Unhealthy Food Research Articles

The relationship between youth's exposure to unhealthy digital food marketing and their dietary intake in Canada.

There is limited evidence on how exposure to digital marketing of unhealthy foods affects youth's dietary behaviours. This study therefore aimed to examine the association between youth's self-reported digital food marketing exposure and dietary intakes, and explore predictors of frequent unhealthy food consumption. A survey was conducted among 1075 youth in Canada (aged 10-17 years) in April 2023. Proportional odds models examined associations between frequency of exposure to digital marketing of unhealthy foods and frequency of consumption of those foods, adjusted for sociodemographic characteristics and digital device usage. Compared with participants reporting no exposure to digital fast-food marketing in the past week, those exposed ≥4 times per week were more likely to consume fast food more frequently. Youth exposed to digital marketing of sugary drinks and salty/savoury snacks ≥1 time(s) in the previous week were more likely to consume these foods on a greater number of days, compared with those reporting no exposure to this marketing in the past week. Reporting exposure to digital marketing of desserts/sweet treats every day or more than once a day was associated with more frequent consumption of desserts/sweet treats. Province of residence (Ontario/Quebec) and total daily time spent online predicted more frequent consumption of fast-food, sugary drinks, salty/savoury snacks and desserts/sweet treats. Overall, more frequent self-reported exposure to digital marketing of unhealthy foods is associated with more frequent consumption of these foods by Canadian youth. Regulations are needed to help protect youth from digital food marketing, which may help reduce their unhealthy food consumption.

Classic Dietiology or Holistic Nutritional Approach: What Type of Nutrition are We Working Towards?

In order to describe the negative aspects produced by the industrialized production of food that we present in this article, I have coined a definition that summarizes all the negative contents of the current diet: "PESTIFOOD", which is the portmanteau of the words PESTICIDE and FOOD. After a brief premise on the importance that healthy food has for the survival of living things, I critically describe the intensive production of food and the negative impact it has had on the emergence of numerous metabolic pathologies. So that due to the lack of nutritional value of the foods that industrial production provides us, we must record the growing development of new pathologies linked mainly to junk food and Pestifood. In the current state of degradation of food resources, not even the adoption of fortified foods or supplements can solve the root problem, represented by the use of chemical substances to improve production and extend the expiry date of foods. The only solution to the food problem for the future will be that of eco-sustainable choices, to recover the value of food as "our true medicine" - Hippocrates.

Leisure Screen Time and Food Consumption among Brazilian Adults.

Screen time, involving activities like watching television (TV), and using tablets, mobile phones, and computers (electronic devices), is associated with the consumption of unhealthy foods. This study aimed to analyze the association between prolonged leisure screen time and healthy and unhealthy food consumption indicators among Brazilian adults (≥18 years). Data from the National Health Survey (NHS), conducted in 2019 (n = 88,531), were used. Prolonged leisure screen time (screen time ≥ 3 h/day) was analyzed in three dimensions: watching TV; use of electronic devices; and total screen time (TV and electronic devices). Food consumption was analyzed in two dimensions: healthy (in natura and minimally processed foods) and unhealthy (ultra-processed foods). Poisson regression models were used to calculate prevalence ratios (crude and adjusted (PRa)) by sociodemographic factors (sex, age, schooling, income, area of residence, and race/color) and health factors (weight status, self-rated health, and presence of noncommunicable disease), to assess the association between prolonged screen time and food consumption indicators. Among Brazilian adults, the prevalence of prolonged screen time was 21.8% for TV and 22.2% for other electronic devices for leisure. The highest frequency of watching TV for a prolonged time was observed among women, older adults, and those with a lower income and schooling. Prolonged use of electronic devices was more common among young adults and those with intermediate schooling and income. Prolonged screen time was associated with an unhealthy diet, due both to the higher consumption of unhealthy foods (PRa = 1.35 for TV, PRa = 1.21 for electronic devices, and PRa = 1.32 for both types) and the lower consumption of healthy foods (PRa = 0.88 for TV, PRa = 0.86 for electronic devices, and PRa = 0.86 for both). Prolonged screen time was negatively associated with the consumption of healthy foods and favored the consumption of unhealthy foods among Brazilian adults.

