bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Healthy Start scheme and its association with food expenditure in low-income families in the UK
Authors: Parnham J , Millett C , Chang K , von Hinke S , Pearson-Stuttard J , Vamos E P 
Published: October 2020

Abstract

Background
The Healthy Start programme is a statutory benefit-in-kind in the United Kingdom (UK) which aims to enable low-income families to purchase fruit, vegetables, cow's milk and infant formula through the provision of vouchers. The scheme was introduced in 2006, however, the effect on food purchasing in participating households has not been evaluated within an eligible population. This study aimed to determine whether participation in the Healthy Start (HS) scheme is associated with differences in food purchasing in a representative sample of households in the United Kingdom.

Methods
Cross-sectional analysis of the Living Costs and Food Survey dataset (2010-2017). All households with a child (0-3 years) or pregnant woman were included in the analysis (n = 4,869). Multivariable quantile regression was used to compare the expenditure and quantity of fruit and vegetable, infant formula and total food purchases between Healthy Start participating, eligible non-participating, nearly-eligible and ineligible households.

Results
54% (n = 475) of eligible households participated in Healthy Start. After accounting for covariates, no significant difference was found in the quantity or expenditure of fruit and vegetable purchases between Healthy Start participating and non-participating households. Fruit and vegetable expenditure (£/week) was found to be higher in nearly eligible (β1.60; 95% CI 0.79, 2.41) and ineligible households (β2.56; 95% CI 1.77, 3.35) compared to Healthy Start eligible households.

Conclusions
The present study did not demonstrate significant differences in the fruit and vegetable expenditure of HS participating and non-participating households. The analysis demonstrates that inequalities in fruit and vegetable purchasing persists in the UK. Improved participation and increased voucher value may be needed to promote well-being and counteract the harmful effect of poverty on fruit and vegetables purchasing.

Key messages
The study found no evidence of different food purchases between Healthy Start participating and non-participating households. Increased voucher value may be needed to counteract food-price inflation. The paper reflected persistent socioeconomic inequalities in the UK, indicating the Healthy Start scheme does not sufficiently counteract the harmful effects of poverty on food purchasing.
Eating habits of women of childbearing age from Varna, Bulgaria
Authors: Chamova R , Dimitrova T 
Published: October 2020

Abstract

Background
Eating habits of childbearing age women are an important public health determinant. The inappropriate dietary pattern of women in reproductive age leads to deviations in their nutritional status with possible adverse health consequences for them and their offspring. Both malnutrition and over nutrition can adversely affect reproductive abilities of women as well as the course and outcome of a possible pregnancy.

Methods
We conducted a cross-sectional study on dietary habits of 107 women, aged 19 to 42 years, in Varna, Bulgaria between March-December 2019. Exclusion criteria were pregnancy and lactation. A questionnaire was applied composed of questions on diet, dietary pattern, food frequency consumption, and the respondents' physical activity. The results were compared with the National Food Based Dietary Recommendations for Adults in Bulgaria. Data was statistically analysed with SPSS version 19.

Results
The average age of participants was 25.65 ± 7.48 years. 22.4% of the surveyed women followed no particular diet. 35.5% and 30.8% of the respondents had daily consumption of milk and dairy products respectively. Meat consumption 3-4 times a week was reported by 29.9% of the respondents. Only 1/4 of the respondents consumed fish each week. The relative share of women who did not consume fish was 10.3%. Daily consumption of fruits and vegetables was 42.1% and 57% respectively.

Conclusions
The majority of the surveyed women does not follow the National recommendations for consumption frequency of milk, dairy products, meat, fish, fruits and vegetables. Respondents who do not consume fish, meat or milk and dairy products are at risk of deficiencies of both micronutrients and macronutrients. It's necessary to raise awareness about healthy eating and associated health risks.

