LIFANA - toward developing a meal recommender system as a dietary support app for the elderly.

Background: Though a variety of eHealth/mHealth dietary solutions exist, many are ill-adapted to the target population and local eating habits. A specific need exists for the elderly, a growing vulnerable population with limited digital literacy. The LIFANA project aimed at developing a mobile nutrition solution, i.e. a dietary meal-recommender app for personalized meal planning useful for the elderly. Methods: In addition to considering age, gender, and physical activity, the app assured sufficient intake of calories and proteins. The solution was optimized to consider local eating culture in Portugal (PT)/The Netherlands (NL) where it was tested. Recipes (>300) were included and aligned with national food composition dietary databases (FCDBs) to analyse their nutritional values for meal planning. Individual dietary preferences, food restrictions (i.e., allergies), and budget considerations were included in the user profile. The development process involved user integration, including focus groups and usability evaluations, followed by longer field trials in Portugal (n=53 participants, age 60-81 y, 14 months) and the Netherlands (n=107, age 52-86 y, 3 months). Endpoints regarding acceptance/usage frequency, anthropometric measures and (in PT) blood pressure and body fat were collected. Results: 23/34 elderly finalized the trials in PT/NL. No significant changes in anthropometry or other assessed markers, including blood pressure, were observed. 9% (NL) and 47% (PT) of users reported that they would consider using the solution if it were on the market. Conclusions: Via an iterative adaptive process, a dietary app was developed and improved that demonstrated acceptance/user-friendliness comparable to other tools available on the market and allowed - despite the COVID crisis - for stable anthropometric markers and blood pressure. However, it was also observed that additional features, such as a link to an online shopping app, and closer personal follow-up was associated with increased usability and acceptance of the solution and thus further personalization and nudges are warranted to increase employment of such dietary apps.

The Singaporean foodscape - Convenience, choice, entertainment, and sociality for young workers.

Singapore is famous for its diverse, affordable, and exciting foodscape. This paper focuses on understanding the multifaceted role that the Singaporean food environment plays in working young adults' lives, and how young adults interact with this environment to make food choices. Using a focused ethnographic approach, including 33 semi-structured interviews and participant-observation, we explore the ways in which busy working young adults interact with the foodscape. The food environment provides young adults, who eat out frequently, with highly accessible food options that cater to their budgets and palates. They often dine at hawker centres and similar food establishments with colleagues, friends and family. These establishments offer accessible, affordable, and appealing food. Overall, the foodscape provides a source of popular entertainment through the exploration of diverse cuisines and novel shared social experiences. Young adults are heavy users of social media to maintain social networks and to explore the food environment. Capitalizing on this, food marketing on social media targets this group with the promotion of food-related experiences. While it may not always promote healthy eating, the Singaporean foodscape offers convenience, choice, entertainment, and sociality. In the process, it facilitates the formation of cultural and national identity and the protection of mental well-being through the maintenance and development of relationships, and a sense of belonging.

Bitter Is Better: Wild Greens Used in the Blue Zone of Ikaria, Greece.

The current study reports an ethnobotanical field investigation of traditionally gathered and consumed wild greens (Chorta) in one of the five so-called Blue Zones in the world: Ikaria Isle, Greece. Through 31 semi-structured interviews, a total of 56 wild green plants were documented along with their culinary uses, linguistic labels, and locally perceived tastes. Most of the gathered greens were described as bitter and associated with members of Asteraceae and Brassicaceae botanical families (31%), while among the top-quoted wild greens, species belonging to these two plant families accounted for 50% of the wild vegetables, which were consumed mostly cooked. Cross-cultural comparison with foraging in other areas of the central-eastern Mediterranean and the Near East demonstrated a remarkable overlapping of Ikarian greens with Cretan and Sicilian, as well as in the prevalence of bitter-tasting botanical genera. Important differences with other wild greens-related food heritage were found, most notably with the Armenian and Kurdish ones, which do not commonly feature many bitter greens. The proven role of extra-oral bitter taste receptors in the modulation of gastric emptying, glucose absorption and crosstalk with microbiota opens new ways of looking at these differences, in particular with regard to possible health implications. The present study is also an important attempt to preserve and document the bio-cultural gastronomic heritage of Chorta as a quintessential part of the Mediterranean diet. The study recommends that nutritionists, food scientists, and historians, as well as policymakers and practitioners, pay the required attention to traditional rural dietary systems as models of sustainable health.

