Public Health Nutrition最新文献

{"title":"Characterising \"obesogenic\" versus \"protective\" food consumption, and their value chain among Ghanaian households.","authors":"Reginald Adjetey Annan, Nana Ama Frimpomaa Agyapong, Robert Aidoo, Charles Apprey, Linda Nana Esi Aduku, Elizabeth C Swart","doi":"10.1017/S1368980025000114","DOIUrl":"https://doi.org/10.1017/S1368980025000114","url":null,"abstract":"<p><strong>Objectives: </strong>This paper explores the characteristics of Ghanaian households' consumption of obesogenic versus protective foods, including their retail, distribution, and origin.</p><p><strong>Design: </strong>A household food consumption survey was conducted using an adapted Prospective Urban and Rural Epidemiology study Food Frequency Questionnaire. Product pathways for selected obesogenic (processed meat, Sugar-Sweetened Beverages, and biscuits) and protective (cooked vegetables, legumes, and fish) foods were traced from retailers through distributors/wholesalers to producers.</p><p><strong>Setting: </strong>Rural and urban communities in the Ashanti Region and selected retail/wholesale/producers nationwide.</p><p><strong>Participants: </strong>612 households, 209 retailers and 185 wholesalers/distributors.</p><p><strong>Results: </strong>About 20% of households consume Sugar-Sweetened Beverages (SSB) and confectionery weekly, and just 2% consumed processed meat. Of the protective foods, fish had the highest proportion of households consuming weekly (74.5%), followed by cooked vegetables (53.1%) and legumes (22.8%). Frequent SSB consumption is higher in younger (p<0.001), male (p=0.010), urban (p<0.001), and more educated (p<0.001) food purchaser households. Below 10% of households followed the healthiest dietary pattern (high-protective-and-low-obesogenic) but higher in older and more educated food purchaser households. In contrast, most households (about 80%) consumption patterns did not discriminate between obesogenic and protective foods. Generally, characteristics of purchasers from retail/wholesale outlets agree with those of households, where obesogenic foods were retailed to younger, less educated buyers than older, more educated ones. While the protective foods had a strong local producer presence, the obesogenic foods were predominantly imported.</p><p><strong>Conclusion: </strong>Household consumption and retail/distribution of obesogenic foods are associated with socio-demographic characteristics, but obesogenic foods are almost entirely produced outside Ghana. Policies that regulate importation on health grounds can promote a healthier food environment.</p>","PeriodicalId":20951,"journal":{"name":"Public Health Nutrition","volume":" ","pages":"1-36"},"PeriodicalIF":3.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to the Mediterranean diet and colorectal cancer risk: a large case control study in the Moroccan population.","authors":"Khaoula El Kinany, Zineb Hatime, Achraf El Asri, Abdelilah Benslimane, Meimouna Deoula, Btissame Zarrouq, Pagona Lagiou, Karima El Rhazi","doi":"10.1017/S1368980025000199","DOIUrl":"https://doi.org/10.1017/S1368980025000199","url":null,"abstract":"<p><strong>Objective: </strong>The Mediterranean diet (MD) is a dietary pattern associated with several health benefits, including reduction of risk for various cancers. We conducted a study to investigate associations between adherence to the MD and colorectal cancer (CRC) subtype risk among Moroccan adults.</p><p><strong>Design: </strong>A matched case-control study.</p><p><strong>Setting: </strong>The five major university hospitals in Morocco.</p><p><strong>Participants: </strong>A total of 3032 subjects (1516 CRC patients and 1516 controls) matched on age, sex and center, were recruited between September 2009 and February 2017 at five major hospitals in Morocco. Diet was assessed using a validated Food Frequency Questionnaire (FFQ). Adherence to the Mediterranean diet was assessed through a score, ranging from 0 (no adherence) to 10 (maximal adherence) and divided into three categories (low, middle and high). Conditional logistic regression was performed to calculate multivariable odd ratios (OR) and 95% confidence intervals (CI) with low adherence (score 0-3) as referent, adjusting for potential confounding factors.