The impact of changes in opioid dependency treatment upon COVID-19 transmission in Sydney, Australia: a retrospective longitudinal observational study.

BACKGROUND: In April 2020, in response to the COVID-19 public health emergency, South Eastern Sydney Local Health District (SESLHD) Drug and Alcohol services modified their delivery of opioid dependency treatment (ODT) to reduce spread of COVID-19 and maintain continuity of care by increasing use of takeaway doses (TADs), transferring clients to local community pharmacies for dosing and encouraging the use of long-acting depot buprenorphine (LADB) which enabled once a month dosing. METHODS: This study was a retrospective longitudinal case-control study conducted from August 1st, to November 30th, 2021. Eligible clients were those admitted for treatment with SESLHD ODT Services prior to August 1st,2021 and who remained in treatment beyond November 30th, 2021. COVID-19 diagnoses were determined by a COVID-19 PCR and extracted from the electronic Medical Records (eMR) Discern Reporting Portal. Demographic, clinical and dosing related data were collected from eMR and the Australian Immunisation Register (AIR). RESULTS: Clients attending SESLHD ODT services had significantly greater odds of acquiring COVID-19 than the NSW adult population at large (OR: 13.63, 95%CI: 9.64,18.88). Additionally, amongst SESLHD ODT clients, being of Aboriginal and Torres Strait Islander origin was associated with greater odds of acquiring COVID-19 (OR = 2.18, CI: 1.05,4.53); whilst being employed (OR = 0.06, CI:0.01,0.46), receiving doses at pharmacy (OR = 0.43, CI: 0.21,0.89), and being vaccinated (OR = 0.12, CI: 0.06,0.26) were associated with lower odds. Every additional day of attendance required for dosing was associated with a 5% increase in odds of acquiring COVID-19 (OR = 1.05, CI: 1.02,1.08). CONCLUSIONS: Clients attending SESLHD ODT services are significantly more likely to acquire COVID-19 than the NSW population at large. Promoting vaccination uptake, transferring clients to pharmacy, and reducing the frequency of dosing (by use of takeaway doses or long-acting depot buprenorphine) are all potential methods to reduce this risk.

[Study on determination methods and analysis of micronutrients in take-away meals].

OBJECTIVE: To comprehensively analyze the trace nutrient contents in take-away meals, the simultaneous detection method of common vitamins in take-away meals were explored based on the samples' matrix, and the content of trace nutrients in take-away meals was analyzed combined with inductively coupled plasma-mass spectrometry(ICP-MS) detection of common elements. METHODS: Fifty-seven take-away meals were collected randomly and analyzed. Vitamins were determined by high performance liquid chromatography-ultraviolet detector tandem fluorescence detector after pretreatment of samples including enzymatic digestion, hydrolysis and extraction. The separation was performed on a C_(18) column(250 mm×4.6 mm, 5 µm) with ion-pair acid reagents as the mobile phase for water-soluble vitamins and methanol for fat-soluble vitamins. Vitamin B_1, vitamin B_2, nicotinic acid, nicotinamide and vitamin A were detected by ultraviolet detector(UVD), while vitamin B_6 and E by fluorescence detector(FLD). Elemental analysis of calcium, magnesium, sodium, potassium, zinc, selenium and copper in the take-away meals was carried out according to GB 5009.268-2016 by ICP-MS to comprehensively evaluate the contents of micronutrients. RESULTS: Through optimization of chromatography and sample pretreatment conditions, the sensitivity of the established detection method can meet the needs of micronutrient evaluation with the detection limits and quantification limits of vitamins in the range of 0.002-0.098 mg/100 g and 0.007-0.327 mg/100 g, respectively. Good precision was obtained(<10%). The spiked recovery rates were 80.5%-103.8%(n=6). The result showed that the contents of micronutrients in take-away meals were generally low. The detection rates of vitamins ranged from 21.1% to 98.2%. CONCLUSION: The proposed method is simple and sensitive, and the contents of vitamins and elements determined were low in the collected take-away meals.

Heavy metal risk of disposable food containers on human health.