Healthiness of food products promoted through placement strategies in Australian online supermarkets: a cross-sectional study

BackgroundProminent product placement is a core promotional tactic in retail food environments. How this practice has been adapted for online supermarkets, and the extent to which it is applied to healthier and less healthy food products in this setting, is largely unknown. We aimed to investigate placement-type promotions of food products in Australian online supermarkets.MethodsWe developed a new method to assess placement promotions and applied it to the online stores of the two largest supermarket retailers in Australia. Each online store was audited across six ‘locations’ (input prior to data collection), including a randomly selected high socio-economic position area and low socio-economic position area from each of the three largest Australian cities. The names, page locations and type of placement strategy of promoted food products were captured, with product healthiness assessed using the Health Star Rating (HSR) nutrient profiling system. Descriptive statistics summarised the page locations of promoted products and the placement strategies used to promote them, and chi-squared tests applied to compare product healthiness by retailer and socio-economic position.ResultsWe recorded 12,152 food products promoted through placement strategies, 99% of which were eligible for a HSR. Overall, 44% of products promoted through placement strategies were unhealthy. Cross-promotions and recommendations was the most common strategy recorded overall (55.9% of all strategies), and advertisements and site content was the strategy most likely to promote unhealthy products (53.7% of products unhealthy). One retailer was more likely to promote unhealthy products (46% v 43%, p = 0.004) and unhealthy products were more likely to be promoted in more disadvantaged than less disadvantaged locations (45% vs 43%, p = 0.05), though the magnitudes of difference were small.ConclusionsA considerable number of unhealthy products are likely presented to online grocery shoppers in Australia. Public health policies targeting unhealthy food promotions may need to be updated, including with consideration of the different ways that products can be prominently displayed online, to avoid exacerbating risks of diet-related disease and health inequalities. Our novel methodology could be used for ongoing monitoring of online supermarkets in Australia and elsewhere to inform such policies.

Behavioral, Clinical, and Coronary Artery Calcium Screening for Prevention and Treatment of Subclinical Atherosclerosis: Implications for Health Education

ABSTRACT Background In the USA, heart disease is the leading cause of death for women and men. Coronary artery disease (CAD) is the most common type of heart disease. Purpose To investigate the association between behavioral and non-behavioral risk factors associated with subclinical atherosclerosis. Methods Patients referred for a CT angiography completed a demographic/behavioral questionnaire and medical history interview for CAD risk factors. Risk factor data were correlated with CAD subclinical atherosclerosis scores for 521 participants. Results Frequency among four levels of CAD revealed: no disease 38%, mild atherosclerotic 20%, moderate atherosclerotic 30%, and severe atherosclerosis 12%. Significant (p ≤ .05) demographic variables were as follows: age, race, marital status, and employment status. Significant predictive behavioral variables were as follows: tobacco use, daily water intake, sodium consumption, exercise days per week, and junk food consumption. Risk factors significantly associated with subclinical CAD included hypertension, diabetes, sleep apnea, and abnormal coronary calcium score. Discussion Multi-slice CT angiography allows early reliable evaluation of subclinical atherosclerosis and correlation with behavioral/non-behavioral risk factors with level of CAD, instrumental to primary and secondary CAD prevention, limiting tertiary CAD treatment. Translation to Health Education Practice Study results have implications for Health Educators with regard to intervention research planning, implementation, and evaluation.

Taste or health: The impact of packaging cues on consumer decision-making in healthy foods

According to the theory of dietary regulation, consumers frequently encounter conflicts between healthiness and tastiness when selecting healthy foods. This study explores how packaging cue that highlight “tasty” versus “healthy” affect consumers’ intentions to purchase healthy food. After an Implicit Association Test (IAT) confirmed a perceived lack of tastiness in health foods in the Preliminary study, Study 1 analyzed pricing and packaging details of the top 200 most-popular items in each of the ten healthy food categories on a major online shopping platform. Results showed that products with taste-focused cues commanded higher prices, indicating stronger consumer acceptance of healthy foods marketed as delicious. To address the causality limitations of observational studies, Study 2 used an experimental design to directly measure the impact of these cues on purchase intentions and perceptions of energy, healthiness, and tastiness. Findings revealed that taste-focused cues significantly boosted purchase intentions compared to health-focused cues, although they also diminished the perceived healthiness of the products. Moreover, in the control group exposed to unhealthy food options, health-emphasized packaging also increased purchase intentions, indicating that consumers seek a balance between healthiness and tastiness, rather than prioritizing health alone. Study 3 further explored the impact of cognitive load over these cue influences, revealing a heightened inclination among consumers to purchase healthy products with taste-focused cue under high cognitive load state. These insights have direct implications for food packaging design, suggesting that emphasizing a balance of taste and health benefits can effectively enhance consumer engagement. The study, which conducted in China, also opens avenues for future research to explore similar effects, maybe in different cultural contexts, different consumer groups, and under varied cognitive conditions.

