"Do you think adolescents' food intake is satisfactory?" - Views of Indian parents and teachers.

Adolescents develop food habits that affect both their present and future health. Underpinned by the stakeholder theory, this study was designed to explore the perspective of parents and nutrition educators regarding urban Indian adolescents' food habits. Thirty-two educators and 280 parents from five independent, English-speaking, secondary schools in Kolkata, India completed a paper-based instrument consisting of both closed and open-ended measures. Qualitative data were subjected to thematic analysis informed by the Template Analysis Technique. Descriptive and cross-tabulation analyses were employed to assess quantitative data. Three quarters (75%) of the respondents were dissatisfied with the ubiquitous consumption of energy-dense, nutrient-poor foods and sugar-sweetened beverages as well as the low intakes of healthy foods like fruits and vegetables among urban Indian adolescents. Six reasons were advanced for such unhealthy consumption including i) Proliferation of fast food retail outlets; ii) Hyper-palatability of fast food; iii) Marketing of fast food on electronic and social media; iv) Diminished household cooking practices; v) Lack of food knowledge; vi) Tendency to seek peer group acceptance. Both parents and educators suggested some healthy eating strategies aimed at improving the food and nutrition situation in Indian secondary schools to foster healthy eating among pupils. These included: i) Restrictions on the sale of unhealthy foods in school canteens; ii) Increased availability of attractive and palatable nutritious foods; iii) Discussion of the advantages of consuming healthy foods and inclusion of food preparation techniques in the school curriculum; iv) Home Economics coursework to be made mandatory for students. The findings suggest that Indian parents and teachers are likely to support changes to the food and nutrition curricula and to school food provision to foster healthy eating among adolescents.

Association between food liking and the dietary quality in Australian young adults.

BACKGROUND AND OBJECTIVES: An individual's liking for food maybe associated with food consumption. This study investigates the association between food liking and dietary quality in Australian young adults. METHODS AND STUDY DESIGN: Food liking and food frequency data were collected via an online Food Liking Questionnaire (FLQ) and Food Frequency Questionnaire (FFQ). Food liking scores were calculated for groupings of foods. FFQ Food intake data was used to calculate diet quality using a 13 item Dietary Guideline Index (DGI). The relationship between food liking and DGI was assessed using linear regression models and the difference was assessed using an independent sample t-test and One-way ANOVA. RESULTS: Data were available from n=2,535 participants (BMI=24 (SD 3.74), age=21.9 (SD 5.05) years, female=77.1%). Liking for grains, vegetables, fruits, dairy, plant-based protein, was weakly positively associated with diet quality. Liking for animal-based protein, fat and oil, sweet food, and salty food, was weakly negatively associated with diet quality. Liking for grains, vegetables, fruits, dairy, plant-based protein and healthy foods increased across increasing DGI tertiles, and liking for animalbased protein, fat and oil, sweet food, salty food and discretionary foods decreased across increasing DGI tertiles. CONCLUSIONS: The results were logical with increased liking for healthy or discretionary foods linked with increased consumption of those foods. The results reinforce the strategy to introduce a variety of healthy food groups early in life to initiate flavour-nutrient learning and increase liking for healthy foods.

A systematic review and meta-analysis of 24-h urinary output of children and adolescents: impact on the assessment of iodine status using urinary biomarkers.

