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1.
BMC Public Health ; 21(1): 1029, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-34074273

RESUMO

BACKGROUND: In Bangladesh overweight and obesity among urban school children are on the rise. Urban school children tend to consume foods dense in calories and few fruits and vegetables which is associated with overweight and obesity. The current study explored the barriers and opportunities for promoting healthy diets among school children from the perspective of teachers and parents in Dhaka, Bangladesh. METHODS: We conducted 14 key informant interviews with teachers and principals, six focus group discussions with 31 mothers of school children (5 to 15 year old) and 14 structured observations of the school food environment. Inductive thematic analysis was performed manually. RESULTS: Schools were important for development of food preferences of children, however, most school cafeterias provided foods based on profit rather than health considerations. A shift in food culture resulted in making eating out acquire many meanings beyond convenience. Mothers, especially those who were employed, struggled to prepare healthy foods due to time pressure. Mothers were generally concerned about chemicals added to raw foods in markets which led to limited fruit and vegetable consumption. CONCLUSIONS: There were many challenges to promoting healthy foods to school children within and outside the school. It is important to formulate policies and guidance to create a supportive environment for healthy foods in and in the proximity of schools. It is also important to educate consumers about identifying and choosing healthy foods. Laws related to food safety should be adequately implemented to boost the population's confidence in safety of available healthy foods in the food system.


Assuntos
Serviços de Alimentação , Instituições Acadêmicas , Adolescente , Bangladesh , Criança , Pré-Escolar , Dieta Saudável , Feminino , Grupos Focais , Frutas , Humanos , Pesquisa Qualitativa , Verduras
2.
Artigo em Inglês | MEDLINE | ID: mdl-34066312

RESUMO

BACKGROUND: The COVID-19 pandemic has been disseminating fear in the community, which has affected people's quality of life, especially those with health problems. Health literacy (HL), eHealth literacy (eHEAL), and digital healthy diet literacy (DDL) may have potential impacts on containing the pandemic and its consequences. This study aimed to examine the association between the fear of COVID-19 scale (FCoV-19S) and the health-related quality of life (HRQoL), and to examine the effect modification by HL, eHEAL, and DDL on this association. METHODS: A cross-sectional study was conducted in 11 hospitals across Vietnam from 7 April to 31 May 2020. Data were collected on 4348 outpatients, including demographic characteristics, HL, eHEAL, DDL, FCoV-19S, and HRQoL. Multiple linear regression and interaction models were used to explore associations. RESULTS: Patients with higher FCoV-19S scores had lower HRQoL scores (unstandardized coefficient, B = -0.78, p < 0.001). HL (B = 0.20, p < 0.001), eHEAL (B = 0.24, p < 0.001), and DDL (B = 0.20, p < 0.001) were positively associated with higher HRQoL scores. The negative impact of FCoV-19S on HRQoL was significantly attenuated by higher eHEAL score groups (from one standard deviation (SD) below the mean, B = -0.93, p < 0.001; to the mean, B = -0.85, p < 0.001; and one SD above the mean, B = -0.77, p < 0.001); and by higher DDL score groups (from one SD below the mean, B = -0.92, p < 0.001; to the mean, B = -0.82, p < 0.001; and one SD above the mean, B = -0.72, p < 0.001). CONCLUSIONS: eHealth literacy and digital healthy diet literacy could help to protect patients' health-related quality of life from the negative impact of the fear of COVID-19 during the pandemic.


Assuntos
COVID-19 , Letramento em Saúde , Telemedicina , Estudos Transversais , Dieta Saudável , Medo , Hospitais , Humanos , Pandemias , Qualidade de Vida , SARS-CoV-2 , Inquéritos e Questionários , Vietnã
3.
Nutrients ; 13(6)2021 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-34071870

RESUMO

The COVID-19 pandemic has been present for many months, influencing diets such as the gluten-free diet (GFD), which implies daily challenges even in non-pandemic conditions. Persons following the GFD were invited to answer online ad hoc and validated questionnaires characterizing self-perceptions of the pandemic, current clinical condition, dietary characteristics, adherence to GFD, anxiety, and depression. Of 331 participants, 87% experienced shortage and higher cost of food and 14.8% lost their jobs. Symptoms increased in 29% and 36.6% failed to obtain medical help. Although 52.3% increased food preparation at home and purchased alternative foodstuffs, 53.8% had consumed gluten-containing foods. The Health Eating Index was intermediate/"needs improvement" (mean 65.6 ± 13.3 points); in 49.9% (perception) and 44.4% (questionnaire), adherence was "bad". Anxiety and depression scores were above the cutoff in 28% and 40.4%, respectively. Adherence and mental health were strongly related. The likelihood of poor adherence was 2.3 times higher (p < 0.004) in participants declaring that pandemic altered GFD. Those suffering depressive symptoms were 1.3 times more likely to have poor adherence (p < 0.000). Depression and faulty GFD (mandatory for treatment) appear, affecting a high proportion of participants, suggesting that support measures aimed at these aspects would help improve the health condition of people that maintain GFD. Comparisons of data currently appearing in the literature available should be cautious because not only cultural aspects but conditions and timing of data collection are most variable.