The Relationship Between Junk Food with the Incidence of Early Menarche Among Female Students Aged 9 – 12 Years Old at Al-Iman Private Elemantary School South Tangerang City

Background : Early menarche is tihe first menstruation experienced by fertile woman under the age of 12 years. The condition of early menarche is because it gets more production of the hormone estrogen than other woman in general. One of the factors in occurrence of early menarche is caused by nutritional status as junk food as a food that is high in calories and fat but low in dietary fiber and if excessive consumption will stimulate the acceleration of reproductive organ maturity. Objective : To determine the relationship between junk food consumption with the incidence of early menarche among female students agen 9-12 years old at Al-Iman Private Elemantary School. Methods : This research is oobservational analytic with a cross sectional approach. The number of samples was 30 with the Quota Sampling technique. The instrument used was a questionnaire. Data were analyzed using the chi square test. Result : This study shows that there is a relationship between junk food consumption with the incidence of early menarche with the result of chi suare test with the alternative Fisher`s Exact Test obtained a value of p = 0,007 which means p < α = 0,05 and 95% CI 2,167 – 128,176. Conclusion : There is a relationship between junk food consumption with the incidence of early menarche among female students at Al-Iman Private Elemantary School. Suggestion: For further researchers to examine other variable that have not been studied with larger sample.

Plant-based diet indices and their interaction with ambient air pollution on the ovarian cancer survival: A prospective cohort study

BackgroundAmbient air pollution might serve as a prognostic factor for ovarian cancer (OC) survival, yet the relationships between plant-based diet indices (PDIs) and OC survival remain unclear. We aimed to investigate the associations of comprehensive air pollution and PDIs with OC survival and explored the effects of air pollution-diet interactions. MethodsThe present study encompassed 658 patients diagnosed with OC. The overall plant-based diet index (PDI), the healthful PDI (hPDI), and the unhealthful PDI (uPDI) were evaluated by a self-reported validated food frequency questionnaire. In addition, an air pollution score (APS) was formulated by summing the concentrations of particulate matter with a diameter of 2.5 microns or less, ozone, and nitrogen dioxide. Cox proportional hazard models were applied to calculate hazard ratios (HRs) and 95 % confidence intervals (CIs). The potential interactions of APS with PDIs in relation to overall survival (OS) were assessed on both multiplicative and additive scales. ResultsThroughout a median follow-up of 37.60 (interquartile: 24.77–50.70) months, 123 deaths were confirmed. Comparing to the lowest tertiles, highest uPDI was associated with lower OS of OC (HR = 2.06, 95 % CI = 1.30, 3.28; P-trend < 0.01), whereas no significant associations were found between either overall PDI or hPDI and OC survival. Higher APS (HR for per interquartile range = 1.27, 95 % CI = 1.01, 1.60) was significantly associated with worse OC survival, and the association was exacerbated by adherence to uPDI. Notably, an additive interaction was identified between combined air pollution and uPDI (P < 0.005 for high APS and high uPDI). We also found that adherence to overall PDI aggravated associations of air pollution with OC survival (P-interaction = 0.006). ConclusionsJoint exposure to various ambient air pollutants was significantly associated with lower survival among patients with OC, particularly for those who predominantly consumed unhealthy plant-based foods.

Implicit attitudes toward obesity-related cues and their relation to body mass index, psychosocial functioning, and health behavior.

