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2nd Edition of Nutrition, Diets and Public Health

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (28 March 2023) | Viewed by 27266

Special Issue Editors

Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria
Interests: digital public health; digital food environment; food marketing; public health nutrition; nutrition assessment; nutrition surveys; nutritional epidemiology; malnutrition; chronic disease prevention; school and community food environments; plant-based diets

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Guest Editor
Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria
Interests: public health nutrition; obesity; childhood obesity; obesity and chronic disease prevention; chronic disease; school- and community-based obesity prevention programs; school and community food environments; nutrition assessment; plant-based diets; interventions in the management of obesity

Special Issue Information

Dear Colleagues,

The determinants of healthy eating and nutrition are multifaceted and range from individual determinants, the social environment, the physical environment, and the economic environment. All these determinants are included in the interdisciplinary area of public health nutrition, which covers research, interventions, programs, practices, and policies to improve nutrition, nutritional status, or nutrition-related disease of populations. The individual factors include behavioral factors and characteristics that affect the choice of food, e.g., preferences, perceptions, nutritional knowledge, or psychological factors. The social and physical environment in which one lives includes the culture, family, or friends but also social media and all infrastructures that affect food availability, e.g., food outlets in the vicinity of work sites, schools, or home. Within the broader perspective is the economic environment, which includes prices of food, food security, or food marketing.

For this Special Issue on “Second Edition of Nutrition, Diets, and Public Health”, we are interested in original research, narrative reviews, systematic reviews, and meta-analyses concerning new evidence on the relationships between nutrition, diet, and health within a broad public health context. The topics we are interested in are broad, and we would be delighted to have highly up-to-date topics such as plant-based diets, food marketing, and ultra-processed foods included.

Dr. Eva Winzer
Prof. Dr. Maria Wakolbinger
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • nutrition
  • diet, food
  • public health nutrition
  • chronic diseases
  • obesity
  • interventions
  • policies
  • environmental determinants
  • nutritional epidemiology

Related Special Issue

Published Papers (11 papers)

