Work environment adversity and non-communicable Disease risk among drivers working for application-based-cab-aggregators in an Indian metropolis : Assessment of work environment adversity and its association with ncd risk factors among application based cab aggregators in Bengaluru, India: a cross sectional study.

BACKGROUND: Bengaluru, a metropolis in Southern India, is one of the largest markets for cab aggregator companies. Drivers working for these companies play a vital role in urban transportation but unlike other drivers, their work pattern is stressful, which could increase their proneness to NCD risk factors. Understanding associations between work environment adversity and NCD risk factors among these drivers will help to plan specific health promotion and NCD prevention programs including provision of basic occupational health services. OBJECTIVES: The study aims to test for an association between work environment adversity and selected Non-communicable Disease (NCD) risk factors among Application Cab Aggregator drivers in Bengaluru city and to estimate the prevalence of selected NCD risk factors among the ABCA drivers. METHODOLOGY: This cross-sectional study was conducted in Bengaluru city among 340 eligible and consenting ABCA drivers with at least one-year experience. Drivers were recruited through a multi-stage sampling procedure and time-period sampling, from transportation and leisure zones in the city. Data was collected through interviews using specifically developed semi-structured tools to assess work environment adversity and NCD risk factors. Prevalence of NCD risk factors is presented per 100 drivers with 95% confidence intervals. Multivariate Logistic regression analysis was conducted to quantify the strength of the association between work environment adversity categories and NCD risk factors. Ethical clearance was obtained from the NIMHANS Ethics Committee. RESULTS: Nearly 97% of the 340 drivers reported having one or more NCD risk factors. Working more than 5 days a week, more than 7 + hours a day, staying away from family, and working night shifts were closely associated with higher risk for NCD risk factors among ABCA drivers. Drivers with work environment adversity scores between 5 and 10 were associated with higher odds of Physical Inactivity (OR = 3.1), Unhealthy diets (OR = 1.62), and Tobacco Use (OR = 3.06). CONCLUSION: The study highlights the association between work environment adversity and NCD risk factors and indicates a dire need for NCD prevention programs, basic occupational health services, and social security provisions for ABCA cab drivers.

Akt Signaling and Nitric Oxide Synthase as Possible Mediators of the Protective Effect of N-acetyl-L-cysteine in Prediabetes Induced by Sucrose.

The aim of this work was to evaluate possible mechanisms involved in the protective effect of N-acetyl-L-cysteine (NAC) on hepatic endocrine-metabolic, oxidative stress, and inflammatory changes in prediabetic rats. For that, normal male Wistar rats (60 days old) were fed for 21 days with 10% sucrose in their drinking water and 5 days of NAC administration (50 mg/kg, i.p.) and thereafter, we determined: serum glucose, insulin, transaminases, uric acid, and triglyceride levels; hepatic fructokinase and glucokinase activities, glycogen content, lipogenic gene expression; enzymatic and non-enzymatic oxidative stress, insulin signaling pathway, and inflammatory markers. Results showed that alterations evinced in sucrose-fed rats (hypertriglyceridemia, hyperinsulinemia, and high liver fructokinase activity together with increased liver lipogenic gene expression and oxidative stress and inflammatory markers) were prevented by NAC administration. P-endothelial nitric oxide synthase (P-eNOS)/eNOS and pAKT/AKT ratios, decreased by sucrose ingestion, were restored after NAC treatment. In conclusion, the results suggest that NAC administration improves glucose homeostasis, oxidative stress, and inflammation in prediabetic rats probably mediated by modulation of the AKT/NOS pathway. Administration of NAC may be an effective complementary strategy to alleviate or prevent oxidative stress and inflammatory responses observed in type 2 diabetes at early stages of its development (prediabetes).

The Global Diet Quality Score predicts diet quality of women of reproductive age in Addis Ababa, Ethiopia.