Differences in automatic cognitive processes exist among individuals with overweight and obesity, thus there is a need to expand our conceptualization of overweight and obesity to emphasize the predictive utility of these automatic processes, rather than focusing solely on behavioral outputs. Implicit association tests (IATs) may afford a noninvasive method of examining automatic preferences that might contribute to overweight and obesity; namely, preferences for unhealthy foods and sedentary behavior versus healthy foods and physical activity. The purpose of the current study was to examine whether implicit attitudes toward foods and physical activity differed based on body mass index (BMI) status. The relationships between implicit attitudes and key psychosocial factors and health behaviors were also examined. Participants (N = 127) included undergraduate students with an average age of 19.05 years old (SD = 1.52). Average BMI of the sample was 24.20 (SD = 4.93); 33.8% met criteria for overweight or obesity. Participants completed an IAT and questionnaires. There were no differences in implicit preferences based on BMI or BMI status. Overall, the sample demonstrated implicit preferences for healthy foods and active words, and preferences were not linked to the corresponding behavioral outputs, though preferences were linked to various indices of emotion and emotion regulation. Future research should explore an extended model to examine how implicit preferences might impact intentions to engage in protective versus risky obesity-related health behaviors, and the various psychosocial factors that might impact the translation of those preferences and intentions in actual behavioral outputs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Adolescents' unhealthy snacking behaviour during the school journey and the association with transport modes and food outlets along the school route.

Active transport to and from school provides an opportunity for adolescents to engage in physical activity, but travelling through an obesogenic environment may have unintended consequences on their snacking behaviour. This study aimed to: (1) identify whether adolescents' unhealthy snacking behaviour was associated with school transport modes and food outlets on their estimated school route and (2) explore whether food outlet density on the school route differed between school transport modes. Adolescents (n = 406; aged 15.1 ± 1.4 years; 50.7% boys; 63.5% New Zealand European) from all 12 secondary schools in Dunedin city, Aotearoa New Zealand, completed an online survey. School transport modes (active, motorised or mixed) and unhealthy snacking data were collected. Food outlet data were collected using Google Places Application Programming Interface (API). Home-to-school route and distance were estimated using geographical information system (GIS) analysis based on a walkable road network. Data were analysed using the chi-square test and logistic regression. Overall, 26.4% of adolescents reported purchasing and consuming unhealthy snacks or soft drinks on the way to school and 41.4% from school. The odds of unhealthy snacking during the school journey was higher among mixed transport users than active transport users on the way to (odds ratio (OR) = 2.73, 95% confidence interval (CI) = 1.39-5.36) and from school (OR = 2.68, 95% CI = 1.40-5.13). No differences were observed by food outlet type. There were no food outlets on the estimated school route for 44.8% of adolescents. The presence of more than one food outlet per kilometre of the estimated school route differed between active (38.7%), motorised (42.6%) and mixed transport users (46.4%; p = 0.006). School transport modes were significantly associated with adolescents' unhealthy snacking behaviour and food outlets on their school journey. Policy measures which minimise exposure to unhealthy food outlets may reduce unhealthy snacking among adolescents.

Pendidikan Gizi di UPT SDN 060831 Medan dan Pengaruhnya terhadap Perubahan Pengetahuan, Perilaku, dan Sikap

School-aged children who engage in improper eating behaviors may face serious nutritional problems. During this crucial growth stage, meeting their nutritional needs must be closely monitored. A lack of knowledge about nutritional education can lead children to choose unhealthy foods. Healthy foods are those that contain balanced nutrition. The influx of fast food into Indonesia's food sector can also influence the eating habits of the population. To prevent future nutritional issues, it is important to provide nutritional education to elementary school children to enhance their knowledge, attitudes, and practices in choosing healthy foods and snacks. The food menu for school-aged children should contain balanced nutrition to meet the body's needs. This study aims to examine the impact of nutritional education on the knowledge of fifth-grade students at UPT SDN 060831 Medan regarding the consumption of healthy and nutritious foods. The study involved 64 respondents divided into two groups: those who received nutritional education and those who did not. The respondents were fifth-grade students aged 10–13 years. Data were collected through questionnaires. A pre-test was initially conducted on both groups. Then, the education group received four sessions of nutritional education. Two months later, final data were obtained through a post-test. The results of the study indicated that providing nutritional education had an impact on the knowledge, attitudes, and food consumption behaviors of fifth-grade students at UPT SDN 060831 Medan.

