Journal of Health, Population, and Nutrition最新文献

{"title":"The effect of nutrition education and counseling on the nutritional status of pregnant women in Ethiopia, 2025: a systematic review and meta-analysis.","authors":"Samuel Dagne Chanie, Werkneh Melkie Tilahun, Yonatan Menber, Yosef Wasihun, Zenebe Abebe Gebreegziabher, Zewudu Andualem, Ayenew Takele Alemu, Azeb Geddif, Genet Gedamu Kassie, Kalkidan Worku Mitiku, Mahider Awoke Belay, Mulat Belay Simegn","doi":"10.1186/s41043-025-01047-2","DOIUrl":"10.1186/s41043-025-01047-2","url":null,"abstract":"<p><strong>Objectives: </strong>This systematic review and meta-analysis aimed to evaluate the effect of nutrition education and counseling on the nutritional status of pregnant women in Ethiopia, to guide future public health efforts.</p><p><strong>Study design: </strong>Systematic review and meta-analysis.</p><p><strong>Method: </strong>Online databases, including PubMed, Scopus, Cochrane Library, Embase, and Google Scholar, were searched from 2014 up to December 2024. The review was conducted following PRISMA 2020 guidelines. Sub-group analysis, the I² test, funnel plot, and Egger's test were performed. A weighted mean difference was used to measure the outcome.</p><p><strong>Result: </strong>Nine studies were included in the analysis. nutritional interventions significantly improved mid-upper arm circumference in the intervention group compared to the control group (mean difference = 0.75, 95% confidence interval: 0.37, 1.13). Community-based interventions showed greater effectiveness (mean difference = 1.03, 95% CI 0.66, 1.41), and interventions lasting 6 months or more were more impactful (mean difference = 0.75, 95% CI 0.37, 1.13). Medium-intensity counseling also yielded better results than high-intensity counseling (mean difference = 0.76, 95% CI 0.28, 1.24). Individual-based interventions had a larger effect (mean difference = 0.98, 95% CI 0.17-1.78) compared to group-based ones (mean difference = 0.64, 95% CI 0.20-1.08). Theory-based counseling significantly improved mid-upper arm circumference (mean difference = 0.99, 95% CI 0.58, 1.40).</p><p><strong>Conclusion: </strong>Nutrition education has a significant positive impact on the nutritional status of pregnant women, with the most effective results observed in community-based settings, extended interventions, medium-intensity counseling, individualized approaches, and theory-driven frameworks. PROSPERO registration number: CRD42025638888.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":"44 1","pages":"334"},"PeriodicalIF":2.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Both body roundness index and the body mass index increase the prevalence of stroke but reduce the risk of all-cause mortality.","authors":"Yaying Xu, Lele Chen, Jianqiang Zhang","doi":"10.1186/s41043-025-01052-5","DOIUrl":"10.1186/s41043-025-01052-5","url":null,"abstract":"<p><strong>Background and objective: </strong>Obesity is a risk factor for stroke. The Body Roundness Index (BRI) is a new obesity indicator based on the eccentricity theory and combined with height and waist circumference, which reflects the level of visceral fat more accurately than traditional indicators. However, its association with stroke remains unclear. This study aims to compare the associations of the BRI and body mass index (BMI) with stroke and its prognosis.</p><p><strong>Methods: </strong>The data of 29,745 participants in the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2018 were analyzed. Based on weighted logistic regression, weighted COX regression, and restricted cubic spline, the associations of BRI and BMI with the odds of stroke and the risk of all-cause mortality were analyzed; the receiver operating characteristic (ROC) curve and concordance index were used to evaluate the performance of BRI and BMI in predicting stroke and Survival outcome.</p><p><strong>Results: </strong>After adjusting for all confounding factors, weighted logistic regression and weighted Cox regression respectively showed that both BRI (odds ratio [OR]: 1.06, 95% confidence interval [CI]: 1.02-1.10, P = 0.004) and BMI (OR: 1.01, 95%CI 1.00-1.03, P = 0.03) were independently and positively associated with stroke. Meanwhile, both BRI (hazard ratio [HR]: 0.91, 95%CI 0.86-0.98, P = 0.01) and BMI (HR: 0.95, 95%CI 0.92-0.97, P < 0.0001) significantly reduced the risk of all-cause mortality among stroke survivors. The receiver operating characteristic (ROC) curve showed that the area under the curve (AUC) of BRI for predicting stroke was 0.62, while that of BMI was 0.545, and the difference between the two was significant (P_DeLong < 0.001). The time-dependent c-index curve demonstrated that BRI and BMI had comparable abilities to predict the risk of all-cause mortality among stroke survivors.