bluuebunny/crossref_metadata_2025_split huggingface dataset:
The transition towards a healthy and sustainable food system at local level: the Brussels City case
Authors: Lorenzo i Sunyer N , Vandevijvere S 
Published: October 2024

Abstract

Despite the European Union’s political efforts to promote healthier and more sustainable food systems, challenges persist, with these systems not yet achieving sustainability and still exacerbating health inequalities. The EU-funded FEAST project aims to catalyse this transition through different actions including by focusing on mapping factors shaping food environments in five European cities, including Brussels. This study focuses on mapping existing policies and initiatives by the city government supporting healthier and more sustainable food systems in Brussels City. Policies were then categorized based on Food-EPI domains, types of policies (i.e. financial incentive) and role of the government (i.e. policy development). Results indicated that while Brussels City has a clear strategy (Good Food Strategy) and objectives (Climate Action Plan) to support the transition, there is a notable emphasis on sustainability over health which could be explained by the absence of a dedicated public health expert in the local government. While there are numerous policies focused on improving the school environment (i.e. healthy and sustainable canteens, banned sodas and snack provision, forbidden advertising inside and nearby of unhealthy foods), there is a lack of corresponding measures for public spaces. Furthermore legislative policies are practically inexistent possibly due to jurisdictional barriers from higher governmental levels. Stakeholder interviews will be conducted in the next phase to delve deeper into these issues and to explore potential facilitators and barriers faced in the development and implementation process of these policies. Overall, this research sheds light on the policy landscape in Brussels City, highlighting both progress, areas for improvement and policy gaps in advancing towards healthier and more sustainable food systems.

Key messages
• Despite EU political efforts to prioritise more sustainable food systems, relevant barriers are still present at local level in Brussels City, hampering the development and implementation of policies.
• In Brussels relevant policies for healthier and more sustainable food systems have been implemented, especially in the school environment, but health seems to be overshadowed by sustainability.
Food depiction in posts of the most popular Lithuanian influencers on Instagram and Facebook
Authors: Basijokas R , Austys D 
Published: October 2024

Abstract

Background
Considering that content published in social networks might act as risk factor to health, we aimed to assess the prevalence of posts depicting food published by Lithuanian influencers on Facebook and Instagram.

Materials and methods
All publicly available posts (6425 in total) created by 21 most popular Lithuanian influencers on Facebook and Instagram in 2022 were included. The content analysis of the posts was performed and information about food and other health-related factors was registered. Distribution of the posts depicting food was assessed according to social networks, gender, age, and number of followers of influencers.

Results
Every fourth (22.6%) post presented foods. Among these posts, fast food was presented in 10.2%, sweets - in 35.5%, vegetables - in 59.5%, fruits and berries - in 40.7%, cereals - in 39.2%, dairy products - in 36.8%, meat - in 26.6%, sea food - in 12.1%. Overall, women, older influencers, influencers with higher number of followers more frequently posted posts depicting vegetables (respectively, 21.0% vs 5.5%, 18.6% vs 6.7%, 18.3% vs 9.3%), fruits and berries (respectively, 14.5% vs 3.8%, 12.0% vs 6.4%, 11.4% vs 8.3%), cereals (respectively, 13.7% vs 4.7%, 12.2% vs 5.6%, 11.2% vs 8.2%), dairy products (respectively, 13.0% vs 3.2%, 11.0% vs 5.0%, 10.8% vs 6.3%), meat (respectively, 8.6% vs 4.1%, 7.9% vs 4.4%). Women and older influencers more frequently depicted sweets (respectively, 13.3% vs 7.1%, 12.6% vs 7.1%), sea food (respectively, 4.4% vs 1.5%, 3.8% vs 2.0%). More posts portraying food in general, fast food, vegetables, milk and dairy products were posted on Instagram (respectively, 27.5% vs 19.8%, 3.4% vs 2.1%, 16.6% vs 13.4%, 10.0% vs 8.3%) (p ≤ 0.05).