Evaluation on PCOS in Hypothyroidism among Young Females in the Age Group of 18-25 Years: A Study from Tamilnadu, India

A multifactorial ailment, polycystic ovary syndrome, is typified by persistent anovulation along with indications of excess androgen without the presence of other particular diseases of the pituitary, thyroid, or adrenal glands that might cause comparable symptoms. Because polycystic ovarian syndrome is frequently accompanied by obesity, elevated insulin resistance and increased metabolic and cardiovascular risk factors are commonly linked to the condition. In Kulasekharam, Tamil Nadu, India, at the Sree Ramakrishna Medical College of Naturopathy and Yogic Sciences and Hospital, the study was conducted. Women who are between the ages of 18 and 25 are taking part in the research. After outlining the purpose of the study, verbal consent was obtained. This survey received 30 responses. There are thirty questions in the survey. The following subjects were included in the questionnaire's parameters: food, menstruation disorders, anxiety, hair care, and digestive problems. The study excluded female subjects who were unwilling or uncooperative. Most women are affected by polycystic ovarian syndrome. Their food is not well- balanced and healthy. Women also need to be better informed on the importance of maintaining good hygiene, eating a balanced diet, drinking enough water, and the dangers of junk food. They also need to learn more about gut dysbiosis and how to prevent exposure to environmental pollutants. Future medical treatments should concentrate on these areas in order to improve young women's general health and wellness.

Pangan fungsional dari bahan pangan tradisional: tinjauan pustaka

With the development of the times, most people often consume fast food or what is commonly referred to as junk food. The long-term effect causes many people to experience degenerative diseases like heart disease, diabetes, hypertension, cancer, and osteoporosis. Therefore, there is a need for solutions so that people can maintain a lifestyle to support their health. The solution is in the form of functional food derived from traditional ingredients, such as tempeh, tape, and also several types of spices. Functional foods are food ingredients that can provide many additional benefits to the body, apart from the basic nutritional functions of these foods. For example, such as consuming antioxidants derived from phytochemical compounds contained in some of these traditional ingredients. Phytochemical compounds that can act as antioxidants are used to counteract free radicals that occur in the body. These antioxidants can be obtained from tempeh, tape, and several spices. The spices include ginger, kencur, turmeric, temulawak, galangal, and cinnamon. Processed functional food products from several spices are used as health drinks, herbs, teas, juices, syrups, and sweets. Functional food from traditional ingredients has the potential to be developed. This is due to the sufficient production of raw materials and the community's need for functional food from these traditional ingredients. Regulations regarding functional food from traditional ingredients are considered insufficient, even though the government has made regulations regarding foods that have special nutrition. The aim of this study is to elaborate several traditional food ingredients and its function to help in maintaining the health in the body. As a results, this paper presents some research data that has been done previously related to some of the advantages of traditional food ingredients

Managing Type 2 Diabetes During the COVID-19 Pandemic: Scoping Review and Qualitative Study Using Systematic Literature Review and Reddit.

The COVID-19 pandemic impacted how people accessed health services and likely how they managed chronic conditions such as type 2 diabetes (T2D). Social media forums present a source of qualitative data to understand how adaptation might have occurred from the perspective of the patient. Our objective is to understand how the care-seeking behaviors and attitudes of people living with T2D were impacted during the early part of the pandemic by conducting a scoping literature review. A secondary objective is to compare the findings of the scoping review to those presented on a popular social media platform Reddit. A scoping review was conducted in 2021. Inclusion criteria were population with T2D, studies are patient-centered, and study objectives are centered around health behaviors, disease management, or mental health outcomes during the COVID-19 pandemic. Exclusion criteria were populations with other noncommunicable diseases, examining COVID-19 as a comorbidity to T2D, clinical treatments for COVID-19 among people living with T2D, genetic expressions of COVID-19 among people living with T2D, gray literature, or studies not published in English. Bias was mitigated by reviewing uncertainties with other authors. Data extracted from the studies were classified into thematic categories. These categories reflect the findings of this study as per our objective. Data from the Reddit forums related to T2D from March 2020 to early March 2021 were downloaded, and support vector machines were used to classify if a post was published in the context of the pandemic. Latent Dirichlet allocation topic modeling was performed to gather topics of discussion specific to the COVID-19 pandemic. A total of 26 studies conducted between February and September 2020, consisting of 13,673 participants, were included in this scoping literature review. The studies were qualitative and relied mostly on qualitative data from surveys or questionnaires. Themes found from the literature review were "poorer glycemic control," "increased consumption of unhealthy foods," "decreased physical activity," "inability to access medical appointments," and "increased stress and anxiety." Findings from latent Dirichlet allocation topic modeling of Reddit forums were "Coping With Poor Mental Health," "Accessing Doctor & Medications and Controlling Blood Glucose," "Changing Food Habits During Pandemic," "Impact of Stress on Blood Glucose Levels," "Changing Status of Employment & Insurance," and "Risk of COVID Complications." Topics of discussion gauged from the Reddit forums provide a holistic perspective of the impact of the pandemic on people living with T2D, which were found to be comparable to the findings of the literature review. The study was limited by only having 1 reviewer for the literature review, but biases were mitigated by consulting authors when there were uncertainties. Qualitative analysis of Reddit forms can supplement traditional qualitative studies of the behaviors of people living with T2D.

