Impact of a daily legume-based meal on blood and anthropometric parameters in a group of omnivorous adults: A pilot study.

This pilot study aimed to assess the impact of substituting a traditional lunch for a vegetarian legume-based meal on blood and anthropometric parameters in a group of omnivorous adults. A one-group comparison, quasi-experimental dietary intervention was designed. A vegetarian legume-based meal was offered for 8 consecutive weeks (weekdays) to non-vegetarian individuals (n = 26), (28 years [P25 = 20.0, P75 = 35.5]; 21.9 kg/m2 [P25 = 21.3, P75 = 24.8]). Sociodemographic data, health status and lifestyle-related information were recorded. Three-day food records were used to collect food intake at baseline and at the end of the intervention. Anthropometric parameters were recorded and fasting blood analyses were performed following standard procedures. Wilcoxon signed-rank test was used for statistical comparisons. A p-value <0.05 was considered statistically significant. Participants showed a median intake of 79.8 g of cooked legumes per meal, meaning 13 (50.0%) subjects met the Portuguese daily legume intake recommendations during the intervention days. There were no statistically significant differences in anthropometric parameters. Transferrin concentration increased after 8 weeks (+12.5 mg/dL; p = 0.001). Total cholesterol concentration reduced after 8 weeks (-6 mg/dL; p = 0.041), as well as low-density lipoprotein (LDL) cholesterol (-7 mg/dL; p = 0.003). Triglycerides (+9 mg/dL; p = 0.046), fasting glucose (+2 mg/dL; p = 0.037) and HbA1c (+0.1 mg/dL; p = 0.010) concentration increased after the 2-month legume-based trial. Results suggest a cholesterol-lowering potential of legume-rich diets. However, unfavourable results regarding the impact on glucose metabolism-related biomarkers and triglyceride levels were observed. The study's limitations in design and sample size emphasise the importance of conducting further research with larger cohorts to attain more conclusive findings.

Evaluating E-Health Literacy, Knowledge, Attitude, and Health Online Information in Portuguese University Students: A Cross-Sectional Study.

BACKGROUND: The main objective of the present study was to assess e-health literacy in a sample of Portuguese university students and its association with the level of knowledge and seeking for COVID-19-related information. METHODS: This cross-sectional online study was conducted on Portuguese university students. All students completed a questionnaire consisting of demographic characteristics, e-health Literacy Scale (eHEALS), and a questionnaire about knowledge, attitude, and health online information seeking. RESULTS: A total of 534 students (76.8% women), with a mean age of 24.3 years old (SD = 7.8), participated in this cross-sectional study, 53.0% of students were from non-health sciences. The mean score of eHEALS literacy was 28.8 (SD = 5.6). Most students (71.1%) classified the Internet as a useful, or very useful, tool in helping them make health related decisions. The use of the Internet as a tool to research health information for a period of two or more hours (OR = 1.9; CI 95% = 1.2; 3.4), to search online for health information on professional websites (OR = 2.3; CI 95% = 1.4; 3.6), to search in official media (OR = 2.3; CI 95% = 1.4; 3.9), and to study in the field of health sciences (OR = 1.6; CI 95% = 1.1; 2.6) increased the likelihood of having sufficient e-health literacy. CONCLUSION: From a public health perspective, there is a need to develop programs that increase health literacy among university students.

Dietary Adequacy in Older Adult Nursing Home Residents of the Northern Iberian Peninsula.

According to the latest data, Spain (19.4%) and Portugal (21.8%) are the two European countries with the highest percentage of older adults. Concerns about diet quality are increasing, especially among institutionalized older people, who are at the greatest risk of malnutrition. To assess the adequacy of dietary intake of 186 older adults (>65 y) institutionalized in public nursing homes (NH) in Galicia (Northwest Spain) and the Porto district (Northern Portugal), a cross-sectional study has been carried out. The double-weighing method and a country-specific food composition database were employed for nutritional assessment. Nutritional adequacy was assessed based on the recommendations of the EFSA and WHO. Caloric intake in Spanish NHs was higher than in Portuguese facilities; 20.3% and 35.8% of Spanish and Portuguese residents, respectively, had a protein intake below the EFSA recommendation, and 46.2% and 44.9% of residents in Portugal and Spain, respectively, had lipid intakes below the reference intake range. Further, 45.5% of the residents in Portugal and 66.9% in Spain had a carbohydrate intake within the recommended range. Salt intake was higher than the recommendation for 67.0% and 32.3% of the residents in Spain and Portugal, respectively. This study supports the notion that institutionalized older adults are prone to significant nutritional inadequacies.