Assuntos
COVID-19/prevenção & controle , Doença Celíaca/psicologia , Dieta Livre de Glúten/psicologia , Cooperação do Paciente/psicologia , Quarentena/psicologia , Adulto , Ansiedade/epidemiologia , Ansiedade/psicologia , Doença Celíaca/dietoterapia , Depressão/epidemiologia , Depressão/psicologia , Dieta Livre de Glúten/estatística & dados numéricos , Dieta Saudável , Feminino , Abastecimento de Alimentos/estatística & dados numéricos , Humanos , Masculino , Cooperação do Paciente/estatística & dados numéricos , Quarentena/estatística & dados numéricos , SARS-CoV-2 , Inquéritos e Questionários
5.
Medicine (Baltimore) ; 100(18): e25505, 2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-33950925

RESUMO

BACKGROUND: The argument on the efficacy of medical nutritional therapy and comprehensive nutritional care remains to be resolved. Therefore, we conducted this protocol of systematic review and meta-analysis to evaluate the efficacy between medical nutritional therapy and comprehensive nutritional care for patients with gestational diabetes mellitus (GDM). METHODS: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols reporting guidelines and the recommendations of the Cochrane Collaboration to conduct this study. Reviewers will search the PubMed, Cochrane Library, Web of Science, and EMBASE online databases using the key phrases "gestational diabetes mellitus," "comprehensive nutrition care," and "medical nutritional therapy" for all cohort studies published up to May 20, 2021. There is no restriction in the dates of publication or language in the search for the current review. The studies on cohort study focusing on comparing medical nutritional therapy and comprehensive nutrition care for GDM patients will be included in our meta-analysis. The outcomes include blood glucose levels, complications, weight change, and incidence of cesarean section. Where disagreement in the collection of data occurrs, this will be resolved through discussion. RESULTS: We hypothesized that these 2 methods would provide similar therapeutic benefits. OSF REGISTRATION NUMBER: 10.17605/OSF.IO/SC8HJ.


Assuntos
Diabetes Gestacional/terapia , Dieta Saudável , Terapia por Exercício/métodos , Educação em Saúde/métodos , Glicemia/análise , Cesárea/estatística & dados numéricos , Terapia Combinada/métodos , Aconselhamento/métodos , Diabetes Gestacional/sangue , Diabetes Gestacional/diagnóstico , Estudos de Viabilidade , Feminino , Humanos , Metanálise como Assunto , Período Pós-Prandial , Gravidez , Revisões Sistemáticas como Assunto , Resultado do Tratamento
6.
BMC Med Educ ; 21(1): 280, 2021 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-34001085

RESUMO

BACKGROUND: Poor-quality diet is associated with one in five deaths globally. In the United States, it is the leading cause of death, representing a bigger risk factor than even smoking. For many, education on a healthy diet comes from their physician. However, as few as 25% of medical schools currently offer a dedicated nutrition course. We hypothesized that an active learning, culinary nutrition experience for medical students would improve the quality of their diets and better equip them to counsel future patients on food and nutrition. METHODS: This was a prospective, interventional, uncontrolled, non-randomized, pilot study. Ten first-year medical students at the Wayne State University School of Medicine completed a 4-part, 8-h course in culinary-nutritional instruction and hands-on cooking. Online assessment surveys were completed immediately prior to, immediately following, and 2 months after the intervention. There was a 100% retention rate and 98.8% item-completion rate on the questionnaires. The primary outcome was changes in attitudes regarding counselling patients on a healthy diet. Secondary outcomes included changes in dietary habits and acquisition of culinary knowledge. Average within-person change between timepoints was determined using ordinary least squares fixed-effect models. Statistical significance was defined as P ≤ .05. RESULTS: Participants felt better prepared to counsel patients on a healthy diet immediately post-intervention (coefficient = 2.8; 95% confidence interval: 1.6 to 4.0 points; P < .001) and 2 months later (2.2 [1.0, 3.4]; P = .002). Scores on the objective test of culinary knowledge increased immediately after (3.6 [2.4, 4.9]; P < .001) and 2 months after (1.6 [0.4, 2.9]; P = .01) the intervention. Two months post-intervention, participants reported that a higher percentage of their meals were homemade compared to pre-intervention (13.7 [2.1, 25.3]; P = .02). CONCLUSIONS: An experiential culinary nutrition course may improve medical students' readiness to provide dietary counselling. Further research will be necessary to determine what effects such interventions may have on the quality of participants' own diets.


Assuntos
Ciências da Nutrição , Médicos , Currículo , Dieta , Dieta Saudável , Humanos , Projetos Piloto , Estudos Prospectivos
7.
Nutrients ; 13(5)2021 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-33946949

RESUMO

Eating habits appear to become less healthy once children move into adolescence. Adolescence is characterized by increasing independence and autonomy. Still, parents continue influencing adolescents' eating habits. This cross-sectional study used a Self-Determination Theory perspective to examine how parents can support preadolescents' food-related autonomy and competence and how these factors are associated with healthy eating motivation and food consumption at school. In addition, the effect of relative healthy food availability at home on preadolescents' food consumption at school was explored. In total, 142 Dutch preadolescents (mean age 12.18) and 81 parents completed questionnaires. The results showed that preadolescents perceived themselves as having higher food-related autonomy and lower competence to eat healthily as compared to their parents' perceptions. A path analysis was conducted to test the hypothesized model. Although parental support was positively associated with food-related autonomy, higher food-related autonomy was related to less healthy food intake at school. On the other hand, competence to eat healthily indirectly affected preadolescents' healthy intake ratio through their healthy eating motivation. Finally, the relative availability of healthy options at home was positively associated with preadolescents' healthy intake ratio outside the home. Findings from the study advance the understanding of individual and environmental factors that influence eating habits during the key life period of early adolescence. The results may inform interventions aiming to guide preadolescents to make healthy food choices on their own.