Associations between Global Diet Quality Score and Risk of Metabolic Syndrome and Its Components: Tehran Lipid and Glucose Study.

Various food quality indicators have been proposed as tools for predicting metabolic syndrome (MetS). This study investigated the association between global diet quality score (GDQS) and the risks of developing MetS and its components. In this secondary analysis, we included elective adult participants (n=4,548) from the Tehran Lipid and Glucose Study. Dietary data were collected by a valid and reliable semi-quantitative food frequency questionnaire. MetS was defined according to the Iranian modified National Cholesterol Education Program. Multivariable Cox proportional hazard regression models were used to estimate the incidence of MetS in association with GDQS. This study involved 1,762 men and 2,786 women with a mean±standard deviation age of 38.6±14.3 and 35.9±11.8 years, respectively. A total of 1,279 subjects developed MetS during the mean follow-up of 6.23 years. Incidence of MetS was associated with GDQS (hazard ratio [HR], 1; 0.90 [95% confidence interval, CI, 0.82 to 0.98]; 0.84 [95% CI, 0.76 to 0.91]; 0.80 [95% CI, 0.73 to 0.89]; P for trend <0.001) after adjusting for confounding variables. The healthy food group component of GDQS was related to MetS incidence. GDQS in the range of 12%-17% in the fourth quartile was associated with a decrease in incidence of MetS components. Both healthy and unhealthy food group components of the GDQS decreased the incidence of high triglycerides, high blood pressure, and high fasting blood glucose. Higher GDQS was associated with a lower risk of the incidence of MetS or its components among Tehranian adults. Higher intake of healthy food group components and lower consumption of unhealthy food group components of the GDQS predicted lower MetS incidence and risk factors.

Relationship between motivations and dietary behaviours within parent-adolescent dyads: Application of actor-partner interdependence models.

Parents play a substantial role in improving adolescent dietary behaviours. To examine the interdependent relationships between motivations (autonomous and emotional motivation) and dietary behaviours (fruit and vegetable [F/V] and junk food and sugar-sweetened beverage [JF/SSB] intake) within parent-adolescent dyads. This secondary data analysis was conducted on 1522 parent-adolescent dyads using a cross-sectional Family Life, Activity, Sun, Health, and Eating (FLASHE) study. The ratio of boys to girls among the adolescents was approximately equal, and 74% of the parents were mothers. The adolescents were between 12 and 17 years old, and 85.5% of the parents were between 35 and 59 years old. Parents and adolescents completed an online survey on dietary motivations and behaviours. Actor-partner interdependence models were performed within parent-adolescent dyads. F/V and JF/SSB intake was influenced by parents' or adolescents' autonomous motivation (actor-only pattern), except among adolescents with obesity. A dyadic pattern was found in the relationship between autonomous motivation and F/V and JF/SSB intake, but only among adolescents with normal weight. No relationship was found between F/V and JF/SSB controlled motivation and F/V or JF/SSB intake among adolescents with overweight or obesity. Autonomous motivation had a significant relationship with F/V and JF/SSB intake for both parents and adolescents, but the association varied depending on the adolescents' weight. Personalized programmes that foster autonomous motivation to change dietary behaviours should be provided based on the adolescents' weight status.