A socio-ecological framework for examining foodborne parasitic infection risk.

Human liver fluke infection through the consumption of raw freshwater fish is one of the foodborne parasitic infections of global concern. Despite decades of health campaign efforts, high prevalence of infection remains in different areas of the Lower Mekong Basin. This necessitates the consideration of the infection differences between places and the human-environment complexities of disease transmission. This paper used the socio-ecological model as a framework to unraveled the social science dimensions of liver fluke infection. We conducted questionnaire surveys in Northeast Thailand to gather participants' knowledge on liver fluke infection and reasons for raw fish consumption. We synthesized our findings with prior work to identify factors influencing liver fluke infection at four socio-ecological levels. At the individual level, gender and age differences in food consumption habits and personal hygiene of open defection presented the behavioral risks. At the interpersonal level, family tradition and social gathering affected the disease risk. At the community level, physical-social-economic environments of land use and modernization, community health infrastructure and health volunteer support accounted for the varying degree of infection. At the policy level, impacts of regional and national regulations on disease control, health system organization structure, and government development projects were of concerned. The findings provide insights into how infection risks are shaped by people's behavior, social connectedness, interactions with places, and the interplay of these multi-level socio-ecological influences. The framework therefore allows a more comprehensive understanding of liver fluke infection risks to inform a culturally sensitive and sustainable disease control program.

Japanese attitude toward insects as food: The role of tradition.

This study investigated the influence of traditional insect food culture on the acceptance of novel insect foods by comparing a sample from the Kanto area (N = 485) as representative of the Japanese population, and a sample from Nagano Prefecture (N = 198), where entomophagy remains relatively commonly practiced. More than half of the Japanese participants had insect-eating experience (52.0% in the Kanto area, 81.8% in Nagano); however, among them, less than half were currently willing to eat insect foods. Furthermore, when questioned about the dietary substitution of meat and fish with insects, only 7.0% in the Kanto area and 15.7% in Nagano answered positively. Although the regions with a strong insect culture had a higher percentage of people who accepted traditional insect foods, the percentage of people who accepted novel insect foods was not significantly different between the two regions. Results of the regression analysis suggested that food neophobia and food technology neophobia have relatively positive impacts on willingness to eat novel insect foods in Nagano. However, concerns about the taste of insects owing to the experience of eating traditional insect foods counteracted this effect, indicating both positive and negative effects of tradition. Regression analysis of willingness-to-eat and willingness-to-substitute for edible insects suggested that the key to getting people to incorporate insects into their diets is not only to create awareness of the relationship between using insect foods and environmental conservation, but also to dispel concerns about the hygiene of insect foods and develop insect foods with a taste as good as that of meat and fish.

Sociocultural Considerations for Food-Related Quality of Life in Inflammatory Bowel Disease.

The prevalence of inflammatory bowel disease (IBD) is increasing substantially in non-White races and ethnicities in the United States. As a part of promoting quality of life in patients with IBD, the optimization of food-related quality of life (FRQoL) is also indicated. It is known that the practices of food avoidance and restrictive eating are associated with a reduced FRQoL in IBD. Gaining insight into sociocultural influences on FRQoL will aid in the provision of culturally competent interventions to improve FRQoL in patients with IBD.

Impact of cultural and genetic structure on food choices along the Silk Road.