The consumption of disposable materials is booming with the rapid development of urbanization and industrialization, which may inevitably cause the release of toxic and harmful substances during use of them in daily life. This study was to estimate element levels such as Beryllium (Be), Vanadium (V), Zinc (Zn), Manganese (Mn), Cadmium (Cd), Chromium (Cr), Nickel (Ni), Cobalt (Co), Antimony (Sb), Barium (Ba), Lead (Pb), Iron (Fe), Copper (Cu), and Selenium (Se) in leachate and subsequently assess the health risk of exposure to those disposable products such as paper and plastic food containers. We found that a large amount of metals was released from disposable food containers in hot water, and the order of metal concentration is Zn > Ba > Fe > Mn > Ni > Cu > Sb > Cr > Se > Be > Pb > Co > V > Cd. Additionally, the hazard quotient (HQ) of metals in young adults were less than 1, and were decreased in the order of Sb > Fe > Cu > Be > Ni > Cr > Pb > Zn > Se > Cd > Ba > Mn > V > Co. Furthermore, the excess lifetime cancer risk (ELCR) results of Ni and Be indicated that chronic exposure to Ni and Be may have a non-negligible carcinogenic risk. These findings suggest that potential health risk of metals may exist for the individuals to use disposable food containers under high temperature environment.

Psychological determinants of consumption of reusable containers for takeaway food and drinks.

Using food and drink disposable containers has heavy environmental and economic consequences. The widespread adoption of reusable containers is a challenge that requires understanding the psychological determinants and barriers of the behaviour. Two studies were conducted: one with a sample from the general public (study 1, N = 302) and one with respondents having access to a reusable container system at work (study 2, N = 737). Online surveys measured self-reported use of single-use and reusable containers for food and drinks takeaway (studies 1 and 2) and for food delivery (study 1). Stages of change and psychological determinants were also measured to provide behavioural levers. Results indicate that in study 1, most of the sample is aware of the issue associated with single-use containers but has not switched to reusable. In study 2, most respondents say they are already using few single-use and are willing to continue, particularly for drinks to go. Thus, accessibility at the workplace to a reusable container system is associated with higher stages of change. However, many respondents are also in the preactional phase for food takeaway, that is, willing to change but have not started yet. In both studies, perception of control on the behaviour and volitional variables are positively associated with stages of change. This suggests that making reusable containers easier to use and helping individuals plan how and when they can do it could encourage behaviour change.

Changes in patterns of take-away food ordering among youths before and after COVID-19 lockdown in China: the COVID-19 Impact on Lifestyle Change Survey (COINLICS).

BACKGROUND: The lockdown due to COVID-19 may have led to changes in food ordering patterns among youths, which could affect their dietary patterns and the operation of the restaurant industry. OBJECTIVES: This study aimed to examine the impacts of COVID-19 lockdown on patterns of take-away food ordering among youth in China. METHODS: The COVID-19 Impact on Lifestyle Change Survey (COINLICS) was conducted among youths at three educational levels (high or vocational school, college, and graduate school) in China in early May 2020. Information on patterns of take-away food ordering in the months immediately before and after the COVID-19 lockdown period (23 January to 8 April 2020) was collected through an online questionnaire survey. RESULTS: A total of 10,082 participants were included in the analysis. Participants ordering food more than once per week dropped from 15.4 to 9.2%, while 81.1% of participants have never ordered food at both time points. Graduate students, although experiencing a decrease in food ordering for more than once per week (from 33.3 to 10.7%), were more likely to order food compared to undergraduate and high school students. A slight increase was observed for ordering fried food or hamburgers and for breakfast and midnight snacks. CONCLUSIONS: The youth have generally ordered take-away food less frequently after COVID-19 lockdown, and the times and types of ordering have both changed. These findings would contribute solid evidence to the current knowledge pool for reference of health promotion communities to keep youth's lifestyles healthy and of the restaurant industry to achieve more cost-effective operation in China during future health emergencies.

Analysis of Microplastics in Takeaway Food Containers in China Using FPA-FTIR Whole Filter Analysis.

