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In the context of great changes in the food industry, the aim of this research is to investigate if and how the implementation of 4.0 enabling technologies can enhance the economic, environmental and social sustainability of the food sector. A systematic literature review, using a combination of 12 keywords, was carried out on Scopus database with defined inclusion and exclusion criteria in order to answer four selected research questions. Overall, 50 relevant papers were retrieved and analysed by Mendeley and Excel with descriptive statistics. VOSviewer was used for co-occurrence and co-authorship analysis. Results illustrate that the interest in the topic has grown, in particular in Italy, and resume the benefits achievable by the implementation of 4.0 technologies in food industries. Social impacts are new job positions, ergonomic design of workplaces, changes in educational institutions, improved nutrition and better animal welfare. Positive aspects are related even to economic growth, improving food chain performances and decreasing companies' costs. Finally, it allows energy, water, CO2 emissions and food savings. Overall, the work provides a helpful overview to food manufacturers and producers, recommending the introduction of I4.0 technologies to positively influence the sustainable development of the sector and remain competitive in the market. [ABSTRACT FROM AUTHOR]

Gastroenterologists encounter many nutrition-related disorders in their practice, yet the nutritional needs of patients with chronic gastrointestinal (GI) and liver disease are largely unaddressed by treating physicians, due to suboptimal nutrition education. To address this gap, we developed and piloted a culinary medicine course for a GI fellowship training program. The objective of this study is to describe the development, implementation, and acceptability of the course. A registered dietitian, a chef instructor, and a gastroenterology clinical professor trained in culinary medicine developed the four-class tailored curriculum and delivered the classes remotely. Each class had a theme related to commonly encountered GI disorders and included hands-on meal preparation, a nutrition lecture, and a patient case study discussion. Post-course feedback surveys were disseminated. Twenty-three GI physicians enrolled in the course and the attendance rates in classes 1-4 were 83%, 65%, 61%, and 48%, respectively. Among 15 completed feedback surveys, 80% reported that the class contents were either moderately or extremely useful and all endorsed the curriculum for other gastroenterologists. Future studies of culinary medicine programs tailored to medical specialties should identify strategies to maintain engagement and assess the impact on nutrition knowledge, competencies, and translation of these new skills to clinical practice.

BACKGROUND: Obstetricians-gynecologists (OB/GYNs) play a critical role for their pregnant patients during their perinatal period, but research on OB/GYNs knowledge, attitudes, and perceptions regarding plant-based dietary patterns (PBDP) and how this may influence recommendations to patients is lacking. An online cross-sectional survey was conducted to examine OB/GYNs knowledge, attitudes, and perceptions towards a PBDP. METHODS: Postcards were mailed in June 2023 to a convenience sample of 5,000 OB/GYNs across the US using a mailing list provided by the American College of Obstetricians and Gynecologists. Postcards had a brief study description and a QR code that linked to an online survey asking questions about demographics, behavior (e.g., nutritional habits), and other factors that may influence knowledge, attitudes, and perceptions towards a PBDP for their patients. RESULTS: Ninety-six OB/GYNs completed the full questionnaire (~2% response rate). Most (92%) felt that it is within an OB/GYNs role to incorporate nutrition education and counseling within practice. However, 72% felt inadequately trained to discuss nutrition and diet-related issues with patients. Despite a perceived lack of nutrition training, 86% reported that a PBDP was safe and health-promoting, and 81% reported that a well-planned PBDP could adequately meet all nutritional needs of pregnant and lactating patients. CONCLUSION: Findings suggest that OB/GYNs are generally knowledgeable about the components and health benefits of a plant-based diets. However, nutrient adequacy misconceptions and lack of sufficient training to discuss nutrition with patients may result in OB/GYNs not recommending PBDPs to patients. These findings underscore the need to enhance OB/GYN graduate medical education and training by integrating education on PBDPs, therefore improving a clinicians ability to confidently and effectively counsel pregnant persons on this aspect of perinatal care.

In recent years, nutrition has become increasingly important in treating and managing gestational diabetes mellitus. The Health Belief Model (HBM) is a conceptual framework in health behavior research used in some medical research. The present study aimed to evaluate the effect of glycemic index training based on the HBM on metabolic indicators and pregnant women's health-related quality of life. In this open-label, parallel-controlled randomized trial, 90 pregnant women from primary health centers in Iran were recruited and randomly assigned to either the intervention group or the control group, using a block randomization method with a block size of six. The intervention group underwent 12 weeks of nutritional education on the glycemic index and load of foodstuff. The control group only received routine health care. Valid and reliable questionnaires included demographic and prenatal information, physical activity, three days of food records, quality of life (SF-12), and HBM constructs. Fasting blood samples were taken at baseline and end of the study, to assess fasting blood glucose (FBS), fasting insulin, hs-CRP, and lipids. Eighty-four pregnant women with an age mean of 30.12 ± 4.35 completed 12 weeks of intervention. At baseline, there were no significant differences between groups in the HBM subscales (P > 0.05). However, within the intervention group, there was an increase in perceived susceptibilities (mean change 1.45 ± 4.21; P = 0.03) and cue to action (mean change: 1.22 ± 3.38; P = 0.02). In the adjusted model, the General Health subscale of Quality of Life showed a significant increase in the comparison between groups (mean change 13.69 ± 29.83 vs. 0.00 ± 29.58; P = 0.04). Additionally, the adjusted model revealed a notable difference between the groups in serum hs-CRP level, (mean change -0.877 ± 3.47 vs. -0.067 ± 3.40; P = 0.01) and triglyceride level (mean change − 55.24 ± 111.21 vs. 40.92 ± 142.01; P = 0.001). However, in the adjusted model, the total cholesterol levels increased between groups (mean change 22.75 ± 66.17 vs. 30.12 ± 61.33; P = 0.01) at the end of the study. There was no significant difference in glycemic indices (P > 0.05). Participation in a nutrition education program might positively impact nutritional beliefs, behaviors, and some biochemical indicators among pregnant women. Future studies with larger sample sizes and longer follow-ups are warranted. Trial registration number: IRCTID: IRCT20190227042858N1. Registration date: 2019-07-18. [ABSTRACT FROM AUTHOR]

\nHIGHLIGHTSThis study examined the impact of nutrition education on chronotype, sleep quality, and dietary quality among university students. Participants included 317 students with nutrition education and 280 without. Data were collected through questionnaires assessing demographic characteristics, chronotype (using the Morning-Evening Questionnaire), sleep quality (via the Pittsburgh Sleep Quality Index), and dietary habits. Anthropometric measurements and 24-hour food recalls were also recorded. Dietary quality was evaluated using the Healthy Eating Index (HEI)-2020, while dietary fat and carbohydrate quality were assessed with the Fat Quality Index (FQI) and Carbohydrate Quality Index (CQI), respectively. Results indicated that students who received nutrition education had significantly lower body weight, height, and waist circumference compared to those without. Of the students, 8.9% had a morning, 7% had an evening and the rest had an intermediate chronotype. HEI-2020, CQI, and FQI scores were significantly higher in the nutrition education group. Although no significant relationship was found between nutrition education and chronotype, improved dietary and sleep quality were observed in the group with education. This suggested that enhancing nutritional knowledge can positively impact health by improving dietary quality and sleep. Dietary quality, carbohydrate quality and fat quality were found to be higher in the group with nutrition education.No relationship was found between chronotype and nutrition education.A positive relationship was found between nutrition education and sleep quality.As sleep quality decreased, tendency to evening type increased.Dietary quality, carbohydrate quality and fat quality were found to be higher in the group with nutrition education.No relationship was found between chronotype and nutrition education.A positive relationship was found between nutrition education and sleep quality.As sleep quality decreased, tendency to evening type increased. [ABSTRACT FROM AUTHOR]

Objectives: Poor Food security (FS) is associated with risk of diet-related diseases and rising healthcare costs. Produce Prescription Interventions (PRx) are emerging clinical tools to improve FS and diet quality, but their impact in families with children is not well established. This study evaluates the impact of a pediatric PRx on FS and nutrition-related behaviors. Methods: Adult caregivers of children (0-18) were enrolled within a 6-month produce delivery and nutrition education intervention. A validated food security survey was administered pre/post intervention to determine FS scores and "Food Secure" status. Statistical analyses tested pre-post differences in FS scores and proportion of scores within the "Food Secure" range. Semi-structured interviews were performed post-intervention to explore families' experiences with low FS and healthy behaviors and were thematically analyzed. Results: Between October 2021 and December 2022, 82 families were enrolled, 65 completed FS survey at baseline and 54 completed it at post-intervention. FS scores improved post-intervention (P <.05) and a greater proportion of household- and child-level scores fell within the "Food Secure" range post-intervention (P <.05). Twenty-eight interviews were analyzed. Three salient themes were identified: (1) value of healthcare-based screening and intervention, (2) food and education motivate behavior change, and (3) perceptions of post-intervention lifestyle sustainability. Conclusions: Participation in the PRx was associated with improvements in FS and nutrition-related attitudes and behaviors. PRx can be implemented by health systems to improve FS and health behaviors associated with risk for diet-related diseases. Longer-term support may be needed to maintain healthy behavior changes associated with PRx participation. [ABSTRACT FROM AUTHOR]

The article focuses on the challenges faced in transforming the dietetics curriculum, particularly in relation to curriculum drift and overcrowding. Topics include the use of constructive alignment based on constructivist learning theory, the need for an outcome-based approach to curriculum design, and the impact of individual academic decisions on the consistency and effectiveness of the curriculum.

