Development and evaluation of an index assessing adherence to the Norwegian food-based dietary guidelines: the Norwegian Dietary Guideline Index (NDGI).

BACKGROUND: Monitoring adherence to the Norwegian food-based dietary guidelines (FBDGs) could provide valuable insight into current and future diet-related health risks. This study aimed to develop and evaluate an index measuring adherence to the Norwegian FBDGs to be used as a compact tool in nutrition surveillance suitable for inclusion in large public health surveys. METHODS: The Norwegian Dietary Guideline Index (NDGI) was designed to reflect adherence to the Norwegian FBDGs on a scale from 0-100, with a higher score indicating better adherence. Dietary intakes were assessed through 19 questions, reflecting 15 dietary components covered by the Norwegian FBDGs. The NDGI was applied and evaluated using nationally representative dietary data from the cross-sectional web-based Norwegian Public Health Survey which included 8,558 adults.​ RESULTS: The population-weighted NDGI score followed a nearly normal distribution with a mean of 65 (SD 11) and range 21-99. Mean scores varied with background factors known to be associated with adherence to a healthy diet; women scored higher than men (67 vs. 64) and the score increased with age, with higher educational attainment (high 69 vs. low 64) and with better self-perceived household economy (good 67 vs. restricted 62). The NDGI captured a variety of dietary patterns that contributed to a healthy diet consistent with the FBDGs. CONCLUSION: The NDGI serve as a compact tool to assess and monitor adherence to the Norwegian FBDGs, to identify target groups for interventions, and to inform priorities in public health policies.​ The tool is flexible to adjustments and may be adaptable to use in other countries or settings with similar dietary guidelines.

Adaptation and Validation of the S-NutLit Scale to Assess Nutritional Literacy in the Peruvian Population.

Maintaining good dietary practices is a factor that allows a better quality of life; therefore, it is necessary to promote health via the fundamental tool of nutritional literacy. In this context, this study aims to evaluate nutritional literacy in Peru through the S-NutLit tool, which is composed of two dimensions. The scale, composed of 11 items, was applied to 396 Peruvian adults. According to the evaluation of the indicators, an acceptable reliability was found, as was a model fit with excellent estimation according to its indicators (CMIN/DIF 2.559; IFC 0.965; SRMR 0.043; RMSEA 0.063; and PClose 0.070). In this way, we seek to reinforce health promotion activities through a nutritional literacy diagnosis, which, due to its characteristics, can be self-administered and used by health entities and other entities in general that are interested in knowing the eating practices of an individual, which undoubtedly leads to good health.

Health behavior interventions among people with lower socio-economic position: a scoping review of behavior change techniques and effectiveness.

Background: Behavior change interventions can unintendedly widen existing socio-economic health inequalities. Understanding why interventions are (in)effective among people with lower socio-economic position (SEP) is essential. Therefore, this scoping review aims to describe what is reported about the behavior change techniques (BCTs) applied within interventions and their effectiveness in encouraging physical activity and healthy eating, and reducing smoking and alcohol consumption according to SEP. Methods: A systematic search was conducted in 12 electronic databases, and 151 studies meeting the eligibility criteria were included and coded for health behavioral outcomes, SEP-operationalization, BCTs (type and number) and effectiveness. Results: Findings suggest that approaches for measuring, defining and substantiating lower SEP vary. Current studies of behavior change interventions for people of different SEP do not systematically identify BCTs, making systematic evaluation of BCT effectiveness impossible. The effectiveness of interventions is mainly evaluated by overall intervention outcomes and SEP-moderation effects are mostly not assessed. Conclusion: Using different SEP-operationalizations and not specifying BCTs hampers systematic evidence accumulation regarding effective (combinations of) BCTs for the low SEP population. To learn which BCTs effectively improve health behaviors among people with lower SEP, future intervention developers should justify how SEP is operationalized and must systematically describe and examine BCTs.

