This study aimed to develop a shared understanding about the drivers of nutrition security in Puerto Rico (PR) from the collective perspective of multi-sector stakeholders in the agri-food, environmental and the health/disease systems.

A participatory community-based system dynamics approach (group model building) engaged stakeholders during one 4-h workshop March 2023 (followed by two 2.5-h member checking sessions).

San Juan, PR.

Stakeholders (n 22) in PR representing the agri-food, environmental and health/disease systems from multiple sectors (commercial food retail and technology, food production, public servants, academia and civil society) participated in the workshop.

Stakeholders collectively framed nutrition security as an outcome of six interconnected subsystems exacerbated by climate change: (1) governance and public policy; (2) demographic change and rural disinvestment; (3) climate change and adaptive capacity; (4) local food production economy; (5) food culture; and (6) nutrition security and health. Stakeholders identified leverage points mostly focused on strengthening information flow within and across subsystems and expanding cross-sectoral collaboration (systems structures and elements). We identified three paradigms that have the potential to transform the system structure and function: ecological conscience, traditional and healthy food culture, and social cohesion.

These findings deepened the collective understanding of systemic interdependencies that drive nutrition security as stakeholders identified locally feasible leverage points.

The food system is a major contributor to the global burden of disease, ecosystem destruction and climate change, posing considerable threats to human and planetary health and economic stability. Evidence-based food policy is fundamental to food system transformation at global, national and local or institutional levels. This study aimed to critically review the content of universities’ food sustainability policy documents.

A systematic search of higher education institutions’ policies, using targeted websites and internet searches to identify food sustainability policy documents, was conducted between May and August 2023. A quantitative content analysis of the identified documents was conducted independently by multiple researchers using a coding template. Inconsistencies in coding were subsequently checked and amended through researcher consensus.

163 UK higher education institutions.

N/A.

Approximately 50 % of universities had a publicly available food sustainability policy. The most common food sustainability commitments therein were communication and engagement (95·2 %), food waste (94·0 %) and quality standards and certification (91·7 %). The scope of policy commitments varied between institutions; however, comprehensive documents included multifaceted commitments tackling more than one dimension of sustainability, for example, waste mitigation strategies that tackled food insecurity through food redistribution. Few (17·9 %) policies included a commitment towards research and innovation, suggesting university operations are considered in isolation from academic and educational activities.

Multifaceted policy commitments are capable of uniting numerous food-related actions and institutional activities. As such, they are likely to support food system transformation, with broader positive outcomes for the university, students and the wider community.

While associations of ultra-processed food (UPF) consumption with adverse health outcomes are accruing, its environmental and food biodiversity impacts remain underexplored. This study examines associations between UPF consumption and dietary greenhouse gas emissions (GHGe), land use and food biodiversity.

Prospective cohort study. Linear mixed models estimated associations between UPF intake (g/d and kcal/d) and GHGe (kg CO2-equivalents/day), land use (m2/d) and dietary species richness (DSR). Substitution analyses assessed the impact of replacing UPF with unprocessed or minimally processed foods.

368 733 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study.

Europe.

Stronger associations were found for UPF consumption in relation with GHGe and land use compared with unprocessed or minimally processed food consumption. Substituting UPF with unprocessed or minimally processed foods was associated with lower GHGe (8·9 %; 95 % CI: –9·0, –8·9) and land use (9·3 %; –9·5; –9·2) when considering consumption by gram per day and higher GHGe (2·6 %; 95 % CI: 2·5, 2·6) and land use (1·2 %; 1·0; 1·3) when considering consumption in kilocalories per day. Substituting UPF by unprocessed or minimally processed foods led to negligible differences in DSR, both for consumption in grams (–0·1 %; –0·2; –0·1) and kilocalories (1·0 %; 1·0; 1·1).

UPF consumption was strongly associated with GHGe and land use as compared with unprocessed or minimally processed food consumption, while associations with food biodiversity were marginal. Substituting UPF with unprocessed or minimally processed foods resulted in differing directions of associations with environmental impacts, depending on whether substitutions were weight or energy based.

Household food insecurity (HFI) is a social determinant of health globally. Rates of HFI have risen in many high-income countries in recent years, particularly in households with children. The health outcomes associated with HFI for children and adolescents have not been systematically synthesised. This review was conducted to support advocacy efforts for meaningful policy action to reduce HFI in households with children.

A systematic search was conducted in Medline, Embase and PsycInfo databases. Primary studies measuring the association between physical or mental health outcomes and HFI were included. Studies were appraised and population, setting, measures and outcomes were extracted. Findings were grouped by related outcomes. Due to heterogeneity, findings were synthesised narratively. Rapid review methodology was used to accommodate resource constraints.

High-income countries.

Youth aged less than 18 years.

