Rethinking food policy framework to tackle childhood obesity in the Italian context.

Pediatric obesity has been described by the World Health Organization as 1 of the most serious public health challenges of the 21st century. Projections of increasing burdens of pediatric obesity and its related diseases on society highlight the need for urgent and substantial action. Many scientific and public debates about the prevention of childhood obesity are centered around simple dichotomies presenting a single-level solution. In contrast, efficient prevention programs should overcome these overly simplistic dichotomies and proceed in the early years of life within the family environment and the whole society, throughout one's lifetime. Food policies have the potential to counteract pediatric obesity by creating healthy food environments. However, the current food policies approach lacks monitoring indicators to assess short- and long-term impact, and is not well integrated into regional, national, and cross-cutting initiatives. Therefore, redesigning and rethinking food policy strategies and goals is an important opportunity to address childhood obesity, safeguard the planet, and contribute to economic and social prosperity.

Programmes to manage food selectivity in individuals with autism spectrum disorder.

Autism spectrum disorder (ASD) is a complex group of neurodevelopmental disorders characterised by impaired social communication and restricted interests/repetitive behaviours. In this regard, sensory processing difficulties and delayed oral motor skills often predispose individuals with ASD to food selectivity (FS). It is usually associated with repetitive eating patterns that can lead to multiple malnutrition conditions. The objective of this narrative review is to present an overview about the existing nutritional interventions aiming at promoting a healthy eating pattern and addressing food selectivity among individuals with ASD. Regarding the interventions targeting nutrition education, the majority of the analysed studies failed to demonstrate their effectiveness. On the other hand, many educational interventions involving taste or cooking sessions, as well as behavioural interventions for FS, demonstrated effective results. Moreover, multidisciplinary in tailoring such programmes, including psychology speech therapy and nutritional skills, is acknowledged as a key approach.

Dietary recommendations to customize canteen menus according to the nutritional and sensory needs of individuals with autism spectrum disorder.

Individuals with autism spectrum disorders (ASD) are often characterized by food-selectivity, food-neophobia and a marked preference for mild flavor, semi-liquid foods with pale colors. Therefore, they adopt a monotonous dietary pattern, and they prefer ultra-processed food, leading to a high risk of developing malnutrition. In Italy, where 75,072 individuals are diagnosed with ASD, center-based services play a crucial role in their daily management. Despite the centrality of nutrition in maintaining a good state of health, even more for vulnerable subjects, no validated protocol at collective catering level has been developed yet. The manuscript presents customized dietary recommendations aimed at managing the meals for individuals with ASD at collective catering service, derived from a non-systematic literature review exploring food behaviors and nutritional needs in individuals with ASD. Simple practical tips for mealtimes, such as eating together, proper seating, lighting, smell control, presenting food in a simple manner and using the same type of tableware at each meal, to meet the needs of individuals with ASD, were described. The proposal could represent a starting point in developing official guidelines aimed at ASD individuals, in collective catering service.Level of Evidence: Level V.

A new methodology to structure a nutrition educational course: the results of a short-term educational-intervention pilot study.

The incidence of malnutrition in developing countries, such as Kenya, is still high. The most recent international reports outline an increase in the prevalence of overnutrition in Sub-Saharan Africa, where undernutrition and hidden hunger conditions still represent an emergency. Among the factors influencing malnutrition conditions connected to dietary intake and eating habits, evidence shows the importance of food knowledge. Traditionally, in developing countries, women represent the pillar of the food system and impact their children's nutrition: food-based, women-centred strategies are recommended to address nutrient gaps, educate and empower women, and counteract malnutrition. The short communication presents the results of the ACTION project: an educational-intervention pilot study targeting childbearing-age women living in rural areas of Southern Kenya. To evaluate the feasibility of the educational course built, the authors administered to the women a food knowledge questionnaire, before and after the intervention. Study results describe an increase in women's food knowledge after attending the food education course. This encourages to increase education courses which can represent a starting point in improving food habits with a positive effect on the health condition in developing counties too.

Food knowledge level among Tanzanian women of childbearing age: developing a score for the food knowledge questionnaire.