PURPOSE: Urinary iodine concentration (UIC (µg/ml) from spot urine samples collected from school-aged children is used to determine the iodine status of populations. Some studies further extrapolate UIC to represent daily iodine intake, based on the assumption that children pass approximately 1 L urine over 24-h, but this has never been assessed in population studies. Therefore, the present review aimed to collate and produce an estimate of the average 24-h urine volume of children and adolescents (> 1 year and < 19 years) from published studies. METHODS: EBSCOHOST and EMBASE databases were searched to identify studies which reported the mean 24-h urinary volume of healthy children (> 1 year and < 19 years). The overall mean (95% CI) estimate of 24-h urine volume was determined using a random effects model, broken down by age group. RESULTS: Of the 44 studies identified, a meta-analysis of 27 studies, with at least one criterion for assessing the completeness of urine collections, indicated that the mean urine volume of 2-19 year olds was 773 (654, 893) (95% CI) mL/24-h. When broken down by age group, mean (95% CI) 24-h urine volume was 531 mL/day (454, 607) for 2-5 year olds, 771 mL/day (734, 808) for 6-12 year olds, and 1067 mL/day (855, 1279) for 13-19 year olds. CONCLUSIONS: These results demonstrate that the average urine volume of children aged 2-12 years is less than 1 L, therefore, misclassification of iodine intakes may occur when urine volumes fall below or above 1 L. Future studies utilizing spot urine samples to assess iodine status should consider this when extrapolating UIC to represent iodine intakes of a population.

The relationship between culture, food liking, and body mass index in Australian and Thai young adults.

BACKGROUND AND OBJECTIVES: An individual's liking of food may be associated with Body Mass Index (BMI) due to its subsequent impact on food consumption. This study investigates the association between food liking and BMI in young adults from Australia and Thailand. METHODS AND STUDY DESIGN: Food liking data were collected via a validated online Food Liking Questionnaire (FLQ). Food liking scores were calculated for overall liking of groupings of foods: grains, vegetables, fruits, dairy, animal protein, plant-based protein, fat and oil, sweet food, salty food, and alcohol. The relationship between food liking and BMI (calculated from self-reported height and weight) was assessed using linear regression models including country and gender, and mean differences were assessed using independent sample t-test. RESULTS: Data were available from n=4,173 participants (BMI=22.25 (SD 4.18), age=20.6 (SD 4.22) years, female=71.6%, Thai=52.5%). There were significant differences of food liking between countries for all of food groups (p<0.01) except for animal-based protein and plantbased protein liking. BMI was positively, but weakly, associated with liking of animal-based protein (ß=0.20 [0.12, 0.28], p<0.001), and alcohol (ß=0.08 [0.02, 0.13], p<0.01) and negatively associated with plant-based protein (ß=-0.09 [-0.18, -0.01], p<0.05). There was significant difference of food liking between weight status for all of food groups. CONCLUSIONS: This study supports only minor associations between food liking and BMI, but cultural and gender variation in liking was evident.

Assessing Food Liking: Comparison of Food Liking Questionnaires and Direct Food Tasting in Two Cultures.

Food liking can be directly measured in specialised sensory testing facilities; however, this method is not feasible for large population samples. The aim of the study was to compare a Food Liking Questionnaire (FLQ) against lab-based sensory testing in two countries. The study was conducted with 70 Australian and Thai participants (35 Australian, 35 Thai, mean (SD) age 19 (3.01) years, 51% men). Participants completed a FLQ (consisting of 73 food items Australia, 89 Thai) and then, after tasting the food, rated their liking of a selection of 10 commercially available food items using a nine-point hedonic scale. Both tasks were completed on the same day and were repeated one week later. The reliability of and a comparison between methods was determined using Intra-Class Correlation Coefficients (ICC), and the difference was assessed using an independent sample t-test. The results indicate that the test-retest reliability of FLQ and the laboratory-based liking assessment range was moderate (0.40⁻0.59) to excellent (0.75⁻1.00). There were significant differences for the FLQ and the laboratory-based liking assessment between countries for three food items: soft drink, instant vegetable soup, and broccoli (p < 0.01). However, the data produced from the FLQ reflects the laboratory-based liking assessment. Therefore, it provides representative liking data in large population-based studies including cross-cultural studies.

Parents' and Teachers' Views of Food Environments and Policies in Indian Private Secondary Schools.