With the rapid development and popularization of the internet and smartphone industry for ordering and delivery, the consumption of takeaway food is increasing globally, especially in China. However, there is little information about microplastics in takeaway food containers, so their potential risks to human health remain unknown. This study explored the possibility of using focal plane array (FPA)-based micro-FT-IR imaging to detect microplastics released from food containers and evaluated their contents using an automated database matching analysis method. We investigated microplastics in seven types of food containers widely used in China. The most common plastic types observed were polyamide (PA), polyurethane (PU) and polystyrene (PS), which were found to comprise 22.8%, 18.2%, and 8.5% (number of particles) of all microplastics, respectively. Microplastics were found in all seven types of food containers, and the content excluding cellulose was 29-552 items/container. Our research shows that microplastics in takeaway food containers might originate from atmospheric sediment or flakes from the inside surface of the container. According to the content of microplastics in takeaway food containers, people who order takeaway food 5-10 times a month might consume 145-5520 microplastic pieces from food containers.

Place matters: out-of-home demand for food and beverages in Great Britain.

Fiscal policies to influence consumption of food and beverages are increasing globally. Most food demand studies focus on understanding consumer response in the context of food and beverages consumed at home. Yet food and beverages consumed outside of the home play an increasing part in our diets, and demand elasticities for these settings are crucial for assessing the potential impact of such fiscal measures on promoting healthier diets. Utilising a large out-of-home food purchase dataset from Great Britain in 2016-17, this paper analyses the demand for seven food groups across four outlet types, including restaurants, fast-food outlets, food retails and other outlets. We use a demand system approach to estimate price and expenditure elasticites of demand, along with procedures to account for censoring, expenditure and price endogeneity. Our results indicate substantial variations in consumer responses across outlet types. Demand for main meals is expenditure and price elastic in restaurants but inelastic in fast-food outlets. For sugary drinks, the demand is generally price elastic except in fast food outlets. These differences across outlet types highlight the complexity in studying out-of-home food and beverage consumption and the importance of accounting for where consumers buy from when designing, implementing and evaluating consumer responses to fiscal measures.

Associations between online food outlet access and online food delivery service use amongst adults in the UK: a cross-sectional analysis of linked data.

BACKGROUND: Online food delivery services facilitate 'online' access to food outlets that typically sell lenergy-dense nutrient-poor food. Greater online food outlet access might be related to the use of this purchasing format and living with excess bodyweight, however, this is not known. We aimed to investigate the association between aspects of online food outlet access and online food delivery service use, and differences according to customer sociodemographic characteristics, as well as the association between the number of food outlets accessible online and bodyweight. METHODS: In 2019, we used an automated data collection method to collect data on all food outlets in the UK registered with the leading online food delivery service Just Eat (n = 33,204). We linked this with contemporaneous data on food purchasing, bodyweight, and sociodemographic information collected through the International Food Policy Study (analytic sample n = 3067). We used adjusted binomial logistic, linear, and multinomial logistic regression models to examine associations. RESULTS: Adults in the UK had online access to a median of 85 food outlets (IQR: 34-181) and 85 unique types of cuisine (IQR: 64-108), and 15.1% reported online food delivery service use in the previous week. Those with the greatest number of accessible food outlets (quarter four, 182-879) had 71% greater odds of online food delivery service use (OR: 1.71; 95% CI: 1.09, 2.68) compared to those with the least (quarter one, 0-34). This pattern was evident amongst adults with a university degree (OR: 2.11; 95% CI: 1.15, 3.85), adults aged between 18 and 29 years (OR: 3.27, 95% CI: 1.59, 6.72), those living with children (OR: 1.94; 95% CI: 1.01; 3.75), and females at each level of increased exposure. We found no association between the number of unique types of cuisine accessible online and online food delivery service use, or between the number of food outlets accessible online and bodyweight. CONCLUSIONS: The number of food outlets accessible online is positively associated with online food delivery service use. Adults with the highest education, younger adults, those living with children, and females, were particularly susceptible to the greatest online food outlet access. Further research is required to investigate the possible health implications of online food delivery service use.

To dine in or not to dine in: A comparison of food selection and preparation behaviours in those with and without food security.