Thirty-six studies were included. Most were cross-sectional studies conducted in the USA. Outcomes included general health, early childhood, cardiometabolic, asthma, dental caries, mental health, sleep, diet and anaemia. Despite substantial heterogeneity in HFI measures and analysis, findings support associations between HFI and negative outcomes for general health status, asthma, dental caries and mental health. Findings for other outcomes were mixed.

This review clarifies the effects of HFI on children and adolescents. Findings highlight trends for negative physical and mental health outcomes associated with HFI during youth, particularly related to mental health, oral health, asthma and general health status. Policy-level action should address rising rates of HFI and long-term effects on these vulnerable populations.

Multiple sclerosis (MS) is a chronic, auto-immune, neurodegenerative condition with increasing global prevalence. People living with MS (plwMS) have reported limited guidance relating to nutrition information. Paired with varied health literacy levels, this makes plwMS susceptible to nutrition misinformation.

A cross-sectional online social network analysis (SNA) examining nutrition information for MS.

A systematic SNA using Twitter/X and YouTube platforms using NodeXL to summarise metrics. Quality was assessed using the QUEST tool. Content analysis of YouTube videos was synthesised into themes for misinformation.

Online publicly available social media user posts and video content.

Twitter/X SNA revealed keywords used most by an account representing 72·8 % of the user network with common diet mentions including Wahls (57 times), paleo (15 times) and ketogenic (11 times). ‘Favourite count’ metrics were strongly correlated with ‘repost count’ (r = 0·83, P = 0·000). Videos which endorsed a diet were more likely to have a lower QUEST score. User engagement metrics were higher for lower quality videos. The quality of online nutrition information relating to MS was moderate (61 %). Physicians were the most likely source of nutrition information endorsing a diet for MS. The content analysis identified a knowledge gap for both medical professionals and plwMS.

Nutrition misinformation for MS occurs on social media and information quality is variable. Audiences need to be cautioned about users with large followings and evaluate the credibility of all information. This study reiterates the importance of evidence-based information for the MS community.

To identify and present (i) how responsibility for poor diets in the UK is framed across the public, mass media and the government and (ii) how groups experiencing socio-economic disadvantage are presented within this framing.

A scoping review of peer-reviewed literature was conducted using six databases. A systematic narrative synthesis guided by qualitative content analysis was applied to summarise the findings.

Thirty-six articles were included. Studies exploring public perceptions of poor diets acknowledged personal and broader systems drivers, with individual responsibility predominating across studies. Research analysing media portrayals showed similar patterns of individual responsibility among right-leaning newspapers, which focused on individual lifestyle changes. However, left-wing newspapers highlighted the role of the food industry and the government. Studies analysing government policies identified citizens as the primary agents of change through rational decision-making. Framing from socio-economically disadvantaged groups showed a preference for prioritising their own choice, but were limited by household income, food prices and family food preferences. Policies and media portrayals provided limited emphasis on these populations, with individual responsibility narratives prevailing.

The framing of responsibility for poor diets in the UK centred on the individual, obscuring the powerful influence of food manufacturers and retailers and the role of government in providing safe, healthy environments for all. This review highlights the urgent need to challenge this narrative, with the public health nutrition community working collectively to force a radical shift in public, media and policy framing and incite strong regulatory action by governments.

This study compared dietary diversity and nutrient adequacy across age groups and seasons within an indigenous Karen community.

Cross-sectional survey.

Dietary intake was assessed using a single-day 24-h dietary recall among Karen community members living in two villages of Laiwo subdistrict, Sangkhlaburi district, Kanchanaburi province, Thailand.

In total, 312 Karen people participated during the rainy season and 344 during the dry season, including school-age children (6–12 years), working-age people (19–59 years) and older people (≥ 60 years).

Dietary diversity scores and food variety scores significantly differed across age groups for both seasons. However, seasonal dietary diversity score differences were not observed within any group, except for the food variety scores of school-age children. Over 70 % of participants in all age groups had inadequate intake of key micronutrients – Ca, Fe, vitamin A, vitamin C, Zn, vitamin B6 and vitamin B12 – as indicated by nutrient adequacy ratios < 0·75. Moderate to strong positive correlations between dietary diversity scores and nutrient adequacy ratios for energy, vitamin B2, vitamin C, niacin and mean adequacy ratio (r = 0·418–0·691, P < 0·001) were observed exclusively in the dry season and across all age groups.

Among the Karen people, who are also facing triple burden malnutrition, dietary diversity is limited, micronutrient inadequacy is prevalent and overall dietary quality is insufficient despite frequent vegetable consumption. Findings highlight the need to address systemic challenges related to food variety and to promote education on appropriate food quantities, preparation methods and sustainable traditional food systems to improve nutrition.