Assuntos
Comportamento Alimentar , Competência Mental , Pais , Autonomia Pessoal , Criança , Coleta de Dados , Dieta Saudável , Feminino , Humanos , Masculino , Países Baixos , Instituições Acadêmicas , Inquéritos e Questionários
8.
BMC Public Health ; 21(1): 973, 2021 05 22.
Artigo em Inglês | MEDLINE | ID: mdl-34022846

RESUMO

BACKGROUND: Worksite-based nutrition interventions can serve as access points to facilitate healthy eating and translate existing knowledge of cardiometabolic disease prevention. We explored perceptions, facilitators, and barriers for healthy eating in a cafeteria at a large worksite in Mexico City. METHODS: We conducted an exploratory qualitative study in a large department store in Mexico City with ~ 1500 employees. We conducted eight focus group discussions (FGD) with 63 employees stratified by job category (sales, maintenance, shipping, restaurant, cafeteria, administrative staff, and sales managers). Employees were invited to participate in the FGD if they were at the store at the day and time of the FGD for their job type. FGDs were audio-recorded, transcribed verbatim and analyzed using the thematic method. This process involved the researches´ familiarizing themselves with the data, generating initial codes, searching for themes, reviewing the themes, defining and naming themes, and then interpreting the data. RESULTS: Employees defined healthy eating as eating foods that are fresh, diverse, and prepared hygienically. The most commonly reported facilitators of healthy eating at the worksite were availability of affordable healthy food options and employees' high health awareness. Major barriers to healthy eating included unavailability of healthy foods, unpleasant taste of food, and preference for fatty foods and meat. For lower-wage workers, affordability was a major concern. Other barriers included lack of time to eat work and long working hours. CONCLUSION: A broad range of factors affect healthy eating at the cafeteria, some related to nutrition and some related to the employees type of job. Availability of healthy, hygienic, and tasty food at an affordable price could lead to healthier food choices in the worksite cafeteria. These strategies, along with work schedules that allow sufficient time for healthy eating, may help improve dietary behaviors and health of employees.


Assuntos
Dieta Saudável , Serviços de Alimentação , Preferências Alimentares , Humanos , México , Local de Trabalho
9.
J Environ Manage ; 291: 112687, 2021 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-33934023

RESUMO

A deep understanding of the water-food nexus it is of a paramount importance as an avenue for sustainable development. Water forms the foundation for food production and a sustainable use of this resource is essential to guarantee the long-term productivity and to build resilient capacity in food and agricultural systems. Here we present methodological challenges regarding different water footprint (WF) methods applied to different dietary scenarios. The volumetric WF of three theoretical but realistic dietary patterns has been quantified (Omnivorous(O), Vegetarian(V) and Vegan(VG)), by means of the Water Footprint Network methodology. Moreover, the AWARE methodology is applied to assess potential impacts of water use trough the Water Scarcity Footprint (WSF). Diets are set to integrate and consider different drivers for food consumption encompassing the social value of the Mediterranean diet, healthy diet recommendations, food preferences of Italian consumers and the trade dimension of foodstuffs. In terms of volumetric WF, the O diet is the most water intensive one accounting for 2800 L/capita/day. A shift from an O to a V and VG diets allows to reduce the volumetric WF respectively 10% and 14%. Green water consumption accounts for the largest share (85%) in all three scenarios. Considering the WSF, V healthy diet is similar to the VG resulting in 11,069 and 11,130 L H2Oeq/capita/day respectively, whereas the O diet resulted in 11,932 L H2Oeq/capita/day. A sensitivity analysis was performed by changing each food category, one at a time, to its maximum and minimum value, in order to evaluate the significance of changes in the volumetric WF and WSF as well as the variables that mostly contribute to them. Results show that the volumetric WF associated with V and VG diets consumption overlay the O diet in respectively 53.5% and 35.7% of runs, while overlapping is improved comparing WSFs results. In this case, the WSFs of V and VG diets overlay the O diet in 83.5% of runs, suggesting that the alternative dietary scenarios would have little effect on the overall WSF and that the results are particularly sensitive to the different countries of importation. Results demonstrate the need to consider both volumetric WF and WSF with particular attention to trade analysis in order to support the development of new policies with the aim to foster sustainable consumption patterns, while preserving water resources.


Assuntos
Dieta Saudável , Ingestão de Líquidos , Dieta , Insegurança Hídrica , Recursos Hídricos
10.
BMC Public Health ; 21(1): 1014, 2021 05 29.
Artigo em Inglês | MEDLINE | ID: mdl-34051788