</p><p><strong>Results: </strong>Close adherence to the Mediterranean diet (score 6-9) was associated with reduced risk of CRC (ORa = 0.74, 95% CI 0.63-0.86); rectal cancer (ORa = 0.73, 95% CI 0.58- 0.90) and colon cancer (ORa = 0.74, 95% CI 0.60-0.92).</p><p><strong>Conclusion: </strong>Our study, conducted in a southern Mediterranean population, adds to the evidence suggesting a protective effect of MD against CRC risk.</p>","PeriodicalId":20951,"journal":{"name":"Public Health Nutrition","volume":" ","pages":"1-21"},"PeriodicalIF":3.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of mealtime social experiences on student consumption of meals at school: a qualitative analysis of caregiver perspectives.","authors":"Leah Elizabeth Chapman, Wendi Gosliner, Deborah A Olarte, Monica Daniela Zuercher, Lorrene D Ritchie, Dania Orta-Aleman, Marlene B Schwartz, Michele Polacsek, Christina E Hecht, Kenneth Hecht, Anisha I Patel, Punam Ohri-Vachaspati, Margaret Read, Juliana Fw Cohen","doi":"10.1017/S1368980024002349","DOIUrl":"https://doi.org/10.1017/S1368980024002349","url":null,"abstract":"<p><strong>Objective: </strong>To understand caregivers' perceptions about their children's mealtime social experiences at school, and how they believe these social experiences impact their children's consumption of meals at school (both meals brought from home and school meals).</p><p><strong>Design: </strong>Qualitative data were originally collected as part of a larger mixed methods study using an embedded-QUAN dominant research design.</p><p><strong>Setting: </strong>Semi-structured interviews were conducted with United States (U.S.) caregivers over Zoom^TM in English and Spanish during the 2021-2022 school year. The interview guide contained 14 questions on caregivers' perceptions about their children's experiences with school meals.</p><p><strong>Participants: </strong>Caregivers of students in elementary, middle, and high schools in rural, suburban, and urban communities in California (n=46) and Maine (n=20) were interviewed. Most (60.6%) were caregivers of children who were eligible for free or reduced-price meals.</p><p><strong>Results: </strong>Caregivers reported that an important benefit of eating meals at school is their child's opportunity to socialize with their peers. Caregivers also stated that their child's favorite aspect of school lunch is socializing with friends. However, some caregivers reported the cafeteria environment caused their children to feel anxious and not eat. Other caregivers reported that their children sometimes skipped lunch and chose to socialize with friends rather than wait in long lunch lines.</p><p><strong>Conclusions: </strong>Socializing during school meals is important to both caregivers and students. Policies such as increasing lunch period lengths and holding recess before lunch have been found to promote school meal consumption and could reinforce the positive social aspects of mealtime for students.</p>","PeriodicalId":20951,"journal":{"name":"Public Health Nutrition","volume":" ","pages":"1-29"},"PeriodicalIF":3.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A quantitative environmental impact assessment of Australian ultra-processed beverages and impact reduction scenarios.","authors":"Kim Anastasiou, Michalis Hadjikakou, Ozge Geyik, Gilly A Hendrie, Phillip Baker, Richard Pinter, Mark Lawrence","doi":"10.1017/S1368980025000187","DOIUrl":"https://doi.org/10.1017/S1368980025000187","url":null,"abstract":"<p><strong>Objective: </strong>Ultra-processed beverages (UPBs) have known adverse impacts on health, but their impact on the environment is not well understood across different environmental indicators. This study aimed to quantify the environmental impacts of water-based UPBs and bottled waters sold in Australia and assess the impacts of various scenarios which may reduce such impacts in the future.