ISSUE ADDRESSED: Vulnerable populations are disproportionately affected by food insecurity, resulting in heightened risk of suboptimal dietary intake. Food insecure people appear to implement several coping strategies and dietary compromises to avoid hunger. Less explored in the literature is how these strategies impact consumption of food inside and outside of the home. METHODS: An online survey was completed by adults (n = 1292) residing in one of five Australian states. The questionnaire comprised of the six-item US Household Food Security Survey Module, 12 socio-demographic variables and 32 questions related to elements of food literacy. RESULTS: Food insecure respondents were more likely to frequent fast food vs (P = .002), takeaway (P < .001) and food courts (P < .001) than their food secure counterparts. Food secure respondents reported greater use of raw (P = .043) and fresh, pre-prepared produce (P = .002) when cooking, whereas food insecure respondents were more likely to prepare food using only frozen, pre-packaged products (P < .001). No significant differences were found between food security status and the enjoyment and social bonding derived from cooking. CONCLUSIONS: Food insecure respondents appeared to be accessing a poorer quality of food through greater consumption of takeaway and fast food. These dietary compromises are most likely related to perceived financial, time or cooking facility constraints and to a lesser extent food literacy skills. SO WHAT?: This study highlights some of the health and social inequities apparent within food insecure populations. Food insecure households should be supported to access healthy fresh food and in-home cooking practices. While a multi strategy approach is required, healthy food environment policy, particularly in disadvantaged areas, should be considered to guarantee that all Australians have dignified access to nutritious food.

[Associations between Takeaway Food Nutrients and Nutritional Literacy of Takeaway Platform Practitioners in Chengdu].

Objective To investigate the nutritional literacy levels of the takeaway platform practitioners in Chengdu,the takeaway food nutrients,and the correlation between them.Methods We employed a multi-stage random sampling method to investigate the nutritional literacy levels of 100 takeaway platform restaurants in the main urban area of Chengdu and examined the nutritional components of hot set meals in each restaurant.A questionnaire survey was conducted on the nutritional literacy levels of chefs and food matching staff.The correlations of nutrient energy supply rationality with nutritional literacy level and set meal price were then analyzed.Results The total pass rate of nutrition knowledge of chefs/food matching staff was 61.0%.Only 2.0% of the set meals had reasonable total energy supply.The set meals with reasonable energy supply of available carbohydrate,protein,and fat accounted for 3.0%,62.0%,and 21.0%,and those with over energy supply accounted for 97.0%,26.0%,and 73.0%,respectively.The rest set meals provided insufficient energy.There was a positive correlation between the nutritional literacy level and the rationality of protein energy supply(r=0.414,P=0.003).Conclusions The nutritional literacy levels of chefs/food matching staff of takeaway food restaurants in Chengdu are moderate.The hot set meals on the takeaway platform have the problem of excess energy supply.The nutrition knowledge of chefs/food matching staff cannot effectively satisfy rational nutrition matching.The nutritional literacy levels of chefs/food matching staff showed no significant correlation with the rationality of nutrient energy supply.

[Survey on the behavior and attitude of nutrition labels by Chengdu fast food and light meal takeaway merchants].

OBJECTIVE: Learn about the view, cognition, willingness and attitude of the employees of Chengdu fast food takeaway business on nutrition labels and their attitude towards labeling nutrition labels on takeaway meals. METHODS: Using a multi-stage random sampling method, five districts were randomly selected in Chengdu City, Sichuan Province, and two streets were randomly selected in each of the selected districts, and the questionnaire was administered on a one-to-one basis. RESULTS: A total of 834 chefs and caterers were surveyed in the fast food, simple meals category of takeaway businesses. The rate of viewing the nutrition labels on pre-packaged food by chefs and catering staff in takeaway businesses was 48. 07%, and the viewing rate was increasing with the improvement of education(χ~2=15. 379, P=0. 001). The mastery rate of nutrition label knowledge was 15. 08%, which was different for different ages(χ~2=6. 072, P=0. 048). The mastery rate of men(18. 72%) was higher than that of women(9. 91%)(χ~2=12. 193, P<0. 001), and that of chefs(18. 01%) was higher than that of catering staff(12. 88%)(χ~2=4. 172, P=0. 041). The nutritional label understanding intention of the subjects was 28. 10%, and the difference of willingness to know about nutrition label-related knowledge was statistically significant in different age groups(χ~2=6. 183, P=0. 045). The respondents' viewing of nutrition labels was associated with willingness to understand, with a Person coefficient of contingency of 0. 104. The proportion of supporting nutrition labels on takeaway meals was 56. 69%. There were statistically significant differences in attitudes towards nutrition labels on takeaway food packages among respondents of different age groups, gender, education, working years and whether they were chain stores(χ~2=21. 445, 8. 675, 14. 684, 12. 198, 25. 852, P<0. 05). CONCLUSION: The take-out industry chefs and catering staff have insufficient review rate and mastery of nutrition labels, and their willingness to understand nutrition labels is not high.

