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Background: Understanding health behaviour changes during the COVID-19 pandemic can assist in developing strategies to promote healthy lifestyles at such times. The aim of this exploratory study was to examine whether the frequency of consuming unhealthy foods and beverages changed during lockdown and whether certain population subgroups were more likely to make such changes. Method: An online survey was administered to a national sample of 4022 Australian adults (51% female, mean age 48 years). Generalised linear models with generalised estimating equations were used to identify whether demographic characteristics (age, gender, education, presence of children in the household, number of people in the household) and beliefs related to COVID-19 were associated with changes in the frequency of consuming alcohol, sweet snacks, salty snacks, and sugary beverages from pre to during lockdown. Results: Overall, the frequency of consuming the four assessed unhealthy products did not change during lockdown. However, being male and having children at home were consistently associated with unhealthy changes, whereas believing that alcohol or unhealthy diets would exacerbate COVID-19 severity was linked to a decreased frequency of consuming these products respectively. Age, education, and living with more people were also associated with changes in the frequency of consuming some product categories. Conclusion: During lockdown, certain population subgroups appeared to be at increased risk of more frequent consumption of unhealthy foods and beverages. Believing certain consumption habits are linked to adverse health impacts of COVID was found to reduce frequency of consumption of related products, presenting a potential focus for future public health actions. [ABSTRACT FROM AUTHOR]

Excess dietary salt intake is well established as a leading cause of high blood pressure and associated cardiovascular disease, yet current salt intake in India is nearly 11 g per day, more than twice World Health Organization maximum recommended intake of 5 g per day. Although dietary survey data from India indicate that the main sources of dietary salt are salt added during cooking at home, and few salt reduction efforts have focused on interventions at the household level. As a result, there is little evidence of the effectiveness of behavior change programs to reduce salt intake at the household level. The study aims to develop and implement a community based behavioral change intervention to reduce salt intake delivered by front line community‐based health volunteers; and evaluate the preliminary effectiveness, acceptability, and feasibility of delivering a salt reduction behavior change program and potential to support future scale‐up. The study is a pre‐post intervention design, and outcomes will be evaluated from a random sample of 1500 participants from 28 villages in two primary health centers in Siddipet, Telangana. Primary outcome is change in salt‐related KAB (knowledge, attitude, and behavior) score, and secondary outcomes will be changes in salt intake measured by 24 h urinary sodium excretion and change in scores using the subscales of the COM‐B ("capability", "opportunity", "motivation" and "behavior") tool. Findings will be used to inform future public health policies to support implementation of scalable community‐based interventions to reduce salt intake and control hypertension, the leading‐cause of death in India. [ABSTRACT FROM AUTHOR]

This systematic review aims to document salt consumption patterns and the implementation status and potential impact of salt reduction initiatives in Africa, from studies published between January 2009 and November 2019. Studies were sourced using MEDLINE, Embase, Cochrane Library electronic databases, and gray literature. Of the 887 records retrieved, 38 studies conducted in 18 African countries were included. Twelve studies measured population salt intake, 11 examined salt level in foods, 11 assessed consumer knowledge, attitudes, and behaviors, 1 study evaluated a behavior change intervention, and 3 studies modeled potential health gains and cost savings of salt reduction interventions. The population salt intake studies determined by 24-hour urine collections showed that the mean (SD) salt intake in African adults ranged from 6.8 (2.2) g to 11.3 (5.4) g/d. Salt levels in foods were generally high, and consumer knowledge was fairly high but did not seem to translate into salt lowering behaviors. Modeling studies showed that interventions for reducing dietary sodium would generate large health gains and cost savings for the health system. Despite this evidence, adoption of population salt reduction strategies in Africa has been slow, and dietary consumption of sodium remains high. Only South Africa adopted legislation in 2016 to reduce population salt intake, but success of this intervention has not yet been fully evaluated. Thus, rigorous evaluation of the salt reduction legislation in South Africa and initiation of salt reduction programs in other African countries will be vital to achieving the targeted 30% reduction in salt intake by 2025. [ABSTRACT FROM AUTHOR]

Background: Institutions are a recommended setting for dietary interventions and nutrition policies as these provide an opportunity to improve health by creating healthy food environments. In Australia, state and territory governments encourage or mandate institutions in their jurisdiction to adopt nutrition policies. However, no work has analysed the policy design across settings and jurisdictions. This study aimed to compare the design and components of government-led institutional nutrition policies between Australian states and territories, determine gaps in existing policies, and assess the potential for developing stronger, more comprehensive policies.Methods: Government-led institutional nutrition policies, in schools, workplaces, health facilities and other public settings, were identified by searching health and education department websites for each Australian state and territory government. This was supplemented by data from other relevant stakeholder websites and from the Food Policy Index Australia website. A framework for monitoring and evaluating nutrition policies in publicly-funded institutions was used to extract data and a qualitative analysis of the design and content of institutional nutrition policies was performed. Comparative analyses between the jurisdictions and institution types were conducted, and policies were assessed for comprehensiveness.Results: Twenty-seven institutional nutrition policies were identified across eight states and territories in Australia. Most policies in health facilities and public schools were mandatory, though most workplace policies were voluntary. Twenty-four included nutrient criteria, and 22 included guidelines for catering/fundraising/advertising. While most included implementation guides or tools and additional supporting resources, less than half included tools/timelines for monitoring and evaluation. The policy design, components and nutrient criteria varied between jurisdictions and institution types, though all were based on the Australian Dietary Guidelines.Conclusions: Nutrition policies in institutions present an opportunity to create healthy eating environments and improve population health in Australia. However, the design of these policies, including lack of key components such as accountability mechanisms, and jurisdictional differences, may be a barrier to implementation and prevent the policies having their intended impact. [ABSTRACT FROM AUTHOR]

