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Some scholars have shown how the U.S. has deployed several traditional, imperial strategies to maintain global power, including military interventions, support for proxy governments, economic coercion, and the exercise of hegemony. In many countries, though, these strategies cannot effectively work. Some countries have elected leaders that defy U.S. influence, and, in middle‐income countries, the U.S. cannot use economic coercion. The U.S. also cannot militarily invade all countries that possess anti‐American governments. How, then, does the U.S. aim to confront and control anti‐American governments in the contemporary world? I examine U.S. foreign policy towards Venezuela under Hugo Chávez, who recurrently challenged U.S. global power during his time in office. Through interviews with U.S. state elites, who developed policy towards Venezuela, and through analysis of U.S. diplomatic cables, I show how the U.S. has moved away from traditional, imperial modalities and towards new imperial techniques aimed at frustrating political processes within particular countries, as well as containing their global influence. These techniques include pressuring the federal judiciary, utilizing state agencies to fund and support opposition political parties and NGOs, seeking to terminate particular pieces of legislation, and eliminating eligibility for global leadership positions. These efforts do not immediately aim to displace existing governments, but, in the least, they aim to frustrate the domestic efforts of particular governments, and ultimately cultivate conditions favorable for the political opposition to eventually attain political power. [ABSTRACT FROM AUTHOR]

This debate comment addresses populism within the US under Trump, and Venezuela under former President Hugo Chavez. It draws out some of the parallels and disconnects between them, and provides a discussion of politics, human rights, and social policy under them. [ABSTRACT FROM AUTHOR]

In recent decades, several sociologists have moved beyond grand theories of international relations, and empirically examined the motivations of US foreign policy leading into the 21st century. This article discusses the work of three political sociologists who have examined US foreign policy from three prominent perspectives: Michael Mann, William Robinson, and Julian Go. Working from a neo-Weberian perspective, Mann highlights the rise of neoconservatism within the US government that has encouraged foreign expansion. From a neo-Marxist perspective, Robinson emphasizes the importance of transnational capitalist class interests, including the promotion of neoliberal policies, on US foreign policy. And working from a world-systems perspective, Go underscores how the US is a hegemon in decline attempting to regain its imperial footing through military aggression. While these researchers cover much ground and raise important questions, their perspectives also contain several blindspots that future work on issues of US foreign policy could address. Most importantly, these three theoretical perspectives have neglected the importance of ideology in making sense of contemporary US foreign policy, and this article argues that future work should more intensively examine how ideology influences foreign policymaking in the US. [ABSTRACT FROM AUTHOR]

Effective obesity prevention requires a synergistic mix of population-level interventions including a strong role for government and the regulation of the marketing, labelling, content and pricing of energy-dense foods and beverages. In this paper we adopt the agenda of the Australian Federal Government (AFG) as a case study to understand the factors generating or hindering political priority for such ‘regulatory interventions’ between 1990 and 2011. Using a theoretically-guided process tracing method we undertook documentary analysis and conducted 27 interviews with a diversity of actors involved in obesity politics. The analysis was structured by a theoretical framework comprising four dimensions: the power of actors involved; the ideas the actors deploy to interpret and portray the issue; the institutional and political context; and issue characteristics. Despite two periods of sustained political attention, political priority for regulatory interventions did not emerge and was hindered by factors from all four dimensions. Within the public health community, limited cohesion among experts and advocacy groups hampered technical responses and collective action efforts. An initial focus on children (child obesity), framing the determinants of obesity as ‘obesogenic environments’, and the deployment of ‘protecting kids’, ‘industry demonization’ and ‘economic costs’ frames generated political attention. Institutional norms within government effectively selected out regulatory interventions from consideration. The ‘productive power’ and activities of the food and advertising industries presented formidable barriers, buttressed by a libertarian/neolibertarian rhetoric emphasizing individual responsibility, a negative view of freedom (as free from ‘nanny-state’ intervention) and the idea that regulation imposes an unacceptable cost on business. Issue complexity, the absence of a supportive evidence base and a strict ‘evidence-based’ policy-making approach were used as rationales to defer political priority. Overcoming these challenges may be important to future collective action efforts attempting to generate and sustain political priority for regulatory interventions targeting obesity. [ABSTRACT FROM AUTHOR]

This article examines how the Venezuelan government has discursively justified passing legislation that forbids NGOs that promote political rights from receiving foreign funding. Existing theories of globalisation theory fail to fully explain this phenomenon, including world polity/ society and world-systems theories. Instead, I argue that although existing cultural scripts promote the spread of democracy and human rights through NGOs, the Venezuelan government has utilised a discourse of national sovereignty to justify its anti-NGO efforts. I argue that instead of one overarching set of cultural scripts, the world polity/ society contains conflicting cultural scripts. In doing so, I develop the concept of the world cultural toolkit in order help us make sense of these contradictory cultural scripts concerning state policy. [ABSTRACT FROM AUTHOR]

The article analyzes the impact of Venezuela's economic crisis on its influence on regional politics and economic cooperation. It discusses the country's declining influence following the death of Hugo Cháhvez who criticized neoliberalism and representative democracy. Some of Venezuela's foreign relations activities are indicated, including its promotion of the Union of South American Nations (UNASUR) and the Community of Latin American and Caribbean States (CELAC).