Aim: Objective structured clinical examinations have long been used in dietetics education. This observational study aims to describe the development, deployment, feasibility and validity of assessment using an oral interview in place of traditional objective structured clinical examinations, and to determine the ability of this assessment to identify students who are either not ready for placement or may require early support and/or remediation. Methods: Student assessment data were collected over a two‐and‐a‐half‐year period and used to test the predictive ability of an oral interview to determine dietetic placement outcomes and highlight a need for early remediation. Descriptive statistics as well as a between‐group one‐way ANOVA was used to describe results. Results: A total of 169 students participated in the oral interview and subsequent medical nutrition therapy placement over the study period. Significant differences in oral interview score were seen between students who passed placement and students who passed with remediation or those who failed. Oral interview performance was able to predict placement outcome, yet required less resources than traditional objective structured clinical examinations. Conclusion: An oral interview may provide the same utility as the objective structured clinical examination in dietetics education. [ABSTRACT FROM AUTHOR]

Digital technology creates new opportunities to design multisensory learning experiences. Evidence suggests that digital innovation can greatly benefit health education, including nutrition programs. The COVID-19 pandemic disrupted the education sector, forcing schools to modify standard practices from exclusively in-person delivery to online or blended learning. Digitalized curriculums became particularly useful as an Emergency Remote Teaching tool. This article focuses on developing and implementing a multimedia, multisensory, and scalable Hip-Hop Healthy Eating and Living in Schools (H.E.A.L.S.) Nutrition–Math Curriculum (NMC). NMC comprises 20 lessons—music-based multimedia resources used in the classroom or at home. Fourteen lessons represent self-directed online modules (asynchronous learning) hosted on a Learning Management System (LMS) called "Gooru." The remaining six lessons are teacher-facilitated (in person or using Zoom) review sessions (synchronous learning). The article discusses (1) the development of NMC through the lens of the Multisensory Multilevel Health Education Model (MMHEM), (2) the high acceptability of NMC evaluated using a mixed-methods design among minoritized fifth-grade students attending an after-school program, and (3) the students' completion and mastery rates of the NMC modules based on LMS data. Multimedia nutrition education programs integrated with common core curriculum content, such as NMC, may be a promising avenue for disseminating health education to minoritized children living in New York City and similar high fast-food density cities. [ABSTRACT FROM AUTHOR]

This study aimed to explore the preprofessional identity of undergraduate nutrition and dietetic students to guide curriculum development to better support the expectations of students and promote career readiness in a changing profession. Qualitative focus group discussions in March, 2021. An Australian university. First-year students enrolled in the Bachelor of Nutrition (n = 50) or Bachelor of Dietetics (n = 58) at the University of the Sunshine Coast. Student sociodemographics, motivations for and influences on career choice and preprofessional identity, expectations of professional competency and practice, degree, and career expectations. Descriptive statistics were conducted, and focus group discussions were analyzed using the Framework Approach. Motivations and skills were consistent across both cohorts, centering on an interest in nutrition and respectful, professional conduct and communication. Expectations were similar across both degrees, with a focus on placement, real-world learning experiences, and staff support. Career expectations for both cohorts included business ownership. This research provided an understanding of students' preprofessional identity, which was similar for both nutrition and dietetics students. Motivations identified in this research can be used to inform activities across nutrition and dietetic programs that support career readiness. [ABSTRACT FROM AUTHOR]

Summary: Precision fermented dairy (PFD) is a novel technology used to produce milk proteins that can be used to replicate conventional dairy (CD) products. With PFD products likely to be available soon in the United Kingdom, this study aimed to explore consumer acceptance of these products. Specifically, the effect of sharing information related to the process and environmental impact of PFD on overall liking and emotional response for yoghurts labelled as CD and PFD. Overall, all participants (n = 62) were willing to try the yoghurts labelled as PFD, and no significant difference in liking between yoghurts labelled as CD and PFD was found, indicating acceptance and trust. However, sharing information slightly increased liking for PFD yoghurt and evoked more positive emotions ('understanding', 'adventurous' and 'enthusiastic'). In contrast, information decreased liking for CD yoghurt and had minimal impact on the emotional response, but made participants feel slightly 'guilty'. In particular, sharing information led high food‐neophobic and food technology‐neophobic individuals to be more 'understanding' towards PFD in comparison to the low‐neophobic groups. Findings suggest emotional responses can provide deeper insights beyond liking, which will benefit the food industry when reviewing consumer attitudes. The results show promise that consumers will accept PFD products when available, provided the novel technology can mimic the sensory properties of CD. Furthermore, when marketing products, sharing information may increase liking for sustainable products, but future studies would benefit from exploring the effect of different types of information on consumer acceptance. [ABSTRACT FROM AUTHOR]

Background/Objectives: School-based nutrition education interventions can support the development of children's food literacy and healthy eating habits. The Foodbot Factory serious game was developed to support school nutrition education based on Canada's Food Guide and Ontario curriculum. The objective of this research was to refine the Foodbot Factory intervention to include curriculum-based lesson plans that had a high-level of acceptability by stakeholders to support implementation by teachers in classrooms. Methods: A co-design approach was used to engage teacher and dietitian stakeholders in developing five lesson plans for the intervention, who contributed to creating the intervention content in three stages. The stages included reviewing and providing feedback on the initial draft of the lesson plans, participating in facilitated discussion rounds to come to a consensus on the changes required, and completing a final review of the intervention's acceptability. Qualitative data included notes on the lesson plans and recordings from meetings that were analyzed thematically. Results: During the first co-design stage, major revisions were suggested for two-fifths of the lessons by stakeholders. Further stakeholder suggestions were discussed and integrated into the intervention from facilitated discussions, improving the lesson plan content and intervention feasibility. All stakeholders agreed that the final version of the intervention was acceptable and would support classroom nutrition education. Five lesson plans were created and compiled into a unit plan, containing additional teaching resources, to support nutrition education with Foodbot Factory. Conclusions: The co-design process greatly improved the Foodbot Factory intervention and its feasibility for classroom implementation. Including diverse stakeholder perspectives led to unique and different insights to improve the intervention. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction Methods Results Conclusion Dentists and oral health practitioners have a potential role in supporting the prevention and management of noncommunicable diseases. However, the extent to which university education prepares practitioners to provide nutrition care is unclear. This scoping review identifies and synthesises the evidence related to university‐level nutrition education provided to dental and oral health students globally.A scoping review identified relevant literature through search terms “dentistry,” “oral health,” or “oral hygiene”; “dental students” or “dental education”; “nutrition education” or “nutrition science.” Articles were included that examined nutrition education in undergraduate oral health training; or nutrition knowledge, attitudes, confidence, or skills or dietary habits; experts' opinion papers; and position statements. No limitations on the publication years or languages of the articles were applied.A total of 136 articles were included. Half were surveys of students (n = 49) or academic staff (n = 21). The remainder comprised reports of curriculum initiatives (n = 26), opinion papers or narrative reviews (n = 24), position statements (n = 6), curriculum development (n = 6) and curriculum guidelines (n = 9). While dental and oral health students and curriculum experts overwhelmingly recognised the importance of nutrition, most studies that assessed nutrition knowledge of students revealed limited knowledge. Students were not confident in their skills to provide nutrition care. Lack of nutrition experts on teaching teams and unclear expectations about developing nutrition competencies were identified as barriers to greater nutrition education.Nutrition education in university dental and oral health degrees is highly variable. The potential for oral health professionals of the future to promote oral health through nutrition is unrealised. [ABSTRACT FROM AUTHOR]