Impact of the COVID-19 pandemic on the mental and physical health and overall wellbeing of university students in Portugal.

Throughout the pandemic of COVID-19 caused by SARS-CoV-2, university students were considered a vulnerable risk group for mental health impairment and wellbeing deterioration. This study aimed at evaluating the pandemic's impact on the physical and mental health and wellbeing among students of a Portuguese university. This cross-sectional study included 913 participants and ran from June to October 2020. Data collected included sociodemographics, three mental health self-report questionnaires (Depression Anxiety Stress Scale, Eating Disorder Examination Questionnaire and Brief COPE) and lifestyle practices (eating and sleeping patterns, media, and entertainment habits) during the first months of the pandemic, which included a 72-day full national lockdown. Descriptive and correlational statistical analysis were conducted. Students' food habits changed during the pandemic, namely on the consumption of snacks and fast food and, overall, less balanced meals became more prevalent. Additionally, almost 70% of the students reported Body Mass Index changes, while 59% went through sleep pattern changes-these were more pronounced in women and younger students. Over half (67%) of the inquirees exhibited an increase in their stress, depression, and generalized anxiety symptoms. Also, the study demonstrates that students' lifestyles trended negatively during the pandemic and highlights how important regular psychological, health monitoring and emotional support is, amongst this somehow overlooked population throughout the pandemic. Universities should provide support to overcome challenges in future stressful situations. This study might have an impact on how universities and higher education systems approach their students in terms of mental and physical health monitoring and promotion in future situations, non-related with COVID. Moreover, it has a large sample of students well characterized in terms of mental and physical health, which might be of interest for future comparison with other worldwide group of students throughout stressful situations, such as tragic events, wars, pandemics.

Impact of a daily legume-based meal on dietary and nutritional intake in a group of omnivorous adults.

Adopting eco-friendly diets will demand the consumption of more plant-based protein food sources such as legumes. However, assessing the impact of such a dietary shift on the dietary and nutritional intake of traditionally omnivorous populations is needed. The objective of this study was to assess the impact of substituting a traditional omnivorous-based lunch for a vegetarian, legume-based meal on the daily dietary and nutritional intake in a group of omnivorous adults in the city of Porto, Portugal. Nineteen, non-vegetarian, healthy young adults consumed a vegetarian, legume-based meal from Monday to Friday, for 8 consecutive weeks. Socio-demographic data, health status, lifestyle-related information and anthropometric parameters were recorded. Three-day food records were used to collect food intake at baseline and week 8. European Food Safety Authority and World Health Organization reference values were used to assess nutritional inadequacies. Variables were described as medians (P25 and P75 ). Wilcoxon signed-rank and Mann-Whitney tests were used for statistical comparisons. A p-value of <0.05 was considered statistically significant. Participants consumed 38.0 (P25 = 35.0; P75 = 40.0) meals, resulting in an intake of 84.5 g (P25 = 74.9; P75 = 98.4) of cooked legumes per meal, meaning 11 subjects (57.9%) met the Portuguese guidelines for legume consumption (≥80 g/day of legumes). The current dietary intervention did not seem to aggravate the prevalence of nutritional inadequacies for the macro- and micronutrients tested, except for the case of vitamin B12 (52.6% [95% CI: 28.9-75.6] vs. 78.9% [95% CI: 54.4-94.0]). This could be linked to the reduction of dietary sources of this vitamin which is an expected consequence of vegetarian meals. Dietary changes towards grain legume-based diets are desirable yet need to be carefully implemented to prevent exacerbating potential nutrient inadequacies, especially of vitamin B12 .

The Influence of Serious Games in the Promotion of Healthy Diet and Physical Activity Health: A Systematic Review.

