bluuebunny/crossref_metadata_2025_split huggingface dataset:
Avoiding hedonic contrast to increase acceptance of healthy sustainable school meals
Authors: Kokkorou M , Dinnella C , Spinelli S , Wollgast J , Maragkoudakis P , Monteleone E 
Published: October 2024

Abstract

To promote sustainable eating in schools, new approaches for embracing plant-based (PB) meals are needed. Hedonic contrast (HC) describes how liking for one item is influenced by the recent experience of other items of different hedonic valence. Despite its established impact on liking, HC’s effect on intake, particularly in repeated exposure experiments, is limited. Moreover, its effect on food-related emotions remains largely unexplored. Hence, this study investigated how HC influences liking, emotions and intake of an innovative co-created PB dish, served as part of a course meal, at school in a repeated exposure study. Two groups of students (N (HC) =71, mean age=14.5 and N (control) =57, mean age=15.3) were served the same neutrally liked main PB dish (pumpkin stuffed lentils balls (LPA)) after a starter dish (rice with vegetables) which was altered in taste through seasoning and cooking methods to be more (HC) or less (control) tasty. The exposure was repeated once/week for 5 consecutive weeks. Liking and emotional responses for the dishes were recorded through a questionnaire and food consumption by weighting plate waste. HC led to lower liking (p = 0.037) and lower positive emotions (cheerful, pleasure) with high arousal (surprise) for LPA, while increasing negative valence emotions (disappointed). Moreover, LPA consumption was significantly lower in the HC group vs the control (45% vs 60% respectively, p = 0.040), resulting in lower protein intake in the HC group (p = 0.029). The effects of HC remained stable with time. This study, for the first time, reveals a sustained rise in food-related positive high arousal emotions, when foods are presented following less liked food. Since new foods evoking positive valence and high arousal emotions have higher chances to be appreciated than foods evoking positive valence and low arousal emotions, this work opens new perspectives on how to propose new, healthier and more sustainable PB dishes in school canteens.

Key messages
• Avoiding negative contrast between school meals is a promising strategy to ensure higher liking, intake and increased positive emotions over repeated exposure for innovative plant-based dishes.
• To enhance adolescent’s acceptance and uptake of new plant-based dishes in school canteens, it is better to serve them after less tasty options.
Promoting a sustainable diet among office workers in Sweden: A pilot Study
Authors: Halling Ullberg O , Toivanen S , Tillander A , Bälter K 
Published: October 2024

Abstract

Background
Society is facing multiple challenges, including lifestyle-related diseases, alongside global climate change. Actions are needed to promote sustainable lifestyles advocating for healthy and environmentally friendly diets. This study aimed to assess how a sustainable lifestyle, compared to conventional healthy lifestyle education at work, affects participants’ energy intake, nutrient consumption, and diet-related CO2e.

Methods
An 8 week two-armed randomized trial was conducted, comprising a sustainable lifestyle arm (n = 21) and a healthy lifestyle arm (n = 16) based on the theoretical framework of the Behavioral Change Wheel, in total (n = 33) completed the trial. The office workers participated in 6 workshops during working hours. Linear mixed-effects models and analysis of variance tests were used for data analysis. Changes over time are presented as arms combined, along with their respective mean differences.

Results
A significant decrease in mean diet-related CO2e was observed (p &lt; 0.001), with a decrease on average of 0.74 and 0.71 kg CO2e/day. The mean change in daily kilocalorie intake had a significant decrease over time (p = 0.008), on average of 192 and 386 Kcal. Moreover, a significant decrease in mean protein intake was observed (p &lt; 0.001), with a decrease on average of 16 and 18 grams, possibly explaining the decrease in CO2e. No significant differences were observed between the arms at any timepoint.

Conclusions
Promoting sustainable lifestyle habits has a similar impact to advocating for a conventional healthy lifestyle regarding diet. This supports the new Nordic Nutrition Recommendations 2023. Despite the small sample size, insights into facilitating sustainable behaviors can influence public health policies across Europe and the workplace as an arena for health promotion.

Key messages
• The promotion of sustainable and healthy lifestyle habits at work can promote both individual and planetary health by decreasing diet-related CO2e emissions.
• Here we demonstrate that the workplace has the potential to act as an arena to combat climate change.
Hip fracture in elderly: malnutrition and health outcomes. A systematic review and meta-analysis
Authors: Ricciotti G M , Genga A , Chiavarini M , Faggi M I , Rinaldi A , Toscano O D , D’Errico M M , Barbadoro P 
Published: October 2024

Abstract

Background
Hip fracture is a common condition among elderly and one of the leading causes of disability. Malnutrition is widely present in older patients and has been identified in several studies as an important and modifiable prognostic factor for several medical conditions, including hip fracture. The aim of the present study is to evaluate the association between malnutrition, assessed by validated tools, and selected health outcomes for different follow-up intervals from hip fracture, in particular: mortality, changes in mobility/living arrangements and postoperative delirium.