Nutrition education is essential for the development of healthy eating behaviours among children. Over the past few years, multiple nutrition education programmes have been implemented in primary schools. In the current study, the long-term effects of the experiential nutrition education programme ‘Learning Street’ are assessed. This 3-week programme comprises a classroom-based introduction lesson, a visit to a fruit or vegetable (FV) farmer, a cooking workshop, and a joint eating moment. The programme is designed for children aged 8–12 years. Questionnaire outcomes of 11-to-12-year-old children (n = 87) who participated in a Learning Street programme two years before were compared to those of a control group (n = 102) with similar demographics. The questionnaire included questions on children’s FV knowledge, liking, intake, and attitude, as well as their general health attitude, cooking self-efficacy, and cooking attitude. There was a significant difference in FV attitude (Cohen’s d = 0.55; 95% CI: −0.69 to −0.21) and general health attitude (Cohen’s d = 0.37; 95% CI: −0.56 to −0.07) between the intervention and the control groups. For general health attitude, the difference was only significant for a subgroup of children (n = 25) who had participated in two Learning Street programmes. The findings suggest that regularly exposing children to experiential nutrition education may have long-term benefits. [ABSTRACT FROM AUTHOR]

Background: According to the World Health Organization report, immigrants are at increased risk of malnutrition. Nutritional deficiencies in pregnancy are a public health concern and around 20 to 30 percent of pregnant women suffer from it worldwide. There has not been any investigation about the effect of any intervention on improving nutritional intake in pregnant Afghan immigrant women. Therefore, the present study was conducted to determine the effect of nutrition education based on the Health Belief Model (HBM) on food intake in pregnant Afghan immigrant women. Methods: A semi-experimental study study was conducted on 116 Afghan immigrant pregnant women who have the inclusion criteria, were referred to health center No. 2 in Mashhad, Iran in June 2022 until February 2023, and were randomly assigned to the intervention (56) and control (56) groups. The demographic, HBM questionnaire and the standard 24-h food reminder questionnaire were the research tools. The intervention consisted of four sessions of 45–60 min of nutrition education based on the Health Belief Model in groups of 8–10 people. The questionnaires were completed before, immediately, and one month after the intervention by the research units. Data were analyzed with SPSS version 21 software. Results: The intake of energy, protein, carbohydrates, and micronutrients such as iron, calcium, zinc, and vitamin D increased in the intervention group immediately and one month after the intervention significantly compared to before the intervention (P < 0.05). Although all these nutrients intake had a significant decrease in control group women (P < 0.05). Conclusions: Nutrition education based on the health belief model is effective in the nutritional intake of Afghan immigrant pregnant women. According to the importance of getting enough nutrients in pregnancy and its effects on the mother and fetus's health, nutrition education based on the Health Belief Model model is suggested for these mothers. Trial registration: It is registered in the Iranian clinical trials database under the code: IRCT20220629055312N1, Date of first registration: 25/07/2022. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND METHODS RESULTS IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY CONCLUSIONS We sought to determine the impact of school gardens and nutrition education on student fruit and vegetable consumption from limited‐income communities in Alabama.Third grade students at 99 Alabama schools with and without gardens on‐site were randomized to receive either nutrition education or to a wait‐list control group. Multi‐level models were used to assess the effects of treatment and control with and without school gardens.Students attending schools with gardens demonstrated highest consumption of fruits and vegetables prior to treatment. Nutrition education alone translated into significant dietary improvements. Both gardens and education translated into greatest dietary improvements.Devising financially accessible, practical, and culturally relevant ways to improve student health through garden and nutrition education may help improve student diet. Forming comprehensive Extension, SNAP‐Ed, and school collaboration to support gardens, nutrition education, and healthy school policies and systems can be a way to support and sustain healthy student learning environments.Combined gardening and nutrition education is associated with increases in fruit and vegetable consumption among majority rural, Southern students from limited‐resource communities. [ABSTRACT FROM AUTHOR]

Background Methods Results Implications for School Health Policy, Practice, and Equity Conclusions The weight‐normative approach to nutrition education dominates health education programming across the United States, despite evidence that this paradigm contributes to negative outcomes including weight cycling, bias and stigma, the development of disordered eating behaviors, and weight‐based bullying.This study investigates perspectives of 10 potential partners with interest in and potential to influence nutrition education. Through qualitative interviews and document analysis, researchers explored support for a weight‐inclusive curriculum and factors that influence high school nutrition curricular content and implementation.Findings indicate that partners hold both weight‐inclusive and weight‐normative values, guidance around nutrition curricular content is lacking, and state‐level policy is crucial to the valuing and implementation of consistent curricula.Lack of guidance or mandated curricular content contributes to inequities across the state. Weight‐inclusive curricular materials are needed. Administration must take an active role in providing access to professional development and state policy support for curricular implementation is essential.Weight‐inclusive curriculum could serve to improve health outcomes for adolescents. However, successful implementation of, or changes to, health and nutrition curricula will require support and engagement from partners at all ecological levels. [ABSTRACT FROM AUTHOR]

AbstractThe triple burden of malnutrition (TBM) is increasing globally, but significant evidence gaps exist regarding its burden and drivers among children in Southeast Asian (SEA) countries. We systematically searched four databases (PROSPERO-CRD42023420129) and Google Scholar through February 2024. We assessed stunting and overweight prevalence among children aged 0–18 years old across four SEA countries (Indonesia, Malaysia, Thailand, and Vietnam) from recent national surveys. We conducted random-effect meta-analyses to estimate the pooled prevalence of micronutrient deficiencies, and the pooled odds ratio for TBM-associated determinants using an adapted socio-ecological framework. 176 studies were included for systematic review, with 132 studies eligible for meta-analysis. Our findings illustrate significant variation in TBM across countries, dependent on region, age, and sex. Pooled prevalence [95% CI] of anemia, iron, vitamin A, and D deficiencies were 25% [22, 29], 14% [10, 18], 6% [4, 8], and 40% [32, 48], respectively (I2>90%). Determinants of the TBM included child-individual factors, poor early-life nutrition, and family household characteristics including maternal nutrition and education, socioeconomic, family size, sanitation, and food security. However, macro-level environmental impacts were less documented. Our findings emphasize the need for robust, timely monitoring of TBM data, including micronutrient biomarkers, and targeted policy intervention in SEA countries. [ABSTRACT FROM AUTHOR]

Objective: To assess the feasibility and acceptability of a virtual food skills program for children with type 1 diabetes. Methods: Forty‐three patients, aged 6–14 years with type 1 diabetes, participated in an 8‐week online programme, summerlunch+ At Home, that included weekly live cooking classes, asynchronous learning modules, and quizzes accessed through Google Classroom. Grocery delivery or gift cards were provided to all participants to support equitable access to participation. Descriptive results were summarized, and thematic analysis was performed on answers to a post‐intervention questionnaire, parent/caregivers interview transcripts, and facilitators' field notes. Results: Participants reported having a positive experience and would recommend the programme to others. Acceptable elements included the online format, the cooking class demonstrations, and the well‐organized content. Families enjoyed the recipes, expressed an improvement in the families' cooking skills and nutrition knowledge, and noted the program as a way to improve family bonding and reduce participants' sense of social isolation given the opportunity of meeting peers with diabetes. The intervention also appears to increase participants' independence, confidence, and self‐esteem. While grocery cards were easier to coordinate compared with meal kits, both were deemed acceptable by caregivers. Barriers to participation include a distracting home environment and not feeling comfortable on camera. Factors that negatively impacted satisfaction were the large age range of participants and the class timing and duration. Caregivers noted a desire for more diabetes education, enhanced peer‐to‐peer interaction, and incorporation of animal‐based protein recipes in future programmes. Conclusion: The current study demonstrates the feasibility and acceptability of the virtual summerlunch+ At Home cooking and nutrition program that was adapted for children with diabetes. Similar food skills programmes may support the development of food skills imperative to diabetes self‐management long‐term. Further research can continue to assess food literacy skills, glycemic management, and the social benefits of such interventions. [ABSTRACT FROM AUTHOR]