Improving diet quality is recognised as a double-duty action that can simultaneously address multiple forms of malnutrition. This study aimed to assess diet quality among non-pregnant non-lactating women of reproductive age (WRA) in Addis Ababa, Ethiopia. A 1-d quantitative 24 h recall was conducted among 653 non-pregnant/non-lactating women. Diet quality, assessed using the women dietary diversity score (WDDS), the Global Diet Quality Score (GDQS) and the Nova 4 classification reflecting consumption of ultra-processed foods (UPF), was compared. The proportion that meets the minimum dietary diversity for women (MDD-W) was estimated. The average MDD-W score was 2·6 (sd 0·9), with only 3 % of women meeting the MDD-W (≥ 5 food groups). Consumption of wholegrain and legumes was high, but UPF were also consumed by 9 % of the women. GDQS was positively associated with WDDS, age and skipping breakfast and was negatively associated with eating out of home and UPF consumption (P < 0·05). The multivariate regression model showed that GDQS (total) was not associated with wealth but was significantly associated with both UPF and WDDS (P < 0·001). Unlike UPF and WDDS alone, GDQS was able to predict both nutrient adequacy and unhealthy dietary practices. The diet quality of WRA in Addis Ababa is low in diversity, possibly exposing them to higher risk of nutrient inadequacy and non-communicable diseases as reflected by the low GDQS. Understanding what drives food and dietary choices in urban settings is urgently needed.

The health and economic burden associated with sugar-sweetened beverage consumption in Trinidad and Tobago.

BACKGROUND: In Trinidad and Tobago, non-communicable diseases (NCDs) are the leading cause of death. Unhealthy diet is one modifiable NCD risk factor, which contributes to the NCD burden. The consumption of sugar-sweetened beverages (SSBs) has been associated with an increased risk of NCDs. AIM: The aim of this paper is to estimate the burden of disease and economic costs associated with the consumption of SSBs in Trinidad and Tobago as evidence to support the implementation of health and fiscal policies on SSB consumption. METHODS: The results of this study were obtained through the use of a mathematical model which used a comparative risk assessment approach to estimate the health and economic burden associated with SSB intake, by sex and age. RESULTS: Estimates for one year showed that SSB consumption was associated with approximately 15,000 cases of overweight and obesity in adults and 11,700 cases in children, 28% of all the cases of diabetes and overall, an estimated 387 deaths and 9000 years of healthy life were lost due to premature death and disability. Approximately US$23.1 million was spent in the public healthcare system to treat diseases associated with consumption of sugary beverages. CONCLUSIONS: The consumption of SSBs is associated with increases in diseases, deaths and rising healthcare costs in Trinidad and Tobago. It is hoped that the results of this study will provide an added rationale and impetus for the implementation of policies to reduce the consumption of SSBs.

Quantifying the burden of lipid anomalies among adolescents in India.

BACKGROUND: The present study's aim is to quantify the burden of lipid abnormalities (excessive non-high-density lipoprotein (non-HDL) cholesterol and low-density lipoprotein (LDL) cholesterol) among Indian adolescents. Which has emerged as a significant covariate of coronary heart disease (CHD). METHODS: The present study aims to unearth the prevalence of any lipid anomalies, their level, and types of lipid profiles among adolescents in India using the Comprehensive National Nutrition Survey 2016-18 i.e., cross-sectional data. Descriptive and bivariate statistical analyses have been used to check the associations and significant differences between groups of individuals suffering from any type of lipid abnormalities. RESULTS: A total of 35,830 adolescents aged between 10 and 19 years (mean age:14.36 yrs.; SD = 2.81 for males and 14.39 yrs.; SD = 2.78 for females) were included. Roughly 77 percent of the adolescents are suffering from any lipid anomalies. Their mean lipid levels are 140.6 (SD = 32.9), 84.1 (SD = 24.8), 47.3 (SD = 10.7), and 95.3 (SD = 50.0) for total cholesterol, LDL, HDL, and triglycerides, respectively. A higher proportion of adolescents suffered from lipid anomalies among those who were overweight or obese (89%, 95% CI 85, 92) and pre-diabetics (81%, 95% CI 78, 83) compared to each of their counterparts. Furthermore, a considerable proportion of samples with vitamin A (70%, 95% CI 68, 73), D (81%, 95% CI 79, 82), and B12 deficits (73%,95% CI 72, 75), as well as zinc (77%, 95% CI 76, 77), folate (76%, 95% CI 74, 77), and iron deficits (75%,95% CI 73, 77), were suffering from any lipid anomalies. Of individuals who consume an unhealthy diet, 77% (95% CI 76, 78) of them were suffering from any lipid anomalies than others. CONCLUSIONS: The study contends that preventing the increasing burden of lipid abnormalities among Indian adolescents is essential. Vitamin and mineral deficiencies and unhealthy dietary habits are significantly associated with high LDL and non-HDL levels. In the longer run, this might cause the early onset of hypertension, diabetes, and CHDs. Hence, appropriate interventions are needed to curtail these early onsets by primarily focusing on adolescents.