Conclusions
Every fourth post depict food, more frequently on Instagram. Healthy and unhealthy foods are presented with similar frequency. Female influencers, older influencers and influencers with higher number of followers more frequently depict foods.

Key messages
• Both healthy and unhealthy foods are presented with similar frequency on social networks – this might lead to the overconsumption of unhealthy foods.
• Differences in depiction of foods between social networks and influencers with different gender, age and number of followers should be taken into account when implementing public health interventions.
Compliance of eating model of individuals with metabolic syndrome with Bulgarian dietary guidelines
Authors: Radionova Z , Birdanova V 
Published: October 2024

Abstract

Background
The incidence of metabolic syndrome progressively increases among the urban population of Europe. About 1/3 of the Bulgarian adults have metabolic syndrome. Changing the dietary pattern can be a modern approach to control it. The aim of the study is to investigate the eating model of people with metabolic syndrome according to the Bulgarian dietary guidelines.

Methods
Two hundred individuals with metabolic syndrome aged 54.6±10.5 y. were randomly selected from general practitioners’ practices in Pleven region, Bulgaria. A Food Frequency Questionnaire method was applied to assess the eating pattern of the respondents. The frequency of food consumption of different foods was compared with the dietary guidelines for the Bulgarian population over 18 years of age. Data were processed with IBM SPSS v. 25.

Results
Grain consumption met the recommendations in almost all respondents. Only 29% consumed fresh fruits and 42% had intake of milk and milk products according to the requirements. Women ate more fresh vegetables and fruits and dairy products than men (p = 0,032). Risk meat consumption, 2-4 times a week, was found: men preferring more red meat (45%) and women - chicken and poultry (56%). Fish consumption met recommendation (once a week) in only 14.7% of the respondents. The food intake of eggs, vegetables, legumes and nuts were low. The preferred oils were sunflower and olive (once a day by 86% and 15% respectively), and butter (21% - 2-4 times a week). The intake of table salt corresponds to the recommendations in two thirds of the participants. One third consumed confectionery every day. Half did not drink alcohol, but 16% used concentrates once a day.

Conclusions
Foods that increase the nutritional risk for the development of metabolic syndrome and type 2 diabetes - high consumption of confectionery and red meat, low consumption of vegetables, fish and legumes were found. Unbalanced eating model requires new public initiatives to prevent metabolic syndrome.

Key messages
• Men with metabolic syndrome have a higher consumption of unhealthy foods than women.
• Modern Bulgarian dietary guidelines are an important tool for prevention of metabolic syndrome.
Mediterranean diet adherence and food waste among university students
Authors: Gianfredi V , Stacchini L , Catalini A , Passeri C , Romano N , Villa M , Ferranti R , Nucci D 
Published: October 2024

Abstract

Introduction
The Mediterranean diet (MD) is widely acknowledged as both a nutritious and sustainable dietary option. Growing research indicates that dietary habits can impact the amount of food waste produced. The aim of the study was to assess the correlation between adherence to the MD and food waste behavior among university students.

Methods
A cross-sectional study employing a validated, anonymous, online questionnaire was conducted among students at the University of Milan. Food waste was measured using the Italian version of the Household Food Waste Behavior (HFWB) questionnaire, while adherence to the MD was assessed through the Medi-Lite questionnaire. The questionnaire was developed in Microsoft Forms. Data were collected between July and October 2023. Responses to the HFWB were scored from 1 for disagreeing responses to 7 for agreeing resposes. Pearson correlation (ρ) between MD adherence and anti-waste behavior, stratified by gender and for the overall population was calculated.

