Adherence to Mediterranean diet among adults during the COVID-19 outbreak and the economic crisis in Lebanon

Purpose The purpose of this study is to assess the adherence to MedDiet among adults during the COVID-19 pandemic and the economic crisis, using the validated 14-item MedDiet assessment tool. Design/methodology/approach A quantitative research approach, based on the distribution of an online survey throughout the social media platforms, via networking, was the applied method. The structure of the survey included the socio-economic and demographic data along with the weekly adherence to physical activity; and the validated MedDiet assessment tool. The target population included 1,030 Lebanese adults from all provinces. Descriptive statistics were used to explore the characteristics of the sample population. Adherence to the MedDiet was determined by the Med-Diet score ≥ 9. Significant differences among the variables and the adherence to the MedDiet were examined using the chi-square test. Findings Mean adherence to the MedDiet was found to be lower than an adequate score among 60.8% of participants [mean adherence 8/14 < 9 (S.D. 2.2)]. Participants from North Province, those aged 45 years and above, university graduates, participants with an average income and those who exercised for a minimum of 30 min for three times/week had a higher mean of adherence compared to other groups. Higher percentage of those who exercised had adequate adherence compared to those who exercised less or did not. More than 50% of the participants consumed olive oil, vegetables, red meat, butter/margarine, sugary drinks, commercial sweets and sofrito according to recommendations. Less than 50% of the participants consumed fruits, nuts, fish and wine according to the MedDiet standards. More men consumed fruits (55.1%), wine (21%), fish (29%) and nuts (48.5%) than women according to the MedDiet recommendations; however, more women consumed legumes (69.7%) and Sofrito (88.4%) than men, in addition more women preferred consuming chicken over meat (72.3%). Originality/value The findings call for an urgent need of spreading national awareness among adult population in Lebanon to increase the adherence to MedDiet. To add, information gained from this study serve to help understanding nutritional behavior during the COVID-19 pandemic and the economic crisis, so public health authorities can start planning to save the threatened health-care system and preserve the wellness of the population.

Efficacy of L-Arabinose in Lowering Glycemic and Insulinemic Responses: The Modifying Effect of Starch and Fat

L-arabinose is a bio-active compound derived from the side-streams of plant food processing. L-arabinose lowers glycemic and insulinemic responses when added to simple water-based sugary liquids. However, the effect in more complex foods, including fat and starch, is inconsistent. This study assessed the effect of fat or starch in a sugary drink on the efficacy of L-arabinose. Twenty-three healthy volunteers (12 female/11 male; aged 24 ± 3 years; BMI 23 ± 3 kg/m2) participated in a randomised cross-over trial with six drinks: control: 50 g sucrose in water; fat: control + 22 g oil; starch: control + 50 g starch; and all three with and without the addition of 5 g L-arabinose. The addition of L-arabinose to the control drink lowered glucose and insulin peaks by 15% and 52%; for the fat drink by 8% and 45%; and for the starch drink by 7% and 29%. For all three drinks, adding L-arabinose increased glucagon-like peptide 1 (GLP-1) responses and lowered Glucose-dependent insulinotropic polypeptide (GIP) responses. Despite adding large quantities of starch and fat to sugary drinks, L-arabinose significantly lowered postprandial glycemic and insulinemic responses in healthy subjects. These findings suggest that L-arabinose can be functional in more complex foods; however, the factors affecting its efficacy in solid food matrices need to be studied in more detail.

Food consumption of children from zero to 23 months in a Brazilian municipality

Objective: to identify the frequency of food consumption in children aged zero to 23 months. Methods: this analytical research with a quantitative approach was conducted with 911 mothers/guardians of children aged under 23 months. In data collection, sociodemographic information and information on the frequency of food consumption of the child in the last 24 hours were obtained through a questionnaire of food consumption markers from SISVAN. Results: more than two-thirds of the participants reported having offered inappropriate foods for the child's age the day before. Among children under six months of age, inadequate food consumption had a prevalence of 38.3%. In the age group from 6 to 23 months, this frequency of consumption was 88.4%. The most inappropriate foods consumed by children under six months of age were water/tea, fruit, and salty foods. Between the ages of six and 23 months, the consumption of non-breast milk, sugary drinks, stuffed biscuits, sweets, and candies predominated. Conclusion: the consumption of inappropriate foods for age was highly prevalent, especially in children above six months old.

