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Objective: To investigate whether an after-school nutrition education (ASNE) programme can improve the nutrition knowledge and healthy eating behaviour of adolescents from economically disadvantaged families.Design: One-group pretest and posttest design. Nutrition knowledge and dietary intake were collected using a questionnaire, and anthropometric measurements were measured before and after the intervention. Nine components of healthy eating behaviour were assessed with reference to the Dietary Guideline of Taiwan. Pretest and posttest differences were analysed using generalised estimating equations.Setting: Three after-school programmes in central and southern Taiwan. The ASNE programme comprised three monthly 1-h sessions (20-30-min lecture and 30-40-min interaction).Participants: A total of 153 adolescents aged 10-15 years from economically disadvantaged families (seventy-eight elementary students and seventy-five junior high school students).Results: Elementary and junior high school students' nutrition knowledge scores (range 0-6) increased by 0·28 (+ 5·7 %, P = 0·02) and 0·30 points (+ 6·18 %, P = 0·02), respectively, but their fruit intake decreased by 0·36 serving/d (-22·9 %, P = 0·02) and 0·29 serving/d (-18·9 %, P = 0·03), respectively. Junior high school students' mean snacking frequency and fried food intake dropped to 0·75 d/week (-21·3 %, P = 0·008) and 0·10 serving/d (-28·8 %, P = 0·01), respectively.Conclusions: Short-term ASNE programmes can increase nutrition knowledge and reduce snacking frequency and fried food intake despite a decrease in fruit intake among adolescents from economically disadvantaged families. [ABSTRACT FROM AUTHOR]

Objective: To compare two Nutrition and Health Surveys in Taiwan (NAHSITs) 15-18 years apart to evaluate secular changes in ultra-processed food (UPF) consumption and expenditure among Taiwanese adolescents aged 16-18 years and the influences of such changes on dietary quality. Design: This cross-sectional study was based on two representative surveys (NAHSIT 1993-1996, n = 788; NAHSIT 2011, n = 1,274) of senior high school students. Dietary information and food expenditure were based on 24-h dietary recall. All food items were classified into original foods, processed culinary ingredients, processed foods, and UPFs based on NOVA criteria. Dietary quality was categorized as poor or good based on the mean of the Youth Healthy Eating Index--Taiwan Revised. Results: Compared to 1993-1996, adolescents consumed less energy from original foods (55 vs. 39%) but more from processed foods (12 vs. 18%) and UPFs (21 vs. 25%) in 2011, with no apparent gender differences. Those who consumed more UPFs had the lowest proportions of protein energy intake in both surveys (13.7 and 13.1%). Those who consumed more UPFs had higher levels of saturated fat and lower levels of monounsaturated and polyunsaturated fat, dietary fiber, and micronutrient intakes. The participants who consumed more UPFs and fewer original foods exhibited poorer dietary quality. Boys and girls exhibited equal UPF expenditure in both surveys despite an increase in UPF energy consumption. The adjusted odds ratios (95% confidence interval) were 1.33 (1.16-1.52) and 1.36 (1.10-1.69) for the risk of poor dietary quality with 10% increases in UPF energy intake and expenditure, respectively, in 2011. Conclusions: UPF energy consumption among Taiwanese adolescents increased between 1993-1996 and 2011. Observed trends in expenditure suggest that lower UPF costs influenced food choices during this period. Increasing UPF intake and expenditure was associated with poor dietary quality. [ABSTRACT FROM AUTHOR]

Background and Objectives: The extent to which health and survival inequality between indigenous and nonindigenous older Taiwanese is associated with diet is uncertain. Methods and Study Design: Participants from the Elderly Nutrition and Health Survey in Taiwan (1999-2000) formed this cohort. Dietary information was collected by 24-hr recall and simplified food frequency questionnaire. Dietary quality was assessed by dietary diversity score (DDS, 0-6). Annual medical service utilization and expenditure were derived from National Health Insurance claims until 2006. Survivorship was ascertained from the National Death Registry until 2008. Cox proportional- hazards models were used to determine the association between aboriginality and mortality in conjunction with dietary diversity. Results: Indigenes (n=156) compared with nonindigenes (n=l 182) significantly differed in socio-demography, behaviors and chronic disease prevalences. For up to 8 years, indigenes had a higher mortality rate (46.2% vs 33.6%. p=0.003). Indigenes' nutrient intakes were less for polyunsaturated fat. dietary fiber, vitamins and minerals (but more sodium); food intakes more for meat, with less cooking oil. dairy products and fruits; and a lower DDS, (3.61 vs 4.54). They had a 41% higher mortality risk (HR: 1.41. 95% Cl: 1.09-1.81. p=0.0()8). Control for demographic variables did not change the findings. However, the increase in HR was substantially attenuated by the inclusion of DDS (HR: 1.15. 95% Cl: 0.88-1.49. p=0.316). There was no significant interaction between aboriginality and DDS on mortality (p=0.673). Conclusions: Older indigenous Taiwanese have a higher mortality risk than their majority counterparts. Irrespective of aboriginality. the more diverse diet is associated with a lower risk of mortality. [ABSTRACT FROM AUTHOR]