(1) Background: serious games seem to show promising strategies to promote treatment compliance and motivate behavior changes, and some studies have proven to contribute to the literature on serious games. (2) Methods: this systematic review aimed to analyze the effect of serious games in promoting healthy eating behaviors, effectively preventing childhood obesity, and improving physical activity in children. Five electronic bibliographic databases-PubMed, ACM Digital Library, Games for Health Journal, and IEEE Xplore were used to conduct a systematic literature search based on fixed inclusion and exclusion criteria. Peer-reviewed journal articles published between 2003 and 2021 were selected for data extraction. (3) Results: a total of 26 studies were identified, representing 17 games. Half of the studies tested interventions for healthy eating and physical education. Most of the intervention's games were designed according to specific behavioral change theories, predominantly the social cognitive theory. (4) Conclusions: studies confirmed the potential of serious games for obesity prevention but considering the restrictions encountered, we exhort for novel designs with different theoretical perspectives.

Prevalence of nutritional inadequacy in children aged 12-36 months: EPACI Portugal 2012.

Adequate nutritional intake in the first years of life is crucial for future health. The purpose of this study is to assess the adequacy of nutritional intake in Portuguese toddlers. The EPACI Portugal 2012 is a cross-sectional study of a representative sample of toddlers (n = 2230), aged between 12 and 36 months. Data on diets were collected by trained interviewers. The current analysis included 853 children with full data from 3-day food diaries completed by parents/caregivers. Intakes of energy, macro- and micronutrients were estimated through Statistical Program to Assess Dietary Exposure (SPADE). Nutritional adequacy was evaluated using Dietary Reference Values established by the European Food Safety Authority. A large proportion of children exceeded the recommended energy intake. The median daily protein intake was 4.7 g/kg/day, five times more than that recommended. About 9% and 90% of the children consumed a lower proportion of energy than the lower limit of the Reference Intake range for carbohydrates and fat, respectively. Around a third consumed less fibre and magnesium and 100% less vitamin D than the recommended Adequate Intake (AI). Almost a third consumed less vitamin A than the recommended Average Requirement (AR) and 86% of the children showed excessive sodium consumption. Portuguese toddlers consumed a low proportion of energy from fat, had energy and protein intakes above the recommendations and excessive intakes of sodium, and inadequate intakes of vitamin A. Every child consumed less than the recommended AI for vitamin D.

Nutritional intake and food sources in an adult urban Kenyan population.

Urbanisation is hastening the transition from traditional food habits to less healthy diets, which are becoming more common among Kenyans. No up-to-date studies on usual dietary intake and the main food sources of adult Kenyans are available. The aim of the present study was to identify the main food sources of nutrients in the diet of urban adult Kenyans and explore potential associations with demographic variables including age, sex, level of education, occupation and body mass index. The study adopted a cross-sectional design. The dietary intake of 486 adult Kenyans from Nairobi was assessed using a validated, culture-sensitive, semi-quantitative food frequency questionnaire. Binary logistic regression models were used to evaluate associations between food sources and demographic variables. Macronutrient intakes as a proportion of total energy intake (TEI) were within international dietary guidelines. Cereals and grain products (34.0%), sugar, syrups, sweets and snacks (9.8%), fruits (9.7%) and meat and eggs (8.8%) were the major contributors to TEI. Cereals and grain products contributed 42.5% to carbohydrates, followed by fruits (12.4%) and sugar, syrups, sweets and snacks (10.6%). The most important sources of protein and total fat were cereals and grain products (23.3% and 19.7%, respectively) and meat and eggs (22.0% and 18.7%, respectively). Sex, age and level of education were associated with the choice of food groups. Although macronutrient intakes were within guidelines, the Kenyan diet was revealed to be high in sugars, salt and fibre, with differences in food sources according to demographic variables. These results can act as an incentive to national authorities to implement nutritional strategies aiming to raise awareness of healthier dietary patterns among Kenyans.

Widening the Perspectives for Legume Consumption: The Case of Bioactive Non-nutrients.