Methods
A literature search on PubMed, Web of Science and Scopus databases up to September 2023, was conducted to identify all studies involving older subjects that reported an association between MNA/GNRI/PNI/CONUT score and health outcome after hip fracture. Meta-analysis was performed by a random-effects model using risk values (RR/OR/HR) extracted from 14 eligible selected studies.

Results
Malnutrition significantly increased the risk of any adverse outcome by 70% at 1 month, and up to 250% at 1 year, showing an increasing trend with longer follow-up periods. One month after hip fracture, malnutrition significantly increased the risk of postoperative delirium by 275% (OR = 2.75; 95% CI 1.80-4.18; p ≤ 0.05), mortality by 342% (OR = 3.42; 95% CI 2.14-5.48; p ≤ 0.05) and mortality hazard risk by 351% (HR = 3.51; 95% CI 1.63-7.55; p ≤ 0.05). One year after hip fracture, malnutrition significantly increased the risk of transfer to more supported living arrangements by 218% (OR = 2.18; 95% CI 1.58-3.01; p ≤ 0.05), declined mobility by 41% (OR = 1.41; 95% CI 1.14-1.75; p ≤ 0.05), mortality by 368% (OR = 3.68; 95% CI 3.00-4.52; p ≤ 0.05) and mortality hazard risk by 234% (HR = 2.34; 95% CI 1.91-2.87; p ≤ 0.05).

Conclusions
These findings underscore that malnutrition worsens outcomes after hip fracture in elderly, emphasizing the importance of nutritional assessment to mitigate potential adverse consequences.

Key messages
• The results of the present study underscore that malnutrition increases the risk of death and worsens mobility and independence after hip fracture in older adults.
• Routine nutritional status evaluation could prove beneficial in the management of hip fracture older patients in order to prevent potential adverse outcomes.
Adherence to Mediterranean diet and cardiometabolic risk among mountain communities in European Alps
Authors: Squillacioti G , Aguilar Palacio I , Bédard A , El Sherbiny S , Ghelli F , Panizzolo M , Bellisario V , Bono R 
Published: October 2024

Abstract

Background
The Mediterranean diet has emerged as a model promoting a better health status, particularly for cardiovascular diseases prevention. Adherence to the Mediterranean diet (AMD) may vary depending on geographical location and sociocultural factors. Mountains and rural communities may experience lower adherence, also depending on food provision-related services availability. Our cross-sectional study aims to investigate the association between AMD and cardiometabolic risk in a cohort of mountain dwellers. As a secondary aim, we will test if services availability may influence health status via AMD.

Methods
In spring/summer 2023, healthy volunteers from 5 small villages in Italian Alps were enrolled. Dietary habits were investigated by Medi-Lite standardized questionnaire. The waist-to-height ratio (WHtR) was calculated by dividing the waist circumference by height, then used as an anthropometric index for central adiposity and related cardiometabolic risk. Services availability was assessed by network analysis implemented in QGIS. A multilevel logistic regression model, with center as random intercept and adjusted for age, sex, BMI, education and physical activity was used to test the association between AMD and cardiometabolic risk. Ethical approval was provided by University of Turin.

Results
To date, 142 subjects (59.2% females, 49.9±14.0 y.o.) have been enrolled. Preliminary analyses showed that, as compared to the least adherent group, subjects reporting the highest AMD level (3rd tertile of Medi-Lite scoring) were strongly protected from cardiometabolic risk (OR: 0.07, 95% C.I.: 0.01, 0.67; p = 0.021). A similar trend was observed for the 2nd tertile.

Conclusions
Our preliminary findings suggest the beneficial role of the Mediterranean diet also in remotely located populations. We plan to investigate how service availability may impact AMD and, indirectly, cardiometabolic health to reinforce the importance of equity in services distribution for Public Health

Key messages
• Independently of age, sex, BMI, education and physical activity, adherence to the Mediterranean diet can promote cardiometabolic health among rural and mountain communities.
• Mediterranean eating pattern can positively influence central adiposity and should be promoted to ensure more effective prevention strategies in mountain dwellers.
Health disparities continue to report in DEIS schools: Irish COSI Round 6 study
Authors: Ravichandran N , Kilduff O , Slattery J , Lee C , Hunt E , Douglas A , O’Brien S , Murrin C , Kelleher C 
Published: October 2024

Abstract

Background
Previous reports have identified clear differences in the prevalence of overweight and obesity among children living with disadvantaged compared to those living in advantaged circumstances. Childhood obesity is influenced by factors in the home environment, including lifestyle behaviours and socio-economic status. The Childhood Obesity Surveillance Initiative (COSI) family survey provides insights into these factors, particularly in children that attend disadvantaged (DEIS) and non-disadvantaged (non-DEIS) schools.