Key messages
Nutrition of women of childbearing age is an important factor affecting public health. Inadequate dietary habits before conception raises the risk for the course and outcome of pregnancy with consequences for offspring health.
Evaluating knowledge of healthy diet recommendations of Lithuanian adults
Authors: Žandaras Ž , Stukas R 
Published: October 2020

Abstract

Backgroud
Studies show that diet of Lithuanian population does not follow healthy diet recommendations and is related to increased risk of cardiovascular disease. By knowing Lithuanian populations knowledge about the dietary recommendations and in what socio-demographic groups what dietary recommendation knowledge is missing, we could use effective targeted health promotion and prevention programs or provide particular information for those groups.

Methods
Cross-sectional study was conducted in 2019. 1007 residents of Lithuania aged 18-75 were surveyed by anonymous questionnaire. Survey was carried out by using multi-stage stratified random sampling.

Results
Almost half of the respondents (45.5% (95% CI: 45.5; 51.7)) knew how many times a day fruits and vegetables should be consumed. Possession of having this knowledge was significantly associated with female gender (OR = 1.67 (95% CI: 1.29; 2.14)) and higher education (OR = 1.83 (95% CI: 1.41; 2.3)). Only 21.2% (95% CI: 18.7; 23.7) of the respondents knew that bread and grain products should be taken several times a day. More than half of the population knew the recommendations for meat, fish, milk and dairy products 56.7% (95% CI: 53.6; 59.7). Respondents with higher education had a 2.05 times higher chance (OR = 2.05 (95% CI: 1.55; 2.72)) of knowing these recommendations. 39.7% (95% CI: 36.7; 42.8) knew that butter, salt and sweets should be consumed rarely and in small quantities. Having this knowledge was significantly associated with female gender (OR = 1.80 (95% CI: 1.37; 2.34)), higher education (OR = 1.75 (95% CI: 1.32, 2.32)), and living in a bigger city (OR = 1.67 (95) % CI: 1.19; 2.35)).

Conclusions
Lithuanian populations knowledge about the recommendations of healthy nutrition is insufficient, therefore, in order to reduce the morbidity of cardiovascular diseases, it is necessary to provide the population with information on healthy nutrition.

Key messages
The population of Lithuania lacks knowledge about healthy eating recommendations. Although it is necessary to provide all residents of Lithuania with information about health nutrition recommendations, the main focus should be on men and people with lower education.
Parents' knowledge about complementary feeding: an integrative review
Authors: Oliveira E S , Cardoso MVLML , Lopes M M C O , di Moura A F , de Melo G M , Oliveira D T , Girão S G M , Bezerra C M 
Published: October 2020

Abstract
Currently, authorities and specialists in child development and public health have been concerned with the growth and nutritional status of children, especially due to the uncontrollable increase in overweight / obesity that has occurred in recent years. Obesity causes organic-functional complications, such as chronic-degenerative diseases (diabetes, high blood pressure, coronary heart disease), and psychosocial complications, such as withdrawal from social relationships, shame, exclusion and disturbances in body awareness. The objective was to identify in the literature the parents' knowledge about complementary feeding for infants. Integrative literature review based on the guidelines recommended by PRISMA. The search was carried out between the months of May and June 2017 by two researchers independently in the Scopus, PubMed, Scielo, LILACS and CINAHL databases. The following descriptors were used: “infant”, “complementary feeding”, “parents” and “knowledge” and “infant”, “complementary feeding”, “relatives” and “knowledge” in the DECs and MESH respectively. 1,012 studies were identified and a sample of 06 articles was obtained after applying the eligibility criteria. The knowledge evidenced was: use of appropriate utensils for feeding the child, not using cow's milk, caution with processed foods, issues related to breastfeeding and age of introduction of food and other liquids. Even so, there were still mistakes by parents regarding the recommendations of the main bodies dealing with food, such as the use of processed foods from the fourth month of life of the child and the relationship of the “fat” baby being the health model. It was concluded that the knowledge of parents / caregivers about complementary feeding is still permeated by mistakes. Thus, the nursing consultation should focus on health education and search for strategies that facilitate the process of introducing complementary feeding and help parents in this period.

