Springer Science and Business Media LLC

Over the recent past, there has been an increase in nutrition information available to adolescents from various sources, which resulted into confusion and misinterpretation of the dietary advice. Results from international assessment frameworks such as PISA and TIMMS reflect the need for adolescents to critically appraise health information. While a number of scales measuring the critical health literacy of individuals exist; very few of these are devoted to critical nutrition literacy. More so, these scales target individuals with an advanced level of nutrition education, often gaging their proficiency in information appraisal in relation to principles of evidence-based medical research. The purpose of the present study was to examine the psychometric properties of a newly developed critical nutrition literacy scale (CNL-E) measuring adolescents’ perceived proficiency in ‘critically evaluating nutrition information from various sources’. During spring 2015, more than 1600 tenth graders aged 15–16 years from approximately 60 schools in Norway responded to the five-item questionnaire using an electronic survey system. Applying Rasch analysis approach, we examined the psychometric properties of the CNL-E scale employing the RUMM2030 statistical package. To further investigate the dimensionality of the scale and test the underlying structure, we applied multidimensional Rasch modelling using the ConQuest 4 software and confirmatory factor analysis (CFA) using the Lisrel 9.30 software. In our sample, the CNL-E stood out as a valid, reliable and well-targeted scale with good overall fit to the partial credit parameterization of the polytomous unidimensional Rasch model (PCM). All the items were sufficiently statistically independent, had ordered response categories and showed acceptable individual fit to the PCM. No item displayed within-item bias or differential item functioning (DIF). From the observed CNL-E sum score, it is possible to draw plausible conclusions about how individuals critically evaluate nutrition information. Efforts to improve communication of nutrition information could benefit from applying validated measures such as the CNL-E scale. The CNL-E scale provides insight into how individuals without an advanced level of nutrition education, such as adolescents, determine the validity and reliability of nutrition information from various sources.

While there are number of frameworks which focus on supporting the implementation of evidence based approaches, few psychometrically valid measures exist to assess constructs within these frameworks. This study aimed to develop and psychometrically assess a scale measuring each domain of the Theoretical Domains Framework for use in assessing the implementation of dietary guidelines within a non-health care setting (childcare services). A 75 item 14-domain Theoretical Domains Framework Questionnaire (TDFQ) was developed and administered via telephone interview to 202 centre based childcare service cooks who had a role in planning the service menu. Confirmatory factor analysis (CFA) was undertaken to assess the reliability, discriminant validity and goodness of fit of the 14-domain theoretical domain framework measure. For the CFA, five iterative processes of adjustment were undertaken where 14 items were removed, resulting in a final measure consisting of 14 domains and 61 items. For the final measure: the Chi-Square goodness of fit statistic was 3447.19; the Standardized Root Mean Square Residual (SRMR) was 0.070; the Root Mean Square Error of Approximation (RMSEA) was 0.072; and the Comparative Fit Index (CFI) had a value of 0.78. While only one of the three indices support goodness of fit of the measurement model tested, a 14-domain model with 61 items showed good discriminant validity and internally consistent items. Future research should aim to assess the psychometric properties of the developed TDFQ in other community-based settings.

Applying self-regulation strategies have proven important in eating behaviors, but it remains subject to investigation what strategies adolescents report to use to ensure healthy eating, and adequate measures are lacking. Therefore, we developed and validated a self-regulation questionnaire applied to eating (TESQ-E) for adolescents. Study 1 reports a four-step approach to develop the TESQ-E questionnaire (n = 1097). Study 2 was a cross-sectional survey among adolescents from nine European countries (n = 11,392) that assessed the TESQ-E, eating-related behaviors, dietary intake and background characteristics. In study 3, the TESQ-E was administered twice within four weeks to evaluate test-retest reliability (n = 140). Study 4 was a cross-sectional survey (n = 93) that assessed the TESQ-E and related psychological constructs (e.g., motivation, autonomy, self-control). All participants were aged between 10 and 17 years. Study 1 resulted in a 24-item questionnaire assessing adolescent-reported use of six specific strategies for healthy eating that represent three general self-regulation approaches. Study 2 showed that the easy-to-administer theory-based TESQ-E has a clear factor structure and good subscale reliabilities. The questionnaire was related to eating-related behaviors and dietary intake, indicating predictive validity. Study 3 showed good test-retest reliabilities for the TESQ-E. Study 4 indicated that TESQ-E was related to but also distinguishable from general self-regulation and motivation measures. The TESQ-E provides a reliable and valid measure to assess six theory-based self-regulation strategies that adolescents may use to ensure their healthy eating.