Electoral campaign contributions: an obstacle to health-related sugary drinks regulation in Brazil? The case of the Chamber of Deputies

Objective: To assess corporate electoral campaign contributions from industries related to sugary drinks production and the characteristics of the elected officials financed by the sector. Design: Cross-sectional analysis of electoral campaign contributions from corporations related to sugary drinks production (sugary drink industries and sugary drink input industries) to candidates to the Chamber of Deputies, Brazil. Setting: Elections to the 55th Congress (2015-2019), held in October 2014. Participants: Candidates to the Chamber of Deputies, Brazil. Results: Forty-nine companies or corporate groups that produce sugary drinks and 52 corporations that produce inputs for sugary drinks manufacturing contributed to electoral campaigns of candidates in the 2014 Election. Contributions from this industry sector represented 7.3% of all corporate contributions and helped finance 11.7% of the candidates and 46.2% of the elected officials. The transnationals Ambev and Coca-Cola were the first and second biggest donors, respectively. Revenues mediated by political parties, from sugary drink industries, and from corporate members of some industry associations (Abir, Unica and CitrusBR) were more prevalent. Among elected officials, a significant association was found between being financed by the sector and representing the Southeast region, having higher education level and referring themselves as being professional politicians. In the multivariate model, financed candidates were 27% more likely to be elected. Conclusions: Corporations related to sugary drinks production have contributed to the electoral campaigns of almost half of the Federal Deputies in Brazil in 2014. This possibly facilitates access to decision-makers and could help buy influence on legislative proposals, including health-related food policies.

Public Acceptability of Policy Interventions to Reduce Sugary Drink Consumption in Urban Vietnam

This study aims to assess the public acceptability of interventions to reduce sugary drinks in Vietnam, identify the key determinants, and develop a classification of consumers. A cross-sectional survey with 263 urban consumers evaluated perceptions of four potential interventions: restricting choice, taxation, nudging, and labeling. Thereby, specific attention was devoted to perceived intrusiveness and (personal and societal) effectiveness, as well personal characteristics, including Confucius values. Results showed that “hard” interventions like taxation are less acceptable to consumers than “soft” measures such as labeling. Acceptability is generally affected by perceived intrusiveness and effectiveness (especially on other people in the society), while other factors (sugary drink behavior, trust in government’s competence, personal values, age, education) only matter for some of the interventions. Cluster analysis revealed three consumer segments, depicted as anti-taxation (28%), pro-intervention (20%) and pro-labeling (52%), which further underpins the heterogeneity of intervention acceptability.

Changes in the Lifestyle in Spanish University Population during the Confinement for COVID-19

(1) Background: The aim of this study was to evaluate the influence of the lockdown due to COVID-19 pandemic, eating and physical activity behaviours, in a University population. A healthy diet such as the Mediterranean Diet (MD) pattern, rich in fruit and vegetables can prevent degenerative diseases such as obesity, diabetes, cardiovascular diseases, etc. (2) Methods: We conducted a cross-sectional study, data were collected by an anonymous online questionnaire. Participants completed a survey consisting of 3 sections: sociodemographic data; dietary and physical activity behaviour; questionnaire of the Mediterranean Diet (MEDAS-14) and the emotional eater questionnaire Garaulet (EEQ). (3) Results: A total of 168 participants completed the questionnaire 66.7% women, from Spain 79.2%, 76.8% students, living in family home 76.2% and in normal weight 66.1% . Our population did the grocery 1 or less per week (76.8%); decreased or stay the same the consumption of fruits (57.1%), vegetables (58.9%), dairy products (74.4%), pulses (73.2%), fish/seafood (76.8%), white meat (83.3%), red and processed meat (91.1%), snacks (78.6%), rice/pasta/potatoes (78.6%), nuts (83.9%), low alcohol drinks (89.3%), spirits (98.8%) and sugary drinks (91.7%) . Increased cooking time (73.2%) and decreased or stay the same their physical activity (63.7%). University Employees increased more weight (1.01&plusmn;0.02) than students (0.99&plusmn;0.03) (p&lt;0.05). 79.8% of the participant obtained a Medium/High Adherence to the MD. Emotional and very emotional eaters were higher in women group (p&lt;0.01). (4) Conclusions: In the event of further confinement, strategies should be implemented to promote a balanced and healthy diet together with the practice of physical activity, taking special care of the group of women and University Employees.

Intake of Free Sugars and Main Food Category Contributors among French Children, Adolescents and Adults

A high intake of free sugars (FS) is assumed to be associated with overweight and obesity as well as type 2 diabetes mellitus and cardiovascular diseases. Therefore, the World Health Organization (WHO) recommends an intake of FS of less than 10% of daily total energy intake (TEI). The purpose of this study was to update the FS intake data for the French population, including children and adolescents as well as adults, based on the 2019 French Food Behavior and Consumption survey (CCAF). FS intakes were assessed at 67 g/day (15.3% of TEI) in children and adolescents as well as 57 g/day (10.5% of TEI) in adults. The main FS contributors were cakes/pastries, sugary drinks and fruit juices in children as well as sugary products, cakes/pastries and fruit juices in adults. The contribution of FS intakes to TEI fell with age, from 15.6% of TEI in 3–6 years children to around 8–9% for adults older than 50 years. On average, children were above the WHO recommendation of FS intake, but adults were close to or even below the threshold of 10% TEI. These observations are of great importance to prospective public health activities focusing on changes in FS intakes.