Objective To understand the intake of added sugars among primary school students, to analyze the sources and influencing factors of intake, and to propose improvement measures. [WTHZ]Methods [WTBZ]A stratified cluster sampling method was used to select 12,603 primary school students in Lianyungang as the research subjects. A food atlas-based questionnaire was used to investigate the intake of foods with added sugars and calculate daily intake of added sugars. [WTHZ]Results [WTBZ]The median added sugar intake of primary school students was 22.1 g/day, 45.7% of students consumed more than 25 g/day, and 21.7% of students consumed more than 50 g/day. Sugar-sweetened beverages, flavored yogurt, pastries and sweets were the four main sources of added sugar intake among primary school students (accounting for 38.3%, 24.0%, 14.1% and 12.1% respectively). Multiple linear regression analysis showed that boys, higher grade, higher BMI, and less sleep were associated with increased intake of added sugars. [WTHZ]Conclusions [WTBZ]The excessive intake of added sugar by primary school students in Lianyungang was quite prominent. On the one hand, nutrition education should be carried out to publicize the harm of excessive intake of added sugar. On the other hand, it isrecommended to include the added sugar content in the nutrition label to guide teenagers to choose healthy food. [ABSTRACT FROM AUTHOR]

Factors affecting the growth of HIV‐exposed‐uninfected (HEU) children are multi‐factorial, with limited information available on the dietary intake from 6 months. This study compared the dietary intake, micronutrient composition of breastmilk, and growth of HEU and HIV‐unexposed‐uninfected (HUU) infants aged 6 and 12 months in an urban setting. A repeated cross‐sectional study used structured questionnaires to collect socio‐demographic, dietary intake, food group data, and anthropometric measurements in the Siyakhula study. The HEU (48%) and HUU (52%) infants were included (total n = 181). At 6 months, HEU infants had lower weight‐for‐age z‐scores (WAZ) (−0.6 ± 1.1 vs. 0.1 ± 1.2; p < 0.001), length‐for‐age z‐scores (−0.8 ± 1.4 vs. −0.1 ± 1.2; p < 0.001), and mid‐upper‐arm circumference‐for‐age z‐scores (MUACAZ) (0.5 ± 1.1 vs. 1.0 ± 0.9; p < 0.001) than HUU infants. At 12 months, HEU infants had lower WAZ, MUACAZ, and weight‐for‐length z‐scores compared to HUU infants (p < 0.05). Stunting was found at 6 (15%) and 12 (12%) months in HEU infants. The micronutrient composition of breastmilk fed to both groups was similar. Breastfeeding rates were lower in HEU than in HUU infants at 6 (49% vs. 64%; p = 0.005) and 12 (24% vs. 46%; p = 0.002) months. Less than 3% of HEU and HUU infants achieved minimal dietary diversity scores at 12 months. Dietary intake of fat was similar in all breastfed infants, but iron and vitamin B12 were higher in non‐breastfed HEU infants at 12 months. HEU infants had lower breastfeeding rates than HUU infants. A lack of dietary diversity was found in all infants. Nutrition education and counselling in the complementary feeding phase are essential for optimal growth. [ABSTRACT FROM AUTHOR]

Background/objectives: Considering the diverse symptomatology of COVID-19—ranging from mild to severe cases—multi-professional interventions are crucial for enhancing physical recovery, nutritional status, and mental health outcomes in affected patients. Thus, this study aimed to investigate the effects of such an intervention on health-related physical fitness and biomarkers in overweight COVID-19 survivors with varying degrees of symptom severity after 8 weeks and 16 weeks. Methods: This non-randomized clinical trial included 59 overweight COVID-19 survivors (32 males and 27 females) divided into three groups: mild (n = 31), moderate (n = 13), and severe/critical (n = 15). The participants underwent a multi-professional program and were assessed for anthropometric and body composition (primary outcome), as well as physical fitness and biochemical markers (secondary outcome) 8 and 16 weeks before the intervention. Results: After 8 weeks, time effects were observed for the maximum isometric handgrip strength (p < 0.001), maximum isometric lumbar-traction strength (p = 0.01), flexibility (p < 0.001), abdominal strength–endurance (p < 0.001), the sit-and-stand test (p < 0.001), maximum oxygen consumption (p < 0.001), and distance covered in the 6 min walk test (p < 0.001). Additionally, time effects were also observed for fat mass (p = 0.03), body fat percentage (p = 0.02), abdominal circumference (p = 0.01), total cholesterol (p < 0.001), low-density lipoproteins (p < 0.001), and glycated hemoglobin (p < 0.001), with lower values after multi-professional interventions. After 16 weeks, the systolic and diastolic blood pressure showed significant reductions independently of the intervention group (p < 0.001). Conclusion: These findings suggest that multi-professional interventions can provide substantial benefits for post-COVID-19 patients, regardless of the severity of their initial symptoms. [ABSTRACT FROM AUTHOR]

Background: We aimed to evaluate the role of nutrition and behavior education intervention in the prevention and treatment of childhood obesity by comparing changes in obesity-related characteristics among obese children during a follow-up period of 12 months. Methods: This study was designed as a prospective cohort study in children aged between 6 and 18 years, with exogenous obesity who applied to Istanbul Research and Training Hospital, Pediatrics Department, between January 2018 and July 2019. Beginning at the sixth month, a program for nutrition and behavior education for obesity prevention and treatment was initiated and continued during the second half of the study period. Results: The mean age of 59 children (29 females, 30 males) was 11.73 ± 2.78. BMI levels did not show a significant difference in the first 6 months, but decreased significantly during the second 6 months of the study. Screen time, fast eating behavior, overeating behavior and food score index scores also demonstrated significant improvements during the intervention period of the study, between 6 and 12 months. Conclusion: It was concluded that nutrition and behavior education for the prevention and treatment of childhood obesity could be a successful intervention with close follow-up. [ABSTRACT FROM AUTHOR]

Introduction/Objectives: Adults with food insecurity (FI) face barriers to hypertension management, including difficulty adhering to diet recommendations. Few community health worker (CHW) interventions focus on diet to improve blood pressure. This qualitative study elicited patient and CHW perspectives on healthy eating and a future CHW nutrition intervention for patients with hypertension. Methods: Twenty-five patients with hypertension and FI and 5 CHWs participating in a hypertension health coaching program from 5 Boston-area health centers participated in semi-structured interviews from July to September 2023. Interviews were audio recorded, transcribed, and analyzed using the Framework Method. Results: Themes included: 1) Variable patient knowledge about dietary patterns for hypertension management and low confidence in interpreting nutrition labels; 2) Culture influenced healthy food perception; and 3) Barriers to healthy eating included cost, limited cooking abilities/supplies, and competing demands. Patients and CHWs favored simple nutrition education materials (e.g., traffic light nutrition ranking, healthy meals on a budget). Patients had mixed opinions about CHW-accompanied supermarket visits. Conclusions: This study identified culture, knowledge gaps, and budget constraints as factors influencing diet among patients with hypertension and FI. A CHW-delivered intervention could include simplified nutrition education, strategies for healthy eating on a budget, and linkage to community-based food programs. [ABSTRACT FROM AUTHOR]

Background: Multiple sclerosis (MS) is a complex immune‐mediated disease with no currently known cure. There is growing evidence to support the role of diet in reducing some of the symptoms and disease progression in MS, and we previously developed and tested the feasibility of a digital nutrition education program for people with MS. Objective: The aim of this study was to explore factors that influenced engagement in the digital nutrition education program, including features influencing capability, opportunity and motivation to change their dietary behaviours. Methods: Semi‐structured interviews were conducted with people who had MS, and who completed some or all of the program until data saturation was reached. Interviews were analysed inductively using thematic analysis. Themes were deductively mapped against the COM‐B (Capability, Opportunity, Motivation, Behaviour) behaviour change model. Results: Sixteen interviews were conducted with participants who completed all (n = 10) or some of the program (n = 6). Four themes emerged: (1) acquiring and validating nutrition knowledge; (2) influence of time and social support; (3) getting in early to improve health and (4) accounting for food literacy experiences. Discussion: This is the first online nutrition program with suitable behavioural supports for people with MS. It highlights the importance of disease‐specific and evidence‐based nutrition education to support people with MS to make dietary changes. Acquiring nutrition knowledge, coupled with practical support mechanisms, such as recipe booklets and goal setting, emerged as crucial for facilitating engagement with the program. Conclusions: When designing education programs for people with MS and other neurological conditions, healthcare professionals and program designers should consider flexible delivery and building peer support to address the needs and challenges faced by participants. Patient or Public Contribution: Members of the MS Nutrition Research Program Stakeholder Reference Group, which includes people with MS and MS health professionals, provided input during the development of the nutrition education program and study design stages. [ABSTRACT FROM AUTHOR]