Legume grains have provided essential nutrients in human diets for centuries, being excellent sources of proteins, carbohydrates, fatty acids, and fibers. They also contain several non-nutrients that historically have been connotated as toxic but that in recent years have been shown to have interesting bioactive properties. The discussion on the role of bioactive non-nutrients is becoming more important due to increasing science-based evidence on their potential antioxidant, hypoglycemic, hypolipidemic, and anticarcinogenic properties. At a time when legume-based products consumption is being strongly promoted by national governments and health authorities, there is a need to clearly define the recommended levels of such non-nutrients in human diets. However, there is insufficient data determining the ideal amount of non-nutrients in legume grains, which will exert the most positive health benefits. This is aligned with insufficient studies that clearly demonstrate if the positive health effects are due to the presence of specific non-nutrients or a result of a dietary balance. In fact, rather than looking directly at the individual food components, most nutritional epidemiology studies relate disease risk with the food and dietary patterns. The purpose of this perspective paper is to explore different types of non-nutrients present in legume grains, discuss the current evidence on their health benefits, and provide awareness for the need for more studies to define a recommended amount of each compound to identify the best approaches, either to enhance or reduce their levels.

Association between parental and offspring BMI: results from EPACI Portugal 2012.

OBJECTIVE: To assess the longitudinal association between parental BMI and offspring's BMI, in EPACI Portugal 2012. DESIGN: Longitudinal study with retrospective collection of children's anthropometry data since birth. Children's anthropometric data were gathered from individual child health bulletins, and parents' anthropometrics were self-reported. Children's and parents' BMI were classified according to WHO cut-offs. Linear mixed models with random intercept and slope for age were applied to quantify the association between parental BMI and children BMI Z-score (zBMI). SETTING: EPACI Portugal 2012. PARTICIPANTS: Representative sample from the Portuguese population (n 2230) aged from 12 to 36 months. RESULTS: 58·9 % of the fathers and 35·6 % of the mothers were overweight (OW) or obese. Prevalence of infants who were, at least, at risk of OW increased from 17·0 % to 30·3 % since birth to 12 months. About half of the mothers with pre-pregnancy OW and obesity (OB) gained gestational weight above the recommendations. The children from mothers with gestational weight gain (GWG) below the recommendations showed a -0·15 SD lower zBMI (95 % CI -0·23, -0·06) in early life, comparing with mothers within GWG recommendations. Children of obese mothers were more likely to present a higher zBMI (0·24 SD, 95 % CI 0·13, 0·35) throughout the first months of life. CONCLUSIONS: A high prevalence of OW and OB was observed in Portuguese young adults and toddlers. Mothers' pre-pregnancy BMI and insufficient GWG had a direct effect on offspring BMI. Early effective interventions are needed in order to prevent the transgenerational transmission of OB.

Benefits of pulse consumption on metabolism and health: A systematic review of randomized controlled trials.

Pulses are nutrient-dense foods that have for a long time been empirically known to have beneficial effects in human health. In the last decade, several studies have gathered evidence of the metabolic benefits of pulse intake. However, it remains unclear at what amounts these effects may be attained. This study aimed to systematically review the scientific outputs of the last two decades regarding health benefits of pulse consumption and the amounts necessary for positive outcomes to be achieved. A PubMed search including keywords [("dietary pulses", "pulses", "legumes", "grain legumes", "bean", "chickpea", "pea", "lentil", "cowpea", "faba bean", "lupin") and ("inflammation", "inflammatory markers", "C-reactive protein", "blood lipids", "cholesterol", "cardiometabolic health", "cardiovascular disease", "diabetes", "glycaemia", "insulin", "HOMA-IR", "body weight", "body fat", "obesity", "overweight", "metabolome", "metabolic profile", "metabolomics", "biomarkers", "microbiome", "microbiota", "gut")] was performed. Only English written papers referring to human dietary interventions, longer than one day, focusing on whole pulses intake, were included. Most of the twenty eligible publications reported improvements in blood lipid profile, blood pressure, inflammation biomarkers, as well as, in body composition, resulting from pulse daily amounts of 150 g (minimum-maximum: 54-360 g/day; cooked). Concerns regarding methodological approaches are evident and the biochemical mechanisms underlying such effects require further investigation.

A culture-sensitive semi-quantitative FFQ for use among the adult population in Nairobi, Kenya: development, validity and reproducibility.

