| 1. |
- Ahmed, Sayem, et al.
(författare)
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Cost-effectiveness of a market-based home fortification of food with micronutrient powder programme in Bangladesh.
- 2021
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Ingår i: Public health nutrition. - 1475-2727. ; 24:S1, s. 59-70
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Tidskriftsartikel (refereegranskat)abstract
- We estimated the cost-effectiveness of home fortification with micronutrient powder delivered in a sales-based programme in reducing the prevalence of Fe deficiency anaemia among children 6-59 months in Bangladesh.Cross-sectional interviews with local and central-level programme staff and document reviews were conducted. Using an activity-based costing approach, we estimated start-up and implementation costs of the programme. The incremental cost per anaemia case averted and disability-adjusted life years (DALY) averted were estimated by comparing the home fortification programme and no intervention scenarios.The home fortification programme was implemented in 164 upazilas (sub-districts) in Bangladesh.Caregivers of child 6-59 months and BRAC staff members including community health workers were the participants for this study.The home fortification programme had an estimated total start-up cost of 35·46 million BDT (456 thousand USD) and implementation cost of 1111·63 million BDT (14·12 million USD). The incremental cost per Fe deficiency anaemia case averted and per DALY averted was estimated to be 1749 BDT (22·2 USD) and 12 558 BDT (159·3 USD), respectively. Considering per capita gross domestic product (1516·5 USD) as the cost-effectiveness threshold, the home fortification programme was highly cost-effective. The programme coverage and costs for nutritional counselling of the beneficiary were influential parameters for cost per DALY averted in the one-way sensitivity analysis.The market-based home fortification programme was a highly cost-effective mechanism for delivering micronutrients to a large number of children in Bangladesh. The policymakers should consider funding and sustaining large-scale sales-based micronutrient home fortification efforts assuming the clear population-level need and potential to benefit persists.
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| 2. |
- Asif, M., et al.
(författare)
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Developing Neck Circumference Growth Reference Charts for Pakistani Children and Adolescents Using the Lambda-Mu-Sigma (LMS) and Quantile Regression Method
- 2021
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Ingår i: Public Health Nutrition. - : Cambridge University Press. - 1368-9800 .- 1475-2727. ; 24:17, s. 5641-5649
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Neck circumference (NC) is currently used as an embryonic marker of obesity and its associated risks. But its use in clinical evaluations and other epidemiological purposes requires sex and age-specific standardized cut-offs which are still scarce for the Pakistani pediatric population. We therefore developed sex and age-specific growth reference charts for NC for Pakistani children and adolescents aged 2-18 years.Design: Cross-sectional multi-ethnic anthropometric survey (MEAS) study.Setting: Multan, Lahore, Rawalpindi and Islamabad.Participants: The dataset of 10,668 healthy Pakistani children and adolescents aged 2 to 18 years collected in MEAS were used. Information related to age, sex and NC were taken as study variables. The lambda-mu-sigma (LMS) and quantile regression (QR) methods were applied to develop growth reference charts for NC.Results: The 5th, 10th, 25th, 50th, 75th, 90th and 95th smoothed percentile values of NC were presented. The centile values showed that neck size increased with age in both boys and girls. During 8 and 14 years of age, girls were found to have larger NC than boys. A comparison of NC median (50th) percentile values with references from Iranian and Turkish populations reveals substantially lower NC percentiles in Pakistani children and adolescents compared to their peers in the reference population.Conclusion: The comparative results suggest that the uses of NC references of developed countries are inadequate for Pakistani children. A small variability between empirical centiles and centiles obtained by QR procedure recommends that growth charts should be constructed by QR as an alternative method.
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| 3. |
- Berggreen-Clausen, Aravinda, et al.