Key messages
Targeting health strategies on complementary feeding in a timely manner. Guidance for the prevention of obesity in early childhood and the development of non-infectious diseases.
A systematic review of the impact of the Great Recession on food intake
Authors: Jenkins R H , Vamos E P , Taylor-Robinson D , Millett C , Laverty A 
Published: October 2020

Abstract

Background
The 2007-2009 Great Recession significantly impacted global economies, industries, and individuals around the world, with a potential impact on health behaviours including dietary intake. Given the global reach and severity of the Great Recession, changes in food intakes may impacted health and health inequalities internationally. We conducted a systematic review examining whether the Great Recession had an impact on food intakes.

Methods
We searched MEDLINE, Embase, PsycINFO, Health Management Information Consortium (HMIC), CINAHL and Web of Science databases, along with relevant grey literature, in June 2020. Primary quantitative studies with the Great Recession as the exposure and food intake as the outcome and with two time points were eligible for inclusion in this review, assessed independently by two reviewers. The Newcastle Ottawa scale was used for quality assessment. The study was registered with PROSPERO (CRD42019135864).

Results
Forty-one studies from twenty-five countries were included in this review. Studies were heterogeneous in methods and results. Nine of ten studies on energy intake found that total energy intake decreased over the recession. Eight of eleven studies on dietary quality found that the recession was associated with poorer diet. Thirty-four studies assessed impact on individual food groups. They found that consumption of fruits and vegetables, meat and fish, and fast food, confectionery and soft drinks generally decreased while egg and legume consumption increased and carbohydrate consumption exhibited little change. The impact was generally greater on those of lower socio-economic position.

Conclusions
While our review presents mixed findings about the impact of the Great Recession on food intake, there is consistent evidence of a negative impact on diets. Identifying effective policies which mitigate adverse changes in nutrition during economic downturns should be prioritised at the national and international level.

Key messages
Our systematic review of the Great Recession and food intakes demonstrates potential relationships between economic downturns and nutrition – these relationships may be important for health globally. Our systematic review demonstrates that it is important for policy-makers and public health professionals to consider mitigating potential nutritional impacts during economic recessions.
Lower-caloric intake but different nutrient profiles in cognition impaired and in frail elderlies
Authors: Wu S Y , Pan W H 
Published: October 2020

Abstract

Background
Frailty and dementia are two common geriatric syndromes associated with poor nutritional status. The nutritional role in the pathogenesis of frailty and dementia remains unclear. We examined the associations between energy intake and frailty/cognition impairment and also compared the nutrient intake between frail and cognition impaired elderlies by sex.

Methods
Data of 1,920 elderly adults (≧65y) from the 2014-2017 Nutrition and Health Survey in Taiwan was used. Frailty was defined using modified L. Fried criteria. The Chinese Mini-Mental State Examination score was grouped into tertiles: cognitive impairment (score ≦ 23), mild cognitive impairment (score = 24-27), and the normal (score ≧28). Total energy intake was grouped into tertiles. Logistic regression adjusted for age, sex, and sampling strata was used for association test. The trend test was performed using generalized linear model with age adjustment to examine whether various nutrient intake indicators had an ordered relationship with the severity of frailty and cognitive impairment.

Results
Lower energy intake (men &lt;1540 Kcal or women&lt;1182 Kcal) was significantly associated with frailty (odds ratio [OR]: 1.97; 95% confidence interval [CI]: 1.45-2.66) and cognition impairment (OR: 1.88; 95%CI: 1.43-2.47), respectively. Larger number of micronutrients and food substances per Kg body weight exhibited decreasing trends with MCI (protein, fat, carbohydrate, vitamins B1, B2, B3, B6, B12, C, E, Ca, P, Fe, Mg, K, Zn, dietary fiber, and cholesterol) than with frailty (protein, vitamin B1, B3, B6, C, P, Mg, K, Zn, polyunsaturated fatty acids, and dietary fiber).