The complex interplay between genetics, culture, and environment forms an individual's biology, influencing their behavior, choices, and health. However, to what extent information derived from this intertwined network could be quantitatively summarized to provide a glance at an individual's lifestyle is difficult to say. Here, we focused on dietary preferences as cultural proxies and genome-wide data of 543 individuals from six historical Silk Road countries: Georgia, Armenia, Azerbaijan, Uzbekistan, Kazakhstan, and Tajikistan. These lands favored the dispersal of innovations, foods, and DNA halfway across Eurasia, thus representing an ideal subject to explore interactions of cultural factors and genetic ancestry. We used discriminant analysis of principal components to infer cultural clusters, where mixed memberships are allowed. Five different clusters emerged. Of these, clusters 1 and 3, driven by aversion to pork and alcoholic beverages, mirrored genetic admixture patterns with the exception of Azerbaijan, which shares preferences supported by Islamic culture with Eastern countries. Cluster 3 was driven by protein-rich foods, whose preference was significantly related to steppe pastoralist ancestry. Sex and age were secondary clustering factors, with clusters formed by male and young individuals being related to alcohol preference and a reduced liking for vegetables. The soft clustering approach enabled us to model and summarize the individual's dietary information in short and informative vectors, which show meaningful interaction with other nondietary attributes of the studied individuals. Encoding other cultural variables would help summarize an individual's culture quantitatively, thus ultimately supporting its inclusion as a covariate in future association studies.

Satiety and consumers' perceptions: What opinions do Argentinian and Brazilian people have about yogurt fortified with dairy and legume proteins?

This study (1) evaluated the perceptions of Argentinian and Brazilian consumers regarding yogurt fortified with dairy proteins, legume proteins, or a combination of both, and (2) determined the satiety expectations of these foods as well as the consumers' intentions to taste and purchase protein-fortified yogurt. A total of 298 Argentinian and 100 Brazilian participants completed an online survey for this study. The free word association technique was used to investigate their perceptions about "satiety" as a verbal stimulus and 6 concepts of yogurt as visual/verbal stimuli (yogurt, set yogurt, skim set yogurt, skim set yogurt with a high content of dairy proteins, skim set yogurt with a high content of legume proteins, and skim set yogurt with a mix of dairy and legume proteins). The expected satiation and intentions to taste or purchase were evaluated using categorical scales. Regardless of their cultural background, participants from both countries expressed similar associations with the stimuli presented. Yogurt and set yogurt were associated with consumption occasions, sensory characteristics, liking, and foods, whereas skim yogurt was associated with diet food. Products fortified with proteins were associated with healthy foods, regardless of the protein source, and they yielded the highest rates for expected satiation. Brazilian participants were more likely to taste the food with a combination of proteins; however, participants from both countries were indifferent to purchasing the product. Important characteristics in the design and marketing of these products were pleasant sensations, such as "fullness," "satisfied," and snacks to eat "on the go," and the vegetarian consumers' segment. The combination with fruits or cereals, creaminess, and vanilla flavor should also be considered. The study findings could have implications for the dairy industry when designing yogurt fortified with proteins and communicating the nutritional and wholesome properties of these products.

Nutrient Profiling of Japanese Dishes: The Development of a Novel Ajinomoto Group Nutrient Profiling System.

Government agencies and private companies have supported the development of nutrient profiling (NP) systems to facilitate the selection of nutrient-dense foods by consumers, promote nutritious food development, and limit excessive advertising of products with low nutritional value. While most NP models were developed to assess individual foods, the Ajinomoto Group Nutrient Profiling System (ANPS) was developed to assess the overall nutritional value of cooked dishes that are culturally specific to Japan. Based on the national dietary recommendations and nutritional surveys, target values were created for 13 dish categories, while considering the combinations of meal units. For the ANPS, the four evaluating elements were protein and vegetables, which should be encouraged, and sodium and saturated fatty acids, which should be limited. The ANPS algorithm for dishes was the sum of the scores of individual elements, with a maximum of 10 points per serving. The sum of scores was then multiplied by 2.5 to convert to the 100-point scale. Convergent validity was tested using the nutrient-rich food index (NRF) score of 6.3. In total, 1,089 popular Japanese dishes were evaluated using the ANPS, and the median score of ANPS was 70.0 points (interquartile range, 55-78.8), and the average score was 67.7 (standard deviation, 16.5) points. Since salt intake is a major health risk in Japan, this tool was designed to evaluate sodium content with high sensitivity, and low-salt dishes significantly improved sodium and ANPS scores compared with regular dishes. The Pearson's correlation coefficient between the total score of NRF 6.3 and ANPS in 1,089 dishes was r = 0.452 (p < 0.0001). This newly developed ANPS could be used to evaluate culture-specific cooked dishes per serving size. It can determine the nutritional values of dishes, with a high sensitivity to sodium content, a major Japanese nutritional issue. Further research is needed to determine the accuracy and usefulness of the ANPS as a system that would lead to changes in eating behavior nationwide.