RESUMO

BACKGROUND: There is limited evidence for successful weight gain prevention interventions targeting young adults. Developing effective interventions necessitates a theoretical model that can identify barriers and enablers for healthy eating and physical activity among young adults to support weight management. This study empirically examines the utility of the COM-B model as a framework for intervention planning across two behavioural contexts: eating and physical activity. METHODS: A cross-sectional survey research design was employed to empirically test the COM-B model in the contexts of young adult's eating and physical activity behaviours. Informed by the Theoretical Domains Framework, pre-validated measures appropriate for capturing the latency of the COM (Capability, Opportunity, and Motivation) constructs were sourced. Both surveys (eating and physical activity) were administered online to two independent samples of young adults aged 18-35 years. Models were specified and tested using structural equation modelling. RESULTS: A total of 582 (mean age = 22.8 years; 80.3% female) and 455 (mean age = 24.9 years; 80.8% female) participants were included in the physical activity and eating analyses, respectively. The COM-B model explained 31% of variance in physical activity behaviour and 23% of variance in eating behaviour. In the physical activity model (N = 582), capability and opportunity were found to be associated with behaviour through the mediating effect of motivation. In the eating model (N = 455), capability was found to be associated with behaviour through the mediating effect of motivation. Capability was also found to mediate the association between opportunity and motivation. Consistencies and variations were observed across both models in terms of COM indicators. CONCLUSIONS: Findings support the COM-B model's explanatory potential in the context of young adult's physical activity and eating behaviours. Barriers and enablers underlying young adult's physical activity and eating behaviours were identified that represent potential targets for future intervention design. Further research is needed to validate present study findings across different populations and settings.


Assuntos
Comportamentos Relacionados com a Saúde , Motivação , Adulto , Estudos Transversais , Dieta Saudável , Exercício Físico , Feminino , Humanos , Masculino , Adulto Jovem
11.
Vasc Health Risk Manag ; 17: 187-194, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33976549

RESUMO

Background: Ideal cardiovascular health behaviour (CVHB) measures four ideal health behaviours (non-smoking, body mass index <85th Percentile, healthy diet, and physical activity). This study aimed to determine the prevalence, distribution, and correlates of ideal CVHB among adolescents in the Caribbean. Methods: Nationally representative cross-sectional data of 2016 or 2017 with complete CVHB measurements were analysed from 7556 school adolescents from four Caribbean countries. Results: The prevalence of 0-1 ideal metrics CVHB was 20.4%, 2 ideal metrics 48.7%, and 3-4 ideal metrics 30.8%. Only 5.0% had all 4 ideal CVHB metrics, 41.0% intermediate CVH (≥1 metric in the intermediate category and none in the poor category), and 54.0% had poor CVH (≥1 metric in poor category). In adjusted logistic regression analysis, compared to students from Dominican Republic, students from Jamaica (Adjusted Odds Ratio-AOR: 1.36, 95% confidence interval-CI: 1.01-1.85), students from Trinidad and Tobago (AOR: 1.46, 95% CI: 1.17-1.82) and male sex (AOR: 1.35, 95% CI: 1.11-1.64) were positively associated with meeting 3-4 ideal CVHB metrics. In addition, in unadjusted analysis, rarely or sometimes experiencing hunger was negatively and high peer and parent support were positively associated with meeting 3-4 ideal CVHB metrics. Conclusion: The proportion of meeting 3-4 ideal CVHB metrics was low among adolescents in four Caribbean countries. Both high-risk and school-wide intervention programmes should be implemented in aiding to improve CVHB in Caribbean countries. Several factors associated with ideal CVHB were identified, which can be targeted in school health interventions.


Assuntos
Comportamento do Adolescente , Doenças Cardiovasculares/prevenção & controle , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Estilo de Vida Saudável , Comportamento de Redução do Risco , Adolescente , Fatores Etários , Índice de Massa Corporal , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Estudos Transversais , Dieta Saudável , República Dominicana/epidemiologia , Exercício Físico , Feminino , Inquéritos Epidemiológicos , Fatores de Risco de Doenças Cardíacas , Humanos , Jamaica/epidemiologia , Masculino , não Fumantes , Medição de Risco , Suriname/epidemiologia , Trinidad e Tobago/epidemiologia
12.
Artigo em Inglês | MEDLINE | ID: mdl-33946825

RESUMO

High rates of obesity and chronic disease exist in the southeastern United States (US). Knowledge about the attitudes, beliefs, and barriers of the rural low-income Louisiana population regarding healthy eating is limited. Focus Group discussions based on the Theory of Planned Behavior (TPB) were conducted in rural parishes (N = 3) with low-income residents of Louisiana (N = 29). Grounded Theory methods and cross-case analysis were used. The participants were primarily single Black females of age 18-30 years who earned a high school diploma, were employed, and had children. Beliefs included healthy eating was physically beneficial, yet financial impacts and the low palatability of healthy foods were barriers. Professional resources for nutrition education were limited which led to reliance on friends, family, and the internet. Friends and family were positive and negative influences on eating choices. Control beliefs included the high prices and low palatability of healthy foods, the wide availability of Energy Dense Nutrient Poor (EDNP) foods, and low motivation to sustain eating behavior changes. Formative research to optimize campaign distribution channels may improve accessibility to social marketing support and healthy eating resources. Persuasive messages that address control beliefs are needed in social marketing campaigns for rural low-income Louisiana environments.