(författare)
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Food environment interactions after migration : a scoping review on low- and middle-income country immigrants in high-income countries
- 2022
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Ingår i: Public Health Nutrition. - : Cambridge University Press. - 1368-9800 .- 1475-2727. ; 25:1, s. 136-158
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To map and characterise the interactions between the food environment and immigrant populations from low- and middle-income countries living in high-income countries.Design: A scoping review was carried out following the framework outlined by Arksey and O'Malley, as well as Levac et al. Peer-reviewed studies in English published between 2007 and 2021 were included. Two reviewers screened and selected the papers according to predefined inclusion criteria and reporting of results follows the PRISMA-ScR guidelines. A 'Best fit' framework synthesis was carried out using the Analysis Grid for Environments Linked to Obesity (ANGELO) framework.Setting: High-income countries.Participants: Immigrants from low- and middle-income countries.Results: A total of sixty-eight articles were included, primarily based in the USA, as well as Canada, Australia and Europe, with immigrants originating from five regions of the globe. The analysis identified three overarching themes that interconnected different aspects of the food environment in addition to the four themes of the ANGELO framework. They demonstrate that in valuing fresh, healthy and traditional foods, immigrants were compelled to surpass barriers in order to acquire these, though children's demands, low incomes, time scarcity and mobility influenced the healthiness of the foods acquired.Conclusion: This study brought together evidence on interactions between immigrant populations and the food environment. Immigrants attempted to access fresh, traditional, healthier food, though they faced structural and family-level barriers that impacted the healthiness of the food they acquired. Understanding the food environment and interactions therein is key to proposing interventions and policies that can potentially impact the most vulnerable.
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| 4. |
- Denver, Sigrid, et al.
(författare)
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Consumer preferences for low-salt foods - a Danish case study based on a comprehensive supermarket intervention.
- 2021
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Ingår i: Public Health Nutrition. - 1368-9800 .- 1475-2727. ; 24:12, s. 3956-3965
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The objective is to analyze Danish consumers' attitudes to buying food with reduced salt content.DESIGN: The study is based on a comprehensive store intervention that included 114 stores belonging to the same supermarket chain. Three different salt claims were tested for eight weeks on six test products within the categories bread, cornflakes and frozen pizzas. Scanner data were supplemented with 134 brief interviews with consumers in nine selected stores.SETTING: Stores spread across Denmark.PARTICIPANTS: Consumers who buy food in the stores.RESULTS: Statistical regression analyses of the scanner data indicated that none of the three claims significantly affected demand for any of the test products. The interviews confirmed that many consumers were more focused on other elements of the official dietary advice than reduced salt consumption, such as eating plenty of vegetables, choosing products with whole grains and reducing their intake of sugar and fat.CONCLUSIONS: Overall, both the scanner data and the interviews pointed in the same direction, toward the conclusion that salt content is often a secondary factor when Danish consumers make dietary choices.
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| 5. |
- Edenbrandt, Anna
(författare)
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Dietary changes based on food purchase patterns following a type 2 diabetes diagnosis
- 2022
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Ingår i: Public Health Nutrition. - 1368-9800 .- 1475-2727.
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The study explores whether type 2 diabetes (T2D) diagnosis affects food consumption patterns in line with the dietary recommendations provided to individuals in relation to a diagnosis. Design: Based on detailed food purchase data, we explore which dietary changes are most common following a T2D diagnosis. Changes are investigated for several energy-adjusted nutrients and food groups and overall adherence to dietary guidelines. Setting: We use data on diagnosis of T2D and hospitalisation in relation to T2D for a sample of adult Danes registered in the official patient register. This is combined with detailed scanner data on food purchases, which are used as a proxy for dietary intake. Participants: We included 274 individuals in Denmark who are diagnosed during their participation in a consumer panel where they report their food purchases and 16 395 individuals who are not diagnosed. Results: Results suggest some changes in dietary composition following diagnosis, as measured by a Healthy Eating Index and for specific food groups and nutrients, although the long-term effects are limited. Socio-economic characteristics are poor predictors of dietary changes following diagnosis. Change in diet following diagnosis vary with the pre-diagnosis consumption patterns, where individuals with relatively unhealthy overall diets prior to diagnosis improve overall healthiness more compared to individuals with relatively healthy diets prior to diagnosis. Conclusions: Adherence to dietary advice is low, on average, but there is large variation in behavioural change between the diagnosed individuals. Our results stress the difficulty for diagnosed individuals to shift dietary habits, particularly in the long term.
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| 6. |
- Elsayed, Hadil A. Ghazy, et al.