Dietary patterns of Pakistani adults and their associations with sociodemographic characteristics-a community based study.

OBJECTIVE: To identify the dietary patterns and understand their association with sociodemographic characteristics among adults. METHODS: The community-based cross-sectional study was conducted in Islamabad, Lahore, Karachi, Peshawar and Quetta cities of Pakistan from March to November 2018, after approval from the National Bioethics Committee, Islamabad, and comprised adults of either gender. Data was collected using the food frequency questionnaire, and dietary patterns were identified using factor analysis. Multivariate regression analysis was used to assess the association of socio-demographic determinants with dietary patterns. Data was analysed using SPSS 21. Parallel Analysis criterion (Eigen values) was determined along with Monte Carlo simulation. RESULTS: Of the 448 subjects, 206(46%) were males and 242(54%) were females. The largest age group was 36-55 years 199(47.4%). Six dietary patterns were identified: "Vegetables", "Fruits", "Mixed Junk and Processed food", "Dairy and Fast food", "Discretionary" and "Fish". Regression analysis showed that those aged 36-55 years had higher scores for vegetables, fruit and fish pattern (p<0.05). Females scored more for vegetables, fish and fruits, and a significantly low score for discretionary diet pattern (p<0.05). Participants with high education level and socioeconomic status had raised scores for discretionary diet items (p<0.05). CONCLUSIONS: Six distinct dietary patterns among Pakistani adults were identified, showing significant association with sociodemographic characteristics.

Weight Stigma, Chronic Stress, Unhealthy Diet, and Obesity in Chilean Adults.

BACKGROUND: Obesity is highly prevalent around the world, including in Chile. Although various psychological factors have been previously associated with obesity, there has been less attention on the role of weight stigma as a determinant of obesity in Chile. Therefore, the primary aim of this study was to examine the direct effect of weight stigma on obesity and determine whether chronic stress and unhealthy diet mediate the relationship between weight stigma and obesity. METHODS: Faculty and staff from a Chilean university enrolled in the Chilean Study of Psychological Predictors of Obesity and Metabolic Syndrome and completed anthropometric measurements and measures of weight stigma, chronic stress, and unhealthy diet. RESULTS: Three-hundred and eighty-three participants (Mage = 45 years old; 58% female) were included in the present analysis. Structural equation model analyses demonstrated a direct effect of weight stigma on obesity, chronic stress, and unhealthy diet. However, chronic stress and unhealthy diet did not mediate the relationship between weight stigma and obesity. CONCLUSIONS: Weight stigma is an important determinant of obesity and is associated with high levels of chronic stress and unhealthy diet in Chilean adults. Our results provide further support for the multifactorial nature of obesity and can inform future interventions aimed promoting weight loss in people with overweight and obesity.

Does diet play a role in the prevention and management of depression among adolescents? A narrative review.