Assuntos
Dieta Saudável , Marketing Social , Adolescente , Adulto , Criança , Comportamento Alimentar , Feminino , Humanos , Louisiana , Sudeste dos Estados Unidos , Adulto Jovem
13.
BMC Public Health ; 21(1): 891, 2021 05 10.
Artigo em Inglês | MEDLINE | ID: mdl-33971851

RESUMO

BACKGROUND: Food cost and affordability is one of the main barriers to improve the nutritional quality of diets of the population. However, in Argentina, where over 60% of adults and 40% of children and adolescents are overweight or obese, little is known about the difference in cost and affordability of healthier diets compared to ordinary, less healthy ones. METHODS: We implemented the "optimal approach" proposed by the International Network for Food and Obesity/non-communicable diseases Research, Monitoring and Action Support (INFORMAS). We modelled the current diet and two types of healthy diets, one equal in energy with the current diet and one 6.3% lower in energy by linear programming. Cost estimations were performed by collecting food product prices and running a Monte Carlo simulation (10,000 iterations) to obtain a range of costs for each model diet. Affordability was measured as the percentage contribution of diet cost vs. average household income in average, poor and extremely poor households and by income deciles. RESULTS: On average, households must spend 32% more money on food to ensure equal energy intake from a healthy diet than from a current model diet. When the energy intake target was reduced by 6.3%, the difference in cost was 22%. There are no reasonably likely situations in which any of these healthy diets could cost less or the same than the current unhealthier one. Over 50% of households would be unable to afford the modelled healthy diets, while 40% could not afford the current diet. CONCLUSIONS: Differential cost and affordability of healthy vs. unhealthy diets are germane to the design of effective public policies to reduce obesity and NCDs in Argentina. It is necessary to implement urgent measures to transform the obesogenic environment, making healthier products more affordable, available and desirable, and discouraging consumption of nutrient-poor, energy-rich foods.


Assuntos
Dieta Saudável , Programação Linear , Adolescente , Adulto , Argentina , Criança , Custos e Análise de Custo , Dieta , Alimentos , Humanos
14.
Nutrients ; 13(4)2021 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-33808417

RESUMO

The association between healthy eating practices and child dietary intake in childcare centres where parents pack foods from home has received little attention. This study aimed to: (1) Describe the nutritional content of foods and beverages consumed by children in care; and (2) Assess the association between centre healthy eating practices and child intake of fruit and vegetable servings, added sugar(grams), saturated fat(grams) and sodium(milligrams) in care. A cross-sectional study amongst 448 children attending 22 childcare centres in New South Wales, Australia, was conducted. Child dietary intake was measured via weighed lunchbox measurements, photographs and researcher observation, and centre healthy eating practices were assessed via researcher observation of centre nutrition environments. Children attending lunchbox centres consumed, on average 0.80 servings (standard deviation 0.69) of fruit and 0.27 servings (standard deviation 0.51) of vegetables in care. The availability of foods within children's lunchboxes was associated with intake of such foods (p < 0.01). Centre provision of intentional healthy eating learning experiences (estimate -0.56; p = 0.01) and the use of feeding practices that support children's healthy eating (estimate -2.02; p = 0.04) were significantly associated with reduced child intake of saturated fat. Interventions to improve child nutrition in centres should focus on a range of healthy eating practices, including the availability of foods packed within lunchboxes.


Assuntos
Creches/organização & administração , Dieta Saudável , Creches/normas , Fenômenos Fisiológicos da Nutrição Infantil , Pré-Escolar , Estudos Transversais , Dieta , Ingestão de Alimentos , Comportamento Alimentar , Feminino , Promoção da Saúde , Humanos , Masculino , New South Wales
15.
Zhonghua Yu Fang Yi Xue Za Zhi ; 55(4): 485-491, 2021 Apr 06.
Artigo em Chinês | MEDLINE | ID: mdl-33858060

RESUMO

Objective: To explore the relationship between the level of blood homocysteine (Hcy) and the total score of Chinese Healthy Eating Index (CHEI) and its item score. Methods: The subjects were recruited from the East China Natural Population Cohort Study, led by the School of Public Health in Fudan University, which was conducted in Zhongshan Community, Songjiang District of Shanghai from April to September 2017. By using the cluster random sampling method, 8 neighborhood committees were randomly selected from 18 neighborhood committees in Zhongshan community (Beimen, Baiyun, Dongwai, Huaqiao, Lantian village 1, Lantian village 2, Lantian village 4, and Lantian village 5). All the residents who met the standard and had lived in Shanghai for more than half a year were selected as research subjects. 4 995 subjects with complete survey information were finally included in this study. General information (age, sex, disease history, etc.), lifestyle (smoking, drinking, tea drinking, physical activity, etc.), food frequency and blood Hcy concentration were collected through questionnaire survey, physical examination and biological sample detection. The multivariate linear regression model was used to analyze the correlation between blood Hcy concentration and the total score of CHEI and its item score, and the multivariate logistics regression model was used to analyze the correlation between hyperhomocysteinemia (hHcy) and the total score of CHEI and its item score. Results: The age of the subjects was (56.72±9.72) years. The proportion of females, people with middle and high school education and high physical activity was 64.90% (3 241), 50.80% (2 539) and 63.20% (3 157), respectively. The blood Hcy concentration was (11.25±4.90) µmol/L, and the total prevalence of hHcy was 9.3% (467 cases). The results of multivariate linear regression showed that after adjusting for the relevant confounding factors, the blood Hcy concentration of subjects decreased with the increase of the total score of CHEI and the item score of fruit, milk, seafood, poultry and egg, but increased with the increase of the item score of total grain and tuber. In males, blood Hcy levels decreased with the increase of the item score of seafood and poultry [ß (95%CI) values were -0.343 (-0.582, -0.102) and -0.225 (-0.402, -0.046), respectively]. In females, the blood Hcy level decreased with the increase of the total score of CHEI and its item score of milk, egg, seafood and poultry [ß (95%CI) values were -0.130 (-0.207, -0.052), -0.091 (-0.148, -0.034), -0.016 (-0.026, -0.007), -0.069 (-0.122, -0.016), and -0.087 (-0.157, -0.017), respectively]. The results of multivariate logistic regression showed that the higher the total score of CHEI and its item score of milk and seafood, the lower the risk of hHcy [OR (95%CI) value were 0.986 (0.978, 0.995), 0.915 (0.864, 0.969), and 0.862 (0.806, 0.922), respectively]. In females, the higher the total score of CHEI and its item score of milk and seafood, the lower the risk of hHcy [OR (95%CI) values were 0.984 (0.970, 0.999), 0.877 (0.802, 0.958), and 0.845 (0.760, 0.941), respectively]. In males, the higher the total score of CHEI and its item score of seafood, the lower the risk of hHcy [OR (95%CI) values were 0.988 (0.977, 0.998) and 0.858 (0.791, 0.930), respectively]. Conclusion: The dietary pattern of residents in Zhongshan Community, Songjiang District, Shanghai can affect their own blood Hcy concentration and the risk of hHcy. The total score of CHEI and the item score of fruit, milk, seafood, poultry and eggs play an important role in reducing the level of blood Hcy. The higher the total score of CHEI and the item score of milk and seafood, the lower the risk of hHcy.