</p><p><strong>Design: </strong>This study presents a quantitative environmental impact assessment of a major sub-category of UPBs (water-based UPBs, including soft drinks, energy drinks, cordials, fruit drinks) and non-UPBs (bottled waters) in Australia. Alternative mitigation scenarios based on existing health and environmental targets were also modelled using sales projections for 2027. Sales data from Euromonitor International were matched with environmental impact data from peer-reviewed lifecycle assessment databases. Environmental impact indicators included greenhouse gas emissions, land use, eutrophication potential, acidification potential, water scarcity and plastic use.</p><p><strong>Setting: </strong>The Australian beverage supply in 2022 and projected sales for 2027.</p><p><strong>Participants: </strong>N/A.</p><p><strong>Results: </strong>Environmental impacts of UPBs were higher than bottled waters. UPBs accounted for 81-99% of total environmental impacts, partly driven by the volume of sales. Reformulation, reducing UPB consumption and increasing recycling all led to meaningful reductions in environmental impacts but with diverse effects across different environmental indicators. The largest reductions occurred when policy scenarios were combined to represent a suite of policy actions which aimed to meet health and environmental targets (30-82% environmental savings).</p><p><strong>Conclusions: </strong>The results indicate that implementing a suite of policies which act to target multiple drivers of environmental harm are likely to lead to the most environmental benefits.</p>","PeriodicalId":20951,"journal":{"name":"Public Health Nutrition","volume":" ","pages":"1-19"},"PeriodicalIF":3.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographic and Dietary Determinants of the Association between Dietary Fiber Intake and Obesity in Japanese Adults with Type 2 Diabetes: A Cross-Sectional Study (JDDM 78).","authors":"Efrem d'Ávila Ferreira, Mariko Hatta, Laymon Khin, Izumi Ikeda, Mizuki Takeuchi, Yasunaga Takeda, Sakiko Yoshizawa Morikawa, Chika Horikawa, Noriko Kato, Hiroshi Maegawa, Kazuya Fujihara, Hirohito Sone","doi":"10.1017/S136898002500014X","DOIUrl":"https://doi.org/10.1017/S136898002500014X","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between dietary fiber intake and obesity in Japanese outpatients with type 2 diabetes, as well as the demographic and dietary factors influencing this association.</p><p><strong>Design: </strong>Cross-sectional study with nationwide registry data on Japanese type 2 diabetes outpatients (2014-2019). Diet was self-reported via a Food Frequency Questionnaire. Obesity was defined as BMI ≥25 kg/m².</p><p><strong>Setting: </strong>Clinics throughout Japan.</p><p><strong>Participants: </strong>1,565 Japanese outpatients with type 2 diabetes (63.1% men; age range 30-89 years).</p><p><strong>Results: </strong>Multivariate analysis revealed that a higher dietary fiber intake was associated with a lower risk of obesity in all participants (95% CI = 0.439-0.795, p < 0.001). Stratified analysis showed a significant inverse association between fiber intake and obesity in men and the older age groups (59-89 years), but not in women or the younger age group (30-58 years). In men, higher fiber intake was associated with healthier lifestyle behaviors, including increased physical activity (p < 0.001) and non-smoking (p < 0.001), with stronger associations compared to women. Vegetables, fruits, and soybeans/soy products were strongly correlated with fiber, while grains had a weak correlation. Folate was the micronutrient most strongly correlated with fiber.</p><p><strong>Conclusion: </strong>Higher fiber intake was associated with lower obesity risk, particularly in men and older age groups. These findings emphasize the need for targeted public health initiatives promoting the intake of diverse fiber-rich foods to effectively manage obesity. Further research is needed to understand sex- and age-specific factors in the fiber-obesity relationship in diverse populations.</p>","PeriodicalId":20951,"journal":{"name":"Public Health Nutrition","volume":" ","pages":"1-20"},"PeriodicalIF":3.