Unpacking the Public Health Triad of Social Inequality in Health, Health Literacy, and Quality of Life-A Scoping Review of Research Characteristics.

Social inequalities in health, health literacy, and quality of life serve as distinct public health indicators, but it remains unclear how and to what extent they are applied and combined in the literature. Thus, the characteristics of the research have yet to be established, and we aim to identify and describe the characteristics of research that intersects social inequality in health, health literacy, and quality of life. We conducted a scoping review with systematic searches in ten databases. Studies applying any design in any population were eligible if social inequality in health, health literacy, and quality of life were combined. Citations were independently screened using Covidence. The search yielded 4111 citations, with 73 eligible reports. The reviewed research was mostly quantitative and aimed at patient populations in a community setting, with a scarcity of reports specifically defining and assessing social inequality in health, health literacy, and quality of life, and with only 2/73 citations providing a definition for all three. The published research combining social inequality in health, health literacy, and quality of life is heterogeneous regarding research designs, populations, contexts, and geography, where social inequality appears as a contextualizing variable.

Student's experiences with online teaching following COVID-19 lockdown: A mixed methods explorative study.

BACKGROUND: The COVID-19 pandemic lead to a sudden shift to online teaching and restricted campus access. AIM: To assess how university students experienced the sudden shift to online teaching after closure of campus due to the COVID-19 pandemic. MATERIAL AND METHODS: Students in Public Health Nutrition answered questionnaires two and 12 weeks (N = 79: response rate 20.3% and 26.6%, respectively) after the lockdown in Norway on 12 March 2020 and participated in digital focus group interviews in May 2020 (mixed methods study). FINDINGS AND DISCUSSION: Two weeks into the lockdown, 75% of students reported that their life had become more difficult and 50% felt that learning outcomes would be harder to achieve due to the sudden shift to online education. Twelve weeks into the lockdown, the corresponding numbers were 57% and 71%, respectively. The most pressing concerns among students were a lack of social interaction, housing situations that were unfit for home office purposes, including insufficient data bandwidth, and an overall sense of reduced motivation and effort. The students collaborated well in digital groups but wanted smaller groups with students they knew rather than being randomly assigned to groups. Most students agreed that pre-recorded and streamed lectures, frequent virtual meetings and student response systems could improve learning outcomes in future digital courses. The preference for written home exams over online versions of previous on-campus exams was likely influenced by student's familiarity with the former. The dropout rate remained unchanged compared to previous years. CONCLUSION: The sudden shift to digital teaching was challenging for students, but it appears that they adapted quickly to the new situation. Although the concerns described by students in this study may only be representative for the period right after campus lockdown, the study provide the student perspective on a unique period of time in higher education.

Duration of Lactation and Maternal Risk of Metabolic Syndrome: A Systematic Review and Meta-Analysis.

Cardiovascular disease (CVD) is the leading cause of death of women across all ages, and targeting modifiable risk factors, such as those comprised in metabolic syndrome (MetS) (e.g., waist circumference, lipid profile, blood pressure, and blood glucose), is of great importance. An inverse association between lactation and CVD has been suggested, and lactation may decrease the risk of MetS. This systematic review and meta-analysis examined how lactation may affect the development and prevalence of MetS in women. A literature search was performed using Cinahl, Embase, Web of Science, and PubMed. A total of 1286 citations were identified, and finally, ten studies (two prospective and eight cross-sectional) were included. Seven studies (two prospective and five cross-sectional) revealed associations between lactation and MetS, suggesting that breastfeeding might prevent or improve metabolic health and have a protective role in MetS prevention. This protective role might be related to the duration of lactation; however, a lack of controlling for potential confounders, such as parity, might inflict the results. The pooled effect was non-conclusive. Additional research is required to further explore the duration of lactation and its potential role in improving or reversing MetS and its components.

Improving Cardiovascular Health through Nudging Healthier Food Choices: A Systematic Review.

Obesity and metabolic syndrome are considered major public health problems, and their negative impact on cardiovascular disease (CVD) and diabetes mellitus type 2 (DM2) is profound. Targeting modifiable risk factors such as dietary habits is therefore of great importance. Many of today's health challenges with overweight and obesity may have behavioral roots, and traditional methods such as regulations and campaigns are often insufficient to improve dietary choices. Nudging or choice architecture might be a viable tool to influence people's everyday choices and behaviors to better outcomes. This paper reviews the current state of the rapidly expanding number of experimental field studies that investigate the effects/associations of nudging on healthy food choices. A systematic literature search was conducted in PubMed, where 142 citations were identified. Based on selection criteria, six randomized controlled trials and 15 non-randomized controlled trials were ultimately included. The results of this systematic review show that many of the studies included traffic-light labeling, which may be a promising strategy. The reviewed findings, however, also highlight the challenges that confront experimental studies examining the impact of nudging on diet.

Nutrients in Fish and Possible Associations with Cardiovascular Disease Risk Factors in Metabolic Syndrome.