The inactivity physiology paradigm proposes that sedentary behaviors, including sitting too much, are independent of the type of physical activity delineated for health in the Physical Activity Guidelines for Americans. Thus, we hypothesized that, when accounting for behaviors across the entire day, variability in the amount of time spent sitting would be independent of the inter-and intra-individual time engaged in sustained moderate-to-vigorous physical activity (MVPA). Ninety-one healthy women, aged 40–75 years, completed a demographic questionnaire and assessment of height and weight. Participants wore the activPAL activity monitor for one week and time (minutes/day) spent sitting, standing, stepping, and in sustained bouts (bouts ≥10 minutes) of MVPA were quantified. The women were then stratified into groups based on weekly sustained MVPA. Additionally, each day of data collection for each participant was classified as either a “sufficient” MVPA day (≥ 30 min of MVPA) or an “insufficient” MVPA day for within-participant analyses. Time spent sitting, standing, and in incidental non-exercise stepping averaged 64, 28, and 11 hrs/week, respectively, and did not differ between groups with individuals meeting/exceeding the current exercise recommendation of 150 min/week of sustained MVPA in ≥10 minutes bouts (M = 294 min/week, SD = 22) compared to those with none or minimal levels (M= 20min/week, SD = 4). Time spent sitting (M = 9.1 hr/day, SD = 0.19 vs. M = 8.8 hr/day, SD = 0.22), standing (M = 3.9 hr/day, SD = 0.16 vs. M = 3.9 hr/day, SD = 0.15), and in intermittent stepping (M = 1.6 hr/day, SD = 0.07 vs. M = 1.6 hr/day, SD = 0.06) did not differ between days with (~55 min/day) and without recommended MVPA. This study provides the first objective evidence that participation in sustained MVPA is unrelated to daily sitting duration in relatively healthy, middle and older-aged women. More research is needed to extend these findings to other populations and to inform distinct behavioral recommendations focused on sedentary time.

Given the worldwide prevalence of overweight and obesity, there is a clear need for meaningful practical healthy eating advice - not only in relation to food choice, but also on appropriate food portion sizes. As the majority of portion size research to date has been overwhelmingly quantitative in design, there is a clear need to qualitatively explore consumers’ views in order to fully understand how food portion size decisions are made. Using qualitative methodology this present study aimed to explore consumers’ views about factors influencing their portion size selection and consumption and to identify barriers to appropriate portion size control. Ten focus groups with four to nine participants in each were formed with a total of 66 persons (aged 19–64 years) living on the island of Ireland. The semi-structured discussions elicited participants’ perceptions of suggested serving size guidance and explored the influence of personal, social and environmental factors on their food portion size consumption. Audiotapes of the discussions were professionally transcribed verbatim, loaded into NVivo 9, and analysed using an inductive thematic analysis procedure. The rich descriptive data derived from participants highlight that unhealthy portion size behaviors emanate from various psychological, social and behavioral factors. These bypass reflective and deliberative control, and converge to constitute significant barriers to healthy portion size control. Seven significant barriers to healthy portion size control were apparent: (1) lack of clarity and irrelevance of suggested serving size guidance; (2) guiltless eating; (3) lack of self-control over food cues; (4) distracted eating; (5) social pressures; (6) emotional eating rewards; and (7) quantification habits ingrained from childhood. Portion size control strategies should empower consumers to overcome these effects so that the consumption of appropriate food portion sizes becomes automatic and habitual.

Picky eating is prevalent in childhood and is associated with negative health outcomes. Therefore early detection of pickiness is pertinent. Because no psychometric measure of picky/fussy eating has been validated, we aimed to examine the screening efficiency of the 6-item ‘Food Fussiness’ (FF) scale from the Children’s Eating Behavior Questionnaire using structured psychiatric interviews (the Preschool Age Psychiatric Interview), providing meaningful cut-off values based on a large, representative sample of Norwegian 6 year olds (n = 752). Screening efficiency was evaluated using receiver operating characteristic curve analysis, revealing excellent discrimination. The cut-point maximizing the sum of sensitivity and specificity for the scale was found at a score of 3.33 for severe cases and 3.00 when both moderate and severe pickiness were included. The results suggest that the FF scale may provide a tool for identification of clinically significant picky eating, although further assessment may be needed to separate moderate from severe cases.