In recent years, several governments have targeted nongovernmental organizations ( NGOs) by enacting legislation that prohibits foreign funding for them. This article uses diplomatic cables, newspaper articles, and interviews with representatives from NGOs and donors to explain the Venezuelan government's passage of legislation prohibiting foreign funding for political NGOs in 2010. Existent political, sociological, and globalization-oriented theories fail to explain the passage and timing of this legislation. Instead, I utilize and extend global fields theory to examine the Venezuelan government's redirection of its foreign relations, which I argue generated the political opportunity for the government to pass this legislation. I show that the government initially remained keyed into a global subfield involving groups that successfully pressured it to reconsider a more radical form of legislation prohibiting direct foreign funding for all NGOs when it came up for discussion in 2006, including the U.S. and Western European governments, and domestic NGOs. By 2010, however, the government had become embedded within a global subfield involving authoritarian and anti-imperial governments that had already passed similar legislation, and domestic community councils. These newfound relations insulated the government from reconsideration and allowed it the political opportunity to pass a new, less radical piece of legislation. [ABSTRACT FROM AUTHOR]

The Hawaiian people before Western contact gathered at special places during the Makahiki period, a time that was sacred to the god Lono, and during which sports, games and other ceremonies took place. Archaeological excavation and archaeoastronomical investigation together suggest that an approximately 40 m2 rock enclosure in the uplands of Honouliuli on the island of O'ahu was such a special gathering place. Radiocarbon dating indicates that the enclosure was most likely constructed between the late AD 1500s and early AD 1600s, with a notable period of use during the mid-AD 1600s. The archaeoastronomical evidence supports this conclusion, in that the enclosure is precisely aligned upon the horizon rising point in AD 1600 of the Pleiades star cluster (Makali'i in Hawaiian), whose first appearance each November marked the beginning of the four-month Makahiki "annnual harvest" period dedicated to the god Lono. That time period saw the peaking and stabilisation of population on O'ahu, and the expansion of settlements into marginal environmental zones such as Honouliuli. A significant number of temples built around the same time on the island of Maui are oriented in a similar manner. [ABSTRACT FROM AUTHOR]

Despite the close resemblances evident in their major works, their critical stance and their politics, C. Wright Mills and Alvin Gouldner have received strikingly different responses from their sociological peers, and they now occupy very different places in the collective memory of the discipline. This intriguing discrepancy provides the basis here for a comparative case study that examines both ongoing commemorative practices and historical evidence. This paper shows how the sociological community has frequently and approvingly commemorated Mills through introductory textbooks, as well as reading lists for doctoral comprehensive examinations, awards in Mills' honor and biographies of Mills, while doing much less to preserve and promote the memory of Gouldner and his contributions to the field. In an effort to attain a better understanding of such differences, I compare the prescriptions that each advocated for the discipline, especially as these are expressed in Mills' Sociological Imagination and Gouldner's Coming Crisis of Western Sociology. The analysis emphasizes how Mills explicitly sought to move beyond sociology, in a narrow academic sense, and called for well-honed empirical endeavors with relevance for a variety of publics, whereas Gouldner proceeded largely as an academic theorist who demanded sociological-theoretical reform. Unlike Mills, he did not breach the gap between academia and the general public. These findings illustrate an apparent paradox, namely, that American sociology in the twenty-first century may reserve its most esteemed positions for internal critics who advocate movement beyond its contemporary confines. [ABSTRACT FROM AUTHOR]

The level of obesity within the Pacific Islands is extremely high and so is the prevalence of weight-related morbidity and mortality. In contrast, the level of obesity, as defined by the standard WHO classification, remains relatively low in most Asian countries, yet rates of obesity-related disease, such as diabetes and cardiovascular disease are increasing rapidly. Many Asian races appear to be susceptible to the development of excessive abdominal fatness, even at low levels of body mass index (BMI). In addition, the health consequences of weight gain appear to occur at much lower levels of BMI and are more intense than in those of European origin. The exact reasons for these ethnic variations in the development of coronary heart disease (CHD) remain unclear. It is likely that genetic differences contribute to this variation in CHD risk, but different dietary and physical activity patterns may also play a role. The advent of modernisation has resulted in marked changes in the level of physical activity and the food supply available throughout the Asia-Pacific region. There has been a shift towards higher intakes of fats (particularly animal fats and vegetable oils) and sugars. Urbanisation and occupational restructuring have reduced daily physical activity levels. As a result, the population mean BMI and consequent illness is increasing in many countries within the region. Recent studies have shown that infants who were undernourished in utero and then born small have a greater risk of developing abdominal obesity and related morbidity as adults. As undernutrition coexists with overnutrition throughout the Asia-Pacific, focusing efforts to improve nutrition during pregnancy will need to be combined with programs to prevent weight gain in adults if CHD and other chronic diseases are to be effectively tackled in the region. [ABSTRACT FROM AUTHOR]