(författare)
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Relationship between perception of emotional home atmosphere and fruit and vegetable consumption in European adolescents: Results from the I.Family survey
- 2020
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Ingår i: Public Health Nutrition. - 1368-9800 .- 1475-2727. ; 23:1, s. 53-62
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Tidskriftsartikel (refereegranskat)abstract
- Objective:Consumption of fruits and vegetables (F&V) among adolescents falls below recommendations in many Western countries. The impact of social and emotional aspects of family life on adolescent dietary behaviour may contribute to this, yet remains under-investigated. The present study examines the association between adolescents' perceptions of emotional home atmosphere (EHA) and their F&V consumption frequency.Design:An FFQ was used to assess F&V consumption frequency. EHA was assessed by an eight-item measure with three subscales: perceived home warmth, strictness and relational tension. EHA subscales were used as binary variables: a score equal to or above the median value was considered as a higher perception, while a score below the median was considered as a lower perception of the EHA in question. Country differences in meeting the European 5-a-day recommendations were described. Further, the association between EHA and F&V consumption frequency was investigated using multiple linear regression.Setting:Regional examination centres in eight European countries.Participants:Adolescents (n 3196) aged 12-18 years.Results:The mean F&V consumption frequency was 3·27 (sd 2·84) times/d. Only 16·1 % of boys and 18 % of girls in our study sample met the recommendation of five F&V daily. After controlling for age, sex, education level of the parents and country of origin, perceived home warmth was associated with a 16 (95 % CI 9, 22) % higher F&V consumption frequency (P < 0·001).Conclusions:F&V consumption frequency was suboptimal in the survey areas. Interventions targeting perceived warmth as a component of EHA could potentially have a positive effect on adolescents' dietary behaviour.
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| 7. |
- Eustachio Colombo, P., et al.
(författare)
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The importance of school lunches to the overall dietary intake of children in Sweden: A nationally representative study
- 2020
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Ingår i: Public Health Nutrition. - 1368-9800 .- 1475-2727. ; 23:10, s. 1705-1715
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Tidskriftsartikel (refereegranskat)abstract
- Objective:School lunches have potential to foster healthy diets in all children, but data on their importance are relatively scarce. The current study aimed to describe the dietary intake from school lunches by sex and school grade, and to assess how the daily intake, school lunch intake and the daily intake provided by lunch differ by sex and parental education.Design:Cross-sectional. All foods and drinks consumed for 1-3 weekdays were self-reported. Energy, absolute and energy-adjusted intakes of nutrients and food groups were calculated per weekday and per school lunch. Mixed-effects linear models assessed sociodemographic differences in dietary intakes. Nutrient and energy density at lunch and during the rest of the day were compared.Setting:Seventy-nine Swedish primary schools.Participants:Pupils in grades 5 and 8 (N 2002), nationally representative.Results:Lunch provided around half of daily vegetable intake and two-thirds of daily fish intake. Nutrient density was higher and energy density lower at lunch compared with the rest of the day (P < 0·001). Boys had greater energy-adjusted intakes of red/processed meat and lower intakes of vegetables and dietary fibre compared with girls (P < 0·001), overall and at lunch. Daily energy-adjusted intakes of most nutrients/food groups were lower for pupils of lower-educated parents compared with pupils of parents with higher education, but at lunch, only Fe and fibre intakes were significantly lower in this group.Conclusions:School lunches are making a positive contribution to the diets of Swedish children and may mitigate well-established sex differences and social inequalities in dietary intake. © The Authors, 2020.
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| 8. |
- Ferdous, Farzana, et al.
(författare)
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Early childhood malnutrition trajectory and lung function at preadolescence
- 2021
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Ingår i: Public Health Nutrition. - 1368-9800 .- 1475-2727. ; 24:5, s. 1009-1020
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Chronic undernutrition is a common phenomenon in Bangladesh. However, information is grossly lacking to report the correlation between chronic undernutrition trajectory and lung function in children. The aim of the current study was to understand the association between early-childhood chronic undernutrition trajectory and lung function at preadolescence.DESIGN: The current study is a part of the 9-year follow-up of a large-scale cohort study called the Maternal and Infant Nutrition Interventions in Matlab.SETTINGS: The current study was conducted in Matlab, a sub-district area of Bangladesh that is located 53 km south of the capital, Dhaka.PARTICIPANTS: A total of 517 children participated in lung function measured with a spirometer at the age of 9 years. Weight and height were measured at five intervals from birth till the age of 9 years.RESULTS: Over half of the cohort have experienced a stunting undernutrition phenomenon up to 9 years of age. Children who were persistently or intermittently stunted showed lower forced expiratory volume (ml/s) than normal-stature children (P < 0·05). Children who exhibited catch-up growth throughout 4·5 years from the stunted group showed similar lung function with normal counterparts, and a better lung function than in children with the same growth velocity or who had faltering growth. In the multivariable models, similar associations were observed in children who experienced catch-up growth than their counterparts after adjusting for covariates.CONCLUSION: Our data suggest that catch-up growth in height during early childhood is associated with a better lung function at preadolescence.