</p><p><strong>Conclusion: </strong>Both the BRI and the BMI have verified the obesity and stroke paradox. BRI and the BMI are significantly positively correlated with stroke, and the BRI has a stronger ability to predict stroke than the BMI; however, both the BRI and the BMI are significantly negatively correlated with the prognosis of stroke survivors and have comparable predictive abilities.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":"44 1","pages":"340"},"PeriodicalIF":2.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of dietary acid load with abdominal adiposity based on traditional and novel anthropometric indices.","authors":"Niloufar Abdollahpour, Farima Farsi, Glareh Koochackpoor, Hossein Hatamzadeh, Habibollah Esmaily, Mahdieh Zarif Sadeghian, Gordon A Ferns, Najmeh Seifi, Majid Ghayour-Mobarhan","doi":"10.1186/s41043-025-01068-x","DOIUrl":"10.1186/s41043-025-01068-x","url":null,"abstract":"<p><strong>Background: </strong>Central or visceral adiposity is associated with metabolic syndrome and related health problems. The association of dietary acid load (DAL) with body mass index (BMI) and waist circumference (WC) has been studied in a few previous studies. We aimed to investigate the association of dietary acidity with abdominal obesity which was assessed using traditional and more novel indices.</p><p><strong>Methods: </strong>In this cross-sectional study, a total of 6482 participants aged 35-65 years were recruited as part of the MASHAD cohort study. Dietary intakes were assessed using a validated food frequency questionnaire. Dietary acid load was assessed as the potential renal acid load (PRAL), net endogenous acid production (NEAP), and DAL. Central obesity was defined as a WC ≥ 94 cm in men and 80 cm in women, waist-hip ratio (WHR) ≥ 0.9 in men, and 0.85 in women, and body shape index (ABSI) and abdominal volume index (AVI) above the median. Multivariable logistic regression models were applied to determine the association between diet-based acid load scores and abdominal obesity.</p><p><strong>Results: </strong>In the crude and age-adjusted models for women, higher levels of NEAP were related to an increased risk of central obesity, as measured by WC and WHR. For women, NEAP was associated with an increased odds of central obesity based on ABSI in the full-adjusted model (odds ratios (ORs) and 95% confidence intervals (CIs): 1.234 (1.045-1.456)). In both gender groups, higher levels of DAL were related to increased chances of central obesity based on WC, WHR and AVI across all models. However, the multiple logistic regression ORs and 95% CIs for abdominal adiposity indices across levels of PRAL showed no significant association in the fully adjusted model.</p><p><strong>Conclusion: </strong>Our findings suggest that a higher dietary acid measured by NEAP and DAL load may contribute to an increased risk of abdominal obesity. Notably, this effect appears to be more pronounced in women.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":"44 1","pages":"333"},"PeriodicalIF":2.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between Helicobacter pylori infection and diabetes mellitus: an updated meta-analysis of 45 case-control studies.","authors":"Hooman Hadianfard, Ramyar Rahimi Darehbagh, Kimya Ahmadpooryan, Parvin Mohamadi, Yousef Moradi","doi":"10.1186/s41043-025-01088-7","DOIUrl":"10.1186/s41043-025-01088-7","url":null,"abstract":"<p><strong>Background: </strong>Helicobacter pylori (H. pylori) infection is linked to various gastrointestinal and systemic diseases, including diabetes mellitus (DM). This study synthesizes evidence to determine the association between H. pylori infection and the risk of developing DM.</p><p><strong>Objectives: </strong>To quantify the odds ratio (OR) of DM in individuals with H. pylori infection and explore variations across different subgroups.