This article is part of a broader interdisciplinary project investigating the historical, social, and cultural contexts behind individual and collective differences in taste and consumption. It offers a comparative historical study of nonalcoholic beverage (NAB) consumption in Australia and Japan. Australia and Japan are among the largest NAB consumers in the world, and they have a similar history of progression from brewed tea as the main beverage consumed at meals and between meals, to a widespread consumption of bottled beverages. Yet in the contemporary context, both consumer behavior and its impact on nutrition health differ significantly in the two countries. We compare the Australian case, where "soft drinks" are equated with sugar-sweetened beverages, seen as contributing to the global rise in obesity, with thecase of Japan, where sugar-sweetened sodas are widely available, but people also consume large amounts of cold bottled green teas and herbal teas, that are not just "sugarless" but are not sweet at all. We propose that comparing the NAB consumption cultures of Japan and Australia offers us valuable insight into the importance of the cultural dimension of consumption and nutrition health, and the need to consider it when formulating policy. [ABSTRACT FROM AUTHOR]

Abstract Background Excessive consumption of added sugar is negatively associated with many health outcomes. Cakes and biscuits are popular discretionary foods that contribute significant amounts of added sugar to people's diets. Food reformulation may allow an efficient reduction in dietary sugar at a population level without shifting the individual's dietary pattern. Scope and approach The aim of this review was to examine the literature on reformulation of baked products to reduce added sugar. Sucrose plays multiple vital roles in baked products, such as sweetness and bulking, and suitable substitutes must be able to address these functions. A range of potential sucrose substitutes are discussed. Key findings and conclusions Polyols provide both bulk and sweetness though less than sucrose. Non-nutritive sweeteners (NNS) are commonly used in combination with polyols and bulking agents. Stevia, though with a noticeable metallic aftertaste, is the most studied NNS in baked products. Acesulfame-K, sucralose and encapsulated aspartame are also able to replace sucrose with low-calorie carbohydrates (oligofructose, maltodextrin and polydextrose) or polyols. This review indicates that maltitol seems the most suitable sole sucrose substitute at present, while diverse mixtures of NNS, polyols and low-calorie carbohydrates can also deliver the functionalities of sucrose in baked products. Highlights • Cakes and biscuits contribute high amounts of added sugar intake worldwide, and food reformulation is effective to reduce added sugar intake. • Very limited quantity of sucrose can be reduced from cakes and biscuits without replacing sucrose with suitable alternatives. • Non-nutritive sweeteners, polyols and low-calorie carbohydrates in baked products are reviewed as potential alternatives to sucrose • Commercially reformulated low/no added sugar baked products are reviewed. • The currently most feasible options for reformulation of sugar reduced cakes and biscuits are presented. [ABSTRACT FROM AUTHOR]

The article discusses the study which examines the mode by which Fpg and hOGG1 enzymes identify their substrate. It analyzes their activity with various 2'-deoxyguanosine (dG) and 8-oxo-2'-deoxyguanosine (OdG) analogues which varied at only N7 and N8 positions. In addition, results indicate that broad substrate specificity at the imidazole ring of OdG and lends further insight into the mechanism of substrate recognition by two important repair glycosylases.

Background: Obesity is an increasing health concern in Australia among adult and child populations alike and is often associated with other serious comorbidities. While the rise in the prevalence of childhood obesity has plateaued in high-income countries, it continues to increase among children from disadvantaged and culturally diverse backgrounds. The family environment of disadvantaged populations may increase the risk of childhood obesity through unhealthy eating and lifestyle practices. The Strong Families Trial aims to assess the effectiveness of a mixed behavioural and lifestyle intervention for parents and carers of at-risk populations, i.e. families from culturally diverse and disadvantaged backgrounds, in preventing unhealthy weight gain among children aged 5 to 11 years.Methods: Eight hundred families from low socio-economic areas in Greater Western Sydney, NSW, and Melbourne, VIC, will be recruited and randomised into a lifestyle intervention or control group. The intervention comprises 90-minute weekly sessions for 6 weeks (plus two-booster sessions) of an integrated, evidence-based, parenting and lifestyle program that accounts for the influences of family functioning. Primary (anthropometric data) and secondary (family functioning, feeding related parenting, physical activity, consumption of healthy foods, health literacy, family and household costs) outcome measures will be assessed at baseline, immediately following the intervention, and 12 months post-intervention.Discussion: This study will elucidate methods for engaging socially disadvantaged and culturally diverse groups in parenting programs concerned with child weight status.Trial Registration: This study is registered with the Australian New Zealand Clinical Trials Registry ( ACTRN12619001019190 ). Registered 16 July 2019. [ABSTRACT FROM AUTHOR]