BACKGROUND: Depression is one of the major causes of illness and disability, while suicide is the second leading cause of death amongst adolescents. Although many factors determine the mental health of an individual, diet has been gaining popularity as a key modifiable factor in the prevention and management of depression. Nutritional Psychiatry is an emerging field where researchers suggest that the food we consume influences our mental well-being. AIM: This review aims to explore the significance of diet, nutrient deficiencies, imbalances, and unhealthy dietary patterns in the prevention and management of unipolar depression or major depressive disorder among adolescents. METHODS: Electronic databases such as PubMed, Scopus, Google Scholar, Science Direct, and MEDLINE were searched using keywords such as "mental health," "depression," "adolescents," "diet," "dietary pattern," and pertinent articles (N = 68) were retrieved and reviewed. RESULTS: The Mediterranean and traditional diets rich in complex carbohydrates, omega-3 fatty acids, B-group vitamins and several amino acids have shown negative correlation with the incidence of depression. On the other hand, Western dietary patterns (sweetened beverages, processed/ junk food, and foods rich in saturated fatty acids), along with low consumption of fruits and vegetables have been linked to an increased risk of depression among adolescents. CONCLUSION: Dietary modification can prove to be a cost-effective strategy for the prevention and treatment of depression among adolescents. Diet and nutrition need to be recognized as key modifiable targets for the prevention of mental disorders and nutritional medicine should be considered as an integral part of psychiatric treatment.

Association between processed meat intake and asthma symptoms in the French NutriNet-Santé cohort.

PURPOSE: Processed meat intake may adversely affect lung health, but data on asthma remains sparse. The magnitude of the processed meat-asthma association may also depend on other unhealthy behaviors. We investigated the association between processed meat intake and the asthma symptom score, and the combined role of unhealthy weight, smoking, low diet quality, and high processed meat intake on the asthma score. METHODS: In 2017, 35,380 participants to the NutriNet-Santé cohort answered a detailed respiratory web-questionnaire. Asthma was defined by the asthma symptom score (sum of 5 questions; continuous variable). Based on repeated 24-h dietary records collected on a dedicated website, processed meat consumption was classified as 0, < 2, 2-5, > 5 servings/week. We examined the combined role of body mass index (BMI) (< 25 vs. ≥ 25 kg/m2), smoking (never vs. ever), diet quality score (highest vs. lowest), and processed meat (≤ 5 vs. > 5 servings/week) on the asthma symptom score. RESULTS: Participants were aged 54 on average (women: 75%, smokers: 49%, BMI ≥ 25: 32%, ≥ 1 asthma symptoms: 27%). After adjustment for confounders, processed meat intake was positively and significantly associated with asthma symptom score: odds ratios (ORs) (95% CI) for > 5 vs. 0 servings/week were 1.15 (1.04-1.27) in women; 1.23 (1.01-1.50) in men. Compared to participants with 0 unhealthy behaviors, ORs for the asthma symptom score among participants with the 4 combined unhealthy behaviors were 2.18 (1.91-2.48) in women; 2.70 (2.10-3.45) in men. CONCLUSION: High processed meat consumption was associated with higher asthma symptoms, and combining overweight/obesity, smoking, low diet quality, with high processed meat intake was strongly associated with asthma symptoms.

Ginger and avocado as nutraceuticals for obesity and its comorbidities.

Obesity is a worldwide epidemic and is one of the factors involved in the etiology of type 2 diabetes mellitus. Obesity induces low-grade inflammation and oxidative stress. The treatment for obesity involves changes in diet, physical activity, and even medication and surgery. Currently, the use of nutraceutical compounds is associated with health benefits. Ginger and avocado are used for many people all around the world; however, its effect as a nutraceutical compound is less known by the general population. For this reason, we searched information of the literature to point its effects on distinct mechanisms of defense against the obesity its comorbidities. The present review aimed showing that these nutraceuticals may be useful in obesity treatment. Reports have shown that ginger and avocado induce antioxidant and anti-inflammatory effects by improving enzymatic activity and modulating obesity-related impairments in the anti-inflammatory system in different tissues, without side effects. Furthermore, ginger and avocado were found to be effective in reversing the harmful effects of obesity on blood lipids. In conclusion, on the basis of the positive effects of ginger and avocado in in vitro, animal, and human studies, these nutraceuticals may be useful in obesity treatment.