OBJECTIVE: To develop a semi-quantitative FFQ and to evaluate its validity and reproducibility for the assessment of total dietary intake of Kenyan urban adult population, given its non-existence in Kenya. DESIGN: The current study adopted a cross-sectional design. A culture-sensitive semi-quantitative FFQ was developed and its validity was tested relative to three non-consecutive 24-h recalls (24hR). Reproducibility was tested by the test-retest method, with a 3-week interval. Spearman's correlation coefficients and intra-class correlation coefficients were calculated for several macro- and micronutrients. Cross-classification into quartiles and Bland and Altman plots were analysed. SETTING: Nairobi county (Dagoreti South and Starehe constituencies). PARTICIPANTS: A convenient sample was recruited in three different clusters in Nairobi. RESULTS: A culture-sensitive 123-food-item semi-quantitative FFQ showed higher nutrient intakes compared with the 24hR (total energy median 12543·632 v. 8501·888 kJ, P < 0·001). Energy-adjusted and deattenuated Spearman's correlations for macronutrients ranged between 0·21 (total fat) and 0·47 (protein). The agreement in the same quartile varied from 28 % (protein) to 41 % (carbohydrates). Including adjacent quartiles, the range increased: 76 % (protein and fat) to 81 % (carbohydrates). The extreme disagreement was low. The first FFQ application resulted in higher mean values for all nutrients compared with the second FFQ (total energy median 12459·952 v. 10485·104 kJ, P < 0·001). Energy-adjusted correlations for macronutrients ranged from 0·28 (carbohydrates) to 0·61 (protein). Intra-class correlation coefficients for macronutrients were moderate, between 0·6 and 0·7. CONCLUSIONS: The developed semi-quantitative FFQ was shown to be a valid and reproducible tool for ranking urban adult Kenyans according to their dietary intake.

Pulse Consumption among Portuguese Adults: Potential Drivers and Barriers towards a Sustainable Diet.

The transition from diets rich in animal products to plant-based protein foods-like pulses-is crucial, for both environmental sustainability and human health. The aim of this study was to characterize the current consumption and to describe the drivers of and barriers to pulse intake in Portugal. Using a quantitative approach, a semi-structured questionnaire was distributed online, and 1174 valid responses were obtained. The most consumed pulses were beans and peas, consumed at least once a week by 48.3% and 44.4% of the sample, respectively. When participants were asked about the possibility of replacement, even partially, of animal products for pulses, 15.0% stated they would not substitute even in a food scarcity scenario. In the qualitative study, ten individuals involved at different steps of pulses' supply and value chain were interviewed in order to study individual behaviors and experiences linked knowledge and consumption of pulses. It was noticed that the lack of recognition of their nutritional value, the high cooking time and the effect of the anti-nutritional factors were commonly pointed out as barriers. The identification and understanding of perceived barriers for that low consumption will leverage the development of new strategies to promote this promising alternative.

[A Survey Study Assessing Opinions, Knowledge and Training Needs of Physicians Concerning the Field of Transgenic Foods]. / Um Inquérito Sobre a Opinião, Conhecimentos e Necessidades de Formação dos Médicos Relativamente aos Alimentos Transgénicos.

INTRODUCTION: Transgenic (genetically modified) foods are being grown, sold and eaten in Portugal. As such it is important that physicians stay up to date on any negative health consequences of such foods. This study aimed to identify their opinion, knowledge and training needs regarding transgenic foods. MATERIAL AND METHODS: A total of 278 physicians responded to a survey Results: In terms of opinion, 85.8% of physicians had a neutral position, 12.5% had a negative view and a minority (1.7%) was positive. However, 79.8% had a low level of knowledge, 17.7% had an average level of knowledge and only 2.5% showed a high level of knowledge regarding the subject. It should be noted that 91.4% of physicians consider that it is useful to carry out some kind of training during their university education and 65.1% said that it would be very useful during the professional life to have continuing education concerning the issue. Most physicians (83%) could be grouped together according to their interest in learning more. The other group (17%) showed lack of interest. DISCUSSION: Physicians are considered reliable sources, to whom the general population can turn to in order to access valuable health information, which suggests the need to stay up-to-date regarding transgenic foods. CONCLUSION: This is a pioneering study on Portuguese physicians and transgenic foods. Results point to a need for specific training concerning this issue.