School food environments and policies can play a pivotal role in inculcating healthy food habits among young people. This cross-sectional survey explored teachers' and parents' views of the role of school food environments and policies in promoting healthy food consumption among Indian adolescents. Thirty-two teachers and 280 parents from five private, English-speaking, secondary schools in Kolkata, India took part in a short questionnaire survey which included closed and open answer questions. Descriptive and chi-square analyses were performed to compare the responses of parents and teachers. Thematic data analysis underpinned by Template Analysis Technique was employed to examine the qualitative responses. The easy availability and accessibility of energy-dense, nutrient-poor foods, the limited availability of nutritious foods, the absence of written food policies, and inflated prices of nutritious foods were reported as problems in the Indian school food environment. However, the respondents also noted that schools restricted the sale of sugar-sweetened beverages and adopted hygienic food practices. Novel ideas for creating healthy school food environments and effective school canteen policies were also captured during the survey. These findings point to the need to create effective school food policies in Indian secondary schools to help adolescents eat healthily at school. Future research is required to test the feasibility of the implementation of school food policies.

Barriers to Nutrition Promotion in Private Secondary Schools in Kolkata, India: Perspectives of Parents and Teachers.

School-based nutrition promotion is critical to the development of healthy eating habits in adolescents. Unfortunately, most Indian secondary schools do not support healthy eating among adolescents. Therefore, this study was designed to understand the perspectives of teachers and parents regarding the potential barriers to nutrition promotion in Indian secondary schools. Thirty-two teachers and 280 parents from five private English-speaking secondary schools in Kolkata, India took part in a cross-sectional survey. The paper-based survey instrument included both quantitative and qualitative items which were derived from previously published evidence. Descriptive and chi-square analyses were conducted on the quantitative data. Qualitative data were evaluated by thematic data analysis underpinned by the template analysis technique. Five main barriers to nutrition promotion emerged from the study. These included the perceived strong preference for energy-dense, nutrient-poor foods among students; lack of government canteen guidelines; limited engagement of parents, teachers, and adolescents in canteen operations; the widespread display of eye-catching food advertisements; and poor knowledge among canteen personnel with regards to healthy food preparation. These findings about the potential barriers to nutrition promotion provide useful directions for healthy school food policy implementation. Successful implementation of healthy school food policies can inculcate lifelong healthy eating habits among adolescents.

Indian adolescents' perceptions of the home food environment.

BACKGROUND: The home food environment has the potential to influence the eating behaviour of adolescents. This investigation aimed to understand Indian adolescents' perspectives of their home food environments. METHODS: Adolescents aged 14-16 years (n = 1026, 65.3% girls) attending private secondary schools in Kolkata completed a paper-based questionnaire during school time which included questions about family food rules, availability and accessibility of foods at home, and domestic cooking responsibility. Boys' and girls' opinions and experiences were compared through cross-tabulation analyses. RESULTS: Almost all the adolescents reported that fruits (91.6%) and vegetables (95.7%) were always available in their homes. Approximately two-fifths reported that sugar-sweetened beverages (36.2%) and salty snack foods (38.0%) were readily available. In 56.1% households, adolescents were expected to follow certain food rules during mealtimes (e.g. not talking with my mouth full). The majority of the respondents (80.4%) identified mothers as the primary meal providers, only a minority reported that fathers (5.1%) were responsible for preparation of family meals. CONCLUSION: This understanding of the family-environmental determinants of adolescent dietary habits provides useful directions for nutrition promotion interventions. Health and educational professionals associated with adolescents could communicate about the development of healthy home food environments to provide positive health benefits for adolescents and their families.

Immunodominant cytomegalovirus-specific CD8+ T-cell responses in sub-Saharan African populations.