Correlates of English local government use of the planning system to regulate hot food takeaway outlets: a cross-sectional analysis.

BACKGROUND: Greater neighbourhood takeaway food outlet access has been associated with increased takeaway food consumption and higher body weight. National planning guidelines in England suggest that urban planning could promote healthier food environments through takeaway food outlet regulation, for example by restricting the proliferation of outlets near schools. It is unknown how geographically widespread this approach is, or local characteristics associated with its use. We aimed to address these knowledge gaps. METHODS: We used data from a complete review of planning policy documents adopted by local government areas in England (n = 325), which contained policies for the purpose of takeaway food outlet regulation. This review classified local government area planning policies as having a health (diet or obesity) or non-health focus. We explored geographical clustering of similar planning policies using spatial statistics. We used multinomial logistic regression models to investigate whether the odds of planning policy adoption varied according to local characteristics, for example the proportion of children with excess weight or the current number of takeaway food outlets. RESULTS: We observed clusters of local government areas with similar adopted planning policies in the North East, North West, and Greater London regions of England. In unadjusted logistic regression models, compared to local government areas with the lowest, those with highest proportion of 10-11 year olds with excess weight (OR: 25.31; 95% CI: 6.74, 94.96), and takeaway food outlet number (OR: 54.00; 95% CI: 6.17, 472.41), were more likely to have a health-focused planning policy, than none. In models adjusted for deprivation, relationships for excess weight metrics were attenuated. Compared to local government areas with the lowest, those with the highest takeaway food outlet number remained more likely to have a health-focused planning policy, than none (OR: 16.98; 95% CI: 1.44, 199.04). When local government areas were under Labour political control, predominantly urban, and when they had more geographically proximal and statistically similar areas in the same planning policy status category, they were also more likely to have health-focused planning policies. CONCLUSIONS: Planning policies for the purpose of takeaway food outlet regulation with a health focus were more likely in areas with greater numbers of takeaway food outlets and higher proportions of children with excess weight. Other characteristics including Labour political control, greater deprivation and urbanisation, were associated with planning policy adoption, as were the actions of similar and nearby local government areas. Further research should engage with local policymakers to explore the drivers underpinning use of this approach.

Association between hours worked in paid employment and diet quality, frequency of eating out and consuming takeaways in the UK.

OBJECTIVE: To examine associations between hours worked and diet quality, frequency of eating out and consuming takeaways. DESIGN: Data were taken from the National Diet and Nutrition Survey (2008-2014). Associations between hours worked in paid employment and diet quality, assessed using the Diet Quality Index (DQI) and selected foods and nutrients, were tested using linear regression models. Associations between hours worked and frequency of eating out and consuming takeaways were tested using ordinal logistic regression models. All models were adjusted for sex, age, equivalised household income, household composition and household food role. SETTING: UK. PARTICIPANTS: Adults (n 2154) aged 19-64 years in employment. RESULTS: Mean (95 % CI) hours worked per week was 36·1 (35·6, 36·6) and mean DQI score was 41·9 (41·2, 42·5) %. Hours worked was not associated with DQI score, frequency of eating out or consuming takeaways. Hours worked was positively associated with consuming red meat, processed meat and alcohol intake. Adults working more hours had lower intake of fibre but higher total fat and saturated fat intakes if they lived in households with children. CONCLUSIONS: Working hours may not be the main factor driving poor-quality diets among this sample of UK adults in employment. Focusing on consumption of foods prepared outside the household may not be the most efficient way to improve diet quality as effort is needed at all levels. Although it is unclear what is driving the differences in nutrient intakes according to household composition, they are important to consider when developing interventions to improve healthy eating.