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Research

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11 pages, 682 KiB  
Article
Diet in Patients with Myocardial Infarction and Coexisting Type 2 Diabetes Mellitus
by Elżbieta Szczepańska, Magdalena Gacal, Adam Sokal, Barbara Janota and Oskar Kowalski
Int. J. Environ. Res. Public Health 2023, 20(8), 5442; https://doi.org/10.3390/ijerph20085442 - 07 Apr 2023
Viewed by 1470
Abstract
Background: Dietary modifications are recommended alongside pharmacotherapy in treating both diabetes mellitus (DM) and coronary heart disease (CHD) patients. Aims: The primary aim of our study was to assess the diet in patients with type 2 diabetes mellitus (T2DM) and myocardial infarction (MI) [...] Read more.
Background: Dietary modifications are recommended alongside pharmacotherapy in treating both diabetes mellitus (DM) and coronary heart disease (CHD) patients. Aims: The primary aim of our study was to assess the diet in patients with type 2 diabetes mellitus (T2DM) and myocardial infarction (MI) and to identify dietary differences between patients after the first and subsequent cardiovascular (CV) event. The secondary aim was to analyze the differences between men’s and women’s diets. Methods: The study population consisted of patients with DM/T2DM and MI. The research tool was the original author’s questionnaire which was collected personally by a qualified dietician. Results: The study included 67 patients with a mean age of 69 ± 8 years, hospitalized at the Silesian Centre for Heart Diseases in Zabrze in 2019. The study found that patients consumed less bread, whole-grain cereal products, fermented milk products, and vegetables than was recommended. A total of 32.8% of patients reported an intake of sweetened beverages, while 85.1% of participants consumed sweets despite being diagnosed with DM. Except for sweetened drinks, no differences in dietary behaviors were found in the patients after the first and second MI episode. Most of the included patients assessed their diet as appropriate. Conclusion: The dietary assessment of diabetes and myocardial infarction patients indicates that the diet does not comply with dietary recommendations, thus increasing the risk of a recurrent cardiac event despite a previous MI. No differences between the men’s and the women’s nutritional habits were observed. Full article
(This article belongs to the Special Issue 2nd Edition of Nutrition, Diets and Public Health)
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9 pages, 298 KiB  
Article
Empowering Community Leadership: Perspectives of Peer Mentors Facilitating a Food Pantry-Based Nutrition Education Program
by Tracy L. Oliver, Lisa K. Diewald, Amy McKeever, Cerena A. George and Rebecca Shenkman
Int. J. Environ. Res. Public Health 2023, 20(3), 2604; https://doi.org/10.3390/ijerph20032604 - 31 Jan 2023
Viewed by 1533
Abstract
Peer Mentors (PMs) are valuable health educators within food-insecure communities; however, little is known about PMs’ perspectives and experiences after serving in their peer mentor role. Therefore, this qualitative study explored PMs’ (n = 10) perceptions and analyzed data using thematic analysis based [...] Read more.
Peer Mentors (PMs) are valuable health educators within food-insecure communities; however, little is known about PMs’ perspectives and experiences after serving in their peer mentor role. Therefore, this qualitative study explored PMs’ (n = 10) perceptions and analyzed data using thematic analysis based on descriptive phenomenology. Four themes emerged: (1) Successes and Struggles in Sharing Nutrition Knowledge; (2) Establishing a Conducive Learning Environment; (3) The Peer Mentor and Mentee Connection: Impact of Shared Experiences; (4) Empowerment of the Peer Mentor Experience. PMs have many advantages; however, more research is needed to evaluate the sustainability and efficacy of PMs within food-insecure communities. Full article
(This article belongs to the Special Issue 2nd Edition of Nutrition, Diets and Public Health)
13 pages, 346 KiB  
Article
Regional Difference in the Effect of Food Accessibility and Affordability on Vegetable and Fruit Acquisition and Healthy Eating Behaviors for Older Adults
by Dong Eun Lee and Kirang Kim
Int. J. Environ. Res. Public Health 2022, 19(22), 14973; https://doi.org/10.3390/ijerph192214973 - 14 Nov 2022
Cited by 1 | Viewed by 1232
Abstract
The food environment has been determined to affect a range of healthy eating and health indicators, but the study on the regional difference of food environment effects on these outcomes is limited. This study aimed to examine whether food environment factors influence vegetable [...] Read more.