It Seems Italian, Doesn't It? An Exploratory Analysis of English and Spanish Consumers about Italian Appearance Food Products.

The Italian export of agri-food products has been increasingly threatened by the unfair use of misleading Italian symbols (such as the national flag or the green-white-red colors) by non-Italian producers. This research paper investigated what English and Spanish consumers know about "Made in Italy" food, and their attitude towards Italian appearance food products. Primary data were collected in Spain and England, and a probit model was used to identify the determinants of consumers' vulnerability to misleading Italian symbols. We found that merely having Italian symbols on the package might lead almost half of the consumers in the sample to consider food as Made in Italy, regardless of the actual origin. This result confirms the severity of the problem. The econometric model provides suggestions for public actions to mitigate the issue.

Consumer adoption of plant-based meat substitutes: A network of social practices.

This research aimed to understand the consumption practices of plant-based meat substitutes (PBMS). Semi-structured in-depth interviews were conducted with consumers and Social Practice Theory (SPT) was adopted as the theoretical framework to explore emerging themes relating to consumer practices. Findings indicate that consumers engage in a number of related practices that include the acquisition, preparation, and consumption of PBMS which were embedded within a larger network of practices that included storage, substitution, and food safety, as well as broader meat-based, meat-free, plant-based, and social and cultural practices. This paper highlights the importance of social and cultural structures in facilitating product awareness, and meaning and skill development in the context of dietary and behavioural change. Implications for research, marketing, and policymaking practices are discussed with regard to the marketing of plant-based meat substitutes as well as shifting consumer behaviour.

Why We Eat the Way We Do: A Call to Consider Food Culture in Public Health Initiatives.

The way we eat has changed dramatically in only a few decades. While definitions of food culture have previously existed, a clear description of modern food culture that can be used for health promotion is lacking. In this paper, we propose a concept of food culture for application within public health, what a positive food culture looks like compared to negative elements that have dominated in developed countries and the consequences for physical and mental health and wellbeing. We support calls to action from the international community to reconsider the way we eat. All segments of society have a role to play in building a positive food culture, and it is critical that macro (policy and systems) and meso (community) level environmental factors align and provide supportive environments that promote health-enhancing behaviours. Defining food culture is a necessary step towards articulating the complexities that influence food behaviours and impact health. The ultimate goal is collective action to enable population-wide and sustained improvements to the way we eat, and how we think and feel about food.

A Community-Based Approach to Integrating Socio, Cultural and Environmental Contexts in the Development of a Food Database for Indigenous and Rural Populations: The Case of the Batwa and Bakiga in South-Western Uganda.