Aim
This study aims to compare various demographic and socioeconomic factors within the home environment of primary school children across DEIS and non-DEIS schools in Ireland, elucidating the differences in their performance with implications for health policy.

Methods
Parents of 1st and 2nd class children (mean age 7) from 121 sentinel schools invited to participate in the family survey, returned it by post or online using Lime Survey. Ethical approval was secured for COSI R6, with consent from families. Data on demographics, diet, transportation, activities, and clinical characteristics of children in Ireland were collected, anonymised and analysed in SPSS, comparing children from DEIS (n = 147) and non-DEIS (n = 1014) schools.

Results
Around 88% of respondents of returned surveys included in the study (n = 1161) were mothers. Significant disparity in families with diabetes diagnosis or treatment observed between DEIS and non-DEIS schools (10.6% vs. 5.4%, p = 0.016). Breastfeeding rates were higher in non-DEIS schools (57.0% vs. 46.9%, p = 0.015). Children consuming at least 3 portions of fruits and vegetables daily were also higher in non-DEIS schools (58.9% vs. 46.0%, p &lt; 0.001). More children in non-DEIS schools engaged in physical activities outside of school hours (93.7% vs. 74.5%, p &lt; 0.001).

Conclusions
The findings underscore the significant socioeconomic disparities between families whose children attend DEIS and non-DEIS schools in Ireland.

Key messages
• Irish COSI R6 reveals disparities in health-related factors between disadvantaged and advantaged schools.
• Targeted interventions and policies are necessary to address factors influencing child health.
Disparities in Breastfeeding Patterns Persist Despite Improved Rates: Findings from Irish COSI R6
Authors: Ravichandran N , Kilduff O , Slattery J , Lee C , Hunt E , Douglas A , O’Brien S , Murrin C , Kelleher C 
Published: October 2024

Abstract

Background
Breastfeeding is crucial for reducing childhood obesity, recommended exclusively for 6 months by World Health Organisation (WHO). Previous reports have highlighted disparities in breastfeeding patterns between Irish and non-Irish mothers. The Irish Childhood Obesity Surveillance Initiative (COSI) family survey offers insights into breastfeeding rates and patterns in Ireland and their differences between Irish and non-Irish mothers.

Aims
This study aims to compare the breastfeeding rates in Ireland between COSI Round 6 (R6) and COSI R5, elucidating the differences between Irish and non-Irish mothers. Additionally, it aims to establish the association between breastfeeding pattern and socio-economic factors involved in the Irish households.

Methods
Parents of 1st and 2nd class children (mean age 7) from 121 sentinel schools invited to participate in the family survey, returned it by post or online using Lime Survey. Ethical approval was secured for COSI R6, with consent from families. Data on breastfeeding rates and pattern were collected, anonymised, and analysed using SPSS version 29.

Results
Around 88% of respondents were mothers. The number of children breastfed for at least a month increased in R6 (55.7%) compared to R5 (45.6%). The mean duration of exclusive breastfeeding increased to 5.86 months in R6 from 4.91 months in R5, in line with WHO recommendations. Significant disparities were found in breastfeeding patterns, with higher rates among non-Irish mothers (67.8%) compared to Irish mothers (52.6%) (p &lt; 0.001). Linear regression showed a significant association between breastfeeding duration and maternal birth country. Irish mothers exhibited a negative coefficient (b1=-2.442; 95% CI -4.1 to -0.8; p = 0.004), suggesting shorter breastfeeding durations compared to non-Irish mothers.

Conclusions
Breastfeeding rates improved in COSI R6 compared to R5. There are significant disparities in breastfeeding pattern between Irish and non-Irish mothers.

Key messages
• Improved breastfeeding rates indicate good feeding practices in Ireland.
• Targeted interventions and policies are necessary to address the disparities between Irish and non-Irish mothers in breastfeeding patterns.
Strengthening ecosystems
Authors: Geyer G , Teperi J 
Published: October 2024