More than 90% of children in Africa are infected with cytomegalovirus (CMV) by the age of 12 months. However, the high-frequency, immunodominant CD8+ T-cell responses that control CMV infection have not been well studied in African populations. We therefore sought to define the immunodominant CMV-specific CD8+ T-cell responses within sub-Saharan African study subjects. Among 257 subjects, we determined the CD8+ T-cell responses to overlapping peptides spanning three of the most immunogenic CMV proteins, pp65, IE-1 and IE-2, using IFN-γ ELISpot assays. A bioinformatics tool was used to predict optimal epitopes within overlapping peptides whose recognition was statistically associated with expression of particular HLA class I molecules. Using this approach, we identified 16 predicted novel CMV-specific epitopes within CMV-pp65, IE-1 and IE-2. The immunodominant pp65-specific, IE-1, IE-2 responses were all either previously well characterised or were confirmed using peptide-MHC tetramers. The novel epitopes identified included an IE-2-specific epitope restricted by HLA*B*44:03 that induced high-frequency CD8+ T-cell responses (mean 3.4% of CD8+ T-cells) in 95% of HLA-B*44:03-positive subjects tested, in one individual accounting for 18.8% of all CD8+ T-cells. These predicted novel CMV-specific CD8+ T-cell epitopes identified in an African cohort will facilitate future analyses of immune responses in African populations where CMV infection is almost universal during infancy.

Dietary intake and sources of sodium and potassium among Australian schoolchildren: results from the cross-sectional Salt and Other Nutrients in Children (SONIC) study.

OBJECTIVES: To examine sodium and potassium urinary excretion by socioeconomic status (SES), discretionary salt use habits and dietary sources of sodium and potassium in a sample of Australian schoolchildren. DESIGN: Cross-sectional study. SETTING: Primary schools located in Victoria, Australia. PARTICIPANTS: 666 of 780 children aged 4-12 years who participated in the Salt and Other Nutrients in Children study returned a complete 24-hour urine collection. PRIMARY AND SECONDARY OUTCOME MEASURES: 24-hour urine collection for the measurement of sodium and potassium excretion and 24-hour dietary recall for the assessment of food sources. Parent and child reported use of discretionary salt. SES defined by parental highest level of education. RESULTS: Participants were 9.3 years (95% CI 9.0 to 9.6) of age and 55% were boys. Mean urinary sodium and potassium excretion was 103 (95% CI 99 to 108) mmol/day (salt equivalent 6.1 g/day) and 47 (95% CI 45 to 49) mmol/day, respectively. Mean molar Na:K ratio was 2.4 (95% CI 2.3 to 2.5). 72% of children exceeded the age-specific upper level for sodium intake. After adjustment for age, sex and day of urine collection, children from a low socioeconomic background excreted 10.0 (95% CI 17.8 to 2.1) mmol/day more sodium than those of high socioeconomic background (p=0.04). The major sources of sodium were bread (14.8%), mixed cereal-based dishes (9.9%) and processed meat (8.5%). The major sources of potassium were dairy milk (11.5%), potatoes (7.1%) and fruit/vegetable juice (5.4%). Core foods provided 55.3% of dietary sodium and 75.5% of potassium while discretionary foods provided 44.7% and 24.5%, respectively. CONCLUSIONS: For most children, sodium intake exceeds dietary recommendations and there is some indication that children of lower socioeconomic background have the highest intakes. Children are consuming about two times more sodium than potassium. To improve sodium and potassium intakes in schoolchildren, product reformulation of lower salt core foods combined with strategies that seek to reduce the consumption of discretionary foods are required.

Saporin-conjugated tetramers identify efficacious anti-HIV CD8+ T-cell specificities.

Antigen-specific T-cells are highly variable, spanning potent antiviral efficacy and damaging auto-reactivity. In virus infections, identifying the most efficacious responses is critical to vaccine design. However, current methods depend on indirect measures or on ex vivo expanded CTL clones. We here describe a novel application of cytotoxic saporin-conjugated tetramers to kill antigen-specific T-cells without significant off-target effects. The relative efficacy of distinct antiviral CD8+ T-cell specificity can be directly assessed via antigen-specific CD8+ T-cell depletion. The utility of these reagents is demonstrated here in identifying the CD8+ T-cell specificity most effective in preventing HIV progression in HIV-infected HLA-B*27-positive immune controllers.