Food knowledge (FK) is one of the factors that contribute to malnutrition conditions in developing countries, together with food safety, food security and food access. FK is defined as 'the competence to understand healthy nutrition concepts'; it impacts individuals' life due to its relationship with food behaviour and eating habits. Therefore, acting on FK can represent a starting point for improving the health status of vulnerable populations. The authors present a total score of an FK questionnaire (FKQ) and its relation to the socio-demographic characteristics of a specific target population: Tanzanian women of childbearing age. The results of the manuscript complement evidence of construct validity of the FKQ by providing an algorithm to compute a total score as a measure of FK. The strength of this tool, and its score, lies in the fact that the questionnaire has been validated and is easy to administer.

Autism Spectrum Disorder and collective catering service: results of the pilot study FOOD-AUT.

Objective: Individuals with Autism Spectrum Disorder (ASD) often exhibit a low dietary diversity due to food selectivity that leads them to a marked preference for high-energy-density food, exposing them to risk of malnutrition. Despite these aspects, specific recommendations and targeted menus for this population are missing. The pilot study FOOD-AUT addresses this issue by developing canteen menus meeting the nutritional and sensory needs of adults with ASD, aiming to reduce their food selectivity, and consequently improving their health. Methods: The project, funded by Gruppo Pellegrini S.p.A, was conducted at the daycare service of Sacra Famiglia Onlus Foundation, between March-2022 to March-2023. The study was divided into two phases. Observational phase: a comparison was made between the enrolled subjects' nutritional needs and the nutrient content of the administered menus during the daycare service. Then mealtime compliance was assessed using standardized meal evaluation forms, both quantitative and qualitative. Intervention phase: canteen menus targeted to the individuals' nutritional and sensory needs were administered and their acceptability was evaluated. Results: Twenty-two individuals with ASD, aged 19-48, 72.7% males, were enrolled. Overweight and obesity prevalence were 54.5 and 18.2%, respectively. The observational phase showed how the most accepted foods had specific sensorial characteristics in line with the scientific literature. Adapting the menus improved food acceptance and reduced food waste. Conclusion: The results highlighted the need for adapted menus and greater attention to the way meals are delivered and consumed to improve nutritional status and therefore health of this population at increased risk of malnutrition. Clinical trial registration: ClinicalTrial.gov, unique identifier: NCT05978895.

Validation of a Food Knowledge Questionnaire on Tanzanian Women of Childbearing Age.

The present manuscript describes the validation of a food knowledge questionnaire (FKQ) for Tanzanian childbearing age women. The FKQ was derived from the Ugandan version and was adapted according to Tanzanian culture and food habits, including 114 closed-ended questions, divided into five different sections. The FKQ was administered to 671 Tanzanian childbearing-age women who were eligible if they: (i) were aged between 14 and 49 years old, (ii) had not been diagnosed with any disease and (iii) lived in the urban or peri-urban area of the Arusha and Morogoro region. The validation process of the FKQ was conducted in Tanzania and the recruitment occurred between August and October 2020. The final version of the validated questionnaire was characterized by a total of 88 questions, divided into ten different sections; each section aimed to investigate a different aspect of food knowledge, except for section A, which collected information related to the social and demographic characteristics of the respondent. The food knowledge questionnaire showed good construct validity and content validity to assess knowledge and food practices in Tanzanian women of childbearing age and could be used in future studies to identify women at higher risk of unhealthy eating habits and food choices.

The development of a food knowledge questionnaire for tanzanian women of childbearing age.

BACKGROUND: The incidence of malnutrition in developing countries, such as many of those located in Sub-Saharan Africa, is still high, especially in vulnerable categories such as women of childbearing age. Among the several factors influencing dietary intake and eating habits, evidence shows the importance of food knowledge (FK), essential in establishing and maintaining strategies aimed at reducing the burden of disease and promoting wellbeing. The present research was aimed at describing the methodology for designing a questionnaire to investigate Food Knowledge in Tanzania women of childbearing age. METHODS: The Food Knowledge Questionnaire (FKQ) was developed by adapting items from the Ugandan questionnaire to cultural background and food habits of Tanzanian women of childbearing age. A pilot version of the FKQ was tested on a small sample of respondents, 83 women of childbearing age living in the region of Arusha. After describing the sample and the scorings, the pilot version of the questionnaire was analysed through Multiple Correspondence Analysis, aimed at exploring the relationships between items and the properties of the scoring system. RESULTS: The exploratory analyses of the questionnaire allowed to identify those items not related to the others and whose scores were not related to food knowledge, therefore constituting the basis for the questionnaire to be refined and validated. DISCUSSION: The final version of the Tanzanian FKQ "to be validated" ended up consisting of five sections: Section A, about social and economic information (17 questions); Section B, related to health experts advice (5 questions); Section C1 and C2 about food groups (7+7 questions); Section D about diseases and nutrition (6 questions). The questionnaire includes 114 close-ended questions in total. The exploratory analyses performed have led to define the relationships between items and latent constructs, allowing to identify of "correct food knowledge" and "incorrect food knowledge" archetypals.