Issue Addressed: Community‐based healthy eating and exercise programs are effective interventions to support some people with chronic conditions. This research aimed to explore the experiences and perceptions of participants regarding the integration of nutrition education into a successful group based exercise program for people with chronic medical conditions. Methods: Semi‐structured interviews were conducted with past participants of a community based group exercise program (Health Moves) with embedded nutrition advice based in a regional area of New South Wales. A total of 60 individuals who had participated in the Health Moves program between 2017 and 2019 were invited to participate and 19 (32%) randomly selected participants consented to be interviewed. Interviews explored participants' experiences, program impacts, and barriers to sustaining changes post program. Similar concepts and patterns were grouped into themes. Results: Four themes were identified that described the experiences with a community‐based group exercise intervention with a nutrition component. The major themes evident were that Health Moves facilitated motivation (via access to health professionals, peer support, accountability, affordability); and there were challenges identified to sustaining change (including cost, comorbidities, end of program support, environmental factors); Nutrition advice was valuable for some but not for all (difficulty recalling nutrition components, superficial coverage) Practical and interactive nutrition advice is desired. Conclusions: Participants expressed a high degree of satisfaction with the program but require ongoing support to sustain changes post program. The position and integration of nutrition education within this exercise program was perceived by participants to be suboptimal. Increased access to practical, interactive nutrition education components may improve participant satisfaction and engagement. So What?: Key findings from this research include a desire for removal of didactic nutrition education sessions and request for increased peer support. Modifications to the program include the integration of interactive self‐paced nutrition modules. Peer support partnerships are now encouraged by trainers to support ongoing motivation of participants to keep training together outside the structured exercise program and transition to managing their own exercise routine. Discussions between organisations involved about ongoing pathway/program support or reduced cost 'off peak' gym membership is underway to help with costs incurred by participants. [ABSTRACT FROM AUTHOR]

Purpose: Agriculture and food production contribute to climate change. There is mounting pressure to transition to diets with less environmental impact while maintaining nutritional adequacy. MyPlanetDiet aimed to reduce diet-related greenhouse gas emissions (GHGE) in a safe, nutritionally adequate, and acceptable manner. This paper describes the trial protocol, development, and testing of personalised nutrition feedback in the MyPlanetDiet randomised controlled trial (RCT). Methods: MyPlanetDiet was a 12-week RCT that provided standardised personalised nutrition feedback to participants based on new sustainable healthy eating guidelines (intervention) or existing healthy eating guidelines (control) using decision trees and corresponding feedback messages. To test the personalised nutrition feedback, we modelled a sample of 20 of the MyPlanetDiet participants baseline diets. Diets were modelled to adhere to control and intervention decision trees and feedback messages. Modelled nutrient intakes and environmental metrics were compared using repeated measure one-way analysis of covariance. Results: Intervention diets had significantly lower (p < 0.001) diet-related GHGE per 2500 kilocalories (kcal) (4.7 kg CO2-eq) relative to control (6.6 kg CO2-eq) and baseline (7.1 kg CO2-eq). Modelled control and intervention diets had higher mean daily intakes of macronutrients (carbohydrates, fibre, and protein) and micronutrients (calcium, iron, zinc, and iodine). Modelled control and intervention diets had lower percent energy from fat and saturated fat relative to baseline. Conclusions: Adherence to the MyPlanetDiet personalised nutrition feedback would be expected to lead to better nutrient intakes and reduced diet-related GHGE. The MyPlanetDiet RCT will test the effectiveness and safety of personalised feedback for a more sustainable diet. Trial registration number and date of registration: Clinical trials registration number: NCT05253547, 23 February 2022 [ABSTRACT FROM AUTHOR]

Simple Summary: Cancer patients frequently encounter significant emotional and psychological challenges that can adversely affect their overall well-being and treatment outcomes. To address these challenges, we developed the Cancer Patient Empowerment Program (CancerPEP), a comprehensive, home-based intervention that incorporates physical exercise, nutritional guidance, and social support. CancerPEP builds on the success of the Prostate Cancer Patient Empowerment Program (PC-PEP), which has demonstrated positive effects on psychological well-being in prostate cancer patients. In this study, we also evaluated whether adding a Heart Rate Variability (HRV) biofeedback device could enhance the effectiveness of CancerPEP. Our findings indicate that while CancerPEP significantly reduced psychological distress and improved emotional well-being across cancer patients—including a breast cancer subgroup—at the end of the intervention (the 6-month point), the addition or lack of an HRV device did not significantly contribute to these improvements for the full sample. These results suggest that CancerPEP, similar to PC-PEP, is a valuable addition to standard cancer care, providing a holistic approach to support patients both mentally and emotionally. However, the inclusion of the HRV device may not be necessary to achieve these benefits. Background/Objectives: Psychological distress is a significant concern among cancer patients, negatively affecting their quality of life and adherence to treatment. The Cancer Patient Empowerment Program (CancerPEP) was developed as a comprehensive, home-based intervention aimed at reducing psychological distress by incorporating physical activity, dietary guidance, and social support. This study aimed to evaluate the feasibility, accrual and attrition rates, safety, and effectiveness of the CancerPEP intervention, with and without the biofeedback device, on psychological distress from baseline to 6 months, specifically focusing on the effects of group randomization and the difference between pre- and post-intervention results. Methods: This single-site, crossover randomized clinical trial included 104 cancer patients who were randomized to receive the CancerPEP intervention, with or without a Heart Rate Variability (HRV) biofeedback monitor. At 6 months, participants who did not receive the device were allowed to use one until the end of the year, while those who did receive the device were followed up to 12 months. Randomization was stratified by the presence or absence of clinically significant psychological distress and metastatic status. Psychological distress was assessed using the Kessler Psychological Distress Scale (K10) at baseline, 6 months, and 12 months. The primary endpoint was the presence of nonspecific psychological distress, as measured by the K10 scale at 6 months from the trial start, based on group randomization. A secondary exploratory analysis assessed psychological distress at baseline, 6 months, and 12 months for both groups, while controlling for group randomization and prognostic covariates. Prognostic covariates included age; comorbidities; time between diagnosis and randomization; treatment modality; relationship status; and use of prescribed medications for anxiety, depression, or both. An exploratory sub-analysis was conducted for the breast cancer subgroup, based on the sample size available after recruitment. The trial is registered at ClinicalTrials.gov (NCT05508412). Results: The provision of the HRV biofeedback monitor in conjunction with the CancerPEP intervention did not significantly affect the primary outcome in either the full sample or the breast cancer subgroup, indicating that the HRV biofeedback provision was not beneficial in this trial. No self-reported or otherwise discovered adverse events at the 6-month mark were observed. About 10% of participants were lost to follow-up in both the early and late HRV monitor provision groups. Participation in the CancerPEP program led to a significant reduction in psychological distress over time. The odds of psychological distress were significantly higher at the start of the trial than at the end of the intervention (aOR = 2.64, 95% CI: 1.53–4.56) or 6 months after the intervention (aOR = 2.94, 95% CI: 1.62–5.30). Similarly, in the breast cancer subgroup, distress was higher at the trial's start than at 6 months, i.e., after the intervention (aOR = 2.25, 95% CI: 1.24–4.08), or at the end of the trial at 12 months (aOR = 2.73, 95% CI: 1.35–5.52). Conclusions: CancerPEP significantly reduces psychological distress in cancer patients, with consistent improvements noted across various cancer types and stages, including benefits specifically for breast cancer patients. These findings build upon the success of the Prostate Cancer Patient Empowerment Program (PC-PEP), indicating that a similar comprehensive intervention can be advantageous for all cancer patients and may be further tailored to address specific needs. With its holistic approach—encompassing physical, dietary, and psychosocial support—CancerPEP shows promise as a vital component of survivorship care. Ongoing 24-month evaluations will yield critical data on its long-term benefits. Additionally, a randomized trial with a control group (usual care without intervention) for breast cancer patients is currently under way and could potentially guide the integration of CancerPEP into standard oncology care to enhance patient outcomes and quality of life. [ABSTRACT FROM AUTHOR]