"Doing a good thing for myself": a qualitative study of young adults' strategies for reducing takeaway food consumption.

BACKGROUND: Increasingly the population is eating meals and snacks prepared outside the home, especially younger adults. Takeaway foods can be energy-dense, high in saturated fat and sodium, and deleterious to health. Extending studies examining the barriers to healthy eating, this paper explores strategies employed by young adults who report reducing consumption of unhealthy takeaway foods. METHODS: Young adults aged 18 to 35 years in paid employment were recruited to participate in eight semi-structured focus groups. In response to initial findings, recruitment for the final four groups refocused on participants who either wanted, were in the process of, or had changed their takeaway food habits. Focus group recordings were transcribed verbatim and coded by two researchers for recurrent themes using an inductive method. RESULTS: Forty-eight participants with a mean BMI of 23.4 kg/m2 and mean age of 25 years took part, of which 34 were female, and 27 were born outside Australia. Four broad strategies emerged: altering cognitions about consumption/reduction of takeaway food; practical changes to behaviours; finding external support; and, reconfiguring social events. In detail, participants cognitively recast takeaway food consumption as negative (expensive and unhealthy) and reducing consumption of such foods or consuming healthy alternatives as a (positive) self-care action. Setting goals and making personal rules around consumption, and consciously making practical changes, such as planning for food shopping, were other strategies. Externally derived support including supportive food environments and friends and family passively reduced exposure to unhealthy takeaway food. Finally, some participants actively created social environments supportive of healthy choices. CONCLUSIONS: Our participants reported strategies they believed led to them successfully reduce their takeaway food consumption by matching the attractions (e.g., convenience) and countering apparent disincentives for reducing consumption (e.g., losing a reward) of takeaway food. They reported eschewing more short-term rewards and costs, to prioritise their health, believing that avoiding these foods would benefit them personally and financially. The identified strategies are consistent with documented techniques for successful behaviour change and corresponded to all levels in the social-ecological model from intrapersonal factors to public policy. The findings could underpin health promotion strategies to support this at-risk group.

Characterization of an Unusual Foodborne Illness Including an Outbreak and Sporadic Illness Caused by Three Bacterial Pathogens Via a Takeaway Service.

Takeaway food services are an emerging business in China and have a potential impact on food safety. An unusual foodborne illness associated with takeaway food delivered through a logistics company on August 27, 2018 is reported. Epidemiological investigations showed that 28 patients from 2 companies were diagnosed with gastroenteritis symptoms. The major symptoms included nausea (24, 85.71%), vomiting (24, 85.71%), diarrhea (22, 78.57%), and abdominal pain (22, 78.75%). Laboratory investigations showed that six Staphylococcus aureus isolates, three Salmonella enteria serovar livingstone isolates, and one Vibrio parahaemolyticus isolate were detected. Six S. aureus isolates were detected from one patient, food, and a food handler, and all six S. aureus isolates had the same pulsed-field gel electrophoresis (PFGE) pattern and multilocus sequence typing (MLST) genotype. Staphylococcal enterotoxin A was detected from food and the six S. aureus isolates. These results confirmed that S. aureus isolates were the major agent causing this foodborne illness. Three Salmonella isolates with the same PFGE pattern and MLST genotype were detected from patients. This was the first time that Salmonella isolates have been identified as causing a foodborne disease outbreak in China. Only one O4:K8 serotype of V. parahaemolyticus with the tdh gene isolate was detected from one patient. These results confirmed that this was an unusual foodborne illness that included an outbreak associated with two different pathogens and a third pathogen sporadic illness. Takeaway services pose a risk to public health because they have the potential to distribute contaminated products over a large geographic area within a short time. Therefore, more attention should be paid to prevent and control foodborne illnesses caused by contaminated food from takeaway services.

Relationship between mean daily energy intake and frequency of consumption of out-of-home meals in the UK National Diet and Nutrition Survey.