The food environment has been determined to affect a range of healthy eating and health indicators, but the study on the regional difference of food environment effects on these outcomes is limited. This study aimed to examine whether food environment factors influence vegetable and fruit acquisition and healthy eating behaviors in urban and rural areas using a nationwide dataset. The study participants were community-dwelling older adults aged 65 years and older (n = 830) who participated in the 2019 Consumer Behavior Survey for Food provided by the Korea Rural Economic Institute. Food environment factors were assessed using questionnaires measuring perceived food accessibility and affordability. The negative perceptions of food environment were related to lower vegetable and fruit acquisitions and poor healthy eating behaviors. The higher risks of low vegetable and fruit acquisitions in older rural adults were related to a negative perception of food accessibility only (odds ratio [OR]: 2.34, 95% confidence interval [CI]: 1.27–4.32 for vegetable; OR: 1.96, 95% CI: 1.02–3.75 for fruit). For older urban adults, negative perceptions of both food accessibility and food affordability were related to the increased risk of low vegetable acquisition (OR: 2.03, 95% CI: 1.07–3.83 for food accessibility; OR: 2.52, 95% CI: 1.26–5.04 for food affordability). In terms of healthy eating behaviors, for those who perceived that either food accessibility or affordability was poor, older urban adults were less likely to have various and healthy food eating behaviors when they had a negative perception of affordability (OR: 0.47, 95% CI: 0.25–0.90 for variety; OR: 0.23, 95% CI: 0.11–0.46 for eating healthy foods); however, older rural adults were less likely to have the behaviors when they had a negative perception of accessibility (OR: 0.49, 95% CI: 0.21–0.97 for variety; OR: 0.28, 95% CI: 0.13–0.63 for eating healthy foods). In conclusion, the negative perceptions of food accessibility and affordability were related to low vegetable acquisition and poor healthy eating behaviors. The effects of food accessibility and affordability on vegetable and fruit acquisitions and healthy eating behaviors were different between urban and rural areas. Full article
(This article belongs to the Special Issue 2nd Edition of Nutrition, Diets and Public Health)
21 pages, 1796 KiB  
Article
Empirical Dietary Patterns Associated with Food Insecurity in U.S. Cancer Survivors: NHANES 1999–2018
by Christian A. Maino Vieytes, Ruoqing Zhu, Francesca Gany, Amirah Burton-Obanla and Anna E. Arthur
Int. J. Environ. Res. Public Health 2022, 19(21), 14062; https://doi.org/10.3390/ijerph192114062 - 28 Oct 2022
Cited by 2 | Viewed by 1685
Abstract
(1) Background: Food insecurity (FI) is a public health and sociodemographic phenomenon that besets many cancer survivors in the United States. FI in cancer survivors may arise as a consequence of financial toxicity stemming from treatment costs, physical impairment, labor force egress, or [...] Read more.
(1) Background: Food insecurity (FI) is a public health and sociodemographic phenomenon that besets many cancer survivors in the United States. FI in cancer survivors may arise as a consequence of financial toxicity stemming from treatment costs, physical impairment, labor force egress, or a combination of those factors. To our knowledge, an understanding of the dietary intake practices of this population has not been delineated but is imperative for addressing the needs of this vulnerable population; (2) Methods: Using data from NHANES, 1999–2018, we characterized major dietary patterns in the food insecure cancer survivor population using: i. penalized logistic regression (logit) and ii. principal components analysis (PCA). We validated these patterns by examining the association of those patterns with food insecurity in the cancer population; (3) Results: Four dietary patterns were extracted with penalized logit and two with PCA. In the pattern validation phase, we found several patterns exhibited strong associations with FI. The FI, SNAP, and Household Size patterns (all extracted with penalized logit) harbored the strongest associations and there was evidence of stronger associations in those moderately removed from a cancer diagnosis (≥2 and <6 years since diagnosis); (4) Conclusions: FI may play an influential role on the dietary intake patterns of cancer survivors in the U.S. The results highlight the relevance of FI screening and monitoring for cancer survivors. Full article
(This article belongs to the Special Issue 2nd Edition of Nutrition, Diets and Public Health)
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13 pages, 588 KiB  
Article
Certain Dietary Nutrients Reduce the Risk of Eye Affliction/Retinopathy in Individuals with Diabetes: National Health and Nutrition Examination Survey, 2003–2018
by Guoheng Zhang, Xiaojia Sun, Tianhao Yuan, Changmei Guo, Ziyi Zhou, Ling Wang and Guorui Dou
Int. J. Environ. Res. Public Health 2022, 19(19), 12173; https://doi.org/10.3390/ijerph191912173 - 26 Sep 2022
Cited by 4 | Viewed by 2041
Abstract
As the global trend of diabetes intensifies, the burden of vision-threatening retinopathy, particularly diabetic retinopathy (DR), is increasing. There is an urgent need to seek strategies for early prevention and control of DR. This study attempted to comprehensively evaluate the relationship between dietary [...] Read more.