The Association between Healthy Eating Index-2015 and Serum Metabolic Parameters in Women with Gallstone Disease: A Case-Control Study.

Background: One of the most prevalent gastrointestinal tract ailments is gallstone disease (GD). Diet has been acknowledged as a modifiable GD risk factor. The Healthy Eating Index (HEI) is a scale for evaluating the quality of diets; therefore, this study aimed to determine whether the HEI-2015 score was associated with serum metabolic parameters in women with GD. Methods: This case-control study was conducted on a sample of 75 women diagnosed with GD and 75 healthy women at the Gastroenterology and Hepatology Clinic of Shahid Beheshti University of Medical Science in Tehran, Iran. Standard laboratory methods were employed to measure the biochemical parameters. The participants' habitual dietary intake was assessed using a validated food frequency questionnaire (FFQ). The HEI-2015 score was computed for all participants. The study employed multivariate logistic regression to identify the optimal predictor of GD. The Pearson Correlation was employed to determine the correlation between the HEI-2015 and serum metabolic parameters. Results: The study found a significant negative association between the risk of GD and serum HDL-c (OR: 0.84; 95% CI: 0.76-0.95, P=0.008). Moreover, a significant positive association was detected between HOMAIR (OR: 3.27; 95% CI: 1.16-9.19, P=0.025), and the risk of GD. The study did not find a statistically significant correlation between the HEI-2015 and serum parameters. Conclusion: While an association was discovered between certain serum metabolic parameters and the risk of GD, the results do not provide a significant association between serum metabolic parameters and HEI-2015 score.

Social capital and healthy eating among two ethnic minority groups in Yunnan Province, Southwest China: the mediating role of social support and nutrition knowledge.

Background: Although social capital has been linked to dietary intake particularly in disadvantaged populations, little is known about the mechanisms. This study aimed to investigate whether social support (SS) and nutrition knowledge (NK) mediate the association between social capital and healthy eating habits. Methods: A probability sample of two ethnic minority groups in Yunnan Province, Southwest China were included (n = 1,033, mean age 47.5 ± 14.7 years). Bonding and bridging social capital (BOC and BRC) were assessed with the Personal Social Capital Scale (PSCS-16). Dietary data were evaluated with the Chinese Healthy Eating Index (CHEI), a measure of diet quality which reflects adherence to the Chinese Dietary Guidelines. NK and SS were measured with a validated questionnaire and scale, respectively. Structural Equation Modeling was used to calculate the direct, indirect and total effects of social capital on CHEI scores. Results: The mean score of CHEI was 57.4 ± 9.8, which was significantly lower in men and older people. Low adherence to dietary guidelines were to observed in the consumption of dairy, beans, nuts, animal-source food vegetables and fruits. BOC and BRC were positively associated with CHEI score (ß = 0.37 and 0.38, all p < 0.05). Social support and nutrition knowledge mediated 45.9 and 39.5% of the total effect of social capital on CHEI score, respectively. Conclusion: Social capital appears to enhance adherence to dietary guidelines by improving nutrition knowledge and social support. Nutrition promotion programs therefore should consider incorporating strategies that foster social capital development, particularly in disadvantaged populations.

Effects of a Yoga Program Combined with a Mediterranean Diet on Nutritional Status and Functional Capacity in Community-Dwelling Older Adults: A Randomized Controlled Clinical Trial.