Purpose: Recent evidence suggests that plant-based diets may reduce the risk of breast cancer (BC). However, the macronutrient composition of plant-based diets and its potential impact on BC risk has not been well explored. This analysis investigated the association of macronutrient composition with BC risk across a spectrum of plant-based diet indexes using a multidimensional approach.This study followed 64,655 participants from the Etude Epidémiologique auprès de femmes de la Mutuelle Générale de l’Education Nationale (E3N) cohort from 1993 to 2014. Diets were evaluated using validated 208-item diet history questionnaires at baseline (1993) and follow-up (2005), to calculate adherence to the overall plant-based diet (PDI), healthful plant-based diet (hPDI), and unhealthful plant-based diet (uPDI). The association of macronutrient composition with BC risk was assessed via generalized additive time-dependent Cox models across different levels of these indexes. Response surfaces were generated to visualize compositional associations at the 25th, 50th, and 75th percentile of each index (low, moderate, and high).A total of 3,932 incident BC cases were identified during the 21-year follow-up. There was a significant association between macronutrient composition and BC risk for hPDI, uPDI, and PDI (all P < 0.001). Akaike information criterion favored the hPDI model for characterizing the association between macronutrients and BC. BC risk was highest for individuals with a lower hPDI score who also consumed a diet containing lower protein (10%), lower carbohydrate (35%), and higher fat (55%). The lowest risk of BC was observed in those with higher hPDI scores with the lowest intake of protein (10%). At higher PDI and uPDI, diets containing higher protein (30%) and fat (45%) had the highest BC risk.These results demonstrate a complex relationship between macronutrient composition, plant-based diet quality, and BC risk. Further research is needed to examine specific foods that may be driving these associations.The protocol is registered at clinicaltrials.gov as NCT03285230.Design: Recent evidence suggests that plant-based diets may reduce the risk of breast cancer (BC). However, the macronutrient composition of plant-based diets and its potential impact on BC risk has not been well explored. This analysis investigated the association of macronutrient composition with BC risk across a spectrum of plant-based diet indexes using a multidimensional approach.This study followed 64,655 participants from the Etude Epidémiologique auprès de femmes de la Mutuelle Générale de l’Education Nationale (E3N) cohort from 1993 to 2014. Diets were evaluated using validated 208-item diet history questionnaires at baseline (1993) and follow-up (2005), to calculate adherence to the overall plant-based diet (PDI), healthful plant-based diet (hPDI), and unhealthful plant-based diet (uPDI). The association of macronutrient composition with BC risk was assessed via generalized additive time-dependent Cox models across different levels of these indexes. Response surfaces were generated to visualize compositional associations at the 25th, 50th, and 75th percentile of each index (low, moderate, and high).A total of 3,932 incident BC cases were identified during the 21-year follow-up. There was a significant association between macronutrient composition and BC risk for hPDI, uPDI, and PDI (all P < 0.001). Akaike information criterion favored the hPDI model for characterizing the association between macronutrients and BC. BC risk was highest for individuals with a lower hPDI score who also consumed a diet containing lower protein (10%), lower carbohydrate (35%), and higher fat (55%). The lowest risk of BC was observed in those with higher hPDI scores with the lowest intake of protein (10%). At higher PDI and uPDI, diets containing higher protein (30%) and fat (45%) had the highest BC risk.These results demonstrate a complex relationship between macronutrient composition, plant-based diet quality, and BC risk. Further research is needed to examine specific foods that may be driving these associations.The protocol is registered at clinicaltrials.gov as NCT03285230.Results: Recent evidence suggests that plant-based diets may reduce the risk of breast cancer (BC). However, the macronutrient composition of plant-based diets and its potential impact on BC risk has not been well explored. This analysis investigated the association of macronutrient composition with BC risk across a spectrum of plant-based diet indexes using a multidimensional approach.This study followed 64,655 participants from the Etude Epidémiologique auprès de femmes de la Mutuelle Générale de l’Education Nationale (E3N) cohort from 1993 to 2014. Diets were evaluated using validated 208-item diet history questionnaires at baseline (1993) and follow-up (2005), to calculate adherence to the overall plant-based diet (PDI), healthful plant-based diet (hPDI), and unhealthful plant-based diet (uPDI). The association of macronutrient composition with BC risk was assessed via generalized additive time-dependent Cox models across different levels of these indexes. Response surfaces were generated to visualize compositional associations at the 25th, 50th, and 75th percentile of each index (low, moderate, and high).A total of 3,932 incident BC cases were identified during the 21-year follow-up. There was a significant association between macronutrient composition and BC risk for hPDI, uPDI, and PDI (all P < 0.001). Akaike information criterion favored the hPDI model for characterizing the association between macronutrients and BC. BC risk was highest for individuals with a lower hPDI score who also consumed a diet containing lower protein (10%), lower carbohydrate (35%), and higher fat (55%). The lowest risk of BC was observed in those with higher hPDI scores with the lowest intake of protein (10%). At higher PDI and uPDI, diets containing higher protein (30%) and fat (45%) had the highest BC risk.These results demonstrate a complex relationship between macronutrient composition, plant-based diet quality, and BC risk. Further research is needed to examine specific foods that may be driving these associations.The protocol is registered at clinicaltrials.gov as NCT03285230.Conclusion: Recent evidence suggests that plant-based diets may reduce the risk of breast cancer (BC). However, the macronutrient composition of plant-based diets and its potential impact on BC risk has not been well explored. This analysis investigated the association of macronutrient composition with BC risk across a spectrum of plant-based diet indexes using a multidimensional approach.This study followed 64,655 participants from the Etude Epidémiologique auprès de femmes de la Mutuelle Générale de l’Education Nationale (E3N) cohort from 1993 to 2014. Diets were evaluated using validated 208-item diet history questionnaires at baseline (1993) and follow-up (2005), to calculate adherence to the overall plant-based diet (PDI), healthful plant-based diet (hPDI), and unhealthful plant-based diet (uPDI). The association of macronutrient composition with BC risk was assessed via generalized additive time-dependent Cox models across different levels of these indexes. Response surfaces were generated to visualize compositional associations at the 25th, 50th, and 75th percentile of each index (low, moderate, and high).A total of 3,932 incident BC cases were identified during the 21-year follow-up. There was a significant association between macronutrient composition and BC risk for hPDI, uPDI, and PDI (all P < 0.001). Akaike information criterion favored the hPDI model for characterizing the association between macronutrients and BC. BC risk was highest for individuals with a lower hPDI score who also consumed a diet containing lower protein (10%), lower carbohydrate (35%), and higher fat (55%). The lowest risk of BC was observed in those with higher hPDI scores with the lowest intake of protein (10%). At higher PDI and uPDI, diets containing higher protein (30%) and fat (45%) had the highest BC risk.These results demonstrate a complex relationship between macronutrient composition, plant-based diet quality, and BC risk. Further research is needed to examine specific foods that may be driving these associations.The protocol is registered at clinicaltrials.gov as NCT03285230.Registry: Recent evidence suggests that plant-based diets may reduce the risk of breast cancer (BC). However, the macronutrient composition of plant-based diets and its potential impact on BC risk has not been well explored. This analysis investigated the association of macronutrient composition with BC risk across a spectrum of plant-based diet indexes using a multidimensional approach.This study followed 64,655 participants from the Etude Epidémiologique auprès de femmes de la Mutuelle Générale de l’Education Nationale (E3N) cohort from 1993 to 2014. Diets were evaluated using validated 208-item diet history questionnaires at baseline (1993) and follow-up (2005), to calculate adherence to the overall plant-based diet (PDI), healthful plant-based diet (hPDI), and unhealthful plant-based diet (uPDI). The association of macronutrient composition with BC risk was assessed via generalized additive time-dependent Cox models across different levels of these indexes. Response surfaces were generated to visualize compositional associations at the 25th, 50th, and 75th percentile of each index (low, moderate, and high).A total of 3,932 incident BC cases were identified during the 21-year follow-up. There was a significant association between macronutrient composition and BC risk for hPDI, uPDI, and PDI (all P < 0.001). Akaike information criterion favored the hPDI model for characterizing the association between macronutrients and BC. BC risk was highest for individuals with a lower hPDI score who also consumed a diet containing lower protein (10%), lower carbohydrate (35%), and higher fat (55%). The lowest risk of BC was observed in those with higher hPDI scores with the lowest intake of protein (10%). At higher PDI and uPDI, diets containing higher protein (30%) and fat (45%) had the highest BC risk.These results demonstrate a complex relationship between macronutrient composition, plant-based diet quality, and BC risk. Further research is needed to examine specific foods that may be driving these associations.The protocol is registered at clinicaltrials.gov as NCT03285230. [ABSTRACT FROM AUTHOR]