Results
A total of 2,617 students (70% females, age 18-23 years 52%) completed the questionnaire. The average MD adherence score was 10.2 (± 2.2), with 65% of the sample being adherent to the MD. MD score was higher among female (10.4), compared to males (10.1, p &lt; 0.001). Females show a more anti-waste behavior (score=5.3±0.8) compared to males (score=5.2±0.7, p &lt; 0.001). MD adherence statistically significant correlated with anti-waste behavior in the overall sample (ρ = 0.27; 95% CI 0.24-0.31, p &lt; 0.001) and within each gender group (Females: ρ = 0.27; 95% CI 0.22-0.35, p &lt; 0.001; Male: (ρ = 0.28; 95% CI 0.22-0.35, p &lt; 0.001)

Conclusions
This study provides evidence of the weak, positive correlation between adherence to the MD and household food waste behavior. Advocating for the MD could enhance health while simultaneously lowering food waste levels, which may have beneficial effects on environmental sustainability and the management of food resources.

Key messages
• Adherence to the Mediterranean diet linked to lower food waste among university students.
• Mediterranean diet promotes health and less waste, aiding environmental sustainability.
Enabling effective knowledge sharing through a Knowledge Hub
Authors: Pavlickova A , Henderson D 
Published: October 2024

Abstract
The objective of the THCS Knowledge Hub is to facilitate and implement effective knowledge sharing and capacity-building activities for the transformation of health and social care systems in Europe, tailored to the users’ needs and local context in order to prepare the ground for the transformation of health and social care systems. The Hub acts as personalised and interactive “matchmaking” platform which will allow the potential users to (a) access, provide and search for personalised and tailored resources generated in the THCS community but also beyond, reflecting the local maturity and conditions enabling the transformation of health and social care systems; (b) facilitate a support for the potential adaptation and transferability of these resources across the European health and social care settings through the functional use of THCS Innovation Transferability Framework; (c) enable the policy dialogue and capacity-building support for policy-makers in order to enhance their skills, knowledge and experience in health and social care transformation; (d) access and engage with THCS community of experts and ecosystems in order to maximise the access and use of the exiting knowledge and expertise for the transformation of health and social care systems; (e) signpost to existing evidence and resources related to health and social care transformation to enable effective knowledge sharing (educational webinars, peer review activities, study visits, training workshops), exchange of good practices and experience in transforming health and social care systems.
Food insecurity and fruit and vegetable consumption in Belgium
Authors: Berger N , Lebacq T , Vandevijvere S , De Ridder K , Le Dieu E , Van Campenhout E , Vasquez M S , Bel S , Moyersoen I 
Published: October 2024

Abstract

Background
Food insecurity is a substantial and growing concern in many high-income countries. Yet, representative data on the extent of the issue in the general Belgian population is lacking. This study aims to assess the extent of food insecurity in Belgium, identify those at risk of food insecurity, and explore the relationship between food insecurity and fruit and vegetable consumption.

Methods
We used data from the Belgian National Food Consumption Survey 2022-2023, a representative sample of the Belgian population aged 3 years and older (n = 2,800). Food insecurity was assessed using the 3 screening questions derived from the USDA Household Food Security Survey Module. Frequencies of fruit and vegetable consumption were obtained from a food propensity questionnaire. Prevalence of food insecurity was estimated using post-stratification weights. Logistic regression models were used to determine the association between frequency of fruit and vegetable consumption and food insecurity, adjusting for gender, household composition, educational attainment, and income.

Results
Preliminary results indicate that 12.6% of population experienced some form of food insecurity. Those who experienced food insecurity consumed fruit and vegetables less frequently than others, after adjustment for other socio-economic variables (ORs&gt;4.00, p-values&gt;0.05).

Conclusions
This study confirms that food insecurity is a substantial concern in Belgium. Food insecurity should be routinely monitored at the national level. Experiencing food insecurity appears to be negatively associated with the consumption of healthy foods such as fruits and vegetables and thus with the overall quality of the diet. Further research should be supported to identify effective strategies to reduce food insecurity in Belgium. Policy attention should be given to ensure financial accessibility to healthy foods and their attractiveness, especially for people experiencing food insecurity.

