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Background: Evidence suggests that people living in poverty often experience inadequate nutrition with short and long-term health consequences. Whilst the diets of low-income households have been subject to scrutiny, there is limited evidence in the UK on the diet quality and food practices of households reporting food insecurity and food bank use. We explore lived experiences of food insecurity and underlying drivers of diet quality among low-income families, drawing upon two years of participatory research with families of primary school age children.

Methods: We report on a mixed-methods study of the relationship between low income, food bank use, food practices and consumption from a survey of 612 participants, including 136 free text responses and four focus groups with 22 participants. The research followed a parallel mixed-methods design: qualitative and quantitative data were collected separately, although both were informed by participatory work. Quantitative data were analysed using binary and multinomial logistic regression modelling; qualitative data were analysed thematically.

Results: Lower income households and those living with food insecurity struggle to afford a level of fruit and vegetable consumption that approaches public health guidance for maintaining a healthy diet, despite high awareness of the constituents of a healthy diet. Participants used multiple strategies to ensure as much fruit, vegetable and protein consumption as possible within financial constraints. The quantitative data suggested a relationship between higher processed food consumption and having used a food bank, independent of income and food security status.

Conclusions: The findings suggest that individualised, behavioural accounts of food practices on a low-income misrepresent the reality for people living with poverty. Behavioural or educational interventions are therefore likely to be less effective in tackling food insecurity and poor nutrition among people on a low income; policies focusing on structural drivers, including poverty and geographical access to food, are needed.

This study aims to evaluate the nutrient profile, carbon footprint and water footprint of one-month menus presented in five hospitals in Turkey and compare their environmental impacts with that of the Mediterranean diet.

The energy and nutrient content of menus were compared with recommendations of the Turkey Dietary Guidelines (TUBER) 2022. Nutrient profiles of hospital menus were evaluated using Nutrient Rich Food 9.3 (NRF 9.3) and SAIN-LIM models. The carbon and water footprints of the menus were calculated and compared with those of the Mediterranean diet.

Menus’ energy and nutrient content did not conform with TUBER 2022. The SAIN-LIM score of Hospital A (5.7 ± 1.1) was significantly higher than that of Hospitals C (4.8 ± 0.7, p = 0.001) and E (5.1 ± 0.7, p = 0.025). The carbon footprint of Hospital A was significantly lower (2.6 ± 0.3 kg CO₂ eq/person/day) and that of Hospital D (4 ± 0.9 kg CO₂ eq/person/day) was significantly higher than those of others (p < 0.001). While other menus were similar (p > 0.05), the water footprint of Hospital A was significantly lower (3.5 ± 0.7 L/kg, p < 0.001). In addition, if the menus were suitable for the Mediterranean diet, a reduction of 2.2–23.4% in the carbon footprint and 37.5–58.6% in the water footprint could be achieved. Moreover, menus’ carbon and water footprints were negatively correlated with NRF 9.3 and SAIN-LIM scores.

The primary aim should be to ensure that the planned menus follow the dietary guidelines. In addition, it is an undeniable fact that sustainable nutrition is a complex process with many dimensions. However, it seems possible to improve the nutrient profiles of the menus and reduce their environmental footprint with minor changes to be made in food services.

It seems possible to improve the nutrient profiles of the menus and reduce their environmental footprint with minor changes. For both health and environmental impacts, food services should switch to menus suitable for the Mediterranean diet.

The findings provide new insights into hospital menus’ quality and environmental impact.

The study aims to have adults discuss experiences, practices needs and feelings related to health management, diet and food security.

A total of 22 immigrants were recruited from the Open School of Immigrants in Piraeus, Attica, Greece, to participate in focus group discussions. The discussions were audio recorded and thematically analyzed. Three major themes were developed: pathways to health care, nutrition management and experiences related to food shortages.

Most of the participants identified internet as the most commonly used way to obtain health advice; they also stated that unexpected ill-health is usually accompanied by feelings of fear, anxiety and loneliness. Immigrants, who had visited a public hospital in Greece, identified the language barrier as the most challenging issue, followed by the long waiting lists. Fear and anxiety of hospital visits was an important factor in their decision to vaccinate against COVID-19. Lack of time, high cost of healthy food and lack of knowledge were the most common obstacles to a healthy diet. One in two immigrants reported that they have faced food insecurity issues in the past. Stress, psychological distress and irritation were reported, due to food shortages, especially during the first few years of arriving in Greece. The exclusion of some foods, reduced portion sizes and buying cheaper foods were among the coping strategies to address food shortages.

The study offers an insight into immigrant’s experiences, practices and feelings about managing health issues and could be useful for health-care practitioners, researchers and policymakers.

Background: Rising food bank usage in the UK suggests a growing prevalence of food insecurity. However, a formalised, representative measure of food insecurity was not collected in the UK until 2019, over a decade after the initial proliferation of food bank demand. In the absence of a direct measure of food insecurity, this article identifies and summarises longitudinal proxy indicators of UK food insecurity to gain insight into the growth of insecure access to food in the 21st century.