Role of HIV-specific CD8+ T cells in pediatric HIV cure strategies after widespread early viral escape.

Recent studies have suggested greater HIV cure potential among infected children than adults. A major obstacle to HIV eradication in adults is that the viral reservoir is largely comprised of HIV-specific cytotoxic T lymphocyte (CTL) escape variants. We here evaluate the potential for CTL in HIV-infected slow-progressor children to play an effective role in "shock-and-kill" cure strategies. Two distinct subgroups of children were identified on the basis of viral load. Unexpectedly, in both groups, as in adults, HIV-specific CTL drove the selection of escape variants across a range of epitopes within the first weeks of infection. However, in HIV-infected children, but not adults, de novo autologous variant-specific CTL responses were generated, enabling the pediatric immune system to "corner" the virus. Thus, even when escape variants are selected in early infection, the capacity in children to generate variant-specific anti-HIV CTL responses maintains the potential for CTL to contribute to effective shock-and-kill cure strategies in pediatric HIV infection.

Iodine Intakes of Victorian Schoolchildren Measured Using 24-h Urinary Iodine Excretion.

Mandatory fortification of bread with iodized salt was introduced in Australia in 2009, and studies using spot urine collections conducted post fortification indicate that Australian schoolchildren are now replete. However an accurate estimate of daily iodine intake utilizing 24-h urinary iodine excretion (UIE µg/day) has not been reported and compared to the estimated average requirement (EAR). This study aimed to assess daily total iodine intake and status of a sample of primary schoolchildren using 24-h urine samples. Victorian primary school children provided 24-h urine samples between 2011 and 2013, from which urinary iodine concentration (UIC, µg/L) and total iodine excretion (UIE, µg/day) as an estimate of intake was determined. Valid 24-h urine samples were provided by 650 children, mean (SD) age 9.3 (1.8) years (n = 359 boys). The mean UIE of 4-8 and 9-13 year olds was 94 (48) and 111 (57) µg/24-h, respectively, with 29% and 26% having a UIE below the age-specific EAR. The median (IQR) UIC was 124 (83,172) µg/L, with 36% of participants having a UIC < 100 µg/L. This convenience sample of Victorian schoolchildren were found to be iodine replete, based on UIC and estimated iodine intakes derived from 24-h urine collections, confirming the findings of the Australian Health Survey.

HLA-B*14:02-Restricted Env-Specific CD8+ T-Cell Activity Has Highly Potent Antiviral Efficacy Associated with Immune Control of HIV Infection.

Immune control of human immunodeficiency virus type 1 (HIV) infection is typically associated with effective Gag-specific CD8+ T-cell responses. We here focus on HLA-B*14, which protects against HIV disease progression, but the immunodominant HLA-B*14-restricted anti-HIV response is Env specific (ERYLKDQQL, HLA-B*14-EL9). A subdominant HLA-B*14-restricted response targets Gag (DRYFKTLRA, HLA-B*14-DA9). Using HLA-B*14/peptide-saporin-conjugated tetramers, we show that HLA-B*14-EL9 is substantially more potent at inhibiting viral replication than HLA-B*14-DA9. HLA-B*14-EL9 also has significantly higher functional avidity (P < 0.0001) and drives stronger selection pressure on the virus than HLA-B*14-DA9. However, these differences were HLA-B*14 subtype specific, applying only to HLA-B*14:02 and not to HLA-B*14:01. Furthermore, the HLA-B*14-associated protection against HIV disease progression is significantly greater for HLA-B*14:02 than for HLA-B*14:01, consistent with the superior antiviral efficacy of the HLA-B*14-EL9 response. Thus, although Gag-specific CD8+ T-cell responses may usually have greater anti-HIV efficacy, factors independent of protein specificity, including functional avidity of individual responses, are also critically important to immune control of HIV.IMPORTANCE In HIV infection, although cytotoxic T lymphocytes (CTL) play a potentially critical role in eradication of viral reservoirs, the features that constitute an effective response remain poorly defined. We focus on HLA-B*14, unique among HLAs associated with control of HIV in that the dominant CTL response is Env specific, not Gag specific. We demonstrate that Env-specific HLA-B*14-restricted activity is substantially more efficacious than the subdominant HLA-B*14-restricted Gag response. Env immunodominance over Gag and strong Env-mediated selection pressure on HIV are observed only in subjects expressing HLA-B*14:02, and not HLA-B*14:01. This reflects the increased functional avidity of the Env response over Gag, substantially more marked for HLA-B*14:02. Finally, we show that HLA-B*14:02 is significantly more strongly associated with viremic control than HLA-B*14:01. These findings indicate that, although Gag-specific CTL may usually have greater anti-HIV efficacy than Env responses, factors independent of protein specificity, including functional avidity, may carry greater weight in mediating effective control of HIV.