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary intakes, food behaviours, and health indicators among Métis youth in Manitoba, Canada.","authors":"Chantal Perchotte, Olena Kloss, Joyce Slater, Alan Katz, Bhanu Pilli, Aynslie Hinds, Marcelo L Urquia, Julianne Sanguins, Chris Green, Jaime Cidro, Dan Chateau, Nathan Nickel, Thomas Falkenberg","doi":"10.1017/S1368980025000151","DOIUrl":"https://doi.org/10.1017/S1368980025000151","url":null,"abstract":"<p><strong>Objective: </strong>Poor diets and food insecurity during adolescence can have long lasting effects, and Métis youth may be at higher risk. This study, as part of the Food and Nutrition Security for Manitoba Youth (FANS) study, examines dietary intakes, food behaviours, and health indicators of Métis compared to non-Métis youth.</p><p><strong>Design: </strong>This observational cross-sectional study involved a cohort of adolescents completed a self-administered web-based survey on demographics, dietary intake (24-h recall), food behaviours, food security, and select health indicators.</p><p><strong>Setting: </strong>Manitoba, Canada.</p><p><strong>Participants: </strong>Participants included 1587 Manitoba grade nine students, with 135 (8.5%) self-identifying as Métis, a distinct Indigenous nation living in Canada.</p><p><strong>Results: </strong>Median intake of sugar was significantly higher in Métis (89.2 g) compared with non-Métis (76.3 g) participants. Percent energy intake of saturated fat was also significantly higher in Métis (12.4%) than non-Métis (11.6%) participants. Median intakes of Grain Products and Meat and Alternatives servings were significantly lower among Métis than non-Métis (6.0 vs. 7.0 and 1.8 vs. 2.0, respectively) participants. Intake of Other Foods was significantly higher in Métis (4.0) than non-Métis (3.0). Significantly more Métis participants were food insecure (33.1%) compared to non-Métis participants (19.1%). Significantly more Métis participants ate family dinners and breakfast less often than non-Métis participants, and had lower self-reported health. Significantly more Métis participants had a BMI classified as obese compared to non-Métis participants (12.6% vs. 7.1%).</p><p><strong>Conclusions: </strong>The dietary intakes observed in this study, both among Métis and non-Métis youth, are concerning. Many have dietary patterns that put them at risk for developing health issues in the future.</p>","PeriodicalId":20951,"journal":{"name":"Public Health Nutrition","volume":" ","pages":"1-23"},"PeriodicalIF":3.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring under-five child malnutrition in Bangladesh: Analysis using the Extended Composite Index of Anthropometric Failure (ECIEF).","authors":"Farzana Akhter Bornee, Mohammad Rocky Khan Chowdhury, Badrun Naher Siddique, Baki Billah, Farjana Akter, Md Nazmul Karim","doi":"10.1017/S1368980025000138","DOIUrl":"https://doi.org/10.1017/S1368980025000138","url":null,"abstract":"<p><strong>Objective: </strong>The current study is an attempt to explore under-five child malnutrition in a low-income population setting using the Extended Composite Index of Anthropometric Failure (ECIAF).</p><p><strong>Design: </strong>Data from the Bangladesh Demographic and Health Survey 2017-18 were analyzed. Malnutrition using ECIAF was estimated using stunting, wasting underweight and overweight. Multilevel logistic regression models identified factors associated with malnutrition. Geospatial analysis was conducted using R programming.</p><p><strong>Setting: </strong>Bangladesh.</p><p><strong>Participants: </strong>Children under five years of age.