Assuntos
Dieta Saudável , Hiper-Homocisteinemia , Idoso , China/epidemiologia , Estudos de Coortes , Feminino , Homocisteína , Humanos , Masculino , Pessoa de Meia-Idade
16.
Artigo em Inglês | MEDLINE | ID: mdl-33808432

RESUMO

BACKGROUND: Reaching and engaging individuals, especially young adults, in web-based prevention programs is challenging. 'No Money No Time' (NMNT) is a purpose built, healthy eating website with content and a social marketing strategy designed to reach and engage a young adult (18-34 year olds) target group. The aim of the current study was to conduct a process evaluation of the 12-month social marketing strategy to acquire and engage NMNT users, particularly young adults. METHODS: a process evaluation framework for complex interventions was applied to investigate the implementation of the social marketing strategy component, mechanisms of impact and contextual factors. Google Analytics data for the first 12 months of operation (17 July 2019 to 17 July 2020) was evaluated. RESULTS: in year one, 42,413 users from 150+ countries accessed NMNT, with 47.6% aged 18-34 years. The most successful channel for acquiring total users, young adults and return users was via organic search, demonstrating success of our marketing strategies that included a Search Engine Optimisation audit, a content strategy, a backlink strategy and regular promotional activities. For engagement, there was a mean of 4.46 pages viewed per session and mean session duration of 3 min, 35 s. Users clicked a 'call-to-action' button to commence the embedded diet quality tool in 25.1% of sessions. The most common device used to access NMNT (63.9%) was smartphone/mobile. Engagement with 'quick, cheap and healthy recipes' had the highest page views. CONCLUSIONS: findings can inform online nutrition programs, particularly for young adults, and can apply to other digital health programs.


Assuntos
Dieta Saudável , Marketing Social , Adolescente , Adulto , Dieta , Promoção da Saúde , Humanos , Adulto Jovem
17.
Nutr Metab Cardiovasc Dis ; 31(5): 1445-1453, 2021 05 06.
Artigo em Inglês | MEDLINE | ID: mdl-33812736

RESUMO

BACKGROUND AND AIMS: How Mediterranean-style diets impact cardiovascular and health outcomes in patients with diabetes and chronic kidney disease (CKD) is not well known. Our aim was to investigate the association between diet quality, using Mediterranean Diet Scores (MDS) and health outcomes. METHODS AND RESULTS: This is a post-hoc analysis of an RCT and longitudinal study investigating patients with diabetes and CKD. MDS was calculated annually. Scores were analyzed for correlation with lipids, HbA1c, serum potassium, health-related quality of life (HRQOL) and depression. 178 diet records from 50 patients who attended two or more visits were included. Mean MDS was moderate (4.1 ± 1.6) and stable over time. Stage 1-2 vs 3-5 CKD had lower raw MDS (3.8 ± 1.5 vs 4.6 ± 1.5, p < 0.001). Having hyperkalemia was associated with a lower raw MDS scores (3.6 ± 1.6 vs 4.2 ± 1.5, p = 0.03) but not energy adjusted MDS. MDS was not associated with HbA1c or lipids. High vs low MDS was associated with improved HRQOL (mental health 84.4 ± 14.3 vs 80.3 ± 17.1, p < 0.05; general health 62.6 ± 21.0 vs 56.3 ± 19.8, p < 0.001) and fewer depressive symptoms (9.1 ± 7.4 vs 11.7 ± 10.6, p = 0.01). CONCLUSIONS: Low MDS was associated with reduced kidney function and health related quality of life, but not other markers of cardiovascular risk. Further studies are needed to understand the nature and direction of the association between diet quality and disease outcomes in this population.