(1) Background: With the aging population, effective interventions are needed to enhance the health of older adults. This study investigated the combined effects of yoga and the Mediterranean diet on various health outcomes in community-dwelling older adults; (2) Methods: The study employed a randomized controlled trial design with a total of 116 older adults randomized to an experimental group (n = 57) that underwent a combined yoga and Mediterranean diet program and a control group (n = 59) that did not receive any intervention. Nutritional status was assessed using the Mini Nutritional Assessment, flexibility with the Back Scratch Test and the Chair Sit-and-Reach Test, balance, gait, and fall risk with the Tinetti Scale, and muscle strength with a dynamometer and the 30 s Chair Stand Test; (3) Results: Regarding nutritional status, there were significant differences between the experimental group and the control group (Cohen's d = 0.02). The participants in the experimental group showed greater balance (11.12 ± 3.01 vs. 10.03 ± 2.35, Cohen's d = 0.41 and gait (7.63 ± 1.96 vs. 6.69 ± 2.50, Cohen's d = 0.44) with respect to the control group. In terms of flexibility, the experimental group showed statistically significant improvements in the right arm (Cohen's d = 0.43), left arm (Cohen's d = 0.64), right perineum (Cohen's d = 0.42), and left leg (Cohen's d = 0.37) Finally, in terms of strength, participants in the experimental group experienced statistically significant improvements in grip strength and lower body strength (Cohen's d = 0.39 and 0.81, respectively); (4) Conclusions: The study highlights the potential benefits of a 12-week intervention combining yoga with a Mediterranean diet to improve the health and functional capacities of community-dwelling older adults.

Impact of a Cooking Intervention on the Cooking Skills of Adult Individuals with Type 2 Diabetes Mellitus: A Pilot Study.

OBJECTIVE: To investigate the impact of the Nutrition and Culinary in the Kitchen (NCK) Program on the cooking skills of Brazilian individuals with type 2 diabetes mellitus (T2DM). METHODS: A randomized controlled intervention study was performed, with intervention and control groups. The intervention group participated in weekly sessions of the NCK Program for six weeks (including two in-person practical cooking and three online cooking workshops). The cooking recipes were adapted by replacing high glycemic index ingredients with low and medium glycemic index alternatives. Of note, the recipes did not contain added sugars or sweeteners, were based on the use of fresh or minimally processed foods, herbs, and spices, and were sensorially tested by individuals with T2DM before use in the intervention. The study outcomes were participant score changes on the seven scales. A validated online instrument was administered to the control and intervention groups at baseline (T1) and post-intervention (T2). Parametric and non-parametric tests were used to assess the differences between the T1 and T2 parameters. RESULTS: Of the 60 individuals enrolled, 44 answered the questionnaire at both times. The findings revealed a 45.37% ± 93.57% increase in Knowledge of Cooking Terms in the intervention group, whereas the control group showed a 3.82% ± 16.17% reduction (p = 0.008). There was an increase in all the other cooking skills and healthy eating scales from T1 to T2 in the intervention group, but the differences were not significant. CONCLUSIONS: The development of cooking skills can contribute to increasing culinary knowledge and the availability of time to cook at home. The results contribute to the planning of health actions aimed at individuals with DM2 through culinary interventions and public food and nutrition policies.

The Impact of Sustainability Courses: Are They Effective in Improving Diet Quality and Anthropometric Indices?

There are studies on the effect of general nutrition education on diet quality and anthropometric measurements, while studies showing the effectiveness of sustainable nutrition education, which also addresses the effect of food on the environment, are quite limited. This study aimed to investigate the effects of sustainable nutrition education on diet quality, anthropometric measurements, and the carbon footprint (CFP) and water footprint (WFP) of diet. A total of 160 university students received 1 h of sustainable nutrition education for 6 weeks. Before, at the end of, and 2 months after the courses, 24 h food consumption records were taken to assess diet quality and CFP and WFP values of diet, and Mediterranean diet (MedDiet) and Healthy Eating Index (HEI)-2020 scores were evaluated. The results of the study showed that sustainable nutrition education increased MedDiet score by 1.86 points and HEI-2020 score by 7.38 points. This education program also decreased body weight, body mass index (BMI), fat mass, and neck circumference. Sustainability education has a positive impact on calcium, potassium, and magnesium intakes, a negative impact on vitamin B12 and zinc intakes, and no effect on total protein intake. Education resulted in a 22% reduction in CFP and a 10% reduction in WFP.