Key messages
• Food insecurity is an major concern in Belgium and should be routinely monitored.
• Financial accessibility to healthy foods should be improved, especially for those facing food insecurity.
Perception of fatphobia and pesocentrism within medical consultation
Authors: Chávez Castillo S D , Cordero García P , Abonce Bautista K A , Pérez Villanueva M , Morales Morales D K , Hernández Valenzuela D , León Barroso O D , Villegas-Dominguez J E 
Published: October 2024

Abstract

Background
About 42% of adults living with overweight or obesity suffer a marked pattern of stigmatization and thanks to this discrimination the risk of death has increased up to 60%.

Objectives
To identify the factors that contribute to the perception of fatphobia and pesocentrism within the first level of medical care.

Methods
A prospective cross-sectional study was carried out. Statistical analysis was performed with X2 test and 95% confidence interval (OR/CI95%).

Results
104 participants with obesity and overweight were included. The factors associated with the perception of pesocentrism were, started eating plans before the age of 10 years (3.38/1.12-10.7); being denied consultation for being a fat person (0.27/-0.16-0.46); perceiving mistreatment by the physician regarding weight (0. 2/0.13-0.3); perceiving physical harassment by the physician (0.23/0.16-0.82); perceiving discomfort on physical examination (0.44/0.23-0.82); perceiving fat-phobic behaviors by the physician (5.45/3.24-9.16). Factors associated with perceived fatphobia were, started eating plans before the age of 10 years (4.89/1.71-14.01); being denied consultation for being a fat person (0.19/-0.08-0.44); perceiving mistreatment by the physician regarding weight (0. 07/0.04-0.15); perceiving physical harassment by the physician (0.11/0.06-0.19); perceiving discomfort on physical examination (0.28/0.11-0.67); perceiving weight-centered behaviors by the physician (0.05/0.01-0.23). All with p value &lt;0.05.

Conclusions
Factors such as the beginning of eating plans in childhood, refusal of consultation for being a fat person, mistreatment regarding weight, physical harassment by the physician, discomfort during physical examination are associated with and favor the perception of both fat-phobia and weight-centeredness in the medical consultation.

Key messages
• It is of vital importance to know more about the concepts of fatphobia and pesocentrism, in order to promote non-discrimination around them.
• Fatphobia and pesocentrism are still little known issues within the medical community, the perception of them is due to discriminatory behaviors that have been normalized.
Realising the health benefits of City Development Plan in Ireland: The process and influence of HIA
Authors: Kenny T , O’Mullane M , Nash K , Harris-Roxas B , Kavanagh P , McHugh S , Green L 
Published: October 2024

Abstract

Background
The built environment is a major determinant of health. This research examined the process of implementing a health impact assessment (HIA) of a city development plan, using HIA guidance developed by Institute of Public Health Ireland. HIA is an established approach to facilitate a Health for All Policy approach and is a practical tool used to appraise the potential health effects of a policy, programme or project prior to implementation.

Methods
This mixed methods study underpinned by action research and implementation science frameworks, explored the process and experiences of undertaking an HIA on the Cork City Development Plan (2022-2028). A total of 36 stakeholders across a variety of institutions, sectors, and including members of the public, were involved in the HIA.

Results
We found there was an appetite for HIA’s use to facilitate cross sectoral working to identify, mitigate, and address health inequalities. Data derived from interviews, surveys and workshops indicate that while most stakeholders involved saw the value HIA could bring to their work, further efforts are required to realise the benefits of HIA as a decision-support tool. Barriers included lack of familiarity of HIA across sectors, and for those involved in carrying out the HIA, lack of adequate training, time and access to local data.

Conclusions
HIA can contribute to embedding a Health for All Policies approach, however, greater effort from the public health professionals is required to advocate for HIA as a tool to influence policy. Our results suggest that its practical application requires (i) intersectoral training on HIA that supports a broader understanding of the social determinants of health, (ii) knowledge of the purpose and remit of the policy, plan or programme being appraised and (iii) ensuring a broad range of relevant expertise and experience on the steering group tasked with leading the HIA.