Objective: To analyze the contribution of ultra-processed foods to the intake of free sugars among different age groups in Australia. Methods: Dietary intakes of 12,153 participants from the National Nutrition and Physical Activity Survey (2011–12) aged 2+ years were evaluated. Food items collected through two 24-h recalls were classified according to the NOVA system. The contribution of each NOVA food group and their subgroups to total energy intake was determined by age group. Mean free sugar content in diet fractions made up exclusively of ultra-processed foods, or of processed foods, or of a combination of un/minimally processed foods and culinary ingredients (which includes table sugar and honey) were compared. Across quintiles of the energy contribution of ultra-processed foods, differences in the intake of free sugars, as well as in the prevalence of excessive free sugar intake (≥ 10% of total energy) were examined. Results: Ultra-processed foods had the highest energy contribution among children, adolescents and adults in Australia, with older children and adolescents the highest consumers (53.1% and 54.3% of total energy, respectively). The diet fraction restricted to ultra-processed items contained significantly more free sugars than the two other diet fractions. Among all age groups, a positive and statistically significant linear association was found between quintiles of ultra-processed food consumption and both the average intake of free sugars and the prevalence of excessive free sugar intake. Conclusion: Ultra-processed food consumption drives excessive free sugar intake among all age groups in Australia. [ABSTRACT FROM AUTHOR]