BACKGROUND: Out-of-home meals have been characterised as delivering excessively large portions that can lead to high energy intake. Regular consumption is linked to weight gain and diet related diseases. Consumption of out-of-home meals is associated with socio-demographic and anthropometric factors, but the relationship between habitual consumption of such meals and mean daily energy intake has not been studied in both adults and children in the UK. METHODS: We analysed adult and child data from waves 1-4 of the UK National Diet and Nutrition Survey using generalized linear modelling. We investigated whether individuals who report a higher habitual consumption of meals out in a restaurant or café, or takeaway meals at home had a higher mean daily energy intake, as estimated by a four-day food diary, whilst adjusting for key socio-demographic and anthropometric variables. RESULTS: Adults who ate meals out at least weekly had a higher mean daily energy intake consuming 75-104 kcal more per day than those who ate these meals rarely. The equivalent figures for takeaway meals at home were 63-87 kcal. There was no association between energy intake and frequency of consumption of meals out in children. Children who ate takeaway meals at home at least weekly consumed 55-168 kcal more per day than those who ate these meals rarely. Additionally, in children, there was an interaction with socio-economic position, where greater frequency of consumption of takeaway meals was associated with higher mean daily energy intake in those from less affluent households than those from more affluent households. CONCLUSIONS: Higher habitual consumption of out-of-home meals is associated with greater mean daily energy intake in the UK. More frequent takeaway meal consumption in adults and children is associated with greater daily energy intake and this effect is greater in children from less affluent households. Interventions seeking to reduce energy content through reformulation or reduction of portion sizes in restaurants, cafés and takeaways could potentially lead to reductions in mean daily energy intake, and may reduce inequalities in health in children.

Paying for convenience: comparing the cost of takeaway meals with their healthier home-cooked counterparts in New Zealand.

OBJECTIVE: Convenience and cost impact on people's meal decisions. Takeaway and pre-prepared foods save preparation time but may contribute to poorer-quality diets. Analysing the impact of time on relative cost differences between meals of varying convenience contributes to understanding the barrier of time to selecting healthy meals. DESIGN: Six popular New Zealand takeaway meals were identified from two large national surveys and compared with similar, but healthier, home-made and home-assembled meals that met nutrition targets consistent with New Zealand Eating and Activity Guidelines. The cost of each complete meal, cost per kilogram, and confidence intervals of the cost of each meal type were calculated. The time-inclusive cost was calculated by adding waiting or preparation time cost at the minimum wage. SETTING: A large urban area in New Zealand. RESULTS: For five of six popular meals, the mean cost of the home-made and home-assembled meals was cheaper than the takeaway meals. When the cost of time was added, all home-assembled meal options were the cheapest and half of the home-made meals were at least as expensive as the takeaway meals. The home-prepared meals were designed to provide less saturated fat and Na and more vegetables than their takeaway counterparts; however, the home-assembled meals provided more Na than the home-made meals. CONCLUSIONS: Healthier home-made and home-assembled meals were, except one, cheaper options than takeaways. When the cost of time was added, either the home-made or the takeaway meal was the most expensive. This research questions whether takeaways are better value than home-prepared meals.

Lifestyle behaviours associated with 5-year weight gain in a prospective cohort of Australian adults aged 26-36 years at baseline.

BACKGROUND: Whether not meeting common guidelines for lifestyle behaviours is associated with weight gain is uncertain. This study examined whether 5-year weight gain was predicted by not meeting guidelines for: breakfast consumption (eating between 6 and 9 am), takeaway food consumption (<2 times/week), television viewing (<2 h/day) and daily steps (≥10,000 steps/day). METHODS: One thousand one hundred and fifty-five Australian participants (43% men, 26-36 years) completed questionnaires and wore a pedometer at baseline (2004-06) and follow-up (2009-11). Weight was measured or self-reported, with a correction factor applied. For each behaviour, participants were classified according to whether they met the guideline: consistently met at baseline and follow-up (reference group); not met at baseline but met at follow-up; met at baseline but not met at follow-up; consistently not met at baseline and follow-up. For each behaviour, weight gain was calculated using linear regression. Weight gain by number of guidelines met was also examined. RESULTS: Mean 5-year weight gain was 2.0 kg (SD:6.3). Compared to the reference group, additional weight (mean, 95% CI) was gained among those who did not meet the guideline at follow-up, or consistently did not meet the guideline, for breakfast (1.8 kg, 0.7-2.9; 1.5 kg, 0.1-2.8); takeaway food (2.2 kg, 0.7-3.6; 1.9 kg, 0.7-3.1); watching television (1.9 kg, 0.9-2.9; 1.4 kg, 0.4-2.3); and daily steps (2.6 kg, 1.1-4.04; 1.6 kg, 0.5-2.7). Those who met ≤1 guideline at follow-up gained 3.8 kg (95% CI 2.3-5.3) more than those meeting all guidelines. CONCLUSION: Individuals who adopted healthier behaviours between baseline and follow-up had similar weight gain to those who met the guidelines at both time points. Encouraging young adults to meet these simple guidelines may reduce weight gain.