Key messages
• HIA can contribute to embedding a Health for All Policies approach.
• Stakeholders do see the value that HIA can bring to their work, however, further efforts are required to realise the benefits of HIA as a decision-support tool.
Impact Assessments - existing procedures and potentials for health and health equity
Authors: Gruber G , Weigl M , Ecker S , Haas S , Antony D 
Published: October 2024

Abstract

Impact assessment tools are used in policy making all over Europe, some have a legal foundation, others were performed voluntarily for certain measures. Usually, impact assessment procedures are dedicated to specific policy areas or political fields. As policies often have impacts in more than one political area, an interlinkage of impact assessments would be appropriate - also to foster co-benefits of policy making. To follow this approach of a more integrated way of impact assessment, it is necessary to gain an overview and understanding of different procedures in place on national level. As policy making is important for designing healthy living environments, a specific task in the EU Joint Action Prevent NCD is focussing on fostering health and well-being through impact assessment procedures. Therefore, an assessment of the existing impact assessments in the participating member states will be performed in 2024. By using a document analysis of guiding material like guidelines, standards or web applications for the specific impact assessment types, it will be investigated how health and health equity aspects are already included. A qualitative comparison of the results can deliver similarities and differences but also promising practices in the member states. The preliminary results of this analysis will be presented. By learning about the different impact assessment procedures in place, potential synergies and entry points for health and health equity could be found. In a next step, a comprehensive checklist for health and health equity should be developed and piloted in the member states. The final version of checklist should be a guiding material that could be included in various Impact Assessment procedures.

Key messages
• Impact assessment procedures are important for policy making and can foster co-benefits in various political fields.
• By learning about the different impact assessment procedures in place, potential synergies and entry points for health and health equity could be found.
Objective and subjective physical activity assessment in obese patients with eating disorders
Authors: Wiesinger H-P , Bannert B , Kaiser E , Riffer F , Kutschar P 
Published: October 2024

Abstract

Background
Discrepancies between objective and subjective measures of physical activity have been reported in healthy populations but remain unexplored in adults with obesity and psychosomatic disorders. Exercise is key for reducing these disorders, yet physiological and psychosomatic factors may complicate valid activity assessments in this population. Here, we compare self-reporting with actigraph data in a clinical setting.

Methods
Over two years, 27 obese patients (21 female, 6 male; 43±14 yrs; 41.3±5.7 kg·m−2) with eating disorders (EDE-Q) were recruited from an Austrian Psychosomatic Center. Total physical activity was assessed using the metabolic equivalent (MET min/w) and sitting time (min/d). Objective data were collected using the SenseWear® wristband (SWA) during weeks 3-4 of patients’ clinical stay. SWA was worn for ≥18 h/d on ≥ 4 days, including one weekend day. Patients self-administered the International Physical Activity Questionnaire (IPAQ-SF) in alignment with the ∼7 days of SWA wear. Concurrent validity - SWA as a criterion - was assessed using regression analyses, and proportional bias was examined with regression and equality line similarity analyses.

Results
Comparison showed an overestimation of total activity (+45%; p&lt;.001) and underestimation of sitting time (-28%; p&lt;.001) with IPAQ-SF vs SWA. Within-patient correlations were poor for MET (r=.92, p&lt;.001) and impractical for sitting time (r=.27, p=.018), with a proportional bias for both outcomes (p≤.001). Converting objective to subjective measures yielded typical errors of 232 (total activity) and 90 min (sitting time).

Conclusions
The observed disparities emphasize the need to integrate sensor-based assessment of physical activity into clinical practice or tailored public health initiatives for adult obesity and psychosomatic disorders. However, further research is needed to evaluate the long-term impact of incorporating accurate SWA data on intervention efficacy in this vulnerable group.

Key messages
• There was strong evidence for meaningful differences in objective vs subjective physical activity assessments in obese patients with eating disorders.
• Integrating objective measures into treatment seems crucial to improve exercise-guided interventions and address the global obesity and psychosomatic disorders pandemic.