Novel Foods and Sustainability as Means to Counteract Malnutrition in Madagascar.

Although the trends of international reports show an increase in overweight and obesity, even in developing countries, there are still areas of the world, such as Sub-Saharan Africa, strongly affected by undernutrition. Specifically, in Madagascar, the percentage of stunted children under 5 is extremely high. Furthermore, the COVID-19 pandemic is expected to increase the risk of all forms of malnutrition, especially in low-income countries, including Madagascar, with serious intergenerational repercussions. This narrative review aims at investigating eating habits and cooking methods of the Malagasy population, addressing sustainable healthy diets through promotion of novel foods. While novel foods are a recent concept, there are data that describe how they may contribute to counteract food insecurity and malnutrition considering context and place. Efforts to promote native, traditional foods as Moringa oleifera, an indigenous plant in Asia and Africa including Madagascar, rich in protein and micronutrients, as well as edible insects, alternative sustainable source of protein, lipids, iron, and zinc, would provide not only nutritional but also cultural and economic benefits. The potential synergies between food traditions and agroecology have the potential to impact health addressing larger issues of sustainability and food security. Regional, national, and international policies are needed to develop and support one health approach actions.

Indigenous vegetables: a sustainable approach to improve micronutrient adequacy in Tanzanian women of childbearing age.

BACKGROUND/OBJECTIVES: Increasing dietary diversity is a viable strategy for addressing micronutrient malnutrition in women of childbearing age (WCA) from low-income countries. Recently, it has been demonstrated that some indigenous vegetables (IV) with high nutrient density may help to ameliorate micronutrient's intake. The Minimum Dietary Diversity index for Women (MDD-W) could be considered as a proxy to describe one important dimension of women's diet quality. This cross-sectional study aimed at exploring aspects contributing to micronutrients adequacy in Tanzanian WCA, with a focus on IV consumption and other socio-demographic factors. SUBJECTS/METHODS: Data collection was conducted among urban and peri-urban women in Arusha city, Tanzania. Socio-demographic factors were collected using a structured interview. Information on IV consumption and MDD-W calculation were obtained using a 24-h recall. RESULTS: One-hundred and forty-one women aged 14-49 years were interviewed. Sixteen per cent of the sample consumed at least one portion of IV/day. The total median MDD-W was 4.0 (IQR. 3.0-5.0) and it was adequate in the 44% of the sample. Women who consumed IV had MDD-W 0.66 points (95% CI: 0.02-1.30, p = 0.046) higher than those who did not; consuming IV had an odds ratio of more than three times concerning women not consuming IV (OR: 3.30, 95% CI: 1.24-8.81, p = 0.017). CONCLUSIONS: The IV consumption is positively associated with micronutrient adequacy and its absence from the diet can be an indicator of micronutrient deficiencies in vulnerable people such as WCA. For that reason, this study suggests that IV consumption may improve micronutrient deficiency in WCA.

Potential role of neglected and underutilized plant species in improving women's empowerment and nutrition in areas of sub-Saharan Africa.

In the context of the nutrition transition, women in sub-Sahara Africa are a critical target group from a nutrition standpoint, and they experience significant discrimination in food production. Food-based, women-centered strategies are recommended to address nutrient gaps, and to educate and empower women. In this context, local natural resources, such as neglected and underutilized plant species (NUS), may contribute to adding nutritional value, enriching diet diversity, and ensuring nutrition security. The aim of the current narrative review is to investigate the nutritional status of the sub-Saharan African population and the potential role of local agriculture strategies in improving food production and diet diversity and in expanding income-generating activities for women. The nutritional properties of the most important regional NUS are also discussed.