Conclusions
The lower the energy intake, the higher the odds ratio for frailty and for dementia. Dietary quality expressed by nutrient intake per Kg body weight was poorer in elderlies with cognition impairment than those with frailty.

Key messages
Lower energy intake is associated with MCI and with frailty, respectively. The MCI elderlies involve more micronutrient deficiencies than the frail counterpart.
Assessment of lead food contamination and dietary intake in a Northern Italian population
Authors: Malavolti M , Filippini T , Fairweather-Tait S J , Malagoli C , Vescovi L , Vinceti M 
Published: October 2020

Abstract

Background
Lead is a heavy metal naturally occurring in the environment and also released by some anthropogenic activities. Food is one the major sources of human exposure for non-occupationally exposed individuals. In this study, we aimed at characterizing lead (Pb) content in foods consumed in Northern Italy population, in order to estimate its dietary intake.

Methods
We measured lead content in 908 food and beverage samples bought at small shops and supermarkets of the Northern Italy provinces of Modena and Reggio Emilia, through inductively coupled plasma mass spectrometry. We used a validated semi-quantitative food frequency questionnaire to assess the dietary habits of a representative sample of 719 individuals (319 males and 400 females) aged 18-87 years residing in Northern Italy (Emilia Romagna). We estimated weekly dietary intakes of Pb, and we compared them with safety standards set by the European Food Safety Authority (EFSA).

Results
In this population, vegetables and vegetables products were the main contributors to Pb intake. The highest levels of Pb were in edible offal, and then in crustaceans, dry fruits, chocolate free sweet confectionery, and coffee and tea as beverages. In general, Pb levels in our samples were comparable and did not exceed the average contamination levels reported by EFSA in various European countries. We found a comparable average Pb intake in both sexes. Average weekly intake of Pb was below EFSA recommended provisional tolerable weekly intake.

Conclusions
Our study provides an updated assessment of lead exposure through diet in a Northern Italian community. Although environmental lead contamination and exposure have markedly decreased in the last decades, recent evidence pointed out that a safety threshold value cannot yet be established for prevention of adverse effects due to lead exposure, since even low levels of lead intake may still increase the risk of chronic renal disease and hypertension.

Key messages
Food is one the major lead sources of human exposure for non-occupationally exposed individuals. Lead levels in Northern Italian population studied are comparable and do not exceed the average contamination levels reported by European Food Safety Authority in various European countries.
Factors influencing food insecurity rates: A county by county observation from 2017 in New Jersey
Authors: Ignace K , Souza M , Borges C 
Published: October 2020

Abstract
This observational study aimed to investigate food insecurity prevalence for children under 18 in New Jersey using secondary data from 2017. Total food insecurity rates per county for children under 18 and all people were gathered from the NJ Department of Health. Age and Sex 5-year estimates for total population and children were collected from the US Census. The median income in the past 12 months from 2013-2017 was collected from the US Census in addition to family poverty status in the past 12 months from 2013-2017. Additional data was collected from the Social Capital Index. A bivariate analysis and a chi-square test revealed that nine independent variables were correlated to food insecurity prevalence by county in New Jersey among children under the age of 18. The significant variables were total food insecurity prevalence for all people in a county (p=.000), median income in the past 12 months in 2017 age-adjusted dollars (p=.000), percent of families below the poverty level (p=.000), county-level index (p=.000), family unity (p=.000), institutional health (p=.002), collective efficacy (p=.003), percent of adults over the age of 18 not covered under any type of health coverage (p=.006), and percent of families headed by a single parent (p=.000). Regarding the multivariate analysis, only two variables were still significant. Median income (p=.030) and poverty status (p=.007). These two variables are strongly associated with food insecurity prevalence among children under the age of 18. Health insurance status and household income are correlated with food insecurity. Food insecure children were more likely to live in areas with high deprivation and experience both individual-level poverty and neighborhood deprivation.