Development and Preliminary Feasibility of iByte4Health: A Mobile Health (mHealth) Pediatric Obesity Prevention Intervention to Engage Parents with Low-Income of Children 2–9 Years

This research describes the development and preliminary feasibility of iByte4Health, a mobile health (mHealth) obesity prevention intervention designed for parents with a low-income of children 2–9 years of age. Study 1 (n = 36) presents findings from formative work used to develop the program. Study 2 (n = 23) presents a 2-week proof-of-concept feasibility testing of iByte4Health, including participant acceptability, utilization, and engagement. Based on Study 1, iByte4Health was designed as a text-messaging program, targeting barriers and challenges identified by parents of young children for six key obesity prevention behaviors: (1) snacking; (2) physical activity; (3) sleep; (4) sugary drinks; (5) fruit and vegetable intake; and (6) healthy cooking at home. In Study 2, participants demonstrated high program retention (95.7% at follow-up) and acceptability (90.9% reported liking or loving the program). Users were engaged with the program; 87.0% responded to at least one self-monitoring text message; 90.9% found the videos and linked content to be helpful or extremely helpful; 86.4% found text messages helpful or extremely helpful. iByte4Health is a community-informed, evidenced-based program that holds promise for obesity prevention efforts, especially for those families at the increased risk of obesity and related disparities. Future work is warranted to test the efficacy of the program.

An in-depth multidimensional review of hypertension in adolescents in relation to obesity: Risk approach management is the solution

Background: The emergence of isolated high blood pressure (HBP) among adolescents and its relation to obesity needs to be investigated. Aim: This study aims to assess prevalence, underlying risk factors, and consequences of HBP among adolescents in Egypt. Methods: We consolidated findings from three studies. The first one examined 150 adolescents (age: 16–18 years) for HBP and obesity using body mass index (BMI); the second one studied 150 adolescents for the lifestyle risk factors in relation to depression, anxiety, general health score, and suicidal score (SS) using relevant tools; the third one was a nested case–control study of 60 obese versus 60 non-obese adolescents examined for HBP, BMI, lifestyles and dietary habits, biochemical markers as lipid profile, fasting blood sugar (FBS), insulin, and homeostatic model assessment for insulin resistance (HOMA-IR). Results: In Stage I, the prevalence of HBP was 8% of whom, 58.3% were obese. Stage II: Dietary risk behavior as junk foods (high in salt) and soft drinks was 75.3% and 80%, respectively, and was linked with a high SS. Smoking was associated with a high anxiety score (p<0.05) and not playing sports with a higher depression score (p<0.05). The nested case–control study for obese versus non-obese showed that HBP (both systolic and diastolic) was significantly higher in the obese. Consumption of junk foods, sugary drinks, and inactivity was significantly higher in the obese (p<0.05). Lipid profile, FBS, fasting insulin, and HOMA-IR were significantly higher in the obese group versus non-obese control group (p<0.05). Conclusion: Lifestyle and unhealthy diet are the underlying cause of HBP, obesity, and mental health problems including SS, atherosclerosis, and high FBS. Increasing awareness about risk factors and using them in clinical practice for early detection of HBP is recommended.

Sugary drink consumption and risk of kidney and bladder cancer in Japanese adults

Globally, sugary drinks are widely consumed, however, few epidemiologic studies have investigated the association between sugary drink consumption and risk of kidney and bladder cancer. We examined the association of sugary drinks with risk of kidney and bladder cancer in 73,024 participants from the Japan Public Health Center-based Prospective Study who reported no history of cancer. Sugary drink consumption was assessed using a validated food frequency questionnaire at study baseline (1995–1999). Individuals were followed to December 31, 2013. Multivariable Cox proportional hazards regression models were used to calculate hazard ratios (HR) and 95% confidence intervals (CIs). During 1,069,815 person years of follow-up, 169 kidney cancer and 297 bladder cancer cases were documented. After adjusting for potential confounders, no greater risk of kidney and bladder cancer was observed. However, sugary drink consumption was positively associated with the risk of kidney cancer (HR for 100 ml/day increase in consumption was 1.11 [95% CI 1.01–1.22]) and bladder cancer (HR for 100 ml/d increase in consumption was 1.11 [95% CI 1.01–1.22]) among women after exclusion of cases diagnosed in the first three years of follow-up. In this large prospective cohort, consumption of sugary drinks was significantly associated with a small increase in hazard ratio for kidney and bladder cancer among women after exclusion of cases diagnosed within the first three years.