Social marketing targeting healthy eating and physical activity in young adult university students: A scoping review.

Adult obesity has remained a key health concern globally. Theory-based social marketing interventions are considered effective for improving dietary and physical activity (PA) behaviours. However, their application in universities is not yet established. This review aimed to identify social marketing strategies targeting healthy eating and/or PA behaviours of young adult university students and outline the intervention effectiveness. Literature search, screening, and data extraction followed the Joanna Briggs Institute (JBI) methodology for scoping reviews. PubMed/Medline and Scopus databases were searched for intervention and exploratory studies published between January 1, 2000, and September 20, 2023. Twelve articles were selected based on the eligibility criteria. Although different in study design, all studies reported improved healthy eating-related outcomes, while three showed improved PA-related outcomes. One study incorporated all six of the social marketing benchmarks, but the majority identified two. Most studies focused on behavioural objective, formative research, and marketing mix in their intervention design. Four studies incorporated behaviour change theories in development of the social marketing campaigns. Social marketing using social media could be a significant approach for improving healthy eating and PA in young adult university students when behavioural change theories and all social marketing benchmarks are adopted. More generalizable longer-term investigation into the effectiveness of this approach in university young adults is needed to tackle adult obesity related health issues.

Dietary Quality and Diet-Related Factors Among U.S. Emerging Adults (18-23y) Are a Cause for Concern, NHANES 2015-2018.

BACKGROUND: Poor dietary quality is a risk factor for diet-related chronic disease and suboptimal nutritional patterns often begin early in the life course. While the dietary intakes of young children, adolescents, and middle-aged and older adults are well established, much less is known about emerging adults, who represent a unique timepoint in life, as they are undergoing significant changes in food environments, autonomy, finances, and caregiver and parental involvement. OBJECTIVE: To examine dietary quality, as assessed via the Healthy Eating Index (HEI), by demographic, socioeconomic, and health-related characteristics among U.S. emerging adults (18-23y) who participated in the 2015-2018 National Health and Nutrition Examination Survey (NHANES). METHODS: NHANES data were collected via a household interview and 2 24-hour dietary recalls (24HR). Usual dietary intakes from the 24HRs were approximated using the multivariate National Cancer Institute Method to compute mean HEI-2015 overall and component scores (range 0-100, higher scores indicating higher dietary quality). RESULTS: Overall dietary quality among U.S. emerging adults [HEI-2015: 50.3±1.3] was significantly lower than other U.S. adults (≥24y) [HEI-2015: 56.3±0.5; p<0.0001], with differences primarily driven by lower intakes of whole fruit, vegetables, and whole grains, and higher intakes of sodium, refined grains, and saturated fat. Few differences in HEI-2015 scores were noted across population subgroups by sex, food security, family income, and food assistance program participation, except for added sugar; intakes of added sugar were significantly higher among women, food insecure, and food assistance program participants as compared to their counterparts, respectively. CONCLUSIONS: Dietary quality is poor among U.S. emerging adults and persists across all population subgroups, suggesting a significant need for tailored public health interventions to improve dietary quality among this population. Future research investigating to what extent emerging adults prioritize healthful behaviors and exploring other indicators for identifying nutritionally vulnerable subgroups may be impactful for identifying disparities among this life stage.

Effectiveness of Health Action Interventions in Enhancing Diet Quality and Glycemic Control Among Individuals With Type 2 Diabetes Mellitus: A Systematic Review of Randomized Clinical Trials.