Key messages
Median income and poverty status are strongly associated with food insecurity prevalence among children under the age of 18. Food insecure children were more likely to live in areas with high deprivation and experience both individual level poverty and neighborhood deprivation.
Herbal medicine use and its associated factors in the region of Sousse (Tunisia)
Authors: Limam M , Sahli J , Khalfallah I , Mellouli M , Ghardallou M , Mtiraoui A , Zedini C , Ajmi T 
Published: October 2020

Abstract

Background
Patients use medicinal plants as the first-line treatment for many chronic and acute medical conditions. The lack of access to conventional health care, historical, cultural and economic considerations contributes to the important use of these plants. The purpose was to identify medicinal plants used by primary Health Care Centers' visitors in the region of Sousse (Tunisia) and to assess its associated factors.

Methods
A cross-sectional descriptive study was conducted among Primary health care centers' visitors of the region of Sousse (Tunisia) in 2018. We randomly selected 18 primary health centers and 50 participants were chosen from each center. Data were collected using a pre-tested questionnaire, filled through a direct interview with participants which explores: socio-demographic variables and medicinal plants' use (name of plants, symptoms, methods of preparation, routes of administration, plant source, tolerance and side effects).

Results
900 persons were included with a female predominance (72.4%). The median age of participants was 48 years ranging from 18 to 93. 65.2% (n = 587) of them report using medicinal plants to heal. The most common sources of information were family (90.5%), beliefs and traditions (56.4%). Fifty-three (53) plants were used to treat different disorders. The most used plants are: verbena (81.6%), rosemary (53.3%), mint (52%) and thyme (45.1%). The most reported treated symptoms were: flu and gastro-intestinal disorders. Plants utilization was associated to: lower age, female gender, marital status, high level of education and social existence of protection coverage.

Conclusions
Plants use should be based on well-conducted scientific results specifying the mechanism of action of plants, the therapeutic and toxic dose through researches on local plants samples and extracts.

Key messages
It seems essential to train health professionals on herbal therapy during their studies and practice. The further step after this picture of the herbal medicine use in the Region of Sousse, is to evaluate the safety and the efficacy of their use.
Nutritional profile of ultra-processed foods advertised in small food retailers
Authors: Borges C A , Kikuta C , Jaime P C 
Published: October 2020

Abstract

Background
It is necessary to analyze the nutritional profile and advertising claims of ultra-processed foods available in small food retailers.

Methods
This is an observational cross-sectional study that carried out an audit on small food businesses. Information was collected on advertising, price, ingredient list, nutritional composition and portion size. All investigated foods were grouped according to the NOVA food classification. Food advertising was categorized into 11 different consumer appeals. The relationship between the type of advertising appeal of the ultra-processed food and its nutritional profile was analyzed. A comparison was made between the nutritional composition of the advertised food and the recommendations of sugar, saturated fat and sodium of the Pan American Health Organization (PAHO).

Results
The most prevalent ultra-processed foods in small retailers were sweets and treats (18.5%); sugary sweetened beverages (15.7%), sausages (12.0%) and baked goods (11.1%). Most of the advertising on the packaging of ultra-processed foods was about healthy eating and physical activity and sensory aspects of the product (color, flavor, texture). Foods classified as high in sugars had the highest number of advertisements related to healthy eating and physical activity, foods high in sugar and saturated fats, had the highest number of advertisements related to sensory aspects, healthy eating and physical activity and foods high in sodium and / or saturated fats, had more advertising related to convenience.

Conclusions
Identifying that advertising for ultra-processed foods is associated with health and well-being, physical activity and sensory aspects leads us to a better understanding of the factors that influence consumer perception in small businesses. Advertising for foods rich in sugar, saturated fat and sodium based on health and well-being should be better regulated by public agencies in Brazil, supporting consumers to make healthier choices.

Key messages
Ultra-processed foods induce to consume large quantities, due to the convenience and the advertising present in their packaging that stimulate a healthy life, physical activity and sensory aspects. It is necessary support and defend changes in nutrition labeling, in order to clarify the nutritional information to consumers.