Các nghiên cứu về mối liên hệ giữa đồ uống có ga và nguy cơ ung thư đã cho ra những kết quả không nhất quán. Chưa có bất kỳ bài tổng quan hệ thống và phân tích tổng hợp nào công bố trước đây điều tra mối liên hệ theo liều lượng giữa mức độ tiếp xúc và nguy cơ ung thư hoặc đánh giá độ tin cậy của những chứng cứ hiện có. Do đó, chúng tôi đặt mục tiêu chứng minh các mối liên hệ và đánh giá độ chắc chắn của chứng cứ để thể hiện sự tự tin của chúng tôi vào những mối liên hệ này. Chúng tôi đã tìm kiếm trên các cơ sở dữ liệu Embase, PubMed, Web of Science, và Thư viện Cochrane từ khi bắt đầu đến tháng 6 năm 2022, để đưa vào các nghiên cứu đoàn hệ triển vọng liên quan. Chúng tôi đã sử dụng mô hình spline hình khối hạn chế để thực hiện phân tích tổng hợp theo liều lượng và tính toán các ước lượng tác động tuyệt đối để trình bày kết quả. Phương pháp đánh giá, phát triển và đánh giá khuyến nghị (GRADE) được sử dụng để đánh giá độ tin cậy của chứng cứ. Bốn mươi hai bài báo, bao gồm 37 đoàn hệ, đã tuyển sinh 4.518.547 người tham gia được đưa vào. Với chứng cứ độ tin cậy thấp, việc tiêu thụ tăng lên 250 mL/ngày đồ uống có đường (SSBs) có liên quan đáng kể với nguy cơ ung thư vú cao hơn 17%, nguy cơ ung thư đại trực tràng cao hơn 10%, nguy cơ ung thư đường mật cao hơn 30% và nguy cơ ung thư tiền liệt tuyến cao hơn 10%; việc tiêu thụ tăng lên 250 mL/ngày đồ uống ngọt nhân tạo (ASBs) có liên quan đáng kể với nguy cơ bệnh bạch cầu cao hơn 16%; việc tiêu thụ nước trái cây 100% tăng lên 250 mL/ngày có liên quan đáng kể với nguy cơ ung thư tổng quát cao hơn 31%, nguy cơ u hắc tố cao hơn 22%, nguy cơ ung thư biểu mô tế bào vảy cao hơn 2% và nguy cơ ung thư tuyến giáp cao hơn 29%. Các mối liên hệ với những loại ung thư cụ thể khác là không đáng kể. Chúng tôi đã tìm thấy mối liên hệ theo liều lượng tuyến tính giữa việc tiêu thụ SSB và nguy cơ ung thư vú và thận, và giữa việc tiêu thụ ASB và nước trái cây 100% với nguy cơ ung thư tụy. Một sự gia tăng tiêu thụ SSB 250 mL/ngày có liên quan tích cực với nguy cơ ung thư vú, đại trực tràng và ung thư đường mật. Tiêu thụ nước trái cây cũng có liên quan tích cực với nguy cơ ung thư tổng quát, ung thư tuyến giáp và u hắc tố. Tuy nhiên, mức độ tác động tuyệt đối là nhỏ và chủ yếu dựa trên độ chắc chắn thấp hoặc rất thấp của chứng cứ. Mối liên hệ giữa việc tiêu thụ ASB với nguy cơ ung thư cụ thể là không chắc chắn. PROSPERO: CRD42020152223

Descriptive norms (what other people do) relate to individual-level dietary behaviour and health outcome including overweight and obesity. Descriptive norms vary across residential areas but the impact of spatial variation in norms on individual-level diet and health is poorly understood. This study assessed spatial associations between local descriptive norms for overweight/obesity and insufficient fruit intake (spatially-specific local prevalence), and individual-level dietary intakes (fruit, vegetable and sugary drinks) and 10-year change in body mass index (BMI) and glycosylated haemoglobin (HbA1c). HbA1c and BMI were clinically measured three times over 10 years for a population-based adult cohort (n = 4056) in Adelaide, South Australia. Local descriptive norms for both overweight/obesity and insufficient fruit intake specific to each cohort participant were calculated as the prevalence of these factors, constructed from geocoded population surveillance data aggregated for 1600 m road-network buffers centred on cohort participants’ residential addresses. Latent growth models estimated the effect of local descriptive norms on dietary behaviours and change in HbA1c and BMI, accounting for spatial clustering and covariates (individual-level age, sex, smoking status, employment and education, and area-level median household income). Local descriptive overweight/obesity norms were associated with individual-level fruit intake (inversely) and sugary drink consumption (positively), and worsening HbA1c and BMI. Spatially-specific local norms for insufficient fruit intake were associated with individual-level fruit intake (inversely) and sugary drink consumption (positively) and worsening HbA1c but not change in BMI. Individual-level fruit and vegetable intakes were not associated with change in HbA1c or BMI. Sugary drink consumption was also not associated with change in HbA1c but rather with increasing BMI. Adverse local descriptive norms for overweight/obesity and insufficient fruit intake are associated with unhealthful dietary intakes and worsening HbA1c and BMI. As such, spatial variation in lifestyle-related norms is an important consideration relevant to the design of population health interventions. Adverse local norms influence health behaviours and outcomes and stand to inhibit the effectiveness of traditional intervention efforts not spatially tailored to local population characteristics. Spatially targeted social de-normalisation strategies for regions with high levels of unhealthful norms may hold promise in concert with individual, environmental and policy intervention approaches.