Background: Recently, there has been a growing interest in exploring AI-driven chatbots, such as ChatGPT, as a resource for disease management and education. Objective: The study aims to evaluate ChatGPT's accuracy and quality/clarity in providing nutritional management for Type 2 Diabetes (T2DM), the Metabolic syndrome (MetS) and its components, in accordance with the Academy of Nutrition and Dietetics' guidelines. Methods: Three nutrition management-related domains were considered: (1) Dietary management, (2) Nutrition care process (NCP) and (3) Menu planning (1500 kcal). A total of 63 prompts were used. Two experienced dietitians evaluated the chatbot output's concordance with the guidelines. Results: Both dietitians provided similar assessments for most conditions examined in the study. Gaps in the ChatGPT-derived outputs were identified and included weight loss recommendations, energy deficit, anthropometric assessment, specific nutrients of concern and the adoption of specific dietary interventions. Gaps in physical activity recommendations were also observed, highlighting ChatGPT's limitations in providing holistic lifestyle interventions. Within the NCP, the generated output provided incomplete examples of diagnostic documentation statements and had significant gaps in the monitoring and evaluation step. In the 1500 kcal one-day menus, the amounts of carbohydrates, fat, vitamin D and calcium were discordant with dietary recommendations. Regarding clarity, dietitians rated the output as either good or excellent. Conclusion: Although ChatGPT is an increasingly available resource for practitioners, users are encouraged to consider the gaps identified in this study in the dietary management of T2DM and the MetS. [ABSTRACT FROM AUTHOR]

Background: Integrating nutrition care into physiotherapy can address modifiable risk factors contributing to chronic diseases, providing comprehensive and effective patient care, and supporting a wellness-oriented approach to healthcare. Objective: To investigate physiotherapists' self-perceived confidence in their competence in nutrition care in Ireland. Methods: Cross-sectional study using data from a validated online survey tool. Four constructs of competence in nutrition care were assessed: knowledge, skill, communication and counseling, and attitude. Open-ended responses were collected to gather opinions on nutrition knowledge requirements. Participants were chartered physiotherapists representing public and private workplaces across geographical settings in Ireland. Results: 447 physiotherapists completed the survey. Most were female (n = 364, 81%), in private practice (n = 136, 31%), and located in a city (n = 215, 48%) with a mean 17 years post-qualification experience. Participants' self-perceived confidence in nutrition care competence was positive (mean score of 107.2/175). However, knowledge (mean score of 18.5/35) and skills (mean score of 27.2/55) related to nutrition care received lower ratings. Age and years of practice were positively associated with higher confidence in providing nutrition care. Most participants (n = 314, 71%) agreed that additional nutrition education is needed. Three overarching themes were identified regarding nutrition knowledge requirements: importance of providing nutrition advice, stated knowledge needs for nutrition education and training, and feasibility of nutrition care within physiotherapy practice. Conclusions: Physiotherapists in Ireland have confidence in provision of nutrition care but rated their knowledge and skills in nutrition as relatively low. Nutrition knowledge and skill are essential for physiotherapist practice as they can significantly impact patients' outcomes. [ABSTRACT FROM AUTHOR]

Background: A sleeve gastrectomy (SG) is a lifelong treatment that improves health and better outcomes are associated with follow‐up. However, there is lack of access or high attrition to aftercare. This potentially contributes to sub‐optimal dietary intake and a lack of evidence for nutrition interventions. The present study assessed the feasibility and preliminary efficacy of a nutrition intervention to improve diet quality in Australian adults living with a SG. Methods: Adults (n = 96) post‐SG were recruited into a cross‐sectional diet quality study, with 68 eligible for randomisation to an intervention or wait‐list control group. Over 10 weeks, a Facebook group was used to post daily nutrition education. Feasibility outcomes included participant recruitment, engagement, retention and acceptability. Preliminary efficacy was assessed using change in Australian Recommended Food Score (ARFS). Linear mixed models were used to measure differences in mean outcome between the experimental groups over time. Results: Sixty‐eight participants (97% female) aged 48.2 ± 9.8 years, body mass index 33.1 ± 5.8 kg/m2, and mean ± SD ARFS 39 ± 9 points were randomised to the intervention, with 66% retention at 10 weeks. At follow‐up, diet quality increased for the intervention group (mean ARFS, 95% confidence interval = 0.2 [−1.5 to 1.9]) and decreased for the control group (mean ARFS, 95% confidence interval= −2.0 [−5.2 to 1.2]) with no between group difference (p = 0.2). Participants (n = 30) rated the intervention positively. Conclusions: Recruiting and retaining adults post‐SG into a nutrition intervention is feasible. Low‐cost recruitment attracted strong interest from women to identify greater support to know what to eat following SG. A future fully powered trial to assess intervention efficacy is warranted. Highlights: An online nutrition education intervention for Australian adults' post‐sleeve gastrectomy has been found to be effective and feasibleThe interventions attracted strong interest, especially from women, who were looking for greater support in understanding what to eat after a sleeve gastrectomy.Researchers recommend conducting a fully powered trial to assess the efficacy of this intervention further. [ABSTRACT FROM AUTHOR]

Background: Adequate nutritional knowledge and healthy dietary behaviours are essential for promoting rational nutrition for children. However, lack of nutritional knowledge and unhealthy dietary behaviours are common among Chinese children. Therefore, we developed a school‐based nutrition education (NE) program to assess its impacts on nutritional knowledge and dietary behaviours in pupils. Methods: In this trial, one school was assigned as an intervention group (n = 199) and the other two schools were designated as a control group (n = 140). Children in the intervention group received the NE program in addition to their regular health curriculum, whereas the control group continued with their usual health curriculum without any NE program materials. Results: Concerning nutritional knowledge, the mean difference (follow‐up minus baseline) of average knowledge scores in the intervention group was significantly higher than that in the control group (1.99 ± 3.22 vs. 0.66 ± 3.60, p = 0.001). However, subgroup analysis revealed that this difference disappeared among boys and students with malnutrition status. Regarding dietary behaviours, the NE program significantly increased the proportion of children exhibiting high frequencies of meat and nuts consumption in the intervention group, along with diverse food choice at breakfast. Additionally, it markedly reduced the proportion of children exhibiting high frequencies of sugar‐sweetened beverages and fast food consumption. Structural equation modelling analyses indicated a significant direct effect of NE intervention on nutritional knowledge and an indirect effect on dietary behaviours. Conclusions: The NE program effectively enhanced nutritional knowledge scores and further improved dietary behaviours among Chinese primary school students. Future NE programs should pay more attention to boys and children with malnutrition. Highlights: The nutrition education (NE) program is a school‐based initiative that aims to provide NE and assess its impacts on nutritional knowledge and dietary behaviours in pupils.The NE program significantly enhanced students' nutritional knowledge, particularly among female students and those with normal weight.A marked increase in the proportion of children consuming meat and nuts was observed, whereas there was a decrease in the proportion of consuming sugar‐sweetened beverages and fast food.Structural equation modelling analyses indicated that the NE intervention had a significant direct effect on nutritional knowledge and an indirect effect on dietary behaviours. [ABSTRACT FROM AUTHOR]