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted following PRISMA 2020 guidelines. Databases including Medline, Web of Science, Scopus, EMBASE, Ovid, and CINHAL were searched for case-control studies from January 1990 to January 2025. Eligible studies investigated the association between H. pylori and DM. Data extraction was performed independently by two reviewers, and study quality was assessed using the Modified Newcastle-Ottawa Scale (NOS). Random-effects models were utilized to calculate pooled ORs, with heterogeneity assessed via I² statistic. Subgroup analyses included H. pylori detection methods, age groups, geographic regions, DM types, HbA1c levels, duration of DM, and study quality.</p><p><strong>Results: </strong>From 280 records, 45 case-control studies were included, involving 529 million diabetes cases worldwide in 2021. The pooled OR was 1.547 (95% CI: 1.243-1.926), indicating that H. pylori infection increases the risk of DM by approximately 1.56 times. Heterogeneity was moderate (I² = 46.03%). Subgroup analyses showed stronger associations with non-invasive H. pylori detection methods (OR = 1.99), in the 40-60 age group (OR = 2.00), and for type 2 diabetes (OR = 2.25). Geographic variations were significant, with Asia showing the highest OR (2.17). No significant publication bias was detected, and sensitivity analyses confirmed the robustness of our findings.</p><p><strong>Conclusion: </strong>This meta-analysis confirms a significant association between H. pylori infection and an increased risk of DM, particularly type 2. The findings underscore the potential benefits of considering H. pylori testing in diabetes management strategies, especially in high-risk populations. Further research should focus on longitudinal studies to establish causality and explore biological mechanisms.</p><p><strong>Registration: </strong>This review was registered in PROSPERO (CRD42025637126).</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":"44 1","pages":"330"},"PeriodicalIF":2.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of south Asian food pattern in calorie restriction diet among young adults with overweight and obesity in Dhaka city- a randomized controlled trial.","authors":"A K Obidul Huq, Joyce Proggya Biswas, Umme Sabiha Farshi, Umme Batul, Jiniya Sanam Mim, Nargis Akhter Jahan","doi":"10.1186/s41043-025-01065-0","DOIUrl":"10.1186/s41043-025-01065-0","url":null,"abstract":"<p><strong>Objectives: </strong>As prevalence of obesity is emerging in urban settings of Bangladesh, the study aims to investigate the effects of calorie-restriction (CR) diet in weight reduction by applying the local South Asian dietary pattern.</p><p><strong>Methodology: </strong>An 8-weeks randomized controlled trial among 120 young adults aged 18-35 year with overweight and obesity from Dhaka city were randomized where 60 participants were in a calorie-restriction diet group with South Asian food pattern, and the rest in a control group followed an ad libitum diet without any dietary counselling for 8 weeks. Participants underwent weight measurement at two weeks' intervals to determine the change in body weight with continuous weight loss motivation and rearranged meal plans to avoid repetition.</p><p><strong>Results: </strong>Mean 2.47 kg (95% CI: 1.94, 3.01; p < 0.001) weight reduction in CR group (n = 58; 2 dropouts) group and mean 0.313 kg (95% CI: -0.36,0.053; p < 0.142) weight gain in control (n = 60) group was observed. The Body Mass Index dropped from mean 26.68 kg/m² (95% CI: 26.02,27.34; p < 0.001) to 25.65 kg/m² (95% CI: 24.99,26.32; p < 0.001) in the CR group.</p><p><strong>Conclusion: </strong>The results of this study of weight reduction intervention provide primary evidence of successful weight loss by following local food patterns. It is an attempt to evaluate the feasibility of South Asian diet in established dietary regime. Further studies on different biochemical parameters (e.g., lipid profile, glucose) and long-term trials in the South Asian region are recommended.</p><p><strong>Clinical trial registration: </strong>This trial is retrospectively registered at anzctr.org.au as ACTRN12625000219482 at 27th March, 2025.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":"44 1","pages":"332"},"PeriodicalIF":2.