Comprehensive food lists and databases are a critical input for programs aiming to alleviate undernutrition. However, standard methods for developing them may produce databases that are irrelevant for marginalised groups where nutritional needs are highest. Our study provides a method for identifying critical contextual information required to build relevant food lists for Indigenous populations. For our study, we used mixed-methods study design with a community-based approach. Between July and October 2019, we interviewed 74 participants among Batwa and Bakiga communities in south-western Uganda. We conducted focus groups discussions (FGDs), individual dietary surveys and markets and shops assessment. Locally validated information on foods consumed among Indigenous populations can provide results that differ from foods listed in the national food composition tables; in fact, the construction of food lists is influenced by multiple factors such as food culture and meaning of food, environmental changes, dietary transition, and social context. Without using a community-based approach to understanding socio-environmental contexts, we would have missed 33 commonly consumed recipes and foods, and we would not have known the variety of ingredients' quantity in each recipe, and traditional foraged foods. The food culture, food systems and nutrition of Indigenous and vulnerable communities are unique, and need to be considered when developing food lists.

Contribución de las organizaciones sociales "ollas comunes" a la alimentación de la población chilena en tiempos de pandemia por COVID-19

RESUMEN Las "ollas comunes" (OC) son organizaciones sociales temporales que entregan alimentación gratuita en periodos de crisis. En Chile, resurgen el año 2020 a raíz de la pandemia del COVID-19, y si bien han aparecido en otros períodos de la historia, no ha sido cuantificada su contribución. El objetivo de este estudio fue determinar su contribución a la alimentación y nutrición de las/os chilenas/os, mediante la caracterización y análisis de su oferta alimentaria. Se realizó un estudio descriptivo mediante la aplicación de una encuesta online a voluntarias/os de todo el territorio nacional, la cual incluyó una caracterización del encuestado/a, de la OC que representa y de las preparaciones ofrecidas, en base a lo cual se obtuvo el aporte calórico y nutricional. Contestaron 117 OC (5,1% zona norte, 85,5% centro y 9,4% sur) cuya contribución principal fue con almuerzos (95,9%) con una mediana de 150 (p25: 100 - p75: 200) raciones diarias, compuestas por plato de fondo (95,9%), pan (80,5%) y ensalada (74,8%). Las preparaciones más prevalentes fueron legumbres (91,1%), arroz (78%) y fideos (77,2%). Estos almuerzos aportaron en promedio un 23% del requerimiento energético diario y aportan con el 35% del requerimiento de fibra, pero su aporte en vitamina B12, zinc y hierro fue bajo respecto del requerimiento y aporte esperado para el tiempo de comida. Hasta la fecha, estos datos son los primeros publicados sobre el tema, siendo útiles para determinar su aporte a la seguridad alimentaria del país en tiempos de crisis.

ABSTRACT "Communal Pots" (CP) are temporary social organizations that provide free food in times of crisis. In Chile, as a result of the COVID-19 pandemic, in 2020 the CP resurfaced and, although they have appeared in other periods of history, how they benefitted the population is unknown. The objective of this study is to determine the contribution of the CP to the diet and nutrition of Chileans, through the characterization and analysis of their food supply. For this, a descriptive study was carried out based on an online survey sent to volunteers from all over the country after signing the informed consent. The survey included characterization of the respondent and the CP they represented, the preparations offered by the CP, based on which the caloric and nutritional contribution was obtained. In total, 117 CP answered; 5.1% from the north, 85.5% from the center and 9.4% from the south of Chile. Their main contribution was providing lunches (95.9%) with a median of 150 (p25: 100 - p75: 200) daily rations, made up of a main entree (95.9%), bread (80.5%) and salad (74.8%). The most popular preparations were legumes (91.1%), rice (78%) and noodles (77.2%). These lunches provide an average of 23% of the daily energy requirement and 35% of the fiber requirement, but their contribution of vitamin B12 (2.5%), zinc (25%) and iron (28% req. woman) was low regarding the requirement and expected contribution for the meal time. To date, these data are the first published, to report on the real influence of this social movement in the country's food security in times of crisis.

How Do French Parents Determine Portion Sizes for Their Pre-Schooler? A Qualitative Exploration of the Parent-Child Division of Responsibility and Influencing Factors.