Assuntos
Diabetes Mellitus Tipo 1/dietoterapia , Diabetes Mellitus Tipo 2/dietoterapia , Dieta Saudável , Dieta Mediterrânea , Rim/fisiopatologia , Qualidade de Vida , Insuficiência Renal Crônica/dietoterapia , Idoso , Fatores de Risco Cardiometabólico , Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 1/fisiopatologia , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/fisiopatologia , Feminino , Nível de Saúde , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Valor Nutritivo , Cooperação do Paciente , Ensaios Clínicos Controlados Aleatórios como Assunto , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/fisiopatologia , Medição de Risco , Fatores de Tempo
18.
Nutrients ; 13(3)2021 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-33803655

RESUMO

Impact of parental feeding practices on children's eating behaviors is well-documented in the literature. Nevertheless, little is known about how many of these behaviors might persist into adulthood. There is a lack of a tool measuring childhood feeding experiences recollected by adults, while the Comprehensive Feeding Practices Questionnaire (CFPQ) is used to measure parental feeding practices applied towards children. The aim of the study was to adapt the CFPQ to measure adults' recollections of their childhood (5-10 years old) feeding experiences, to examine its discriminant validity and then to assess if these practices are related to adults' food choices. In 2020, the modified version of CFPQ (mCFPQ) and questions on current food consumption were administered in a group of 500 adults twice over a two-week interval. The analysis included 443 participants whose questionnaires were correctly completed in both stages of the study. The Q-sorting procedure was used to test for discriminant validity of the questionnaire, i.e., confirmatory and exploratory factor analysis (EFA), Cronbach's alpha, correlations coefficients, and the analysis of the differences between groups according to the intake of certain food products. Test-retest reliability was examined by calculating interclass correlation coefficients (ICC) for each obtained factor. As a result of EFA, five subscales were identified: "Restrictions", "Healthy Eating Guidance", "Pressure and Food Reward", "Monitoring", and "Child Control". Items from these subscales created a new tool-Adults' Memories of Feeding in Childhood (AMoFiC). Test for internal consistency, factor correlations, and discriminant validity proved satisfactory psychometric parameters of AMoFiC. "Pressure and Food Reward" and "Child Control" were associated with higher intake of sweets and salty snacks, whereas "Healthy Eating Guidance", "Monitoring", and "Restrictions" were associated with higher consumption of fresh fruits and vegetables. Despite the fact that the AMoFiC questionnaire requires further research, the findings of the study might be of practical use in counseling addressed to the parents.


Assuntos
Crianças Adultas/psicologia , Inquéritos sobre Dietas/normas , Dieta Saudável/psicologia , Preferências Alimentares/psicologia , Inquéritos e Questionários/normas , Adulto , Criança , Comportamento Infantil/psicologia , Pré-Escolar , Comportamento de Escolha , Análise Fatorial , Feminino , Humanos , Masculino , Rememoração Mental , Poder Familiar/psicologia , Pais/psicologia , Psicometria , Reprodutibilidade dos Testes
19.
Nutrients ; 13(3)2021 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-33806882

RESUMO

Our aim was to assess the association between a priori defined dietary patterns and incident depressive symptoms. We used data from The Maastricht Study, a population-based cohort study (n = 2646, mean (SD) age 59.9 (8.0) years, 49.5% women; 15,188 person-years of follow-up). Level of adherence to the Dutch Healthy Diet (DHD), Mediterranean Diet, and Dietary Approaches To Stop Hypertension (DASH) were derived from a validated Food Frequency Questionnaire. Depressive symptoms were assessed at baseline and annually over seven-year-follow-up (using the 9-item Patient Health Questionnaire). We used Cox proportional hazards regression analyses to assess the association between dietary patterns and depressive symptoms. One standard deviation (SD) higher adherence in the DHD and DASH was associated with a lower hazard ratio (HR) of depressive symptoms with HRs (95%CI) of 0.78 (0.69-0.89) and 0.87 (0.77-0.98), respectively, after adjustment for sociodemographic and cardiovascular risk factors. After further adjustment for lifestyle factors, the HR per one SD higher DHD was 0.83 (0.73-0.96), whereas adherence to Mediterranean and DASH diets was not associated with incident depressive symptoms. Higher adherence to the DHD lowered risk of incident depressive symptoms. Adherence to healthy diet could be an effective non-pharmacological preventive measure to reduce the incidence of depression.


Assuntos
Depressão/epidemiologia , Dieta , Adulto , Idoso , Estudos Transversais , Dieta Saudável , Dieta Mediterrânea , Abordagens Dietéticas para Conter a Hipertensão , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prevalência , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Inquéritos e Questionários
20.
Cochrane Database Syst Rev ; 4: CD008189, 2021 04 29.
Artigo em Inglês | MEDLINE | ID: mdl-33914901