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of TORCH screening and prenatal risk assessment for childbearing-age women in different regions of China.","authors":"Yuan Zhang, Ya Zhang, Jing Wang, Li Lin, Jian Chai, Jinmei Liu, Junxi Zhang, Yongmei Gao, Panpan Sun, Chenglong Wang, Lifang Jiang, Daoxia Li, Yingwu Zhang, Xiaofen Gu, Chaoyu Zhang, Yuanyuan Wang, Xu Ma","doi":"10.1186/s41043-025-01084-x","DOIUrl":"10.1186/s41043-025-01084-x","url":null,"abstract":"<p><strong>Objective: </strong>By conducting TORCH screening and risk assessment analysis on childbearing-age women in different regions of China, the aim is to provide reference for reducing adverse pregnancy outcomes and improving the health status of childbearing-age women.</p><p><strong>Methods: </strong>Between February and May 2021, in the eastern, central, and western regions of China (Beijing, Henan, Gansu), a total of 1,942 couples aged 18 to 49, from both urban and rural areas, were included in this cross-sectional study. TORCH screening was conducted on all these women of childbearing-age, and risk assessment was performed based on the examination results.</p><p><strong>Result: </strong>In this study, toxoplasmosis, rubella, CMV, HSV, IgM positive rate were 0.2%, 0.4%, 0.3%, 0.3%, respectively, and CT, TP, HBsAg, HCV, HIV, positive rate were 0.1%, 0.2%, 2.1%, 0.3%, 0.0%, respectively. The total TORCH screening identified 63.4% of women as having potential risks, compared to 15.5% of routine ToRCH screening. The distribution of the risk population shows significant differences among provinces, ethnicities, education levels, and age groups (p ≤ 0.001). Trend chi-square tests revealed that as the level of education increased, the proportion of the risk population decreased.</p><p><strong>Conclusions: </strong>The TORCH screening utilized in this study demonstrates advantages over ToRCH, as it can identify more women of childbearing age with potential risks before pregnancy, allowing for early interventions. Simultaneously, these findings underscore the necessity for targeted health education, especially for young women in economically underdeveloped areas and those with relatively lower education levels.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":"44 1","pages":"331"},"PeriodicalIF":2.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cholera in Nigeria: a five-decade review of outbreak dynamics and health system responses.","authors":"Tolulope Joseph Ogunniyi, Amaka Perpetual Muoneke, Faith Nimo, Sarah Sokolabe Yisa, Oluwaloseyi Ayomipo Olorunfemi","doi":"10.1186/s41043-025-01096-7","DOIUrl":"10.1186/s41043-025-01096-7","url":null,"abstract":"<p><strong>Background: </strong>Cholera remains a significant public health concern in Nigeria, with recurrent outbreaks over the past five decades. Despite advancements in healthcare, the country continues to record high case fatality rates, largely due to inadequate water, sanitation, and hygiene (WASH) infrastructure, poor health systems, climate variability, and conflict-induced displacement.</p><p><strong>Objective: </strong>This review aimed to examine the historical trends of cholera in Nigeria, identify key drivers of outbreaks, evaluate government and international responses, and recommend strategic measures for prevention and control.</p><p><strong>Methods: </strong>A comprehensive analysis was conducted using historical outbreak data, peer-reviewed literature, and reports from national and international health agencies. The study focuses on outbreaks from 1970 to 2024, highlighting epidemiological trends, response strategies, and systemic challenges.</p><p><strong>Results: </strong>Cholera has persisted as an endemic disease in Nigeria, with major outbreaks recorded in 1991, 2010, and 2021. Case fatality rates often exceeded the World Health Organization's (WHO) recommended threshold of < 1%, indicating systemic deficiencies in outbreak response and healthcare delivery. Contributing factors include poor sanitation, limited access to clean water, underfunded healthcare infrastructure, and weak surveillance systems. Climate change and population displacement due to conflict have further exacerbated the risk of transmission.</p><p><strong>Conclusion: </strong>Nigeria's approach to cholera control remains reactive, with limited progress in sustainable prevention. Multi-sectoral strategies including improved WASH infrastructure, enhanced surveillance, local vaccine production, and community-based interventions are essential to achieving the WHO 2030 cholera elimination goals.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":"44 1","pages":"329"},"PeriodicalIF":2.