Introdução: Há alimentos transgénicos (modificados geneticamente) a serem cultivados, comercializados e consumidos em Portugal. É importante que os médicos se mantenham ao corrente quanto aos impactos de tais alimentos na saúde. Este trabalho propõe-se identificar a opinião, conhecimento e necessidades de formação dos médicos face aos alimentos transgénicos.Material e Métodos: Foi aplicado um inquérito a 278 médicos.Resultados: Em relação à opinião, 85,8% apresentam uma posição neutra, 12,5 % negativa e uma minoria (1,7%) positiva. No entanto, 79,8% têm um nível de conhecimento baixo, 17,7% médio e 2,5% alto. De referir que 91,4% consideram útil existir algum tipo de formação durante a educação universitária e 65,1% destacaram ser muito útil ao longo da vida profissional a existência de formação continuada sobre esta temática. Emergiram dois perfis de médicos: um grupo (83%), interessado em saber mais sobre alimentos transgénicos e outro grupo (17%), desinteressado.Discussão: Os médicos são considerados fontes de referência fiável a quem a população opta por recorrer para obter informação sobre saúde, o que sugere a necessidade de se manter um conhecimento suficiente e atualizado sobre este tema.Conclusão: Este estudo é pioneiro no que se refere ao posicionamento de médicos portugueses relativamente a estes alimentos. Os resultados apontam para uma necessidade de formação específica.

Urban organic community gardening to promote environmental sustainability practices and increase fruit, vegetables and organic food consumption / Prácticas agrícolas ecológicas urbanas para promover la sostenibilidad ambiental y aumentar el consumo de frutas, verduras y alimentos orgánicos

OBJECTIVE: To describe the environmental practices of participants in an urban organic community garden at the beginning of their gardening experience and after a period of six months, and to discover their opinion about how this activity influenced the consumption of vegetables, fruits and organic food. METHOD: Interviews using structured questionnaires were conducted twice with 115 city dwellers: when they started in the vegetable garden and about 6 months later. The questionnaire included questions related to environmental practices. The second evaluation also included questions related to the consumption of organic food, vegetables and fruit. RESULTS: This research showed significant behavioural transformation, including positive outcomes in environmental practices such as recycling and trying to persuade friends or family to recycle, compost leftovers or choose to walk/bike to save petrol. In the opinion of the participants, activities in the organic community garden helped to increase consumption of fruits, vegetables and organic food. CONCLUSIONS: The study results reinforce the hypothesis that an organic community vegetable garden can induce significant, positive behavioural changes among its users. In particular this research suggests horticulture is associated with positive improvements in personal environmental behaviours, awareness of the environment's high social priority and increased consumption of organic food, fruit and vegetables

OBJETIVO: Caracterizar las prácticas ambientales de los participantes de un jardín comunitario orgánico urbano al inicio de su experiencia en prácticas agrícolas y después de 6 meses, así como conocer su opinión sobre cómo esta actividad influyó en el consumo de verduras, frutas y alimentos orgánicos. MÉTODO: Las entrevistas con cuestionarios estructurados se realizaron dos veces a 115 habitantes de la ciudad: cuando comenzaron en la huerta y unos 6 meses después. El cuestionario incluyó preguntas relacionadas con las prácticas ambientales. La segunda evaluación incluyó también preguntas sobre el consumo de alimentos orgánicos, verduras y frutas. RESULTADOS: Se observó una transformación conductual significativa, incluidos resultados positivos en prácticas ambientales como el reciclaje e intentar que amigos o familiares reciclen, la composta de sobras o elegir caminar o ir en bicicleta para ahorrar gasolina. En opinión de los participantes, las prácticas agrícolas de la comunidad orgánica contribuyeron a aumentar el consumo de frutas, verduras y alimentos orgánicos. CONCLUSIÓN: Los resultados del estudio refuerzan la hipótesis de que un huerto comunitario orgánico puede inducir cambios conductuales significativos entre sus usuarios. En particular, esta investigación sugiere que la horticultura se asocia con mejoras positivas en los comportamientos ambientales y la conciencia de la alta prioridad social del medio ambiente y un mayor consumo de alimentos orgánicos, frutas y verduras

Urban organic community gardening to promote environmental sustainability practices and increase fruit, vegetables and organic food consumption.