Background: Understanding the knowledge and beliefs of key stakeholders is crucial in developing effective public health interventions. Knowledge and beliefs about obesity and eating disorders (EDs) have rarely been considered, despite increasing awareness of the need for integrated health promotion programs. We investigated key aspects of knowledge and beliefs about obesity and EDs among key stakeholders in Australia.Methods: Using a semi-structured question guide, eight focus groups and seven individual interviews were conducted with 62 participants including health professionals, personal trainers, teachers and consumer group representatives. An inductive thematic approach was used for data analysis.Results: The findings suggest that, relative to obesity, EDs are poorly understood among teachers, personal trainers, and certain health professionals. Areas of commonality and distinction between the two conditions were identified. Integrated health promotion efforts that focus on shared risk (e.g., low self-esteem, body dissatisfaction) and protective (e.g., healthy eating, regular exercise) factors were supported. Suggested target groups for such efforts included young children, adolescents and parents.Conclusions: The findings indicate areas where the EDs and obesity fields have common ground and can work together in developing integrated health promotion programs. [ABSTRACT FROM AUTHOR]

Objective: There is an urgent need to identify and develop cross-sectoral policies which promote and support a healthy, safe and sustainable food system. To help shape the political agenda, a critical first step is a shared definition of such a system among policy makers across relevant sectors. The aim of the present study was to determine how Australian policy actors define, and contribute to, a healthy, safe and sustainable food system.Design: A Delphi survey, consisting of two rounds, was conducted. Participants were asked how they define, and contribute to, a healthy, safe and sustainable food system (Round 1) and indicate their level of agreement with summary statements (Round 2).Setting: This was an online Delphi survey conducted in Australia.Participants: Twenty-nine and fourteen multisectoral and multilevel policy makers completed Round 1 and Round 2, respectively.Results: The definition included food processing regulation, environmentally friendly food production and access to nutritious food. All agreed that it was important for them to improve access and supply of healthy food and ensure healthy planning principles are applied.Conclusions: There were cross-sectoral differences in definitions and contributions; however, critical consensus was achieved. The study contributes to the definition of key elements of a cross-sectoral food and nutrition policy to meet today's environmental, health, social and economic challenges; however, further research using a more representative multisectoral sample is warranted. [ABSTRACT FROM AUTHOR]

Nutrition therapy is considered a key component of diabetes management, yet evidence around the ideal macronutrient composition of the diet remains inconclusive. A systematic review and meta-analysis was performed to assess the effects of carbohydrate-restricted diets (≤45% of total energy) compared to high carbohydrate diets (>45% of total energy) on glycemic control in adults with diabetes mellitus. Six databases were searched for articles published between January 1980 and August 2016. Primary outcome was between-group difference in HbA1c change. Individual effect sizes were standardized, and a meta-analysis performed to calculate pooled effect size using random effects. 25 RCTs involving 2412 participants were included. Carbohydrate-restricted diets, in particular those that restrict carbohydrate to <26% of total energy, produced greater reductions in HbA1c at 3 months (WMD -0.47%, 95% CI: -0.71, -0.23) and 6 months (WMD -0.36%, 95% CI: -0.62, -0.09), with no significant difference at 12 or 24 months. There was no difference between moderately restricted (26-45% of total energy) and high carbohydrate diets at any time point. Although there are issues with the quality of the evidence, this review suggests that carbohydrate-restricted diets could be offered to people living with diabetes as part of an individualised management plan. [ABSTRACT FROM AUTHOR]

Objectives Globally, one-fifth of the world's children are stunted, however this statistic may be an underestimate as many countries lack comprehensive monitoring of height-for-age. Until a recent national health survey, Negara Brunei Darussalam has lacked the data to offer a comprehensive assessment of height-for-age among children. The aim of this study is to determine the prevalence of and factors associated with stunting among children aged 0-24 months in Negara Brunei Darussalam (Brunei). Methods A cross-sectional analyses of 396 children aged <24 months. Demographic, dietary and anthropometric measurements were recorded. Multivariate logistic regression was used to analyse factors associated with moderate stunting. Results Almost one-quarter of infants (24%) were stunted. Male children and children who were preterm (<37 weeks gestation) were more than twice as likely to be stunted as their counterparts, respectively (OR 2.48; 95% CI 1.49-4.12; OR 2.14; 95% CI 1.06-4.33, respectively). Those who were born low birth weight (<2.5 kg) were three times more likely to be stunted than those born normal birth weight (OR 2.99; 95% CI 1.44-6.17). Conclusions for Practice This study presents data on prevalence of stunting in Brunei based upon the World Health Organization's growth charts. In addition it is also the first time that the factors associated with stunting among infants aged <24 months have been examined in Brunei. The stunting prevalence in Brunei is of concern due to the reported short and long-term negative impact on health later in life. The authors recommend close monitoring of pregnant women who are at risk of delivering low birth weight infants and frequent monitoring of low birth weight infants in line with World Health Organization nutrition goals. Existing height-for-age data should be integrated into global databases. [ABSTRACT FROM AUTHOR]