Multisectoral approach and WHO 'Bestbuys' in Nigeria's nutrition and physical activity policies.

Unhealthy diet and physical inactivity are modifiable risk factors for non-communicable diseases. Policies formulated in line with international guidelines are required for the implementation of population-level interventions to reduce the risks. This study describes the utilization of multisectoral approach (MSA) for the formulation of nutrition and physical activity policies and the extent to which they align with the WHO 'Best Buy Interventions'. The research utilized a descriptive case study design and the theoretical model guiding the study was the Walt and Gilson framework for policy analysis. Data were obtained through the interview of 44 key informants using pre-tested guides and document review of 17 policies and articles obtained from government institutions or through the search of electronic databases. Data were integrated and analysed using thematic analysis. Between 2000 and 2016, Nigeria had formulated 10 nutrition-related policies and 5 guidelines with actions to promote physical activity. Only three nutrition and two physical activity policies adopted a high level of MSA. In line with the WHO best buy interventions, educational interventions for the general population are proposed to reduce sugar and salt intake and replace transfat with polyunsaturated fats but there are no legal regulatory acts to support these actions. Policy documents with actions to reduce physical inactivity do not include the WHO best buys. The country should adopt a wider range of actors to formulate and review policies, integrate all the WHO best buy interventions and develop effective legislation to regulate the salt and sugar content of processed foods.

Unhealthy Snack Food and Beverage Consumption Is Associated with Lower Dietary Adequacy and Length-for-Age z-Scores among 12-23-Month-Olds in Kathmandu Valley, Nepal.

BACKGROUND: Consumption of unhealthy snack foods and beverages (USFBs) in low- and middle-income countries (LMICs) is rising, with global awareness increasing about risks of overnutrition. However, little is known about the relation between USFB consumption and young children's diet/nutritional outcomes in contexts where nutrient density of complementary foods is often low. OBJECTIVES: This study assessed the association of high USFB consumption, compared with low consumption, with nutrient intakes, dietary adequacy, iron status, and growth in young children in Kathmandu Valley, Nepal. METHODS: A cross-sectional survey was conducted in a representative sample of 745 primary caregivers of children aged 12-23 mo. Food consumption was measured through quantitative 24-h recalls, and child anthropometric measurements and capillary blood samples were collected. Using adjusted linear/logistic regression models, nutrient intakes, dietary adequacy, length-for-age and weight-for-length z-scores (LAZ and WLZ, respectively), and iron status were compared between lowest and highest tertiles of consumption based on the contribution of USFBs to total energy intakes (TEIs). Mediation of the relation between USFB consumption and LAZ via lowered dietary adequacy was explored using structural equations modeling. RESULTS: On average, USFBs contributed 46.9% of TEI among the highest tertile of consumers, compared with 5.2% of TEI among the lowest. Compared with low-USFB consumers, high-USFB consumers had lower nutrient intakes and a greater proportion were at risk of inadequate intakes for 8 nutrients. Mean LAZ was nearly 0.3 SD lower among high-USFB consumers than low consumers (P = 0.003), with this relationship partially mediated through dietary adequacy. No associations were found with stunting prevalence or iron status. Prevalence of overweight/obesity was low. CONCLUSIONS: In this LMIC context, high USFB consumption among young children was associated with inadequate micronutrient intakes, which can contribute to poor growth outcomes. Addressing increased availability of USFBs in LMIC food systems should be a priority for policies and programs aiming to safeguard child nutrition.

Regional Overview on the Double Burden of Malnutrition and Examples of Program and Policy Responses: African Region.