There is increasing attention to the importance of healthy and environmentally sustainable food supply and demand but little empirical research exists on how this might be achieved. This study examines the potential for inter-sectoral policy and action to support consumer adoption of healthy and sustainable food behaviours, focusing on three key themes: (1) sectoral understandings of healthy and sustainable food behaviours; (2) modes of governance for inter-sectoral action on healthy and sustainable behaviours; and (3) barriers and enablers to inter-sectoral action. We undertook 29 semi-structured interviews with representatives of key government, food industry and non-government organisations in food-related health and environment sectors in Australia. We found that while definitions of health and sustainability are still diverse and often siloed, the rationale of a combined concept was generally acknowledged. There was also consensus on the need for any action to be inter-sectoral, but diverse views on what such action should entail. The main barriers to inter-sectoral action identified included relationships between food system actors and a lack of organisational attention to the issue. Enablers included political and institutional leadership to drive action as well as sector-specific enablers such as market incentives. Overall a range of governance modes were identified that would potentially create a suite of actions across sectors, as well as opportunities to facilitate their implementation. Drawn together our findings outline a framework for action to move beyond the prevailing focus on individual-level change and develop inter-sectoral action and collaboration to support adoption of healthy and sustainable food behaviours. [ABSTRACT FROM AUTHOR]

Cranial kinesis in birds has been the subject of many functional morphological investigations. One of the mechanisms proposed for avian jaw movement is a mechanical coupling of the upper and the lower jaw by the postorbital ligament. Upper jaw elevation is believed to enable lower jaw movement, which is blocked by the limited extensibility of the ligament. In a previous study it was shown that in the Zebra Finch the elastic force of the postorbital ligament is very small for low and medium amplitude gapes (< 7 mm) and does not block lower jaw depression in this species. However, these experiments were not suited to detect very small ligament forces and the jaw positions were imposed externally, which may affect the kinematics of the skull and thus the stretching of the postorbital ligament. In this study, we investigated in vivo whether the postorbital ligament plays a role during the husking of red millet seeds (diameter 2 mm; max gape 5 mm) in Zebra Finches (Taeniopygia guttata). We measured seed husking time, number of mandibulations, and percentage of rejected seeds before and after surgically removing part of the left and right postorbital ligament. Although no effect was expected removal of the ligament did change husking performance. Individual birds react differently to removal of the postorbital ligament. The data suggest that there is an inverse relationship between husking time and percentage of rejected seeds. Birds that reject more seeds after cutting the postorbital ligament have an average husking time that is similar or even lower than before surgery. When birds have the same rejection rate as before the treatment, husking time is significantly higher in the post-operative condition. Although the postorbital ligament primarily serves to limit the maximal extension of the lower jaw, it is speculated that small amplitude stretching of the ligament may play a role in the fine control of jaw opening during dorsoventral husking movements in estrildids. [ABSTRACT FROM AUTHOR]

Background: Dietary sodium reduction is recommended to reduce the burden of cardiovascular disease. In Vietnam food products including salt, fish sauce and bot canh contribute to ~ 70% of dietary sodium intake. Reduced sodium versions of these products can be produced by replacing some of the sodium chloride with potassium chloride. We aimed to assess the cost-effectiveness of three alternative approaches to introducing reduced sodium products onto the market with a view to lowering population sodium intake in Vietnam.Methods: The three salt substitution strategies included voluntary, subsidised and regulatory approaches targeting salt, fish sauce and bot canh products. Costs were modelled using the WHO-CHOICE methodology. A Markov cohort model was developed to evaluate the cost-effectiveness of each strategy versus no intervention from the government perspective. The model linked each intervention strategy to assumed changes in levels of sodium intake and then to systolic blood pressure. Changes in SBP were linked to a probability of ischaemic heart disease or stroke. The model followed people over their lifetime to assess average costs and quality adjusted life years (QALYs) gained for each strategy.Results: The voluntary salt substitution strategy was assumed to require no investment by government. Following ramp up (years 6+), the average annual costs for the subsidised and regulatory strategies were 21,808,968,902 ₫ (US$ 977,354) and 12,949,953,247 ₫ (US$ 580,410) respectively. Relative to no intervention, all three salt substitution strategies were found to be cost-effective. Cost savings were driven by reductions in strokes (32,595; 768,384; 2,366,480) and ischaemic heart disease (IHD) events (22,830; 537,157; 1,648,590) for the voluntary, subsidised & regulatory strategies, respectively. The voluntary strategy was least cost-effective (- 3445 ₫ US$ -0.15; 0.009 QALYs gained) followed by the subsidised strategy (- 43,189 ₫ US$ -1.86; 0.022 QALYs gained) and the regulatory strategy delivered the highest cost savings and health gains (- 243,530 ₫ US$ -10.49; 0.074 QALYs gained).Conclusion: This research shows that all three modelled salt substitution strategies would be good value for money relative to no intervention in Vietnam. The subsidised alternative would require the highest level of government investment; however the implementation costs will be exceeded by healthcare savings assuming a reasonable time horizon is considered. [ABSTRACT FROM AUTHOR]