends not expected to decrease. Results from meta-reviews and expert assessments are quite in line with robust key messages to deliver to the general public. From a nutritional point of view, lack of fibre, vitamins and antioxidants, and unsaturated fatty acids together with high content in free added sugars, sodium, and saturated/trans fats represent key features for unhealthy dietary patterns and are responsible for most diet-related non-communicable diseases. While the role of animal-derived foods is still controversial due to the registered excess consumption and the environmental impact, a general low intake of plant-derived foods remains a major detrimental factor for health. The concept of diet quality should thus overcome the over simplistic calorie-count when coming to prevent obesity and related non-communicable diseases, while an adequate communication on this matter to the public is highly warrant. Together with these general dietary recommendations relying on nutritional aspects affecting human health, emerging evidence is now also exploring the role of non-nutritional dietary factors. The level of processing, the alteration of the food matrix, the presence of additives (such as flavor enhancers, colorants, emulsifiers, artificial sweeteners, thickeners, foaming/anti-foaming agents, and preservatives) have been demonstrated to play a role in metabolic health and inflammatory-related disorders. These aspects are currently under investigation, but they might represent an underrated concern for public health due to the food market drive and a perfect fit into the obesogenic modern society.

Food Production as a challenge for One Health Approach and Public Health

Abstract A sustainable food production is essential for human sustainability. According to available data, the world's diets and food habits must evolve and change intensely. Nowadays, more than 800 million people suffer from deficient food. On the other hand, more consumers have an unhealthy diet contributing to premature death, obesity, food related non-communicable diseases. Diets must provide an appropriate calorie intake, different of plant-based food, low amounts of animal-based food, unsaturated fats, vitamins and minerals (rather than saturated, refined grains, highly processed foods, and added sugars). It is needed adjustment to various agro-systems, cultural traditions, and individual dietary preferences. However, production must also be sustainably adjusted to meet the global population's growing food demands, as well as using the doughnut economy principle. A sustainable food production requires a One Health approach, and also evolving towards a decarbonized agricultural production by eliminating the use of fossil fuels and land use change losses of CO2 in agriculture. Policies to encourage people to choose healthy diets are needed. Those should include the improvement of the availability and accessibility to healthy food through improved logistics and storage, increased food security, policies that promote buying from sustainable sources, as well as reducing food waste. The mindset change regarding to the agro-system, food production and food usage in a healthy way at individual level, community level, national level and global level are essential for sustainable human population. Healthy eating should be the highest priority of food consumers, as well as its mindset shift from ‘live to eat’ to ‘eat to live’. Consumers should feel safe and healthy, but also think about future generations, respecting agriculture and food production. Sustainable, equitable, healthier, and more inclusive food systems have the power to catalyze the achievement of all 17 SDGs by 2030.

Cleome gynandra: A wonder climate-smart plant for nutritional security for millions in semi-arid areas.

Spider plant (Cleome gynandra) is predominantly used as a traditional leafy vegetable throughout Africa and is considered a rich natural source of essential nutrients such as vitamins, minerals and proteins. With the increase in malnutrition, diet related non-communicable diseases and poverty across the continent of Africa, the spider plant is a bona fide alternative healthy food crop to alleviate these challenges. Spider plant is an erect annual herb that could grow up to 150 cm tall, strongly branched, with a long taproot and few secondary roots. It is commonly consumed in resource-poor communities especially during times of major food scarcity. It is a drought-tolerant and resilient annual vegetable crop capable of growing well in a wide range of climatic and edaphic conditions. Despite the potential benefits and wide adaptability, progressive attempts towards the development of C. gynandra as a crop have been impeded by issues like low investment in research and development resulting in poor seed quality, relatively low yields and susceptibility to pests and diseases. In this paper, we reviewed the research that has been done regarding its morphology, growing conditions, production and utilisation (i.e., nutrition). The current review highlighted the status of the science in advancing the domestication of C. gynandra as a potential power crop for several African countries. The review concluded that with the advancement of modern biotechnology techniques and genome sequencing, there is a compelling case for investment and development in C. gynandra as a candidate for managing micronutrient deficiencies during the post-pandemic era. Finally, the existing knowledge gaps (e.g., breeding) that necessitate explorations were identified and recommendations that could enhance its development and potential commercialisation were made.

A Mixed-Methods Participatory Intervention Design Process to Develop Intervention Options in Immediate Food and Built Environments to Support Healthy Eating and Active Living among Children and Adolescents in Cameroon and South Africa.

Rates of obesity and related non-communicable diseases are on the rise in sub-Saharan Africa, associated with sub-optimal diet and physical inactivity. Implementing evidence-based interventions targeting determinants of unhealthy eating and physical inactivity in children and adolescents’ immediate environments is critical to the fight against obesity and related non-communicable diseases. Setting priorities requires a wide range of stakeholders, methods, and context-specific data. This paper reports on a novel participatory study design to identify and address contextual drivers of unhealthy eating and physical inactivity of children and adolescents in school and in their home neighborhood food and built environments. We developed a three-phase mixed-method study in Cameroon (Yaoundé) and South Africa (Johannesburg and Cape Town) from 2020–2021. Phase one focused on identifying contextual drivers of unhealthy eating and physical inactivity in children and adolescents in each setting using secondary analysis of qualitative data. Phase two matched identified drivers to evidence-based interventions. In phase three, we worked with stakeholders using the Delphi technique to prioritize interventions based on perceived importance and feasibility. This study design provides a rigorous method to identify and prioritize interventions that are tailored to local contexts, incorporating expertise of diverse local stakeholders.