School health and nutrition environments: A multicountry survey in five countries of sub-Saharan Africa region-Burkina Faso, Ethiopia, South Africa, Sudan, and Tanzania.

Schools are increasingly regarded as a key setting for promoting the health, well-being, and development of children and adolescents. In this multicountry cross-sectional survey, we describe the health, nutrition, and food environments of public primary schools in five urban settings in Africa region: Ouagadougou, Burkina Faso; Addis Ababa, Ethiopia; Durban; South Africa, Khartoum, Sudan; and, Dar es Salaam, Tanzania. We evaluated the school health and nutrition (SHN) environments in three main areas: (1) the availability of health-related policies, guidelines, and school curricula, (2) the provision of health, nutrition, and water, sanitation, and hygiene (WASH)services in schools, and (3) the school food environments and eating habits of adolescents. We used stratified random sampling to recruit 79 schools from five countries. Trained fieldworkers collected standardized questionnaire data from 79 school administrators, 765 food vendors, and 4999 in-school adolescents aged 10-15 years. In our study, 24 out of 79 school administrators were aware of their school's health-related policies and guidelines while 30 schools had a specific SHN curriculum. In general, health, nutrition, and WASH services were inadequate. Possibly due to a lack of school kitchens, 14.4% of students bought snacks and unhealthy foods from food vendors. Our study indicates that schools' food and nutrition environments are insufficient to improve adolescent health and nutrition in the African region, including limited coverage of SHN policies, suboptimal facilities and nutrition services, and unregulated food environments. Schools in sub-Saharan Africa need to improve their health and nutrition environments.

Food Environment After Implementation of a Healthy Checkout Policy

In March 2021, Berkeley, California, became the world's first jurisdiction to implement a healthy checkout policy, which sets nutrition standards for foods and beverages in store checkouts. This healthy checkout ordinance (HCO) has the potential to improve customers' dietary intake if stores comply by increasing the healthfulness of foods and beverages at checkouts. To compare the percentage of checkout products that were HCO compliant and that fell into healthy and unhealthy food and beverage categories before and 1 year after HCO implementation in Berkeley relative to comparison cities. In this cohort study in which Berkeley implemented an HCO and other cities did not, a difference-in-differences analysis was conducted of 76 258 product facings at checkouts of 23 stores in Berkeley and 75 stores in 3 comparison cities in California. Data were collected in February 2021 (approximately 1 month before implementation of the HCO) and 1 year later in February 2022 and analyzed from October 2023 to May 2024. The HCO, which permits only the following products at checkouts in large food stores: nonfood and nonbeverage products, unsweetened beverages, and foods with 5 g or less of added sugars per serving and 200 mg or less of sodium per serving in the following categories: sugar-free gum and mints, fruit, vegetables, nuts, seeds, legumes, yogurt or cheese, and whole grains. A product facing's (1) HCO compliance and (2) category, including healthy compliant categories and unhealthy noncompliant categories, determined using a validated photograph-based tool to assess product characteristics. Of the 76 258 product facings at store checkouts, the percentage that were HCO compliant increased from 53% (4438 of 8425) to 83% (5966 of 7220) in Berkeley, a 63% increase relative to comparison cities (probability ratio [PR], 1.63; 95% CI, 1.41-1.87). The percentage of food and beverage checkout facings that were HCO compliant increased in Berkeley from 29% (1652 of 5639) to 62% (2007 of 3261), a 125% increase relative to comparison cities (PR, 2.25; 95% CI, 1.80-2.82). The percentage of Berkeley food and beverage facings consisting of candy, sugar-sweetened beverages, and other sweets significantly decreased (candy: from 30% [1687 of 5639] to 6% [197 of 3261]; PR, 0.21; 95% CI, 0.10-0.42; sugar-sweetened beverages: from 11% [596 of 5639] to 5% [157 of 3261]; PR, 0.41; 95% CI, 0.23-0.75; other sweets: from 7% [413 of 5639] to 3% [101 of 3261]; PR, 0.37; 95% CI, 0.15-0.88), while the percentage consisting of unsweetened beverages (from 4% [226 of 5639] to 19% [604 of 3261]; PR, 4.76; 95% CI, 2.54-8.91) and healthy foods (from 6% [350 of 5639] to 20% [663 of 3261]; PR, 2.90; 95% CI, 1.79-4.72) significantly increased. This cohort study of the first healthy checkout policy found substantial improvements in the healthfulness of food environments at checkouts 1 year after implementation of the policy. These results suggest that healthy checkout policies have the potential to improve the healthfulness of store checkouts.