Large portion sizes can make children overeat, alter their self-regulation abilities and induce weight gain. However, little is known about how parents determine portion sizes for their children. Using semi-structured interviews with 5 fathers and 32 mothers of pre-schoolers, this study examined French parents' food portioning practices. The division of responsibility between parent and child in deciding portion sizes was explored, as well as the influencing factors and possible sources of information. Parents described a wide range of practices. For most, determining portion sizes is an intuitive action that depends on habits and mainly arises from experiences with feeding their child and his/her appetitive traits. Few parents grant autonomy to their child for portioning and serving food, especially for the first serving. Many influencing factors were identified, including child-related (e.g., appetite, food preferences), parent-related (e.g., avoiding food waste), and external factors (e.g., influence of siblings, French food culture). Most parents do not search for information/recommendations to guide their practices. Stimulating optimal self-regulation of eating in children is important and parents can play a crucial role in this. This study identified barriers and facilitators to guide parents in providing appropriate portion sizes and help include children in this decision process.

An exploratory study on the sociocultural consequences of food consumption patterns among African American girls.

African American women, in particular, have learned to navigate through a food consumption landscape that purposefully, and often aggressively, limits their choices and stigmatizes their resulting physical appearance, and renders them collectively unattractive and unworthy. While American women are challenged to subscribe to traditional slim body standards, a faction of Americans have differing opinions. African American (AA) women celebrate larger body types and defy weight stigma. When African Americans make food choices, taste and cost are not the only factors influencing those choices; the cultural role of food is also considered. We conducted semi-structured interviews with 12 African American girls to identify some of the consequences of this consumption practice that challenges what we argue is a hegemonic taste regime surrounding body size. This work further elucidates the ways in which the African American community has operationalized the concept of cultural capital around the issues of body image to create what we suggest is a type of emotional well-being. In addition to uncovering marketing channels promoting anti-obesity campaigns that would be more likely to capture their attention, our findings also reveal that AA girls embrace shapely bodies, despite not necessarily having one themselves, and overall possess a more positive body image than their Caucasian peers. Having shapely bodies was deemed more attractive among romantic interests and acceptable overall in the AA community regardless of the associated health risks associated with consuming unhealthy foods.

Consumption Preferences of Pulses in the Diet of Polish People: Motives and Barriers to Replace Animal Protein with Vegetable Protein.

Today, with easy access to information, people are aware of the health benefits of pulses and their significant role in sustainable consumption. Despite this, the consumption of pulses still remains low in many developed and developing countries. The authors of the study attempted to fill the gaps in knowledge about determinants that influence the consumption of pulses. The study was conducted to identify the motives and barriers which, according to a consumer, influence the level of consumption of pulses. An attempt was made to determine to what extent a consumer is influenced by culinary trends (using the multiple linear regression equation). The survey was conducted on a sample of 1067 Polish respondents. The sample was representative and selected to reflect the social demographic distribution of the respondents. In the research, descriptive statistics were used, as well as a t-test, linear regression statistics, and discriminant function analysis. Pulses are more often considered by women to be healthy and nutritious products as well as a good alternative to meat products. The price of pulses products is very important. Men also consider those qualities to be encouraging to consume pulses, but to a lesser extent than women. The lack of knowledge and skills to prepare tasty meals from pulses is one of the most important barriers which, both in the case of women and men, prevents consumers from eating pulses more often. Identified types of diets of the respondents in the research sample showed differences in the regularity of consumption of different selected pulse products. The obtained results indicated that Polish consumers are influenced by other cuisines of the world in their preferences. The most influential cuisines were the Middle Eastern and Mediterranean, with a variety of dishes that are prepared based on pulse products. It should be emphasized that to increase the consumption of pulses, it is necessary to continue educating society through various channels, e.g., culinary, health, information programs, or by inviting celebrities who enjoy the great trust of the society to take part in the advertisement.