Purpose: To examine the intake and sources of added sugars (AS) of Australian children and adolescents, and compare their intake of free sugars (FS) to the recommended limit set by the World Health Organization (<10 % energy from FS). Method: Data of 4140 children and adolescents aged 2-16 years with plausible intakes based on 2 × 24 h recalls from the 2007 Australian National Children Nutrition and Physical Activity Survey were used. AS content of foods was estimated based on a published method. Intakes of AS and FS, as well as food sources of AS, were calculated. One-way ANOVA was used for comparisons between age groups and gender. Results: The mean (SD) AS intake was 58.9 (35.1) g/day, representing 11.9 (5.6) % of daily energy intake and 46.9 (17.5) % of daily total sugars intake. More than 80 % of the subjects had % energy from FS > 10 %. Significant increasing trends for AS intake, % energy from AS, % energy from FS across age groups were observed. Sugar-sweetened beverages (19.6 %), cakes, biscuits, pastries and batter-based products (14.3 %), and sugar and sweet spreads (10.5 %) were the top three contributors of AS intake in the whole sample. Higher contribution of AS from sugar-sweetened beverages was observed in adolescents ( p < 0.001). Conclusions: A large proportion of Australian youths are consuming excessive amounts of energy from AS. Since the main sources of AS were energy-dense, nutrient-poor foods, interventions which target the reduction in these foods would reduce energy and AS intake with minimal impact to core nutrient intake. [ABSTRACT FROM AUTHOR]

Background Obesity is a public health challenge faced worldwide. Community pharmacists may be well placed to manage Australia's obesity problem owing to their training, accessibility and trustworthiness. However, determining consumers' needs is vital to the development of any new services or the evaluation of existing services. Objective To explore Australian consumers' perspectives regarding weight management services in the community pharmacy setting, including their past experiences and willingness to pay for a specific pharmacy-based service. Design An online cross-sectional consumer survey was distributed through a marketing research company. The survey instrument comprised open-ended and closed questions exploring consumers' experiences of and preferences for weight management services in pharmacy. It also included an attitudinal measure, the Consumer Attitude to Pharmacy Weight Management Services (CAPWMS) scale. Setting and participants A total of 403 consumers from New South Wales, Australia, completed the survey. Results The majority of respondents had previously not sought a pharmacist's advice regarding weight management. Those who had previously consulted a pharmacist were more willing to pay for and support pharmacy-based services in the future. Most consumers considered pharmacists' motivations to provide advice related to gaining profit from selling a product and expressed concerns about the perceived conflicts of interest. Participants also perceived pharmacists as lacking expertise and time. Conclusion Although Australian consumers were willing to seek pharmacists' advice about weight management, they perceived several barriers to the provision of weight management services in community pharmacy. If barriers are addressed, community pharmacies could be a viable and accessible setting to manage obesity. [ABSTRACT FROM AUTHOR]

Issues addressed: Community-based programs that affect healthy environments and policies have emerged as an effective response to high obesity levels in populations. Apart from limited individual reports, little is currently known about these programs, limiting the potential to provide effective support, to promote effective practice, prevent adverse outcomes and disseminate intervention results and experience. The aim of the present study was to identify the size and reach of current community-based obesity prevention projects in Australia and to examine their characteristics, program features (e.g. intervention setting), capacity and approach to obesity prevention. Methods: Detailed survey completed by representatives from community-based obesity prevention initiatives in Australia. Results: There was wide variation in funding, capacity and approach to obesity prevention among the 78 participating projects. Median annual funding was Au$94 900 (range Au$2500-$4.46 million). The most common intervention settings were schools (39%). Forty per cent of programs focused on a population group of ≥ 50 000 people. A large proportion of respondents felt that they did not have sufficient resources or staff training to achieve project objectives. Conclusion: Community-based projects currently represent a very large investment by both government and non-government sectors for the prevention of obesity. Existing projects are diverse in size and scope, and reach large segments of the population. Further work is needed to identify the full extent of existing community actions and to monitor their reach and future 'scale up' to ensure that future activities aim for effective integration into systems, policies and environments. [ABSTRACT FROM AUTHOR]

Issues addressed: Community-based programs that affect healthy environments and policies have emerged as an effective response to high obesity levels in populations. Apart from limited individual reports, little is currently known about these programs, limiting the potential to provide effective support, to promote effective practice, prevent adverse outcomes and disseminate intervention results and experience. The aim of the present study was to identify the size and reach of current community-based obesity prevention projects in Australia and to examine their characteristics, program features (e.g. intervention setting), capacity and approach to obesity prevention. Methods: Detailed survey completed by representatives from community-based obesity prevention initiatives in Australia. Results: There was wide variation in funding, capacity and approach to obesity prevention among the 78 participating projects. Median annual funding was Au$94 900 (range Au$2500-$4.46 million). The mostcommonintervention settings were schools (39%). Forty per cent of programs focused on a population group of ≥50 000 people. A large proportion of respondents felt that they did not have sufficient resources or staff training to achieve project objectives. Conclusion: Community-based projects currently represent a very large investment by both government and non-government sectors for the prevention of obesity. Existing projects are diverse in size and scope, and reach large segments of the population. Further work is needed to identify the full extent of existing community actions and to monitor their reach and future 'scale up' to ensure that future activities aim for effective integration into systems, policies and environments. [ABSTRACT FROM AUTHOR]