Trends in Children’s Exposure to Food and Beverage Advertising on Television

Reducing children's exposure to advertisements promoting unhealthy foods and beverages has been recognized by the World Health Organization as a key strategy to improve children's diets and reduce childhood obesity. To examine changes in children's exposure to food-related (food, beverage, and restaurant) television advertising, including for products high in nutrients to limit (NTL; ie, saturated fat, trans fat, total sugars, and sodium) based on federal Interagency Working Group guidelines, following changes in the voluntary industry self-regulatory Children's Food and Beverage Advertising Initiative (CFBAI). This repeated cross-sectional study used US television ratings data on advertising exposure from The Nielsen Company for 2013, 2014, 2015, 2018, and 2022. Food and beverage product advertisements were assessed for nutritional content. Participants included 2- to 5-year-old and 6-to 11-year-old children. Data analysis was performed from July 2023 to January 2024. Changes in CFBAI standards in 2014 and 2020. The primary outcome was the number of food-related advertisements seen per year and percentage of food and beverage product advertisements high in NTL, on all programming and children's programming (defined as ≥35% child audience share). From 2013 to 2022, total advertisements seen per year declined by 77.6% (from 4611 to 1035) for 2- to 5-year-olds and by 78.5% (from 4860 to 1046) for 6- to 11-year-olds. Advertisements seen on children's programming decreased by 95.1% (from 1703 to 84 per year) for 2- to 5-year-olds and by 97.0% (from 1745 to 52 per year) for 6- to 11-year-olds. The percentages of advertisements for products high in NTL decreased from 2013 to 2022 but were still high: 68.9% for all programming and 63.9% for children's programming for 2- to 5-year-olds, and 68.4% for all programming and 60.6% for children's programming for 6- to 11-year-olds. The majority (51%-52%) of CFBAI-member food and beverage advertisements on children's programming remained high in NTL. Black children saw more food-related television advertisements than White children (58% more for 2- to 5-year-olds and 72% more for 6- to 11-year-olds); however, the percentage of advertisements for food and beverage products high in NTL seen was similar by race. In this repeated cross-sectional study of children's exposure to food-related television advertisements, exposure via children's programming decreased substantially. However, most advertisements seen were still for unhealthy products, and exposure from all programming remained substantial. Findings of more than 90% of advertising exposure not from children's programming and more than 1000 food-related advertisements seen per year suggest the need for government regulations based on time of day rather than programming.

Inequality in breastfeeding and complementary feeding practices in Argentina by household income level in 2018-2019.

Introduction. Diet quality is a right related to survival, healthy growth, prevention of chronic diseases, and malnutrition in all its forms. The objective of this study was to analyze breastfeeding and feeding practices in children younger than 2 years from urban areas of Argentina in 2018-2019 according to their household income level. Population and methods. Secondary analysis of data of the Second National Survey on Nutrition and Health (ENNyS2) of 2018-2019. Breastfeeding and complementary feeding indicators proposed by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) were analized. Data were stratified by household income level. Results. The analysis included 5763 children younger than 24 months old. Although 97% was ever breastfed, only 47% of infants younger than 6 months were exclusively breastfed the previous day and 48% continued with breastfeeding after 1 year old, with a higher prevalence in low-income children. The previous day, 23% of children aged 6 to 23 months did not eat any fruit or vegetable, 60% consumed unhealthy foods, and 50% consumed sweet beverages. The consumption of sweet beverages and the absence of fruit and vegetables were higher in low-income households. Conclusion. The quality of children's diet is far from the recommendations and is conditioned by income. Early initiation of breastfeeding, minimum dietary diversity, fruit and vegetable consumption are lower and sweet beverage consumption is greater in impoverished sectors.