Nutrition and health-related information disclosure on pre-packaged food products from local retail shops in Accra

The prevalence of obesity and diet related non-communicable diseases (NCDs) are rapidly increasing in Africa. Consumption of pre-packaged foods is one of the main drivers of these NCDs. Pre-packaged foods tend to contain high levels of energy, fat, sugar, and salt, which are known risk factors for NCDs. Food labels can guide consumers to make informed healthy food choices. Therefore, it is important to analyze how health-related information is communicated on food labels. In Ghana, there is paucity of evidence on what health-related information is available to consumers of pre-packaged foods. This study describes health-related information on labelled pre-packaged foods sold in local retail shops in Accra. A cross-sectional survey and quantitative content analysis of food label information were employed in this study. Pre-packaged food labels photograph data were sourced from shops and content analyzed to describe their health-related information. Nutrition and health-related information were classified using the International Network for Food and Obesity/Non-Communicable Diseases Research, Monitoring and Action Support (INFORMAS) system. Three hundred and fifty-one (N=351) pre-packaged foods and non-alcoholic beverages were sampled, out of which 2.3% products were unlabelled. Out of 343 labelled products, 92% disclosed ingredient list information and 68.8% had nutrition declaration. Between the two nutrition labelling formats: Back-of-Pack (BOP) and Front of Pack (FOP), BOP was the dominant (87.3%) format. Various types of FOPs were identified however, Guidelines Daily Allowance (GDA) was the most common format. The study found that 18% of labelled pre-packaged foods carried nutrition claim and about 7% had a health claim. Most of the claims were written and the others were a combination of words, numbers, and pictures/symbols. This study has shown a high disclosure of health-related label information on pre-packaged food but information presentations on labels were not consistent. The insight gained from this study shows that the presentation of health-related label information does not meet the current recommendations of Codex and the benchmarks set out by INFORMAS in promoting a healthy food environment. Key words: Pre-packaged Foods, Food/Nutrition labels, health-related information, retail shops, Accra

Consumption of Sugar-Sweetened Beverages and Its Potential Health Implications in Indonesia

The broad availability of sugar-sweetened beverages (SSBs) in the Indonesian market, increasing trend of their consumption, combined with escalating incidence and prevalence of diabetes and related noncommunicable diseases (NCDs), and the ongoing debate on policies, have called for a comprehensive review as described in this study. Data was compiled from various sources but mainly gathered from the reported or published documents because of no direct access to the necessary data set. The lack of studies that assessed the direct relationship between SSB consumption and health outcomes in the Indonesian context also became a strong reason for the preparation of this review to highlight important points for further research, academic reviews, and debates on empiric policies to control sugar consumption at the population level. Sociocultural factors were an apparent and crucial determinant of the sweetness preferences of mainstream Indonesians. They were not capitalized in the available documents and should be embraced in future health promotional measures. Given the high contribution of carbohydrates and sugar to total energy intake in the Indonesian diet, it is pertinent to control the increasing trend of SSBs consumption through interventions on both the supply and demand sides.

Bioaccessibility of Anthocyanins on in vitro Digestion Models: Factors Implicated and Role in Functional Foods Development.

Worldwide, the prevalence of obesity and related non-communicable chronic diseases is high and continues to grow. In that sense, anthocyanins (ANC) have shown beneficial health effects in preventing obesity and metabolic risk factors. Moreover, the demand for functional foods incorporating these compounds has risen significantly in the past years. Thus, there is a need for validations of the functional properties of these formulations; nevertheless, in vivo assays are complex and require a lot of resources. One approach for estimating bioactive compounds&#039; functionality and health benefits is to evaluate their bioaccessibility on a specific food matrix, determined by various factors. This article aims to review different factors influencing the bioaccessibility of ANC evaluated on in vitro digestion models as a functionality parameter, elucidating the effect of chemical composition, raw materials, food matrices, and vehicles for the delivery of ANC. Study searches were performed using PubMed, Web of Science, Scopus, and Science Direct databases. Different factors influenced bioaccessibility and stability of ANC studied by in vitro digestion: i) the raw material used for ANC obtention; ii) food processing; iii) other food components; iv) the extraction method and solvents used; v) the structure of ANC; vi) delivery system (e.g., microencapsulation); vii) pH of the medium; viii) the digestion stage. Simulated digestion systems allow to determine free or encapsulated ANC bioaccessibility in different food matrices, which offers advantages in determining the potential functionality of a food product.

The nutrition transition, food retail transformations, and policy responses to overnutrition in the East Asia region: A descriptive review.

The East Asia region is facing an increasing burden of overweight, obesity and related noncommunicable diseases, resulting from an ongoing nutrition transition. This study aimed to document the growing burden of overweight and obesity, and the accompanying dietary shifts, in the East Asia region and describe the policy responses to this. We present noncommunicable disease risk factor collaboration data on trends in the burden of malnutrition, and Euromonitor International data on trends in dietary purchases, in the East Asia region. We searched the NOURISHING and GINA databases to identify food and nutrition policies implemented in these countries. There is an ongoing nutrition transition in the East Asia region, notably in upper-middle and lower-middle income countries. The prevalence of overweight, obesity, and accompanying health conditions, purchases of ultra-processed foods and beverages, and purchasing from supermarkets, fast-food and takeaway outlets, and other convenience retailers, are increasing. The policy response to this nutrition transition is limited, with the majority of policies implemented in higher-income countries. East Asian countries are facing a growing burden of malnutrition, due in part to the dietary shifts occurring here. An ecological approach to policy intervention is needed to drive transformative food systems change.