Sub-Saharan Africa is experiencing the double burden of malnutrition (DBM) with high levels of undernutrition and a growing burden of overweight/obesity and diet-related noncommunicable diseases (NCDs). Undernourishment in sub-Saharan Africa increased between 2010 and 2016. Although the prevalence of chronic undernutrition is decreasing, the number of stunted children under 5 years of age is increasing due to population growth. Meanwhile, overweight/obesity is increasing in all age groups, with girls and women being more affected than boys and men. It is increasingly recognized that the drivers of the DBM originate outside the health sector and operate across national and regional boundaries. Largely unregulated marketing of cheap processed foods and nonalcoholic beverages as well as lifestyle changes are driving consumption of unhealthy diets in the African region. Progress toward the goal of ending hunger and malnutrition by 2030 requires intensified efforts to reduce undernutrition and focused action on the reduction of obesity and diet-related NCDs. The World Health Organization is developing a strategic plan to guide governments and development partners in tackling all forms of malnutrition through strengthened policies, improved service delivery, and better use of data. It is only through coordinated and complementary efforts that strides can be made to reduce the DBM.

How ready are communities to implement actions to improve diets of adolescent girls and women in urban Ghana?

BACKGROUND: Ghana has reached an advanced stage of nutrition transition, contributing to an increase in nutrition-related non-communicable diseases, particularly amongst urban women. Community involvement is an important factor in the success of efforts to promote healthy eating. The readiness of populations to accept a range of interventions needs to be understood before appropriate interventions can be implemented. Therefore, this study assessed how ready urban communities are to improve diets of women of reproductive age in Ghana. METHODS: Using the Community Readiness Model (CRM), in-depth interviews were conducted with 24 key informants from various sectors in low income communities across two cities in Ghana: Accra and Ho. The CRM consists of 36 open questions addressing five readiness dimensions (community knowledge of efforts, leadership, community climate, knowledge of the issue and resources). Interviews were scored using the CRM protocol with a maximum of 9 points per dimension (from 1 = no awareness to 9 = high level of community ownership). Thematic analysis was undertaken to gain insights of community factors that could affect the implementation of interventions to improve diets. RESULTS: The mean community readiness scores indicated that both communities were in the "vague awareness stage" (3.35 ± 0.54 (Accra) and 3.94 ± 0.41 (Ho)). CRM scores across the five dimensions ranged from 2.65-4.38/9, ranging from denial/resistance to pre-planning. In both communities, the mean readiness score for 'knowledge of the issue' was the highest of all dimensions (4.10 ± 1.61 (Accra); 4.38 ± 1.81 (Ho)), but was still only at the pre-planning phase. The lowest scores were found for community knowledge of efforts (denial/resistance; 2.65 ± 2.49 (Accra)) and resources (vague awareness; 3.35 ± 1.03 (Ho)). The lack of knowledge of the consequences of unhealthy diets, misconceptions of the issue partly from low education, as well as challenges faced from a lack of resources to initiate/sustain programmes explained the low readiness. CONCLUSIONS: Despite recognising that unhealthy diets are a public health issue in these urban Ghanaian communities, it is not seen as a priority. The low community readiness ratings highlight the need to increase awareness of the issue prior to intervening to improve diets.

Appetitive drives for ultra-processed food products and the ability of text warnings to counteract consumption predispositions.

OBJECTIVE: The present study aimed to (i) assess the appetitive drives evoked by the visual cues of ultra-processed food and drink products and (ii) investigate whether text warnings reduce appetitive drives and consumers' reported intentions to eat or drink ultra-processed products. DESIGN: In Study I, a well-established psychometric tool was applied to estimate the appetitive drives associated with ultra-processed products using sixty-four image representations. Sixteen product types with four exemplars of a given product were included. Pictures from the International Affective Picture System (IAPS) served as controls. The two exemplars of each product type rated as more appetitive were selected for investigation in the second study. Study II assessed the impact of textual warnings on the appetitive drive towards these thirty-two exemplars. Each participant was exposed to two picture exemplars of the same product type preceded by a text warning or a control text. After viewing each displayed picture, the participants reported their emotional reactions and their intention to consume the product. SETTING: Controlled classroom experiments SUBJECTS: Undergraduate students (Study I: n 215, 135 women; Study II: n 98, 52 women). RESULTS: In Study I, the pictures of ultra-processed products prompted an appetitive motivation associated with the products' nutritional content. In Study II, text warnings were effective in reducing the intention to consume and the appetitive drive evoked by ultra-processed products. CONCLUSIONS: This research provides initial evidence favouring the use of text warnings as a public policy tool to curb the powerful influence of highly appetitive ultra-processed food cues.