CONTEXT: Diet quality is directly related to glycemic control in individuals with type 2 diabetes mellitus (T2DM). The use of dietary indices can provide a comprehensive understanding of the relationship between diet quality and clinical outcomes. OBJECTIVE: The aim was to evaluate the relationship between diet quality, measured using dietary indices, and its impact on improving glycemic control in individuals with T2DM through health interventions. DATA SOURCE: This study was conducted using 6 databases, including Web of Science, MEDLINE (via PubMed), Embase, Bireme, Scopus, and Cumulative Index to Nursing and Allied Health Literature (CINAHL), as well as the gray literature (Google Academic). DATA EXTRACTION: Randomized clinical trials that evaluated the effectiveness of health interventions in adult and older adult individuals with T2DM and presented data on diet quality evaluated using dietary indices and the percentage of glycated hemoglobin (%HbA1c) were included. DATA ANALYSIS: A total of 3735 articles were retrieved, 4 of which were included in the study selection stages. The quality indices assessed in the studies were the Alternate Healthy Eating Index (AHEI), Healthy Eating Index-2010 (HEI-2010), Diet Quality Index-International (DQI-I), and Diet Quality Index-Revised (DQI-R). A reduction in %HbA1c was observed in 2 studies, which correlated with the AHEI and DQI-I scores in the intervention groups. The approach of using food labels to improve diet quality reduced %HbA1c by 0.08% in the intervention group compared with the control group. Only 1 study found no significant association between the DQI-R index and %HbA1c. Additionally, negative correlations were observed between body weight and the AHEI and DQI-I scores. CONCLUSION: Health interventions improved diet quality, glycemic control, and weight loss in individuals with T2DM. SYSTEMATIC REVIEW REGISTRATION: PROSPERO no. CRD42023430036.

Italian validation of a short version of the Dutch eating behavior questionnaire: Psychometric properties and relationships with self-esteem, eating self-efficacy, and snacking habits in university students.

Background: The Dutch Eating Behavior Questionnaire (DEBQ) is a widely used self-report measure of eating styles, i.e., emotional, restrained, and external. A short and reliable version is useful for screening, routine assessments, and multipurpose surveys. Objective: The short version of the DEBQ by Bailly et al. (2012) was validated in the Italian context in two studies. Concurrent criterion validity was tested by considering gender, body mass index, self-esteem, eating self-efficacy, and snacking habits. Method: Data were collected via online questionnaires administered to two convenience samples of university students (n = 613, n = 856). Results: The three-factor structure of the short version of the DEBQ was supported and was invariant across genders. Correlations among the three eating styles, gender, body mass index, self-esteem, eating self-efficacy, and snacking habits followed the expected pattern. Conclusion: The short form of the DEBQ is psychometrically sound and can be used to investigate eating styles among Italian university students.

Higher orthorexia tendency among female fashion models: an empirical international study.

PURPOSE: Female fashion models are more at risk for developing eating disorders than non-models due to the intense occupational pressure they face. The present study focuses on assessing whether female models are more prone to report orthorexia nervosa signs and symptoms than non-models. METHODS: Female fashion models (n = 179, mean age: 25.9 SD = 4.40 years) and an age adjusted control group (n = 261, mean age: 25.0 SD = 4.97 years) were selected by snowball sampling. Participants filled out an online survey containing anthropometric questions and the 18-item Eating Habits Questionnaire. RESULTS: According to BMI, fashion models were underweight (mean BMI = 18.1 SD = 1.68) while control participants' BMI was in the normal range (mean = 22.1 SD = 4.23, p < 0.001). On all three of Eating Habits Questionnaire subscales fashion models showed significantly higher average value (Knowledge subscale: M = 2.42 among models versus M = 2.08 in the control group, p < 0.01, Cohen's d = 0.52; Problems subscale: M = 1.93 among models versus M = 2.61 in the control group, p < 0.01, Cohen's d = 0.49; Feelings subscale: M = 3.20 among models versus M = 2.96 in the control group, p < 0.01, Cohen's d = 0.38). Orthorexic tendencies were reported by 35.1% of the models versus 20.2% of controls. CONCLUSION: Fashion models are at risk for the development of eating disorders. Even though not yet included in the DSM-5, the assessment of orthorexia nervosa among fashion models seems to be important. It is suggested to take appropriate measures to prevent the spread of disordered eating habits among models as they can lead to the development of anorexia nervosa or bulimia nervosa. LEVEL OF EVIDENCE: Level III, well-designed cohort study.