</p><p><strong>Results: </strong>In Bangladesh, as indicated by the ECIAF, approximately 40.8% (95% Confidence interval (CI): 39.7, 41.9) of children under-five experience malnutrition where about 3.3% (95% CI: 2.9, 3.7) were overweight. Children of parents with no formal education (56.3%, 95% CI: 50.8, 61.8), underweight mothers (53.4%, 95% CI: 50.4, 56.3), belonging to the lowest socio-economic strata (50.6%, 95% CI: 48.3, 53.0), residing in rural areas (43.3%, 95% CI: 41.9, 44.6), and aged below three years (47.7%, 95% CI: 45.2, 50.2) demonstrated a greater age and sex adjusted prevalence of malnutrition. The Sylhet division (Eastern region) exhibited a higher prevalence of malnutrition (>55.0%). Mothers with no formal education (Adjusted odds ratio (AOR): 1.51, 95% CI: 1.08, 2.10), underweight mother (AOR: 1.54, 95% CI: 1.03, 1.83), poorest socio-economic status (AOR: 2.14, 95% CI: 1.64, 2.81), children age 24-35 months of age (AOR: 2.37, 95% CI: 1.97, 2.85), and fourth and above birth order children (AOR: 1.41, 95% CI: 1.16, 1.72) were identified key factors associated with childhood malnutrition while adjusting community and household level variations.</p><p><strong>Conclusion: </strong>In Bangladesh, two out of five children were malnourished and one in 35 children was overweight. Continuous monitoring of the ECIAF over time would facilitate tracking changes in the prevalence of different forms of malnutrition, helping to plan interventions and assess the effectiveness of interventions aimed at addressing both undernutrition and overweight.</p>","PeriodicalId":20951,"journal":{"name":"Public Health Nutrition","volume":" ","pages":"1-30"},"PeriodicalIF":3.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Chain Polyunsaturated Fatty Acids and Painful Temporomandibular Disorder in the Hispanic Community Health Study/Study of Latinos.","authors":"Anne E Sanders, Jianwen Cai, Martha L Daviglus, Olga Garcia-Bedoya, Gary D Slade","doi":"10.1017/S1368980025000102","DOIUrl":"https://doi.org/10.1017/S1368980025000102","url":null,"abstract":"<p><strong>Objective: </strong>Omega-6 and omega-3 long-chain polyunsaturated fatty acids (PUFAs) play opposing roles in inflammation, anxiety, and nociception, all of which are closely associated with chronic pain. We hypothesized that diets high in omega-6 arachidonic acid (C20:4n-6, AA) and low in combined omega-3 eicosapentaenoic acid (C20:5n-3, EPA) and docosahexaenoic acid (C22:6n-3, DHA) would be associated with higher odds of painful temporomandibular disorder (TMD).</p><p><strong>Design: </strong>We analyzed baseline data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Two 24-hr dietary recall surveys quantified intake of long-chain omega-6 and omega-3 PUFAs along with their precursors, linoleic acid (C18:2n-6, LA) and alpha linolenic acid (C18:3n-3, ALA) respectively. Omega-3 PUFAs supplementation was quantified. Interviewer-administered questions assessed TMD. Survey multiple logistic regression estimated covariate-adjusted odds ratios (OR) and 95% confidence limits (CL) for associations between PUFAs and TMD.</p><p><strong>Setting: </strong>From 2008-2011, HCHS/SOL recruited 16,415 adults of Hispanic/Latino backgrounds (Cuban, Puerto Rican, Dominican, Mexican, Central/South American), through field centers located in Miami, FL; San Diego CA; Chicago, IL; and the Bronx, NY.</p><p><strong>Participants: </strong>13,870 participants with non-missing data.</p><p><strong>Results: </strong>In analysis adjusted for covariates, each standard deviation increase in dietary intake of C20:4n-6, AA was associated with 12% higher odds of TMD (OR=1.12, CL:1.01, 1.24). Although the dietary intake of combined long-chain C20:5n-3, EPA and C22:6n-3 DHA was not associated with TMD, each standard deviation increase in omega-3 dietary supplement was associated with lower odds of TMD.</p><p><strong>Conclusions: </strong>A diet rich in C20:4n-6, AA was associated with higher odds of painful TMD.</p>","PeriodicalId":20951,"journal":{"name":"Public Health Nutrition","volume":" ","pages":"1-29"},"PeriodicalIF":3.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The anti-politics of food in South Africa: Transformation, accountability and the nutrition policy subsystem.","authors":"Busiso Helard Moyo, Anne Marie Thow, Florian Kroll, Scott Drimie","doi":"10.1017/S1368980025000163","DOIUrl":"https://doi.org/10.1017/S1368980025000163","url":null,"abstract":"<p><strong>Objective: </strong>To examine power and governance arrangements in food and nutrition policy formulation and agenda-setting in South Africa.