ObjectiveTo investigate nutrition literacy among adult grocery buyers regarding energy-related labelling terms on food packaging.DesignQualitative interviews and quantitative surveys to determine shoppers’ understanding of energy terms (‘energy’, ‘calories’ and ‘kilojoules’) and how energy terms affect perceptions of healthiness and intentions to purchase breakfast cereals, muesli bars and frozen meals.SettingIndividual in-depth interviews and surveys in two metropolitan supermarkets, Sydney, Australia.SubjectsAustralian adults (interview n 40, survey n 405) aged 18–79 years.ResultsThe relationship between energy and perceived healthiness of food varied by product type: higher energy breakfast cereals were perceived to be healthier, while lower energy frozen meals were seen as healthier choices. Likewise, intentions to purchase the higher energy product varied according to product type. The primary reason stated for purchasing higher energy products was for sustained energy. Participants from households of lower socio-economic status were significantly more likely to perceive higher energy products as healthier. From the qualitative interviews, participants expressed uncertainty about their understanding of kilojoules, while only 40 % of participants in intercept surveys correctly answered that kilojoules and calories measured the same thing.ConclusionsAustralian consumers have a poor understanding of energy and kilojoules and tend to perceive higher energy products as healthier and providing sustained energy. This has implications regarding the usefulness of industry front-of-pack labelling initiatives and quick service restaurant menu labelling that provides information on energy content only. Comprehensive and widely communicated education campaigns will be essential to guide consumers towards healthier choices. [ABSTRACT FROM PUBLISHER]

Abstract: The nutritional quality of Australian breakfast cereals is not systematically monitored despite the importance of breakfast for general health. We examined whether the nutritional quality of Australian breakfast cereals has improved between 2004 and 2010, and whether any change could be detected after the introduction of Daily Intake Guide (DIG) front-of-pack labelling. Supermarket surveys were conducted in 2004 and 2010 using the same methodology to collect information from the nutrition information panels of Australian breakfast cereals and the nutrient content of cereals was compared by year. Breakfast cereals with and without DIG labelling in 2010 were also compared. Nutritional quality was assessed using UK Traffic Light criteria. No significant difference was detected in nutritional composition of breakfast cereals between 2004 and 2010. There was no notable improvement in nutritional composition of breakfast cereals marketed as the same product in both years. Overall there has been little improvement in the nutritional quality of Australian breakfast cereals in the 6year period. A large proportion of Australian breakfast cereals were considered high sugar. In conclusion, the introduction of DIG labelling does not appear to have promoted product reformulation, and breakfast cereals carrying DIG labels were not consistently healthier. [Copyright &y& Elsevier]

Objective: To investigate consumers' understanding of terms commonly used to provide guidance about frequency and quantity of food consumption. Methods: A survey of 405 shoppers explored how frequently consumers thought food labeled with the terms "eat often," "eat moderately," "eat occasionally," "a sometimes food," and "an extra food" should be eaten. In a separate phase, 30 grocery buyers responded to open-ended questions about their interpretation of these terms. Results: Responses indicated significant differences in meaning between the terms. However, the specific interpretation of each term varied considerably across respondents. The qualitative research found the terms to be highly subjective, and there was a high degree of uncertainty about the meaning of the term "an extra food" in particular. Conclusions and Implications: Food frequency and descriptive terms currently used do not provide meaningful or consistent nutritional guidance. There is a need for simple, unambiguous terminology. [ABSTRACT FROM AUTHOR]

We aimed to develop an expert consensus on standardizing data collections in specialist obesity management clinics in Australia. A panel of 16 experts participated in a structured consensus‐driven Delphi process to reach agreement on a minimum set of baseline patient data collections for consideration in specialist obesity services. The panel included surgeons, clinicians, allied health professionals (dietician, exercise physiologist, psychologist), a bariatric nurse and obesity researchers. We produced a recommended list of core and useful data items that should comprise the baseline patient data set. Consensus was achieved for recommended measures of demographic, anthropometric, biochemical, weight‐loss history, medication, medical history and comorbidity data items using a 70% agreement threshold. In this iterative process, there was also consideration of specific data items for patients referred for bariatric surgery. We present the first expert panel consensus on recommendations for a minimum and standard set of baseline patient data collections in obesity management services in Australia. These may be relevant to other countries with similar obesity management service models. Implementation of these recommendations should facilitate data pooling for clinical audits and research collaborations across clinics seeking to improve the quality of specialist obesity care. [ABSTRACT FROM AUTHOR]