RESUMO

BACKGROUND: Infertility is a prevalent problem that has significant consequences for individuals, families, and the community. Modifiable lifestyle factors may affect the chance of people with infertility having a baby. However, no guideline is available about what preconception advice should be offered. It is important to determine what preconception advice should be given to people with infertility and to evaluate whether this advice helps them make positive behavioural changes to improve their lifestyle and their chances of conceiving. OBJECTIVES: To assess the safety and effectiveness of preconception lifestyle advice on fertility outcomes and lifestyle behavioural changes for people with infertility. SEARCH METHODS: We searched the Cochrane Gynaecology and Fertility Group Specialised Register of controlled trials, CENTRAL, MEDLINE, Embase, PsycINFO, AMED, CINAHL, trial registers, Google Scholar, and Epistemonikos in January 2021; we checked references and contacted field experts to identify additional studies. SELECTION CRITERIA: We included randomised controlled trials (RCTs), randomised cross-over studies, and cluster-randomised studies that compared at least one form of preconception lifestyle advice with routine care or attention control for people with infertility. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures recommended by Cochrane. Primary effectiveness outcomes were live birth and ongoing pregnancy. Primary safety outcomes were adverse events and miscarriage. Secondary outcomes included reported behavioural changes in lifestyle, birth weight, gestational age, clinical pregnancy, time to pregnancy, quality of life, and male factor infertility outcomes. We assessed the overall quality of evidence using GRADE criteria. MAIN RESULTS: We included in the review seven RCTs involving 2130 participants. Only one RCT included male partners. Three studies compared preconception lifestyle advice on a combination of topics with routine care or attention control. Four studies compared preconception lifestyle advice on one topic (weight, alcohol intake, or smoking) with routine care for women with infertility and specific lifestyle characteristics. The evidence was of low to very low-quality. The main limitations of the included studies were serious risk of bias due to lack of blinding, serious imprecision, and poor reporting of outcome measures. Preconception lifestyle advice on a combination of topics versus routine care or attention control Preconception lifestyle advice on a combination of topics may result in little to no difference in the number of live births (risk ratio (RR) 0.93, 95% confidence interval (CI) 0.79 to 1.10; 1 RCT, 626 participants), but the quality of evidence was low. No studies reported on adverse events or miscarriage. Due to very low-quality evidence, we are uncertain whether preconception lifestyle advice on a combination of topics affects lifestyle behavioural changes: body mass index (BMI) (mean difference (MD) -1.06 kg/m², 95% CI -2.33 to 0.21; 1 RCT, 180 participants), vegetable intake (MD 12.50 grams/d, 95% CI -8.43 to 33.43; 1 RCT, 264 participants), alcohol abstinence in men (RR 1.08, 95% CI 0.74 to 1.58; 1 RCT, 210 participants), or smoking cessation in men (RR 1.01, 95% CI 0.91 to 1.12; 1 RCT, 212 participants). Preconception lifestyle advice on a combination of topics may result in little to no difference in the number of women with adequate folic acid supplement use (RR 0.98, 95% CI 0.95 to 1.01; 2 RCTs, 850 participants; I² = 4%), alcohol abstinence (RR 1.07, 95% CI 0.99 to 1.17; 1 RCT, 607 participants), and smoking cessation (RR 1.01, 95% CI 0.98 to 1.04; 1 RCT, 606 participants), on low quality evidence. No studies reported on other behavioural changes. Preconception lifestyle advice on weight versus routine care Studies on preconception lifestyle advice on weight were identified only in women with infertility and obesity. Compared to routine care, we are uncertain whether preconception lifestyle advice on weight affects the number of live births (RR 0.94, 95% CI 0.62 to 1.43; 2 RCTs, 707 participants; I² = 68%; very low-quality evidence), adverse events including gestational diabetes (RR 0.78, 95% CI 0.48 to 1.26; 1 RCT, 317 participants; very low-quality evidence), hypertension (RR 1.07, 95% CI 0.66 to 1.75; 1 RCT, 317 participants; very low-quality evidence), or miscarriage (RR 1.50, 95% CI 0.95 to 2.37; 1 RCT, 577 participants; very low-quality evidence). Regarding lifestyle behavioural changes for women with infertility and obesity, preconception lifestyle advice on weight may slightly reduce BMI (MD -1.30 kg/m², 95% CI -1.58 to -1.02; 1 RCT, 574 participants; low-quality evidence). Due to very low-quality evidence, we are uncertain whether preconception lifestyle advice affects the percentage of weight loss, vegetable and fruit intake, alcohol abstinence, or physical activity. No studies reported on other behavioural changes. Preconception lifestyle advice on alcohol intake versus routine care Studies on preconception lifestyle advice on alcohol intake were identified only in at-risk drinking women with infertility. We are uncertain whether preconception lifestyle advice on alcohol intake affects the number of live births (RR 1.15, 95% CI 0.53 to 2.50; 1 RCT, 37 participants; very low-quality evidence) or miscarriages (RR 1.31, 95% CI 0.21 to 8.34; 1 RCT, 37 participants; very low-quality evidence). One study reported on behavioural changes for alcohol consumption but not as defined in the review methods. No studies reported on adverse events or other behavioural changes. Preconception lifestyle advice on smoking versus routine care Studies on preconception lifestyle advice on smoking were identified only in smoking women with infertility. No studies reported on live birth, ongoing pregnancy, adverse events, or miscarriage. One study reported on behavioural changes for smoking but not as defined in the review methods. AUTHORS' CONCLUSIONS: Low-quality evidence suggests that preconception lifestyle advice on a combination of topics may result in little to no difference in the number of live births. Evidence was insufficient to allow conclusions on the effects of preconception lifestyle advice on adverse events and miscarriage and on safety, as no studies were found that looked at these outcomes, or the studies were of very low quality. This review does not provide clear guidance for clinical practice in this area. However, it does highlight the need for high-quality RCTs to investigate preconception lifestyle advice on a combination of topics and to assess relevant effectiveness and safety outcomes in men and women with infertility.


Assuntos
Infertilidade/terapia , Estilo de Vida , Nascido Vivo , Cuidado Pré-Concepcional/métodos , Abandono do Hábito de Fumar , Consumo de Bebidas Alcoólicas , Viés , Cafeína/efeitos adversos , Estimulantes do Sistema Nervoso Central/efeitos adversos , Aconselhamento/métodos , Dieta Saudável , Exercício Físico , Feminino , Ácido Fólico/administração & dosagem , Humanos , Infertilidade Feminina/terapia , Nascido Vivo/epidemiologia , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores Sexuais , Complexo Vitamínico B/administração & dosagem , Perda de Peso
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