Differences in the Values and Related Factors of Eating a Balanced Meal among the Younger Generation in Japan.

This study examined young Japanese adults' values regarding the consumption of balanced meals consisting of staples, main dishes, and side dishes and how these values relate to demographics, socioeconomic status, nutrition knowledge, attitudes, skills, behaviors, and diet-related quality of life. Data were obtained from the "Survey on Dietary Habits of the Younger Generation" (2000 responses, ages 18-39), of which 1888 valid responses were analyzed. The principal component analysis identified three value patterns: PC1-valuable yet burdensome; PC2-environment-reliant, weak initiative; and PC3-low value due to hassle. Both PC1 and PC3 were associated with prioritizing prices in food choices and knowledge of a balanced meal. However, PC1 participants valued balanced meals and possessed meal preparation skills, whereas PC3 participants valued balanced meals less and had negative attitudes toward eating them. PC1 was positively associated with the frequency of eating balanced meals while PC3 was negatively associated. PC2 individuals had positive attitudes toward eating balanced meals but were less concerned about nutritional balance when choosing foods themselves. This study highlights the importance of adopting an approach that aligns with the value patterns of the target population.

Practicing Interoceptive Sensitivity as a Couple: A Mixed-Methods Acceptance Analysis of a Dyadic vs. Single Pilot Randomized Controlled Trial.

Training interoceptive sensitivity (IS) might be a first step in effectively promoting intuitive eating (IE). A dyadic interoception-based pilot randomized controlled trial was conducted to increase IE among couples aged 50+. The training consisted of three exercises, a Body Scan (BS), a hunger exercise (HU), and a satiety (SA) exercise. This study explored how spouses accepted the (dyadic vs. single) training. In a mixed-methods convergence design, the findings of a survey (n = 68 couples) and focus groups (n = 4) were synthesized. Moderate general acceptance (e.g., regarding feasibility and low burden) and a hierarchical gradient in favor of the BS (e.g., pleasantness and improved sleep quality) emerged. Barriers concerned a perceived lack of the exercises' usefulness and a limited understanding of the training purpose. A wish for regular feedback and exchange with the study stuff and other participants was expressed. Spousal training involvement was experienced as being rather beneficial. Previously harmonized dietary practices and daily routines appeared as constructive pre-conditions for the joint training. This study highlights the potential and implications of training couples in IS. Future interventions should involve a regular exchange and closer guidance by study staff to promote a better understanding of the processes and goals of IS and IE.

The Associations between Healthy Eating Patterns and Risk of Metabolic Dysfunction-Associated Steatotic Liver Disease: A Case-Control Study.

BACKGROUND: Although several epidemiological studies have identified an inverse association between healthy dietary patterns and metabolic dysfunction-associated steatotic liver disease (MASLD)/non-alcoholic fatty liver disease (NAFLD), little is known about the contribution of the food component to MASLD risk and the association between dietary patterns and severity of MASLD. This study aimed to investigate the association between healthy eating patterns and MASLD risk and severity of MASLD. METHODS: A case-control study including 228 patients diagnosed with MASLD and 228 controls was conducted. The modified Alternate Healthy Eating Index (AHEI), Dietary Approaches to Stop Hypertension (DASH) score, and Alternative Mediterranean Diet (AMED) score were evaluated based on information collected via a validated food-frequency questionnaire. MASLD was confirmed if participants presented with ultrasound-diagnosed fatty liver diseases along with at least one of five cardiometabolic risk factors and no other discernible cause. The logistic regression models were applied to estimate the odds ratio (OR) and 95% confidence interval (95% CI) of MASLD for dietary scores. RESULTS: Compared with participants in the lowest tertile, those in the highest tertile of AHEI had a 60% reduced risk of MASLD (OR: 0.40; 95% CI: 0.25-0.66). Similar associations were also observed for DASH and AMED, with ORs comparing extreme tertiles of 0.38 (95% CI: 0.22-0.66) and 0.46 (95% CI: 0.28-0.73), respectively. Further Stratified analysis revealed that the inverse associations between AHEI and DASH with MASLD risks were stronger among women than men, and the inverse associations between AMED and MASLD risks were more pronounced among participants with normal weight (OR: 0.22; 95% CI: 0.09-0.49). For components within the dietary score, every one-point increase in vegetable score and whole grain score within the AHEI was associated with an 11% (95% CI: 5-16%) and a 6% (95% CI: 0-12%) lower MASLD risk, respectively. Similar inverse associations with those scores were observed for the DASH and AMED. CONCLUSION: Greater adherence to healthy eating patterns was associated with reduced risk of MASLD, with vegetables and whole grains predominately contributing to these associations. These findings suggested that healthy eating patterns should be recommended for the prevention of MASLD.