Food consumption patterns of adolescents aged 14-16 years in Kolkata, India.

BACKGROUND: The nutrition transition has brought about rapid changes in the structure of the Indian diet. The replacement of traditional home-cooked meals with ready-to-eat, processed foods has contributed to an increased risk of chronic diseases in urban Indians. Improving the nutrition of Indians by promoting healthy food consumption in early life and in adolescence would help to reduce these health risks. However, little is known about the quality and quantity of foods and beverages consumed by urban Indian adolescents. Therefore, the aim of this study was to describe the food consumption patterns in a sample of urban Indian adolescents. METHODS: A self-administered, semi-quantitative, 59-item meal-based food frequency questionnaire (FFQ) was developed to assess the dietary intake of adolescents over the previous day. A total of 1026 students (aged 14-16 years) attending private, English-speaking schools in Kolkata, India completed the survey. RESULTS: Overall, the adolescents reported poor dietary intakes; over one quarter (30%) reported no consumption of vegetables and 70% reported eating three or more servings of energy-dense snacks, on the previous day. Nearly half of the respondents (45%) did not consume any servings of fruits and 47% reported drinking three or more servings of energy-dense beverages. The mean consumption of food groups in serves/day varied from 0.88 (SD = 1.36) for pulses and legumes to 6.25 (SD = 7.22) for energy-dense snacks. In general, girls had more nutritious dietary intakes than boys. CONCLUSIONS: The Indian adolescents reported poor food consumption patterns, and these findings highlight the need to design effective nutrition promotion strategies to encourage healthy eating in adolescence and targeting food supply and availability.

PARV4 prevalence, phylogeny, immunology and coinfection with HIV, HBV and HCV in a multicentre African cohort.

Background: The seroprevalence of human parvovirus-4 (PARV4) varies considerably by region. In sub-Saharan Africa, seroprevalence is high in the general population, but little is known about the transmission routes or the prevalence of coinfection with blood-borne viruses, HBV, HCV and HIV.  Methods: To further explore the characteristics of PARV4 in this setting, with a particular focus on the prevalence and significance of coinfection, we screened a cohort of 695 individuals recruited from Durban and Kimberley (South Africa) and Gaborone (Botswana) for PARV4 IgG and DNA, as well as documenting HIV, HBV and HCV status.  Results: Within these cohorts, 69% of subjects were HIV-positive. We identified no cases of HCV by PCR, but 7.4% were positive for HBsAg. PARV4 IgG was positive in 42%; seroprevalence was higher in adults (69%) compared to children (21%) (p<0.0001) and in HIV-positive (52%) compared to HIV-negative individuals (24%) (p<0.0001), but there was no association with HBsAg status. We developed an on-line tool to allow visualization of coinfection data (https://purl.oclc.org/coinfection-viz). We identified five subjects who were PCR-positive for PARV4 genotype-3. Ex vivo CD8+ T cell responses spanned the entire PARV4 proteome and we propose a novel HLA-B*57:03-restricted epitope within the NS protein.  Conclusions: This characterisation of PARV4 infection provides enhanced insights into the epidemiology of infection and co-infection in African cohorts, and provides the foundations for planning further focused studies to elucidate transmission pathways, immune responses, and the clinical significance of this organism.