</p><p><strong>Design: </strong>Analysis of the policy implementation environment and in-depth interviews were conducted focussing on: existing policy content and priorities across food system sectors; institutional structures for cross-sectoral and external stakeholder engagement; exercise of power in relation to food system policies; and opportunities to strengthen action on nutrition.</p><p><strong>Setting: </strong>South Africa.</p><p><strong>Participants: </strong>Interviews were conducted with 48 key stakeholders involved in the food and nutrition policy sphere: government sectors relevant to food systems (n=21), the private sector (n=4), academia (n=10), NGOs (n=11) and farmers (n=2).</p><p><strong>Results: </strong>This study found that there are power dynamics involved in shaping the planning agenda that is inadvertently generating a food system that undermines the right to food. The concept of nutrition governance remains poorly defined and applied in different ways and usually based on a relatively narrow interpretation - therefore limiting policy coherence and coordination. South Africa has strong legal institutions and practices, and social policies that support public provisioning of food, but a non-interventionist approach to the food system.</p><p><strong>Conclusions: </strong>The right to food and nutrition, as outlined in the South African Constitution, has not yet been effectively utilized to establish a robust normative and legal basis for tackling the dual challenges of food insecurity and malnutrition. Currently, the governance of the food system is grappling with substantial obstacles, balancing the influence of powerful stakeholders who uphold the status quo against its responsibilities for food justice.</p>","PeriodicalId":20951,"journal":{"name":"Public Health Nutrition","volume":" ","pages":"1-32"},"PeriodicalIF":3.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The food environment in favelas is associated with the presence of arterial hypertension and diabetes in socially vulnerable women.","authors":"Luiz Gonzaga Ribeiro Silva-Neto, Risia Cristina Egito de Menezes, Juliana Souza Oliveira, Nathalia Paula de Souza, Thays Lane Ferreira Dos Santos, Telma Maria de Menezes Toledo Florêncio","doi":"10.1017/S1368980025000175","DOIUrl":"https://doi.org/10.1017/S1368980025000175","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the relationship between the food environment in favelas and the presence of arterial hypertension and diabetes among women in the context of social vulnerability.</p><p><strong>Design: </strong>A cross-sectional and partially ecological population-based study was conducted in a Brazilian capital city. The healthiness and availability of ultra-processed foods in the food environment were assessed through retailer audits using the AUDITNOVA instrument. The presence of diabetes and arterial hypertension was evaluated based on self-reported prior medical diagnosis. Logistic regression models were applied using generalized estimating equations, adjusted for age, education, race/skin color, and poverty status.</p><p><strong>Participants: </strong>1,882 adult women of reproductive age (20 to 44 years).</p><p><strong>Results: </strong>It was found that 10.9% of women were hypertensive, and 3.2% had diabetes. The likelihood of having diabetes and arterial hypertension decreases with higher levels of healthiness in the food environment (Diabetes [OR: 0.25; 95% CI: 0.07, 0.97]/Arterial hypertension [OR: 0.45; 95% CI: 0.24, 0.81]) and increases with greater availability of ultra-processed foods in their living area (Diabetes [OR: 2.18; 95% CI: 1.13, 4.21]/Arterial hypertension [OR: 1.64; 95% CI: 1.09, 2.47]).</p><p><strong>Conclusions: </strong>These results suggest that characteristics of the consumer food environment have a significant effect on the occurrence of chronic diseases among socially vulnerable women, adding to the existing evidence in the literature and highlighting the need for integrated health care.</p>","PeriodicalId":20951,"journal":{"name":"Public Health Nutrition","volume":" ","pages":"1-24"},"PeriodicalIF":3.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}