Associations between body weight dissatisfaction and diet quality in women with a body mass index in the healthy weight category: Results from the 2014-2015 Swiss National Nutrition Survey.

BACKGROUND: Few studies have examined whether diet quality is lower in women with body weight dissatisfaction compared to women without body weight dissatisfaction. OBJECTIVES: 1) To examine the association between body weight dissatisfaction and diet quality among women (18-65 years old) in the healthy weight body mass index (BMI) category and 2) to explore dietary and behavioral patterns among women with body weight dissatisfaction. DESIGN: Data were extracted from the cross-sectional 2014-2015 Swiss National Nutrition Survey. PARTICIPANTS/SETTING: Population-based sample of 507 women with BMI ≥ 18.5 and < 25 kg/m2. OUTCOME MEASURES: Dietary intakes assessed by dietitians using two non-consecutive computer-assisted multi-pass 24-hour dietary recalls. Diet quality was measured with a slightly modified version of the Healthy Eating Index (HEI) -2020. STATISTICAL ANALYSES PERFORMED: Multiple linear regressions to test the association between body weight dissatisfaction and total HEI-2020 score. Hierarchical cluster analysis to identify subgroups of women with body weight dissatisfaction. RESULTS: Body weight dissatisfaction was not found to be associated with diet quality (ß = - 1.73 [-4.18 ; 0.71], P =0.16). However, women who were dissatisfied with their body weight had lower scores for the HEI-2020 total fruits (P = 0.050) and whole grains (P = 0.014) components than women who were satisfied with their body weight. Four profiles with different dietary patterns were identified among women with body weight dissatisfaction: "Unhealthy diet with dairy", "Protein and fat", "Vegetables without protein", and "Healthier diet without dairy". CONCLUSIONS: Among women with a BMI in the healthy weight category, overall diet quality was not observed to differ between those with or without body weight dissatisfaction. More research is needed to explore the different profiles of dietary intake in women with body weight dissatisfaction.

Evaluating the influence of ultra-processed food intake on associations between dietary indices with systemic inflammation in adulthood and old ages.