Methods: A rapid evidence synthesis of academic and grey literature (2005–present) identified candidate proxy longitudinal markers of food insecurity. These were assessed to gain insight into the prevalence of, or conditions associated with, food insecurity.

Results: Food bank data clearly demonstrates increased food insecurity. However, this data reflects an unrepresentative, fractional proportion of the food insecure population without accounting for mild/moderate insecurity, or those in need not accessing provision. Economic indicators demonstrate that a period of poor overall UK growth since 2005 has disproportionately impacted the poorest households, likely increasing vulnerability and incidence of food insecurity. This vulnerability has been exacerbated by welfare reform for some households. The COVID-19 pandemic has dramatically intensified vulnerabilities and food insecurity. Diet-related health outcomes suggest a reduction in diet quantity/quality. The causes of diet-related disease are complex and diverse; however, evidence of socio-economic inequalities in their incidence suggests poverty, and by extension, food insecurity, as key determinants.

Conclusion: Proxy measures of food insecurity suggest a significant increase since 2005, particularly for severe food insecurity. Proxy measures are inadequate to robustly assess the prevalence of food insecurity in the UK. Failure to collect standardised, representative data at the point at which food bank usage increased significantly impairs attempts to determine the full prevalence of food insecurity, understand the causes, and identify those most at risk.

This purpose of this study was to assess dietary diversity among women of reproductive age (WRA) and the associations between consumption of a diversified diet and overweight/obesity statuses in Ekiti State, Nigeria.

Cross-sectional study of 207 WRA from six local government areas in Ekiti State, Nigeria, was done. A validated interviewer-administered questionnaire was used to collect data on sociodemographic characteristics, dietary intake and anthropometry. Dietary intake was assessed with 24-h dietary recall to calculate the Minimum Dietary Diversity Score for Women (MDD-W). Data were analyzed using descriptive statistics, Spearman rank correlation and Chi square test at α_0.05.

Majority of the participants (65.2%) were aged between 19 and 34 years, 58.5% were married and 49.8% had high school as their highest level of education. Mean MDD-W and body mass index (BMI) were 3.8 ± 0.9 and 25.46 ± 6.4 kg/m², respectively. All participants (100%) consumed foods from the “grains, white roots and tubers” group and majority also from the “meat and poultry” group (79.7%) but ranked low in the consumption of foods from other food groups. Many were overweight (34.8%), obese (14.0%) and a few (1.9%) had morbid obesity. MDD-W was significantly associated with marital status (X² = 7.7, P = 0.022) and BMI (X² = 11.4, P = 0.023) and had a weak positive correlation with BMI (r = 0.189, P = 0.007).

Study shows that both undernutrition and overweight/obesity coexist in the population, indicating a case of double burden of malnutrition (DBM) at a population level. However, further studies may be needed to investigate the extent of DBM at individual levels. Although there was a positive correlation between MDD-W and BMI, it cannot be used to predict causality. Study further reveals that the micronutrient intake of the WRA population in Ekiti is inadequate. Considering the importance of the 10 food groups highlighted in MDD_W to nutrition and health, the promotion of the consumption of foods from these food groups with more attention to the micronutrient-rich ones needs to be heightened.

Diet of participants was not diverse enough, indicating micronutrient inadequacy. Promotion of the consumption of a diverse diet, particularly from the food groups rich in micronutrient, needs to be heightened, while food groups high in calorie should be minimally consumed to forestall DBM.

The COVID-19 pandemic has caused significant mortality and morbidity worldwide. However, the role of dietary patterns as a potential risk factor for COVID-19 has not been well established, especially in studies with large samples. Therefore, this study aims to identify and evaluate the association between major dietary patterns and COVID-19 among adults from Iran.

In this cross-sectional study, the authors included 9,189 participants aged 20–70 who participated in the Yazd Health Study (YaHS) and Taghzieh Mardom-e-Yazd study (TAMIZ). They used factor analysis to extract dietary patterns based on a food frequency questionnaire (FFQ). Then, they assessed the relationship between these dietary patterns and the odds of COVID-19.

This study identified two major dietary patterns: “high protein and high fiber” and “transitional”. Participants in the highest tertile of the “high protein and high fiber” dietary pattern, which included vegetables, fruits, dairy and various kinds of meats such as red meat, fish and poultry, had a lower odds of COVID-19 compared with those in the lowest tertile. However, the “transitional” dietary pattern did not affect the risk of COVID-19.

In conclusion, a “high protein, high fiber” diet may lower the odds of COVID-19. This study suggests that dietary patterns may influence the severity and spread of future similar pandemics.

This study aims to increase knowledge of the ability of nutrition labels to guide consumer choices in real-life environments.

Food consumption and plate waste data were collected from two self-service restaurants (SSR) with different customer groups over six observation days: three control and three intervention (with nutrition labelling) periods. Study Group 1 consisted of vocational school students, mostly late adolescents (N = 1,710), and Group 2 consisted of spa hotel customers, mostly elderly (N = 1,807). In the experimental restaurants, the same food was served to the buffets during the control and intervention periods.