As the global trend of diabetes intensifies, the burden of vision-threatening retinopathy, particularly diabetic retinopathy (DR), is increasing. There is an urgent need to seek strategies for early prevention and control of DR. This study attempted to comprehensively evaluate the relationship between dietary nutrient intake and the risk of DR to provide assistance for doctors in guiding the diet of diabetic patients. Data from eligible participants with diabetes from the US National Health and Nutrition Examination Survey (NHANES) from 2003–2018 were analyzed. Univariate logistic regression was used to assess the association between 58 dietary nutrient intakes and self-reported eye disease risk. Multivariate logistic regression model was used to further evaluate the relationship between the two groups after adjusting relevant confounding factors. A total of 4595 diabetic patients were included. People with self-reported eye affliction/retinopathy had lower dietary fiber, butanoic, octanoic, vitamin A, alpha-carotene, folate, magnesium, copper and caffeine intake compared to those without self-reported eye affliction/retinopathy. The pooled ORs (95% CIs) were 0.78 (0.62–0.98), 0.79 (0.63–0.99), 0.72 (0.58–0.91), 0.74 (0.59–0.93), 0.70 (0.55–0.88), 075 (0.60–0.95), 0.79 (0.64–0.99), 0.67 (0.54–0.84) and 0.80 (0.64–0.99). Dietary cholesterol and hexadecenoic intake were higher, with the pooled ORs (95% CIs) of 1.26 (1.01–1.58) and 1.27 (1.02–1.59), respectively. Our research found that among dietary nutrients, dietary fiber, butanoic, octanoic, vitamin A, alpha-carotene, folate, magnesium, copper and caffeine intake reduced the occurrence of DR. Cholesterol and hexadecenoic intake promoted the occurrence of DR. This suggests that certain dietary nutrients should be paid more attention in the prevention of DR. Full article
(This article belongs to the Special Issue 2nd Edition of Nutrition, Diets and Public Health)
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10 pages, 996 KiB  
Article
Effect of Age and Gender on the Efficacy of a 12-Month Body Weight Reduction Program Conducted Online—A Prospective Cohort Study
by Jakub Woźniak, Katarzyna Woźniak, Olga Wojciechowska, Michał Wrzosek and Dariusz Włodarek
Int. J. Environ. Res. Public Health 2022, 19(19), 12009; https://doi.org/10.3390/ijerph191912009 - 22 Sep 2022
Cited by 1 | Viewed by 2006
Abstract
Overweight and obesity are a cause of many non-communicable diseases leading to an increased risk of death. There are many programs aimed at weight reduction, but few publications have evaluated their effectiveness according to the gender and age of the subjects. The purpose [...] Read more.
Overweight and obesity are a cause of many non-communicable diseases leading to an increased risk of death. There are many programs aimed at weight reduction, but few publications have evaluated their effectiveness according to the gender and age of the subjects. The purpose of this study is to evaluate the effects of age and gender on weight loss outcomes in subjects participating in a 12-month online weight loss program. 400 subjects, 190 men and 210 women, were included in the study. The online intervention consisted of a 15% energy deficit diet and training (RESPO method). Changes in body weight over 12 months were similar (p = 0.14) across age groups. Weight reductions by month were statistically significant (p = 0.0001) in both groups. We noted no differences in weight loss between men and women expressed in kilograms. However, women reduced their body weight to a greater extent, i.e., by 2.7 percentage points, than men. Gender is a factor that may influence the effectiveness of weight loss programs, while age demonstrates no such influence. Our study shows that significant weight reduction during weight loss therapy is achieved by both men and women, but women can expect better results. Full article
(This article belongs to the Special Issue 2nd Edition of Nutrition, Diets and Public Health)
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14 pages, 1319 KiB  
Article
Impact of an Interactive Health Corner Using the Culinary Education Approach in Promoting Long-Term Dietary Changes among Patients Who Seek Public Primary Care Services
by Lynette Mei Lim Goh, Li Ming Chow, Su Yi Ng, Dana Wai Shin Chow and Raymond Boon Tar Lim
Int. J. Environ. Res. Public Health 2022, 19(18), 11488; https://doi.org/10.3390/ijerph191811488 - 13 Sep 2022
Cited by 2 | Viewed by 1364
Abstract
An unhealthy diet is a major risk factor for chronic diseases. Although nutrition education and cooking demonstrations have resulted in favourable dietary changes, it is unclear whether this is sustainable for longer periods. This study aims to evaluate the long-term impact of a [...] Read more.
An unhealthy diet is a major risk factor for chronic diseases. Although nutrition education and cooking demonstrations have resulted in favourable dietary changes, it is unclear whether this is sustainable for longer periods. This study aims to evaluate the long-term impact of a nutrition-led cooking intervention using the culinary education approach on dietary patterns based on My Healthy Plate (MHP). This was a quasi-experimental study involving patients who sought public primary care services in two polyclinics (mean age 59.3 years old). A self-administered survey was done at baseline, 6 months, and 1 year for both the intervention and the comparison groups. Participants in the intervention group were exposed to the health corner, which provided nutrition education and cooking demonstrations using the culinary education approach. A total of 216 participants completed the study at 1 year with a follow-up rate of 86%. Adjusted risk ratios (aRR) were obtained from negative binomial regression. Compared with the comparison group, participants in the intervention group were more likely to report adhering to the requirements of MHP at 6 months (aRR 1.83, 95% CI 1.12–2.99) and 1 year (aRR 1.54, 95% CI 1.10–2.16). Participants in the intervention group were less likely to add salt or sauces to food at 6 months (aRR 0.29, 95% CI 0.12–0.75) and 1 year (aRR 0.21, 95% CI 0.07–0.61) and more likely to remove fat when eating meat at 1 year (aRR 0.30, 95% CI 0.13–0.67) than the comparison group. The interventions at the health corner had a positive impact in helping patients achieve MHP recommendations, not adding salt and sauces to their food, and removing animal fat before eating. There is potential for expanding this initiative to improve healthy eating practices in other polyclinics. Full article