Abstract
The mission of THCS activities with respect to strengthening ecosystems is based on the understanding that the actual transformation of health and care systems is dependent on the ability of numerous actors to align their goals and actions so that they are complementary. At the same time, it is also true that the transformation takes place at national, regional and local levels, making activities and support at these levels essential for the success of THCS. Therefore, the focus lies on connecting and supporting the broad community and other stakeholders in developing ecosystem-wide approaches and creating awareness and urgency among ecosystem layers and components, thus serving as a platform for transformation. One strand of activities for strengthening ecosystems aims at identifying, analysing, describing and disseminating key learnings from successful transformative ecosystems (TE’s). TE’s are broad constellations of interacting organisations and people who are committed, and through aligned actions, able to reach joint, explicitly defined goals in long-term. Making not only the most successful TE’s but also the dynamics explaining their achievements visible, value is being added through three main routes. Firstly, the experiences are distributed widely on European arenas and platforms as well as through national, regional and local channels to inspire ecosystem building processes in earlier stages of maturity. Secondly, collaboration between identified forerunner ecosystems is supported to enable mutual peer-learning. Thirdly, the examples are used to give guidance and inspiration to consortia that are applying for or receiving THCS project funding. As strategic partners of the ecosystem strengthening activities, other work packages of the THCS programme as well as the THCS National Mirror Groups are of great importance.
Healthy lifestyle promotion project among healthcare workers
Authors: Zilli E , Tikvina S , Bonaldo D , Varotto M , Bevilacqua S , Calzavara A , Madia A , Ruffatto A 
Published: October 2024

Abstract

Background
The psychosocial risks generated from difficult work conditions are damaging not only for the workers’ health and safety, but also have a huge impact on the organization and management efficiency.

Description
Some of the primary challenges that health workers face are demanding schedules and stressful shift patterns which lead to higher levels of worker burnout. Ensuring the well-being of healthcare staff is crucial not only for the individual workers, but it also brings important lessons to the community creating an environment built on a culture of health.

Results
In the past year, the Hospital of Cittadella (Province of Padua) has launched a set of programmes structured to help the staff make better lifestyle choices that affect not only their personal life but also create a more sustainable work environment. One of the projects involved various meetings with a Physical Medicine-Rehabilitation physician, a physical therapist, an Occupational Medicine physician and a medical yoga teacher. The encounters, attended by nearly 10% of the hospital staff, were aimed to help healthcare workers create a more balanced lifestyle and to implement physical activity and posture exercises in their daily routine. Four nutrition classes were also organized with the help of a nutritional biologist. The aim of this course was to show the basics of healthy diets supported by scientific data and guide the participants towards realistic and healthy meal plans.

Lessons
In conclusion, increasing the general wellbeing within the healthcare context is not an easy task, especially when organizational circumstances like staff reduction are being faced. These projects represent a small step towards facing these difficulties. It is important to note that the motivation, collaboration, inclusivity, flexibility and reliance are all elements that contribute to better mental and physical health of the healthcare staff which is crucial on an individual, organizational and societal level.

Key messages
• Increasing personal well being amongst healthcare workers can help create a more sustainable work environment.
• A healthy work environment is crucial for a better functioning organization.
Focus on food instead of nutrients improves consumers’ understanding of meals’ nutrition quality
Authors: Viegas C , Lamy E , Prada M , Rocha A 
Published: October 2024

Abstract

Background
Nowadays, most of the information directed to consumers focuses on nutrients, ignoring the impact of the interactions between different foods, origin or degree of processing. The methodologies currently applied have led consumers to confuse foods with nutrients, meat and fish are often referred to as “proteins”, grains and potatoes are referred to as “carbohydrates, forgetting that these foods are source of other nutrients, such as fat, proteins or fibre. Furthermore, its efficacy is compromised by the difficulties of reading labels among consumers.

Objectives
This study aimed to evaluate the understanding about food and nutritional information presented in menus to consumers, comparing the nutrient-focused approach (Nutrition Declaration) and the new food-focused approach (infographic - based on the Portuguese food Guide, from previous research).

Methods
4 different meals were created, 2 balanced and complete in terms of food and nutrient content and 2 unbalanced and uncomplete. A questionnaire was applied, evaluating the understanding of the balance and healthiness of the meals, using the two approaches (nutrient-focused and food-focused). The order of presentation of the approaches and the meals was randomized for all participants. The questionnaire was distributed online through snowball sampling.

Results
221 individuals participated, mostly female (67%), aged 25 to 54 years old. Evaluation of meals (“how balanced” and “how complete” the meal is) using the Nutrition Declaration did not allow to distinguish the quality of meals (Mb = 3,8;Mc=4,0), in opposite the Infographic returned significant differences between M1/M2 (Mb = 4,3;Mc=4,4) and M3/M4 (Mb = 2,5;Mc=2,6) (p &lt; 0.01) allowing consumers to perceive differences between meals. The percentage of consumers that respond “I don’t know” to these questions decreased using the food-focused tool (13% vs 2%).

Conclusions
The food-focused approach allows for better understanding of meals’ nutritional balance.

Key messages
• The infographic provides more information about the daily food portions and how different meals and types of food contribute for complying food and nutritional recommendations.
• The use of the infographic in menus, recipes, cookbooks and clinical advice may improve better food choices and a healthier lifestyle.