Background: Healthy nutritional status, appropriate gestational weight gain and a balanced diet are important predictors of perinatal health outcomes. However, gaps exist in the translation of nutrition recommendations into dietary practices of women before and during pregnancy. The present study explored the relationship between access to nutrition advice, nutrition knowledge, attitudes and practices among pregnant women. Methods: Pregnant women aged > 18 years in Ireland were eligible to complete a self‐administered survey consisting of four subsections (demographics, nutrition knowledge, attitudes and practices) delivered online through Qualtrics. Results: In this convenience sample (n = 334, median [interquartile range] gestation, 25.0 [16.0, 34.0] weeks), 85% had at least an honours bachelor degree and 88.9% planned their pregnancy. Two out of five women received nutrition advice during their pregnancy, mostly from a midwife. Based on the percentage of correct answers (of 15 questions), women with previous nutrition education (e.g., school home economics) had better median [interquartile range] nutrition knowledge than those with none (80.0% [66.7, 86.7%] vs. 73.3% [60.0, 80.0%], p < 0.001). Those who received nutrition advice during pregnancy did not score higher than those who did not (73.3% [66.7, 80.0%] vs. 73.3% [66.7, 80.0%], p = 0.6). Over three‐quarters of participants considered nutritional supplement use to be very or extremely important. Although 73.6% and 92.4% took supplements prior to and during pregnancy, only 25.7% reported compliance with periconceptional folic acid supplementation guidelines. Half of respondents considered healthy eating during pregnancy as very or extremely important. Conclusions: Access to nutrition advice during pregnancy was inadequate with poor nutrition knowledge, attitudes and practices observed. Accessible, evidence‐based nutrition education for women prior to and during pregnancy is required. Highlights: Access to nutrition advice and support during pregnancy was inadequate with poor nutrition knowledge, attitudes and practices observed in a highly educated, primarily low‐risk population of pregnant women in Ireland.Nutrition education for women both prior to and during pregnancy is essential to improving their own health and that of the next generation.Sources of accurate and easily accessible nutrition education and information outside of healthcare professionals need to be considered, as do methods of how best to reach pregnant women, where promising strategies include the use of validated online sources, new content formats such as short‐form videos or new technologies. [ABSTRACT FROM AUTHOR]

Culinary medicine and culinary nutrition programs have emerged as innovative approaches to influencing dietary and lifestyle behavior change. These models vary in reported use of behavioral frameworks for planning purposes and attributing efficacy to current inconsistencies in format and delivery. This report aims to review current practice of behavior change theories in culinary medicine/culinary nutrition, delineate constructs that support positive outcomes, and describe future directions for translational applications in integrating the skills of chefs, nutrition educators, and medical professionals. [ABSTRACT FROM AUTHOR]

Examine the appeal of a virtual avatar-led nutrition education program among youth-serving community partners in North Carolina. We surveyed community partners using the Diffusion of Innovation Theory constructs of relative advantage, compatibility, and complexity. Logistic regression evaluated the appeal and likelihood of the program's future use. Community partners (n = 100) agreed that the program was an innovative (87%) and convenient (85%) way for youth and parents to learn about nutrition. Partners who perceived the program as a relative advantage to current programs had significantly higher odds of future use intention (P = 0.005). Those who found it compatible with organizational and personal values had significantly higher odds of future use (P < 0.001). A nutrition education virtual avatar program is of interest to youth-engaged community partners. Future research examining the potential integration of this type of program within community organizations is warranted. [ABSTRACT FROM AUTHOR]

Assess the impact of a weight-inclusive podcast (WIP) intervention on body appreciation, intuitive eating (IE), anti-fat attitudes, and weight and health attitudes in university students enrolled in an upper-division nutrition course. Quasi-experimental design: Intervention participants listened to 8 weekly WIP episodes (n = 16); the comparison group listened to 8 weekly general nutrition podcasts (n = 29). Intuitive eating, body appreciation, anti-fat attitudes, and general weight and health attitudes were measured preintervention and postintervention. Two-way, repeated measures analysis of variance revealed significant interaction effects of time × group, with participants in the WIP group experiencing significantly greater improvements in body appreciation (P = 0.03) and IE (P = 0.02) and greater reductions in anti-fat attitude scores (P = 0.006) than the comparison group. Podcasts may be a cost-effective tool to improve body appreciation and IE and reduce anti-fat attitudes in future nutrition professionals. Future research would benefit from recruiting prehealth professionals across different majors. [ABSTRACT FROM AUTHOR]

As part of an intervention tailored to individuals with serious mental illnesses in residential settings that aimed to increase dietary intake of fresh vegetables and fruits, we developed and implemented a nutrition and cooking curriculum. To develop the curriculum, we assembled a Workgroup that consisted of professionals from multiple fields. The Workgroup held weekly discussions before drafting what would become the Workbook. Residential staff at partnering housing agencies taught the curriculum to residents. The curriculum Workbook contains six lessons, which are organized around two field trips to a mobile farmers market and a grocery store, and four cooking methods. The Workbook also includes instructions on using FreshConnect Checks at mobile farmers markets. The new curriculum distinguishes itself from other nutrition and culinary literacy curricula in that it delivers knowledge about fresh produce and skills in preparing fruits and vegetables in a way that is tailored to individuals with serious mental illnesses. [ABSTRACT FROM AUTHOR]

Food diaries on social media, known as "what I eat in a day" (WIEIAD) content, are increasingly popular across a variety of platforms, and can potentially affect audiences' attitudes and behaviors regarding diet. WIEIAD content is frequently posted by social media influencers (SMI), who have powerful and persuasive effects on their audiences. Using expectancy-value and social norms as theoretical frameworks, this study examines characteristics of SMIs and the way they talk about diet. A mixed-methods content analysis of YouTube vlogs (n = 83) posted from October 2015 to October 2016, and October 2021 to October 2022 was conducted on SMIs who post WIEIAD vlogs. Results suggested that influencers may want to embrace body positivity, but their WIEIAD day content contains weight normative messaging. Furthermore, influencers send messages about what health should look like and assign social identities to specific diets. Aside from sponsorship, influencers use other persuasive strategies to grow large followers, such as listing positive expectancies of their diets. Future research should examine the effects of WIEIAD content on diet-related attitudes and behaviors. [ABSTRACT FROM AUTHOR]

Background Food provision interventions (eg, produce/food prescriptions, food pharmacies, food voucher programs) that bridge clinic and community settings for improved nutritional health outcomes of at-risk patients have gained momentum. Little is known about the role of nutrition education and potential augmented impact on patient outcomes. Objective To describe intervention designs and outcomes of direct food provision clinic–community programs aimed at improving diabetes-related outcomes (glycated hemoglobin [HbA1c] levels) among patients with type 2 diabetes (T2DM) or prediabetes and food insecurity, and to compare nutrition education components across interventions. Methods The PubMed and Academic Search Complete databases were systematically searched for original peer-reviewed articles (published during 2011–2022) that described the impact of clinic–community food provision programs (ie, produce/food prescriptions, food pharmacies, and food voucher programs) onHbA1c values among adults diagnosed with T2DM or prediabetes and who screened positive for food insecurity or low income. Study designs, intervention approaches, program implementation, and intervention outcomes were described. Results Ten studies representing 8 distinct programs were identified. There was a high degree of variation in the studies' design, implementation, and evaluation. Across the 8 programs, 6 included nutrition education; of these, 1 used a theoretical framework, and 3 incorporated goal setting. Nutrition education covered multiple topical contents, including general nutrition knowledge, fruit and vegetable consumption, and accessing resources (eg, enrolling in the Supplemental Nutrition Assistance Program). Furthermore, the education was delivered through various formats (from 1-on-1 to group-based sessions), educators (community health workers, registered dietitians, physicians), and durations (from a single session to biweekly). All programs with a nutrition education component reported reduced participant HbA1c, and 4 demonstrated an increase in fruit and vegetable purchases or improved dietary quality. The remaining 2 programs that did not include nutrition education yielded mixed results. Conclusion The majority of programs included a nutrition education component; however, there was a high degree of heterogeneity in terms of content, educator, and duration. Patients who participated in programs that included nutrition education had consistent reductions in HbA1c. These observational trends warrant further exploration to conclusively determine the impact of nutrition education on patient outcomes participating in clinic–community food provision programs. [ABSTRACT FROM AUTHOR]

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Objective: To investigate primiparous women's knowledge, attitudes, and practices regarding the physical home food environment (PHFE) and to assess if the first pregnancy provides a teachable opportunity to enhance the PHFE of first-time pregnant couples. Design: Longitudinal in-depth qualitative study involving questionnaires and individual interviews during and after pregnancy. Participants: Fifteen primigravida women. Main outcome measures: Knowledge, attitudes, and behaviors concerning PHFE; lifestyle and dietary habits; and interest in guidance regarding healthy PHFE during the first pregnancy and the transition to motherhood. Analysis: Thematic analysis for qualitative data and descriptive statistics. Results: Key findings include the significance of health, nutrition, and spousal support in the transition to motherhood. The first pregnancy was recognized as a critical period for establishing a healthy PHFE, while noting the physical and emotional challenges involved. A gap was found in guidance regarding PHFE for first-time pregnant women despite their interest in practical advice. Conclusions and Implications: The first pregnancy presents a significant opportunity to improve PHFE. 'Nestrition' (nutritional nesting), a new health-promotion strategy, incorporates nutrition education to enhance this process. These data support future research encompassing partners and diverse at-risk populations prior to the development of effective nutrition education for PHFE in the first pregnancy. [ABSTRACT FROM AUTHOR]