Socioeconomic, demographic and lifestyle-related factors associated with unhealthy diet: a cross-sectional study of university students.

BACKGROUND: Food habits are important to promote and maintain good health throughout life, and unhealthy diet is a modifiable and preventable risk factor. University students are a key group of adults among whom to promote healthy lifestyles. The aim of this study is to determine the factors associated with unhealthy diet in a sample of university students. METHODS: An electronic cross-sectional survey was conducted with university students (n=593) from inland Spain, during the 2016-2017 academic year. The survey collected information on the participants' food habits using an annual food frequency questionnaire. We also collected socioeconomic and demographic data and lifestyle-related information. A multivariate logistic regression was used for analysis. RESULTS: The multivariate logistic regression revealed that the factors associated with an unhealthy diet were: being male, being underweight compared to the reference category (normal weight), having a mother of low socioeconomic status, the family home not being in the university city and, finally, studying a non health-related course CONCLUSION: Among students of the University of Castilla-La Mancha, being male, being underweight, the family home not being in the university city, having a mother of low socioeconomic status, and, finally, not studying a health-related course are the factors associated with a lower quality diet. Following a healthy diet is key in reducing the health costs of non-communicable diseases, and ensuring an acceptable long-term quality of life in populations.

Consumption of junk foods by school-aged children in rural Himachal Pradesh, India.

There has been an increase in the consumption of junk food (JF) among school-aged children (SAC) possibly leading to obesity and diet-related diseases among them. We do not have evidence on consumption of JF in rural areas; hence, we conducted a study to assess the consumption of JF by SAC in rural, Himachal Pradesh. A total of 425 children in the age group of 12-18 years studying in 30 government schools (clusters) were included. The clusters were selected using population proportionate to size sampling methodology. We found high prevalence (36%) of consumption of JF among SAC during the last 24 h. Efforts should be taken to reduce the consumption of JF by promotion of healthy dietary habits and educating children about the ill effects of JF.

Observation and assessment of the nutritional quality of 'out of school' foods popular with secondary school pupils at lunchtime.

BACKGROUND: The contemporary Scottish diet is unhealthy and a risk factor for poor health outcomes including obesity. Over a third of Scottish children are at risk of being overweight or obese, and there have been calls to strengthen the evidence base on the role of the food retail environment around schools in influencing the consumption of unhealthy foods. METHODS: We examined the food retail environment around five secondary schools in Glasgow city, Scotland. Trained fieldworkers observed the food purchasing behaviour of school pupils in local shops. Samples of the most popular foods were subsequently purchased by the research team and assessed for nutritional content, including energy, total and saturated fat, and salt. This was compared with the nutrient standards for school lunches established by the Scottish Government. RESULTS: There was marked variation in the number of outlets identified within a 10 min walk from each school, ranging from five in the area with the lowest number of outlets to thirty in the area with the highest number of outlets. Outlets identified were heterogeneous and included fish and chip shops, kebab shops, convenience stores, newsagents, bakeries, mobile catering units, cafés, pizzerias, sandwich shops and supermarkets. Lunchtime offers and other marketing strategies targeting school pupils were observed at most outlets. Nutritional analysis of the 45 savoury food items purchased was conducted by laboratory staff. Of the foods analysed, 49% of the samples exceeded recommended calorie intake, 58% exceeded total fat recommendations and 64% exceeded saturated fat recommendations, 42% exceeded recommended salt levels. Over 80% of the 45 food items sampled did not comply with one of more of the nutrient standards for fat, saturated fat and salt. Meal deals and promotions of unhealthy foods aimed at pupils were widely available. CONCLUSIONS: The majority of pupils purchased unhealthy convenience food of poor nutritional value at lunchtime in local shops around their school. Further effort is required to implement regulatory levers such as taxation on unhealthy foods, restriction on the concentration of outlets selling unhealthy foods as well as the development of partnerships and additional measures within and beyond schools to promote healthy foods.