BACKGROUND & AIMS: Low-grade systemic inflammation (LGSI) is critical to developing many chronic diseases. In turn, it has been shown that the diet can modulate favorably or unfavorably the inflammatory status. Thus, evaluating the diet from appropriate approaches is fundamental; to do so, there are different proposals for dietary indexes. We aimed to: (i) investigate the association between three well-known dietary indexes and LGSI biomarkers; (ii) test these associations individually or in combination with an indicator of ultra-processed foods (UFPs) intake. (iii) as an additional aim, hypothesizing that all the indexes should be capable of identifying the inflammatory potential of diet, we tested the hypothesis that these indexes agree and correlate with each other. METHODS: Cross-sectional population-based data of adults and older persons (n = 583). Dietary data were obtained through two non-consecutive 24-h dietary recalls (24HDR) and calculated for Dietary Inflammatory Index (DII), Mediterranean-Style Dietary Pattern Score (MSDPS); Brazilian Healthy Eating Index - Revised (BHEI-R) and energy ingested from UPFs (UPFs ratio). An LGSI score was created from some plasma inflammatory biomarkers [C-Reactive Protein (CRP), tumor necrosis factor-alpha (TNF-α), and adiponectin]. Logistic and linear regression models tested the associations between dietary indexes and LGSI score. RESULTS: The MSDPS and DII were significantly associated with our inflammatory score, but the BHEI-R did not. Including UPFs in regression models did not increase the strength of these associations. CONCLUSIONS: From the three scores, the dietary inflammatory index and the Mediterranean-style dietary pattern score (MSDPS) were the ones that showed significant association with the inflammatory biomarker. The combination of the indexes with a ratio of UPF intake did not increase the significance of our analyses. The best agreement between the indexes was found between MSDPS and UPFs ratio; the only pair of indexes considered concordant and correlated was the BHEI-R and DII.

Exploring Children's Knowledge of Healthy Eating, Digital Media Use, and Caregivers' Perspectives to Inform Design and Contextual Considerations for Game-Based Interventions in Schools for Low-Income Families in Lima, Peru: Survey Study.

BACKGROUND: The prevalence of overweight and obesity in schoolchildren is increasing in Peru. Given the increased use of digital media, there is potential to develop effective digital health interventions to promote healthy eating practices at schools. This study investigates the needs of schoolchildren in relation to healthy eating and the potential role of digital media to inform the design of game-based nutritional interventions. OBJECTIVE: This study aims to explore schoolchildren's knowledge about healthy eating and use of and preferences for digital media to inform the future development of a serious game to promote healthy eating. METHODS: A survey was conducted in 17 schools in metropolitan Lima, Peru. The information was collected virtually with specific questions for the schoolchild and their caregiver during October 2021 and November 2021 and following the COVID-19 public health restrictions. Questions on nutritional knowledge and preferences for and use of digital media were included. In the descriptive analysis, the percentages of the variables of interest were calculated. RESULTS: We received 3937 validated responses from caregivers and schoolchildren. The schoolchildren were aged between 8 years and 15 years (2030/3937, 55.8% girls). Of the caregivers, 83% (3267/3937) were mothers, and 56.5% (2223/3937) had a secondary education. Only 5.2% (203/3937) of schoolchildren's homes did not have internet access; such access was through WiFi (2151/3937, 54.6%) and mobile internet (1314/3937, 33.4%). In addition, 95.3% (3753/3937) of schoolchildren's homes had a mobile phone; 31.3% (1233/3937) had computers. In relation to children's knowledge on healthy eating, 42.2% (1663/3937) of schoolchildren did not know the recommendation to consume at least 5 servings of fruits and vegetables daily, 46.7% (1837/3937) of schoolchildren did not identify front-of-package warning labels (FOPWLs), and 63.9% (2514/3937) did not relate the presence of an FOPWL with dietary risk. Most schoolchildren (3100/3937, 78.7%) preferred to use a mobile phone. Only 38.3% (1509/3937) indicated they preferred a computer. In addition, 47.9% (1885/3937) of caregivers considered that the internet helps in the education of schoolchildren, 82.7% (3254/3937) of caregivers gave permission for schoolchildren to play games with digital devices, and 38% (1495/3937) of caregivers considered that traditional digital games for children are inadequate. CONCLUSIONS: The results suggest that knowledge about nutrition in Peruvian schoolchildren has limitations. Most schoolchildren have access to the internet, with mobile phones being the device type with the greatest availability and preference for use. Caregivers' perspectives on games and schoolchildren, including a greater interest in using digital games, provide opportunities for the design and development of serious games to improve schoolchildren's nutritional knowledge in Peru. Future research is needed to explore the potential of serious games that are tailored to the needs and preferences of both schoolchildren and their caregivers in Peru in order to promote healthy eating.