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating socioeconomic influences on Nipah virus vaccination decisions in Bangladesh through machine learning.","authors":"Abu Zobayer, Md Mahmudul Hasan Riyad, Md Jaman Mia, K M Ariful Kabir","doi":"10.1186/s41043-025-01079-8","DOIUrl":"10.1186/s41043-025-01079-8","url":null,"abstract":"<p><p>Nipah virus (NiV) is emerging as a noteworthy public health threat in Bangladesh, with propagation transpiring across accidental person-to-person contact and proximity with contaminated food or animals. Addressing the socio-demographic elements impacting the awareness of NiV is essential for productive public health initiatives. This study explores the impact of socio-demographic characteristics on individuals' willingness to get vaccinated (WGTV) for the Nipah virus during an outbreak in Bangladesh and to develop optimal control strategies using machine learning techniques. A cross-sectional survey in Bangladesh examined socio-demographic factors, health conditions, and common misconceptions about vaccination, and statistical analysis was performed using chi-square tests to identify significant associations between demographic variables and vaccination willingness. Machine learning algorithms, including Random Forest (RF), Decision Tree (DT), and Extreme Gradient Boosting (XGBoost), were employed to predict vaccination willingness and determine feature importance. SHAP (Shapley Additive Explanations) analysis further validated the significance of these features in two distinct scenarios. We analyzed two distinct scenarios in this study. In the first scenario, we utilized all five categories for classification for WGTV, achieving a maximum accuracy of 60.83% with the Random Forest (RF) model. In the second scenario, to address the issue of class imbalance, we transformed the study into a binary classification problem, which significantly improved the model's performance, yielding the highest accuracy of 85% with the RF model. Notably, the model outputs were influenced by demographic parameters such as age and daily interactions, but their influence was mild compared to the predominant influence of socioeconomic characteristics. Analysis validated key predictors, highlighting socioeconomic factors like education and income as the most influential, while demographic factors such as age and gender had a milder effect. The findings underscore the importance of addressing socioeconomic disparities in public health efforts to boost immunization rates, offering valuable insights for policymakers to design targeted interventions and improve health outcomes.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":"44 1","pages":"328"},"PeriodicalIF":2.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing stroke survivors' knowledge: a scoping review of tools and influencing factors.","authors":"Allam Harfoush, Kausik Chatterjee, Hanady Hamdallah","doi":"10.1186/s41043-025-01046-3","DOIUrl":"10.1186/s41043-025-01046-3","url":null,"abstract":"<p><strong>Background: </strong>Stroke survivors' knowledge of their condition is essential for self-management and adherence to secondary prevention strategies. However, current methods for assessing stroke knowledge are not consistent. This scoping review aimed to review existing assessment tools, evaluate their characteristics, and identify factors associated with stroke knowledge to inform the development of more effective, patient-centred educational strategies.</p><p><strong>Review design and methods: </strong>A scoping review was conducted to evaluate existing methods used to assess stroke knowledge and the factors influencing patients' knowledge among stroke survivors. Systematic searches of PubMed, Cochrane, and CINAHL were performed from inception to June 2025. Studies assessing stroke survivors' knowledge were included. Data were extracted on tool characteristics, assessed themes, administration methods, readability, validation, and knowledge-associated factors. Findings were qualitatively synthesised.</p><p><strong>Results: </strong>Thirty-nine studies were included. Most studies assessed mixed cohorts of ischaemic, haemorrhagic, and TIAs. Stroke symptoms and risk factors were the most frequently assessed themes, while rehabilitation, medications, and lifestyle behaviours were less explored. Tools were primarily self-administered questionnaires, typically completed in under 15 min, but often lacked standardised cut-off values and demonstrated limited reporting of development processes. Factors positively associated with knowledge included higher education, younger age, and healthier lifestyles.