Da Amazônia ao guia: os dilemas entre a alimentação quilombola e as recomendações do guia alimentar para a população brasileira / From the Amazon to the guidelines: the dilemmas between quilombola foods and the recommendations of the dietary guidelines for the Brazilian population

Resumo O objetivo deste trabalho é analisar se o hábito alimentar das famílias quilombolas paraenses segue as orientações do Guia Alimentar para a População Brasileira, publicado pelo Ministério da Saúde, em 2014. Foram realizadas entrevistas semiestruturadas nas comunidades de Santo Antônio (Concórdia do Pará, nordeste paraense) e São João (Salvaterra, ilha do Marajó) sob o protocolo CEP 060/07. Foram feitas análises do consumo e das preferências alimentares de acordo com o guia. Os resultados evidenciam: alto consumo de café adoçado, feijão, arroz e farinha; baixa participação de verduras, legumes e frutas na dieta dos entrevistados. Alimentos como pão, leite de vaca, macarrão, margarina e bolacha salgada são as formas comuns de diversificar os alimentos consumidos pelo grupo. Como fontes proteicas, destacam-se a carne vermelha - silvestre ou não -, o pescado, o charque, o frango e o ovo de galinha. São apresentadas algumas contradições do guia quando aplicado às comunidades. Apesar dos avanços do guia, conclui-se que o cumprimento das orientações para uma alimentação adequada e saudável nos grupos quilombolas da região amazônica enfrenta desafios. Guias alimentares são importantes para a saúde e a nutrição da população, porém precisam ser combinados com outros tipos de intervenções que respeitem a diversidade cultural do país.

Abstract The objective of this study is to analyze the food habit of quilombola families in Pará, following the guidelines of the Food Guide for the Brazilian Population published by the Brazilian Health Ministry in 2014. Semi-structured interviews were conducted in the communities of Santo Antônio (Concórdia do Pará, in the Northeast) and São João (Salvaterra, on Marajó Island) under protocol CEP 060/07. Analysis of consumption and preferences were made according to the guide. The results show a high consumption of sweetened coffee, beans, rice and flour, and a low participation of vegetables and fruits in the interviewees' diet. Foods such as bread, cow's milk, pasta, margarine, and salt crackers are common means to diversify the foods consumed by the group. As protein sources, the most notable were red meat - wild or not -, fish, beef jerky, chicken and chicken eggs. Some contradictions of the Guide are discussed in relation to such communities. Despite the advancements promoted by the guide, we conclude that following the guidelines for an adequate and healthy food habit in quilombola groups in the Amazon region presents many challenges. Food guides are important for the health and nutrition of the population; however, they need to be combined with other types of interventions that respect the country's cultural diversity.

Cultural Influences on the Regulation of Energy Intake and Obesity: A Qualitative Study Comparing Food Customs and Attitudes to Eating in Adults from France and the United States.

(1) Background: The influence of food culture on eating behavior and obesity risk is poorly understood. (2) Methods: In this qualitative study, 25 adults in France with or without overweight/obesity participated in semi-structured interviews (n = 10) or focus groups (n = 15) to examine attitudes to food consumption and external pressures that influence eating behavior and weight management. Results were compared to an equivalent study conducted in the United States, thereby contrasting two countries with markedly different rates of obesity. Emerging key themes in the French data were identified through coding using a reflexive approach. (3) Results: The main themes identified were: (1) influence of commensality, social interactions, and pleasure from eating on eating behavior, (2) having a balanced and holistic approach to nutrition, (3) the role of environmental concerns in food consumption, (4) relationship with "natural" products (idealized) and food processing (demonized), (5) perceptions of weight status and management. Stress and difficulties in hunger cue discernment were viewed as important obstacles to weight management in both countries. External pressures were described as a major factor that explicitly influences food consumption in the U.S., while there was an implicit influence of external pressures through eating-related social interactions in France. In France, products considered "natural" where idealized and juxtaposed against processed and "industrial" products, whereas this was not a salient aspect in the U.S. (4) Conclusions: This first comparative qualitative study assessing aspects of food culture and eating behaviors across countries identifies both common and divergent attitudes to food and eating behavior. Further studies are needed to inform the development of effective behavioral interventions to address obesity in different populations.