The nutrition label in the lunch buffet guides customers to eat fewer main foods and salads and to select healthier choices. Increased consumption of taste enhancers (salt and ketchup) was observed in the study restaurants after nutritional labelling. Nutrition labelling was associated with a reduction in plate waste among the elderly, whereas the opposite was observed among adolescents.

The results provide public policymakers and marketers with a better understanding of the effects of nutrition labelling on consumer behaviour. Future studies should further evaluate the effects of nutrition labelling on the overall quality of customer diets and the complex environmental, social, and psychological factors affecting food choices and plate waste accumulation in various study groups.

This study aims to assess dietary choices of pregnant women and its relationship with their anaemia status.

A mixed-method study comprising a survey and three focus group discussions (FGDs). The survey included 380 adult pregnant women with data collected on food choices, preferences and haemoglobin (Hb) status.

More than 50% of women in the study had Hb concentration < 11.0 g/dl; mean Hb was 10.24 g/dl (SD = 1.59). Univariate analysis was used to generate descriptive tabulations for socio-demographic characteristics of respondents, dietary choices for women and anaemia status. T-test and bivariate analysis between dietary diversity score of the women among the food groups consumed as well as their anaemia (Hb) status. This showed that women with high dietary diversity score had improved Hb status (P = 0.003), and those who consumed meat and fish as well as dark leafy vegetables had significantly high diversity scores (P = 0.031 and P = 0.049). Thematic analysis was used for analysing qualitative data.

The sample used in the study is unlikely to be fully representative of pregnant women in the Accra Metropolis. In addition, this study used a cross-sectional study design, making it difficult to establish causal associations between nutritional status and food choice of pregnant women. It does not also show variation in dietary practices by seasons of the year. The scope of the study did not allow for a detailed analysis, and this should be considered in future studies. Also, the study did not explore an obstetric factor like past bleeding history as well as the menstrual cycle of these pregnant women, as these factors are likely to interfere with the anaemia status of the pregnant women.

This paper contributes significant value by specifically focusing on and clarifying the complex relationship between dietary choices and aneamia among pregnant women. It also provides insights into the distinct dietary patterns and preferences of pregnant women, which may be contributing to the high prevalence of aneamia. The results of the study can inform the development of localized, evidence-based interventions to address this critical public health concern, ultimately leading to improved maternal and foetal health outcomes.

Children's food insecurity experiences are largely unrepresented in academic literature. Parents and caregivers cannot always accurately evaluate their children's attitudes or experiences, and even within the same family unit, children and their parents may report differing views and experiences of family food insecurity. The purpose of this narrative review is to identify studies that include children's voices and their perceptions, understanding, and experience of food insecurity in the household.

This narrative review aimed to address the following questions: (1) “What research studies of household food insecurity include children's voices?” and (2) “Across these studies, how do children perceive, understand and experience food insecurity in the household?”. A database search was conducted in October 2022. After inclusion and exclusion criteria were applied, 16 articles remained for review.

The findings from this review were organised into three themes: Theme 1: Ways children coped with accessing food or money for food; Theme 2: Food-related strategies children used to avoid hunger; and Theme 3: Children attempt to mask food insecurity.

Future research should further explore the long-term consequences of social pressures and informal economic engagement on children's well-being and social development. By addressing the social determinants of food insecurity, this study can strive to create supportive environments that enable all children to access adequate nutrition and thrive.

Overall, the findings of this review demonstrate the significant social pressures that shape children's responses to food insecurity. Results suggest that children's decision-making processes are influenced by the desire to maintain social standing and avoid the negative consequences of being food insecure. As such, this review underscores the need for a comprehensive understanding of the social context in which food insecurity occurs and the impact it has on children's lives. Understanding these dynamics is crucial for developing effective interventions and policies addressing the multifaceted challenges food insecure children face.

This review has highlighted a need for interventions to incorporate trauma-informed strategies to protect children from and respond to the psychologically distressing experiences and impact of living in food insecure households.

The aim of this study was to observe how a user’s individual factors in a commercial weight-loss treatment app affect their perceived usefulness of its features and how they relate to each other.

The information was obtained from an online survey with a sample of 412 users from a branded app for a commercial weight-loss treatment using body mass index (BMI), self-efficacy, social support and perceived usefulness as variables.

Users with higher self-efficacy perceived the app’s features as more useful. However, BMI was not a factor except for the psycho-emotional support features, which individuals with obesity perceived as more useful. Likewise, it was found that there weren’t any significant differences in self-efficacy based on their BMI. Lastly, it was found that social support could not be used as a factor to predict self-efficacy.

This study helps understand how individual factors for behavioural change may affect the perceived usefulness of a weight-loss app. Furthermore, the significance of self-efficacy as an influencing factor provides useful information for companies and app developers alike when developing their branded apps.

This study contributes to the body of knowledge on factors affecting user perceptions of weight-loss apps. It also adds to the literature of branded apps as complimentary resources for companies, which has not been studied in detail.