</p><p><strong>Conclusion: </strong>Existing assessments of stroke survivors' knowledge have considerable variability, limited validation, and inconsistent alignment with survivors' information needs. Developing standardised, validated, and patient-centred assessment tools that are tailored to stroke type and accessible across literacy levels is essential for advancing stroke education and supporting long-term recovery. These findings can inform policymakers in tailoring education efforts and designing interventions that directly address knowledge gaps across diverse stroke survivor populations. Future research should prioritise longitudinal evaluation of knowledge and its impact on clinical outcomes.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":"44 1","pages":"327"},"PeriodicalIF":2.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145176095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Veggies4myHeart digital game: an educational tool to promote vegetable consumption in preschool children - a multicentre experimental study.","authors":"Cátia Braga-Pontes, Patrícia V Ferreira, Neuza Barros, Leonel Vieito, Marlene Lages, Sara Simões-Dias, Sophie Bucher Della Torre, Maria P Guarino","doi":"10.1186/s41043-025-01074-z","DOIUrl":"10.1186/s41043-025-01074-z","url":null,"abstract":"<p><strong>Background: </strong>Vegetable consumption as part of a balanced and diversified dietary pattern is associated with a lower risk of cardiovascular disease, cancer, and all-cause mortality. Even though the scientific evidence for these benefits is strong, the consumption of vegetables remains far below recommendations, especially in early childhood. Despite existing literature, the evidence on how to increase vegetable consumption in preschool children remains limited and the development and validation of new strategies should be pursued in varied contexts. The study presented herein aimed to compare the impact of educational sessions based on the serious game Veggies4myHeart and repeated exposure to vegetables on preschool children's willingness to taste them and also their nutrition knowledge, measured at baseline and post-intervention, in Portuguese and Swiss preschool children.</p><p><strong>Methods: </strong>The intervention was carried out in preschools with 39 Portuguese and 45 Swiss children, from 3 to 6 years old, in their preschools, between May 2019 and February 2021. Children participated in weekly 20-minute educational sessions for 5 weeks, delivered by trained nutritionists and incorporating the Veggies4myHeart digital game. Willingness to taste was assessed by offering the five raw vegetables in standard portions and recording whether each child tasted them at baseline, throughout the intervention, and post-intervention. Nutrition knowledge was assessed using three questionnaires applied before and after the intervention. Data were analysed using IBM SPSS software and statistical significance was set at p-value < 0.05.</p><p><strong>Results: </strong>Comparing the results between the two countries post-intervention, statistically significant differences were found in the willingness to taste lettuce, carrot, and red cabbage, with Portuguese children showing more willingness to taste these vegetables than Swiss children (p < 0,05). Improvements in nutrition knowledge, from baseline to post-intervention, were observed in both countries (p < 0,001), but without statistically significant differences between countries (p = 0.114).</p><p><strong>Conclusions: </strong>Despite differences in context and eating habits of Portuguese and Swiss children, the intervention with the Veggies4myHeart digital game increased preschoolers' willingness to taste vegetables, supporting the value of repeated exposure combined with digital tools. Improvement in nutrition knowledge further reinforces the potential of serious games as comprehensive educational strategies for promoting healthy habits in young children.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":"44 1","pages":"326"},"PeriodicalIF":2.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145176138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}