OBJECTIVE: To describe the environmental practices of participants in an urban organic community garden at the beginning of their gardening experience and after a period of six months, and to discover their opinion about how this activity influenced the consumption of vegetables, fruits and organic food. METHOD: Interviews using structured questionnaires were conducted twice with 115 city dwellers: when they started in the vegetable garden and about 6 months later. The questionnaire included questions related to environmental practices. The second evaluation also included questions related to the consumption of organic food, vegetables and fruit. RESULTS: This research showed significant behavioural transformation, including positive outcomes in environmental practices such as recycling and trying to persuade friends or family to recycle, compost leftovers or choose to walk/bike to save petrol. In the opinion of the participants, activities in the organic community garden helped to increase consumption of fruits, vegetables and organic food. CONCLUSION: The study results reinforce the hypothesis that an organic community vegetable garden can induce significant, positive behavioural changes among its users. In particular this research suggests horticulture is associated with positive improvements in personal environmental behaviours, awareness of the environment's high social priority and increased consumption of organic food, fruit and vegetables.

The Push, Pull, and Enabling Capacities Necessary for Legume Grain Inclusion into Sustainable Agri-Food Systems and Healthy Diets.

Legume grains are traditional crops that have been modernized as processed foods and animal protein alternatives in recent years. This modernization has largely been fueled by new technological developments driven by increased consumer demands for plant protein and gluten-free options. However, consumers must be mindful that legumes have other nutritional attributes besides protein that help achieve healthier diets, and recent evidence suggests that consuming 100 g of legume grains per day would promote nutrient-dense diets and could be a target level to harmonize international strategies for recommended daily allowances. The nutritional richness of legumes has been associated with a decrease in numerous disease risk factors and, given their long shelf life, legumes are excellent choices to combat food waste and may have a role to play in countries where cold storage is often a limitation in food preservation. Besides their inclusion in global diets, legumes should be included in sustainable cropping systems. The high number of edible species and cultivars available render them excellent contributors to biodiverse food and feed systems. Legume cultivation allows reducing environmental impacts by means of the ability of legumes to fix atmospheric nitrogen via a symbiosis with nitrogen-fixing bacteria, making them natural fertilizers. Still, despite the well-known health, nutritional, and environmental benefits, legumes are underrepresented in global agri-food systems. Efforts must be made to make legumes more attractive to the farmer, the industry, and ultimately the consumer, and for this proper local, regional, national, and global policy frameworks must be in place. Here, the local scenario of legumes is showcased, and the most relevant push, pull, and enabling capacities required to achieve sustainable diversified agri-food systems with legumes are discussed.

Consumption of dairy, fruits and dark green leafy vegetables is associated with lower risk of adverse pregnancy outcomes (APO): a prospective cohort study in rural Ethiopia.

BACKGROUND: Poor maternal nutrition during pregnancy is a leading modifiable risk factor associated with risks of adverse pregnancy outcomes (APO). Nevertheless, there is paucity of evidence if consumption of some food groups is associated with lower risk of APO, particularly in low-income settings. We aimed to determine whether consumption of some food groups is associated with lower risk of APOs such as: preterm birth (PTB), low-birth weight (LBW), and stillbirth in rural Central Ethiopia. METHODS: A multi-center (8 health centers) prospective cohort study, enrolling 432 pregnant women during their initial antenatal care visit, was employed. All mothers were then followed monthly (for a total of four visits) from enrollment to delivery. Midwives in respective health centers assessed dietary diversity using the Women's individual dietary diversity score and evaluated birth outcomes following standard procedures. Logistic regression models were run to predict association of food groups with the APO. FINDINGS: Out of the 374 pregnant women who completed the study, one in five [74 (19.8%)] experienced at least one of the APO: 34 (9.1%) gave birth to LBW babies, 51(13.6%) had PTB and 17 (4.5%) experienced stillbirth. Poor or inconsistent consumption (<¾ assessments) of dark green leafy vegetables (adjusted odds ratio (AOR) = 2.01; 95% confidence interval (CI): 1.04-3.87), dairy products (AOR = 2.64; 95% CI: 1.11-6.30), and fruits and vegetables (AOR = 2.92; 95% CI: 1.49-5.67) were independently associated with higher APO risks. Whereas, being nonanemic at term (AOR = 0.24; 95% CI: 0.12-0.48) was independently associated with lower APO risks. CONCLUSIONS: Poor or inconsistent consumption of dairy, dark green leafy vegetables and fruits were associated with higher risk of APOs. While community-based trials and mechanistic studies are needed to substantiate these findings, efforts to promote dietary diversity through increased consumption of fruits, vegetables and dairy may be beneficial in this and similar settings.