[Socioeconomic pattern in unhealthy diet in children and adolescents in Spain]. / Patrón socioeconómico en la alimentación no saludable en niños y adolescentes en España.

OBJECTIVE: To investigate the possible association of dietary patterns associated with obesity and socioeconomic status in Spanish children and adolescents. DESIGN: Cross-sectional study. PARTICIPANTS: Data were drawn from the 2007 National Health Survey, conducted on a representative sample of Spanish 0-15 years. In this study we have analyzed 6143 subjects from 5 to 15 years. MAIN MEASUREMENTS: It has been estimated prevalence of breakfast skipping, the prevalence of low consumption of fruit and vegetable and the prevalence of high fast food, snacks and sugary drinks consumption. Socioeconomic status indicators were educational level and social class of primary household earner. In each type of food consumption socioeconomic differences were estimated by prevalence ratio using the higher socioeconomic status as reference category. RESULTS: Both in childhood and adolescence, the magnitude of the prevalence ratio shows an inverse socioeconomic gradient in all foods consumption investigated: the lowest and highest prevalence ratios have been observed in subjects from families of higher socioeconomic status and lower, respectively. CONCLUSION: Unhealthy food related with obesity show a clear socioeconomic pattern in Spanish children and adolescents.

Factors associated with consuming unhealthy food in school children: A population-based study from Hong Kong.

Background and Aims: Unhealthy diets were found to be the main contributor to the overweight problem among adolescents. In this study, we aim to identify the factors causing unhealthy eating habits in adolescents. Methods: School-aged children and adolescents participated in this cross-sectional observational study with additional school and parental consent. A self-administered survey was conducted by 30 primary schools and 25 secondary schools. Participants were asked about the frequency of consuming unhealthy food and the types of unhealthy food consumed. A descriptive analysis was performed to demonstrate the proportions of characteristics. The prevalence of the outcome among participants of various factors was also analyzed using separate binary regression models. Results: A total of 4884 responses were collected. Among primary school students (grade 4, mean age: 10.06), people who (1) were actively gaining weight (aOR: 1.651, 95% CI 1.006-2.708, p = 0.047), (2) went to bed after 11 p.m. (aOR: 1.652, 95% CI 1.065-2.563, p = 0.025), (3) had more than 2 h of gaming (aOR: 2.833, 95% CI 1.913-4.195, p < 0.001), (4) suffered from self-report depressive symptoms (aOR: 1.753, 95% CI 1.233-2.493, p = 0.002) was more likely to consume unhealthy food. As for secondary school students (grade 3, mean age: 15.28), (1) males (aOR: 1.266, 95% CI 1.0004-1.601, p = 0.0496), (2) average-to-high socioeconomic status (Average: aOR: 1.471, 95% CI 1.115-1.941, p = 0.006; High: aOR: 2.253, 95% CI 1.585-3.202. p < 0.001), (3) having more than 2 h of gaming (aOR: 1.342, 95% CI 1.069-1.685, p = 0.011), (4) suffering from psychological distress (aOR: 1.395, 95% CI 1.051-1.852, p = 0.021) were associated with the increased odds of consuming unhealthy food. Conclusion: Several lifestyle and health factors were significantly associated with unhealthy eating behaviors in school-aged children and adolescents in Hong Kong, sharing similarities with many other countries. In conjunction with implementing a policy that addresses factors for unhealthy eating habits, further research should investigate potential interventions targeting these factors to ultimately tackle the overweight and obesity concern for children and adolescents in Hong Kong.