(This article belongs to the Special Issue 2nd Edition of Nutrition, Diets and Public Health)
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13 pages, 844 KiB  
Article
Promotion of Food and Beverages by German-Speaking Influencers Popular with Adolescents on TikTok, YouTube and Instagram
by Eva Winzer, Brigitte Naderer, Simeon Klein, Leah Lercher and Maria Wakolbinger
Int. J. Environ. Res. Public Health 2022, 19(17), 10911; https://doi.org/10.3390/ijerph191710911 - 01 Sep 2022
Cited by 10 | Viewed by 5012
Abstract
The promotion of nutritionally poor food and beverages (F&B) has a proven effect on children’s eating preferences and, therefore, plays a significant role in today’s childhood obesity epidemic. This study’s objective was to assess the prevalence (exposure) and context (power) of the F&B [...] Read more.
The promotion of nutritionally poor food and beverages (F&B) has a proven effect on children’s eating preferences and, therefore, plays a significant role in today’s childhood obesity epidemic. This study’s objective was to assess the prevalence (exposure) and context (power) of the F&B cues in influencer content across three platforms: TikTok, YouTube, and Instagram. The selected influencers were popular with adolescents, with a combined total of more than 34 million followers/subscribers. We employed the YouTube Influencer Marketing Protocol from the World Health Organization (WHO) as our basis for coding. We analysed a total of 360 videos/posts and, of these, 24% contained F&B cues, which is equivalent to 18.1 F&B cues/hour. In total, 77% of the cues were not permitted for children’s advertising, according to WHO criteria, and this was stable across all platforms, with chocolate and sugary confectionery (23%) as the most frequently featured products. Not-permitted F&B had a four-times higher chance of being branded, a five-times higher chance of being described positively, and received significantly more ‘likes’. In 62% of the analysed presentations, the branded product was mentioned, yet only 6% of the content was labelled as advertising. The present analysis delivers further grounds for discussion for policies and regulations of influencer marketing. Full article
(This article belongs to the Special Issue 2nd Edition of Nutrition, Diets and Public Health)
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13 pages, 1594 KiB  
Article
Changes in Package Sizes of Savoury Snacks through Exploration of Euromonitor and Industry Perspectives
by Hei Man Emily Ng, Jessica Xu, Qingzhou Liu and Anna Rangan
Int. J. Environ. Res. Public Health 2022, 19(15), 9359; https://doi.org/10.3390/ijerph19159359 - 30 Jul 2022
Cited by 1 | Viewed by 2695
Abstract
Portion sizes of many energy-dense and nutrient-poor foods and drinks have increased in the past decade, whereas our understanding of the pattern of changes in package sizes remains limited. This study aimed to determine changing trends in sales and package sizes of savoury [...] Read more.
Portion sizes of many energy-dense and nutrient-poor foods and drinks have increased in the past decade, whereas our understanding of the pattern of changes in package sizes remains limited. This study aimed to determine changing trends in sales and package sizes of savoury snacks in Australia, the USA, Japan and Hong Kong, and to investigate industry perspectives for these changes. Sales data (units per capita) between 2006–2020 on savoury snacks were extracted from the Euromonitor International database. Industry perspectives on package size changes were extracted systematically from selected databases, company reports and related websites following the PRISMA-ScR guidelines. The findings showed that sales per capita of savoury snacks of all package sizes increased across all four countries/regions between 2006–2020. Although changes in the proportion of smaller (<100 g) versus larger (>100 g) package size sales in each country/region over time were modest, Japan and Hong Kong exhibited a consistently higher proportion of smaller package sales compared with Australia and the USA (83.3%, 64.4%, 44.3%, 20.2%, respectively). Industry perspectives showed that increasing consumer health consciousness, demands for convenience and portion control were the main contributors to decreasing package sizes of savoury snacks. Industry reports from 2020 showed an increase in larger package size sales due to consumer purchasing behaviour amidst the COVID-19 pandemic. Full article
(This article belongs to the Special Issue 2nd Edition of Nutrition, Diets and Public Health)
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Review