Non-communicable diseases (NSDs) are responsible for two-thirds of all deaths globally, whereas cardiovascular disease (CVD) alone counts for nearly half of them. To reduce the impact of CVD, targeting modifiable risk factors comprised in metabolic syndrome (e.g., waist circumference, lipid profile, blood pressure, and blood glucose) is of great importance. Beneficial effects of fish consumption on CVD has been revealed over the past decades, and some studies suggest that fish consumption may have a protective role in preventing metabolic syndrome. Fish contains a variety of nutrients that may contribute to health benefits. This review examines current recommendations for fish intake as a source of various nutrients (proteins, n-3 fatty acids, vitamin D, iodine, selenium, and taurine), and their effects on metabolic syndrome and the CVD risk factors. Fatty fish is recommended due to its high levels of n-3 fatty acids, however lean fish also contains nutrients that may be beneficial in the prevention of CVD.

Lean Fish Consumption Is Associated with Beneficial Changes in the Metabolic Syndrome Components: A 13-Year Follow-Up Study from the Norwegian Tromsø Study.

BACKGROUND: Fish consumption may have beneficial effects on metabolic syndrome (MetS); however, limited information of such associations exists. This study investigated possible associations between fish consumption and changes in MetS components during a 13-year follow-up period. METHODS: The sample included participants (26-69 years) from the Tromsø Study 4 (1994-1995, n = 23,907) and Tromsø Study 6 (2007-2008, n = 12,981). Data were collected using questionnaires including food frequency questions, non-fasting blood samples, and physical examinations. MetS was defined using the Joint Interim Societies (JIS) definition, in which one point was given for each MetS criteria fulfilled (metabolic score). Longitudinal analyses were performed using Linear mixed models. RESULTS: For both genders, lean fish consumption once a week or more was significantly associated with decreased future metabolic score, decreased triglycerides, and increased high-density lipoprotein (HDL)-cholesterol, whereas decreased waist circumference and blood pressure was identified only for men (age adjusted models). Fatty fish consumption was significantly associated with increased waist circumference for both genders and increased HDL-cholesterol levels in men. Conclusion: The results suggest that fatty and lean fish consumption may influence MetS differently and that lean fish consumption in particular seems to be associated with beneficial changes in the MetS components.

Fish consumption and its possible preventive role on the development and prevalence of metabolic syndrome - a systematic review.

Metabolic syndrome (MetS) has a huge impact on public health, and today lifestyle interventions remain the primary mode for MetS therapy. It is therefore important to elucidate the possible preventive effects of diet and foods, and their MetS-related health implications. To examine how fish consumption affects the development and prevalence of MetS, we systematically reviewed cross-sectional, prospective cohort, and intervention studies conducted among adults (humans) and, reporting consumption of fish or seafood as being related to MetS (prevalence or incidence), where MetS was defined via an established definition. The literature search in PubMed identified 502 citations, and after screening, 49 full-text articles were retrieved and assessed for eligibility. After excluding duplicates and those not meeting the inclusion criteria, seven studies from Croatia, Finland, France, Iceland, Iran, Korea, and US were included. Four studies (one follow-up and three cross-sectional) found associations between fish consumption and MetS (three among men, and one among women), suggesting that fish consumption may prevent or improve metabolic health and have a protective role in MetS prevention. This protective role might be related to gender, and men may benefit more from the consumption of fish. However, lack of controlling for potential confounders may also inflict the results. Additional research is required to further explore fish consumption and its potential role in improving or reversing MetS and its components.

Duration of lactation, maternal metabolic profile, and body composition in the Norwegian EBBA I-study.

OBJECTIVE: There is conflicting evidence as to whether duration of lactation may decrease the risk of subsequent development of an unfavorable maternal metabolic profile, including overweight and obesity. We hypothesized that duration of lactation is associated with a more favorable metabolic profile and healthier anthropometric measurements. SUBJECTS AND METHODS: Ninety-eight parous women were studied from the Norwegian EBBAI-study (Energy Balance and Breast cancer Aspects-study), a cross-sectional study of healthy premenopausal women 25-35 years old. Historical lactation data were collected, anthropometric measurements were taken, fasting blood samples (for serum glucose, triglycerides, total cholesterol, and high-density lipoprotein cholesterol) were drawn, and women were asked to fill in a precoded food diary. RESULTS: Mean time since last birth was 4.7 years, mean number of children was 1.9, mean total duration of lactation was 19 months, and average length of lactation per child was 10.3 months. Women who on average lactated for less than 10 months per child had higher mean levels of fasting serum glucose (5.2 mmol/L vs. 5.0 mmol/L, p=0.04), serum triglyceride (0.91 mmol/L vs. 0.66 mmol/L, p=0.001), and serum cholesterol (4.78 mmol/L vs. 4.32 mmol/L, p=0.004) and a higher waist-to-hip ratio (0.81 vs. 0.77, p=0.001) than women who lactated for 10 months or more per child. The inverse association between average length of lactation per child and waist-to-hip ratio persisted after adjustment for potential confounders. CONCLUSIONS: These results support the hypothesis that duration of lactation may be associated with a healthier metabolic profile and healthier anthropometric measurements, especially lipid levels and waist-to-hip ratio, even years after weaning.