Comparison of sodium content of meals served by independent takeaways using standard versus reduced holed salt shakers: cross-sectional study.

BACKGROUND: Takeaway food has a relatively poor nutritional profile. Providing takeaway outlets with reduced-holed salt shakers is one method thought to reduce salt use in takeaways, but effects have not been formally tested. We aimed to determine if there was a difference in sodium content of standard fish and chip meals served by Fish & Chip Shops that use standard (17 holes) versus reduced-holed (5 holes) salt shakers, taking advantage of natural variations in salt shakers used. METHODS: We conducted a cross-sectional study of all Fish & Chip Shops in two local government areas (n = 65), where servers added salt to meals as standard practice, and salt shaker used could be identified (n = 61). Standard fish and chip meals were purchased from each shop by incognito researchers and the purchase price and type of salt shaker used noted. Sodium content of full meals and their component parts (fish, chips, and fish batter) was determined using flame photometry. Differences in absolute and relative sodium content of meals and component parts between shops using reduced-holed versus standard salt-shakers were compared using linear regression before and after adjustment for purchase price and area. RESULTS: Reduced-holed salt shakers were used in 29 of 61 (47.5 %) included shops. There was no difference in absolute sodium content of meals purchased from shops using standard versus reduced-holed shakers (mean = 1147 mg [equivalent to 2.9 g salt]; SD = 424 mg; p > 0.05). Relative sodium content was significantly lower in meals from shops using reduced-holed (mean = 142.5 mg/100 g [equivalent to 0.4 g salt/100 g]; SD = 39.0 mg/100 g) versus standard shakers (mean = 182.0 mg/100 g; [equivalent to 0.5 g salt/100 g]; SD = 68.3 mg/100 g; p = 0.008). This was driven by differences in the sodium content of chips and was extinguished by adjustment for purchase price and area. Price was inversely associated with relative sodium content (p < 0.05). CONCLUSIONS: Using reduced-holed salt shakers in Fish & Chip Shops is associated with lower relative sodium content of fish and chip meals. This is driven by differences in sodium content of chips, making our results relevant to the wide range of takeaways serving chips. Shops serving higher priced meals, which may reflect a more affluent customer base, may be more likely to use reduced-holed shakers.

Frequency of takeaway food consumption and its association with major food group consumption, anthropometric measures and blood pressure during adolescence.

We prospectively assessed the (1) frequency and socio-economic correlates of takeaway food consumption during adolescence; and (2) association between frequent takeaway food consumption with intakes of major food groups and anthropometric measures and blood pressure (BP). In total, 699 Sydney schoolchildren (380 girls and 319 boys) who had dietary data at both 12 and 17 years of age were included for analyses. Takeaway food consumption was self-reported and based on a single question. Anthropometric measures and BP were collected. The proportion of participants who ate takeaway foods once per week or more increased significantly over 5 years from the age of 12 to 17 years: 35·5-44·1 % (P<0·0001). In total, 12-year-old girls compared with boys had reduced odds of takeaway foods once per week or more at the age of 17 years (P=0·01), multivariable-adjusted OR 0·63 (95 % CI 0·44, 0·90). In total, 12-year-old children who ate takeaway foods once per week or more had significantly lower mean fruit (220·3 v. 253·0 g/d; P=0·03) and vegetable consumption (213·2 v. 247·7 g/d; P=0·004), 5 years later (at 17 years of age). Frequent takeaway food consumption at the age of 12 years was not associated with anthropometric indices and BP at the age of 17 years. Consumption of takeaway foods became more frequent during adolescence, particularly among boys, and it was associated with reduced intake of fruits and vegetables.