Food environment and policies in private schools in Kolkata, India.

School food policies and services have the potential to influence the food practices and eating behaviours of adolescents which in turn may affect their lifestyles and health in adulthood. The aim of this qualitative investigation was to describe the opinions of adolescents, their parents, nutrition educators and school principals about the prevailing food environment and canteen policies in Indian schools. Fifteen adolescents aged 14-15 years, 15 parents, 12 teachers and 10 principals from 10 private schools in Kolkata, India participated in semi-structured interviews. The interview questions were primarily based on the existing literature related to school food environments and policies. Audio recordings were transcribed verbatim and assessed thematically. Throughout the 52 interviews, a number of inadequacies of the school food environment and policies were revealed. These included the absence of written food policies, the widespread supply of unhealthy foods, inadequate provision of healthy foods, misleading messages about food communicated by school authorities, lack of cleanliness in the school canteen and the high cost of canteen food. Current school food environments do not appear to promote healthy eating among adolescents. Therefore, it is important to upgrade the quality of food services in Indian schools through adoption of healthy eating policies.

Hepcidin is a Better Predictor of Iron Stores in Premenopausal Women than Blood Loss or Dietary Intake.

The relationship between dietary intake, circulating hepcidin and iron status in free-living premenopausal women has not been explored. This cross-sectional study aimed to identify dietary determinants of iron stores after accounting for blood loss and to determine whether iron intake predicts iron stores independently of hepcidin in a sample of Australian women. Three hundred thirty eight women aged 18-50 years were recruited. Total intake and food sources of iron were determined via food frequency questionnaire; the magnitude of menstrual losses was estimated by self-report; and blood donation volume was quantified using blood donation records and self-reported donation frequency. Serum samples were analysed for ferritin, hepcidin and C-reactive protein concentrations. Linear regression was used to investigate associations. Accounting for blood loss, each 1 mg/day increase in dietary iron was associated with a 3% increase in iron stores (p = 0.027); this association was not independent of hepcidin. Hepcidin was a more influential determinant of iron stores than blood loss and dietary factors combined (R² of model including hepcidin = 0.65; R² of model excluding hepcidin = 0.17, p for difference <0.001), and increased hepcidin diminished the positive association between iron intake and iron stores. Despite not being the biggest contributor to dietary iron intake, unprocessed meat was positively associated with iron stores, and each 10% increase in consumption was associated with a 1% increase in iron stores (p = 0.006). No other dietary factors were associated with iron stores. Interventions that reduce hepcidin production combined with dietary strategies to increase iron intake may be important means of improving iron status in women with depleted iron stores.

What influences urban Indian secondary school students' food consumption? - A qualitative study.

Indian adolescents' over reliance on foods such as nutrient-poor snacks, sugar-sweetened beverages and take-away foods puts them at significant risk of obesity and several diet-related chronic diseases. Therefore, the factors that influence their dietary behaviours need to be better understood in order to develop effective nutrition promotion strategies. The purpose of this qualitative inquiry was to investigate adolescents', parents', teachers', and school principals' perceptions of the main influences on adolescent eating behaviours. Fifteen adolescents aged 14-15 years, 15 parents, 12 teachers and 10 principals from 10 private English-speaking schools in Kolkata, India, participated in semi-structured interviews. The digitally-recorded conversations were transcribed verbatim and analysed thematically. The 52 interviews revealed a number of factors that may influence adolescents' eating habits including parent and peer influences, home and school food environments, and the mass media. Emerging evidence suggests that future health and nutrition promotion interventions need to target the different influences on Indian teenagers' food consumption.