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| 9. |
- Kwong, Edwin Jit Leung, et al.
(författare)
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Population-level salt intake in the WHO European Region in 2022 : a systematic review
- 2023
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Ingår i: Public Health Nutrition. - 1368-9800 .- 1475-2727. ; 26:S1, s. s6-s19
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Forskningsöversikt (refereegranskat)abstract
- Objective:The World Health Organization (WHO) recommends that adults consume less than 5 grams of salt per day to reduce the risk of cardiovascular disease. This study aims to examine the average population daily salt intake in the 53 Member States of the WHO European Region.Design:A systematic review was conducted to examine the most up-to-date salt intake data for adults published between 2000 and 2022. Data were obtained from peer-reviewed and grey literature, WHO surveys and studies, as well as from national and global experts.Setting:The 53 Member States of the WHO European Region.Participants:People aged 12 years or more.Results:We identified 50 studies published between 2010-2021. Most countries in the WHO European Region (n = 52, 98%) reported salt intake above WHO recommended maximum levels. In almost all countries (n = 52, 98%), men consume more salt than women, ranging between 5.39 – 18.51g for men and 4.27 – 16.14g for women. Generally, Western and Northern European countries have the lowest average salt intake, whilst Eastern European and Central Asian countries have the highest average. 42% of the fifty-three countries (n = 22) measured salt intake using 24h urinary collections, considered the gold standard method.Conclusions:This study found that salt intakes in the WHO European Region are significantly above WHO recommended levels. Most Member States of the Region have conducted some form of population salt intake. However, methodologies to estimate salt intake are highly disparate and underestimations are very likely.
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| 10. |
- López-Borbón, Dilana, et al.
(författare)
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Early pregnancy overweight/obesity and length of residence among immigrants in Sweden : a pooled analysis of Swedish population registers between 1992 and 2012
- 2021
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Ingår i: Public Health Nutrition. - 1368-9800 .- 1475-2727. ; 24:5, s. 796-801
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To examine whether the association between women's origin and early pregnancy overweight and obesity (OW/OB) varies by length of residence in Sweden.Design: This cross-sectional observational study used pooled Swedish population register data from 1992 to 2012. Logistic regression models were run to estimate odds ratios (OR) of early pregnancy OW/OB and 95 % confidence intervals (95 % CI), comparing Swedish-born and immigrants by length-of-residence categories while adjusting for covariates.Setting: Sweden.Participants: In total, 1 771 821 pregnant women, 315 992 of whom were immigrants.Results: With longer residence in Sweden, more immigrant women from various origins exhibited higher odds of experiencing early OW/OB compared with Swedish-born women. Findings specifically showed increased odds of early pregnancy OW/OB with increasing length of residence for women born in Latin America, Europe-27 and Southeast Asia. For example, immigrant women from Latin America residing in Sweden for < 6 years showed similar odds as Swedish-born (OR <= 5 years 0 center dot 92, 95 % CI 0 center dot 87, 0 center dot 98), while their longer residing counterparts showed higher odds than Swedish-born women (OR(6-15 years)1 center dot 21, 95 % CI 1 center dot 14, 1 center dot 28 and OR >= 16 years 1 center dot 68, 95 % CI 1 center dot 59, 1 center dot 78). Mixed results were found for other origins.Conclusions: The current study suggests that host country conditions might play an important role in explaining OW/OB among some groups of immigrant women. Although further studies are needed to disentangle the mechanisms that generate these health inequalities, policy efforts should focus on immigrant reception and early integration to prevent pregnancy-related OW/OB.
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