Background/Objectives: Nutrition plays a significant role in preventive medicine, as up to 80% of chronic diseases could be avoided by adhering to healthy dietary principles. The aim of our study was to identify dietary habits, awareness, and nutrition knowledge in a random sample of Polish healthcare students and professionals. Methods: Initially, a total screened sample consisted of 1287 respondents, yet the actual response/participation rate was 634/1287. A validated questionnaire for the Polish population, the Dietary Habits and Nutrition Beliefs Questionnaire (KomPAN), was used for the assessment. Results: The majority of respondents were females (84.2% of medical students and 87.2% of healthcare professionals), current non-smokers (79.6% of medical students and 85.2% of healthcare professionals), and had a normal waist circumference (76.3% of medical students and 63.1% of healthcare professionals). Both clinical dieticians and students studying clinical dietetics received significantly different scores of dietary indexes (pro-healthy pHDI-10 and non-healthy nHDI-14) vs. respective groups of respondents. Both healthcare students and professionals who self-reported better nutritional knowledge indeed yielded significantly better results in the dietary indexes as well as nutritional knowledge scores. The nutrition knowledge score was positively correlated with pHDI-10 and negatively correlated with nHDI-14, BMI, age, and waist circumference. Conclusions: Our results illustrate lifestyle trends among Polish healthcare students and professionals, and such results should encourage the development of evidence-based dietary policies targeting healthcare providers. High-quality continuing nutrition education should be obligatorily provided to all healthcare providers to enhance their dietary awareness as well as ensure high quality of care and outcomes achieved by the Polish healthcare system. [ABSTRACT FROM AUTHOR]

A good diet during pregnancy is associated with improvements to maternal and fetal health. Nevertheless, excessive weight gain during pregnancy has been reported in several studies. The aim of this review is to determine the dietary habits of pregnant women (measured according to their degree of adherence to the Mediterranean diet, a reference in dietary quality), their knowledge of food and nutrition, and their perceptions of the nutritional education received during their pregnancy, in order to detect intervention needs within that group. The bibliographic search was conducted on three databases (Medline, PubMed central, and Web of Science), using the keywords "pregnancy", "Mediterranean diet", "nutrition knowledge", "nutritional education", and some synonyms. The final selection included 68 original articles. The available evidence indicated that, although pregnant women were aware of the importance of nutrition during pregnancy, their habits showed some room for improvement in terms of diet and physical exercise. Lack of adequate advice was the main barrier to the practice of healthy habits that pregnant women encountered; they considered that the information they received during pregnancy follow-up visits was inadequate. However, the success of interventions within different countries is a source of hope for well-structured nutrition education throughout pregnancy. The lack of nutrition-related knowledge among pregnant women could be originally related to poorly planned nutrition education from healthcare providers. Research focused on the consultations with these healthcare providers could be of help when proposing strategies to improve the content, the depth, and the duration of nutrition education sessions. It should, in any case, be noted that the available evidence in this field is limited to certain geographical origins. Therefore, research that uncovers evidence in different countries will be useful for learning about the factors that condition the habits of pregnant women and, in that way, guide strategies for the improvement of the health of expectant mothers during that stage in their lives. [ABSTRACT FROM AUTHOR]

Objective: Increasing the awareness of adolescents about hedonic hunger, understanding the difference between homeostatic hunger and hedonic hunger, and adolescents learning to control themselves to stop excessive food consumption are extremely important for a healthy adulthood. The study aimed to evaluate the effects of the multi-strategy nutrition education programs (MSNEP) on hedonic hunger, food addiction, nutrition literacy, and nutritional status in adolescents. Methods: This study was planned using a pre-test and post-test design. The MSNEP was conducted with 132 adolescents (11–15 years; 69 boys, 63 girls) for 4 weeks (45 min–1 h/session). Data were obtained using questionnaires with face-to-face interviews at pre-education (baseline) and post-education (week 4 and week 8). The survey form included sociodemographic information, nine item short version of Children's Power of Food Scale (C-PFS-9), the Yale Food Addiction Scale for Children 2.0 (YFAS-C 2.0), the Adolescent Nutrition Literacy Scale (ANLS), anthropometric measurements, and 24-hour dietary recall. Results: A decrease in C-PFS-9 total scores was found compared to the baseline (p < 0.001). While the YFAS-C 2.0 score decreased in boys compared to the baseline (p < 0.05), no significant difference was found in girls (p > 0.05). A difference was found in the ANLS scores for girls (p = 0.01), but no difference was found in the scores for boys during the study (p > 0.05). At week 4, the consumption of dairy products, legumes, vegetables and fruits, bread and grains, nuts, and hard-shelled seeds increased compared to the baseline (p < 0.05). Also, daily protein and fiber intake increased (p < 0.05). Accordingly, a higher YFAS-C 2.0 score predicted greater hedonic hunger. A lower ANLS score was a predictor for higher food taste and food available scores. Conclusions: In conclusion, the MSNEP was found to have positive effects on hedonic hunger, food addiction, nutritional literacy, and healthy eating behaviors. The study revealed differences between girls and boys. In order to maintain healthy body weights in adolescents, it is recommended that the MSNEP be provided in schools. [ABSTRACT FROM AUTHOR]

Malnutrition is a global problem that affects all countries in one or more of its forms, representing one of the greatest challenges worldwide. One of the key contributing factors is food insecurity, which must be evaluated in children with moderate and severe acute malnutrition, as they are at imminent risk of death. Objective: Our objective was to assess food insecurity among children under 5 years old with moderate, and severe malnutrition from Valle del Cauca, a state located in the southwestern region of Colombia. Methods: A descriptive observational study was conducted, including children whose weight-for-height (W/H) indicator was below 2 SD, as recorded on the World Health Organization (WHO) growth charts, or who exhibited severe malnutrition phenotypes such as marasmus or Kwashiorkor. Family and child food security were evaluated using the Latin American and Caribbean Food Security Scale (ELCSA). Results: 58.6% of households with acutely malnourished children experienced food insecurity. A statistically significant relationship was found between food insecurity and children of Afro-Colombian and Indigenous descent. According to caregivers' perceptions, 30.2% of child malnutrition cases were related to poor feeding and caregiving practices. Conclusions: Not all children with acute malnutrition suffer from food insecurity. Therefore, the findings of this research suggest that governmental efforts should focus not only on ensuring food availability, but also on educating caregivers about the importance of a balanced and nutritious diet tailored to the specific characteristics of each region and promoting appropriate caregiving practices. [ABSTRACT FROM AUTHOR]

Background: Nutritional therapy plays a crucial role in diabetes management. Assessing adherence to nutritional recommendations is critical for evaluating whether the current status of nutrition education is appropriate. This study aimed to evaluate adherence to nutritional recommendations according to diabetes status using data from the Korean National Health and Nutrition Examination Survey from 2016 to 2019. Methods: A total of 2,793 participants (55.4% male) were evaluated regarding their adherence to nutritional recommendations. The "aware" group comprised people who had been clinically diagnosed by a physician. The "treated" group comprised people receiving anti-diabetic medications. The "control" group comprised people who achieved an HbA1c level < 6.5%. The "educated" group comprised people who had received nutrition education or counseling at various locations. Results: Among the 1,918 individuals in the "aware" group, only 243 (8.7%) had received nutrition education. Adherence to nutritional recommendations was generally low, with people with diabetes showing slightly higher adherence to total energy intake (59.6% vs. 55.3%) and total sugar intake (88.0% vs. 84.5%) than people without diabetes. However, adherence to total carbohydrate intake was poor in both the treated and educated groups (34.3% and 26.0%, respectively) compared to the untreated and non-educated groups (44.4% and 36.0%, respectively). Conclusions: These findings indicate inadequate nutritional management for people with diabetes in Korea. Nutrition education should be effectively strengthened to achieve nutritional goals. [ABSTRACT FROM AUTHOR]