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28 pages, 517 KiB  
Review
The Role of Diet and Specific Nutrients during the COVID-19 Pandemic: What Have We Learned over the Last Three Years?
by Petra Rust and Cem Ekmekcioglu
Int. J. Environ. Res. Public Health 2023, 20(7), 5400; https://doi.org/10.3390/ijerph20075400 - 04 Apr 2023
Cited by 1 | Viewed by 5166
Abstract
Nutrients and diets have an important impact on our immune system and infection risk and a huge number of papers have been published dealing with various aspects of nutrition in relation to SARS-CoV-2 infection risk or COVID-19 severity. This narrative review aims to [...] Read more.
Nutrients and diets have an important impact on our immune system and infection risk and a huge number of papers have been published dealing with various aspects of nutrition in relation to SARS-CoV-2 infection risk or COVID-19 severity. This narrative review aims to give an update on this association and tries to summarize some of the most important findings after three years of pandemic. The analysis of major studies and systematic reviews leads to the conclusion that a healthy plant-based diet reduces the risks for SARS-CoV-2 infection and especially COVID-19 severity. Regarding micronutrients, vitamin D is to the fore, but also zinc, vitamin C and, to some extent, selenium may play a role in COVID-19. Furthermore, omega-3-fatty acids with their anti-inflammatory effects also deserve attention. Therefore, a major aim of societal nutritional efforts in future should be to foster a high quality plant-based diet, which not only exerts beneficial effects on the immune system but also reduces the risk for non-communicable diseases such as type 2 diabetes or obesity which are also primary risk factors for worse COVID-19 outcomes. Another aim should be to focus on a good supply of critical immune-effective nutrients, such as vitamin D and zinc. Full article
(This article belongs to the Special Issue 2nd Edition of Nutrition, Diets and Public Health)
13 pages, 1130 KiB  
Review
Holistic Framework to Contextualize Dietary Quality Assessment: A Critical Review
by Jessica M. Phelan, Richard R. Rosenkranz, Connor J. Phelan and Sara K. Rosenkranz
Int. J. Environ. Res. Public Health 2023, 20(5), 3986; https://doi.org/10.3390/ijerph20053986 - 23 Feb 2023
Cited by 1 | Viewed by 2171
Abstract
Numerous dietary quality indices exist to help quantify overall dietary intake and behaviors associated with positive health outcomes. Most indices focus solely on biomedical factors and nutrient or food intake, and exclude the influence of important social and environmental factors associated with dietary [...] Read more.
Numerous dietary quality indices exist to help quantify overall dietary intake and behaviors associated with positive health outcomes. Most indices focus solely on biomedical factors and nutrient or food intake, and exclude the influence of important social and environmental factors associated with dietary intake. Using the Diet Quality Index- International as one sample index to illustrate our proposed holistic conceptual framework, this critical review seeks to elucidate potential adaptations to dietary quality assessment by considering—in parallel—biomedical, environmental, and social factors. Considering these factors would add context to dietary quality assessment, influencing post-assessment recommendations for use across various populations and circumstances. Additionally, individual and population-level evidence-based practices could be informed by contextual social and environmental factors that influence dietary quality to provide more relevant, reasonable, and beneficial nutritional recommendations. Full article
(This article belongs to the Special Issue 2nd Edition of Nutrition, Diets and Public Health)
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