BMJ Nutrition, Prevention and Health

Background Health policies promote optimal care, yet policies that address disease-related malnutrition (DRM) are lacking. The purpose of this study was to conduct a scoping review to identify literature on existing and planned policy to address DRM in children or adults and explore the settings, contexts and actors of DRM policy. Methods A search strategy comprising DRM and policy keywords was applied to eight databases on 24 February 2023. Articles that addressed DRM and policy were selected for inclusion after two independent reviews. The health policy triangle (HPT) framework (ie, actors, content, contexts and processes considerations for policy) guided data extraction and thematic analysis. Results A total of 67 articles were included out of the 37 196 identified. Some articles (n=14) explored established policies at the local level related to food and mealtime, nutrition care practices, oral nutritional supplement prescribing or reimbursement. Other articles gave direction or rationale for DRM policy. As part of the HPT, actors included researchers, advocacy groups and DRM champions while content pertained to standard processes for nutrition care such as screening, assessment, intervention and monitoring. Contexts included acute care and care home settings with a focus on paediatrics, adults, older adults. Processes identified were varied and influenced by the type of policy (eg, local, national, international) and its goal (eg, advocating, developing, implementing). Discussion There is a paucity of global DRM policy. Nutrition screening, assessment, intervention and monitoring are consistently identified as important to DRM policy. Decision makers are important actors and should consider context, content and processes to develop and mobilise DRM policy to improve nutrition care. Future efforts need to prioritise the development and implementation of policies addressing DRM.

Katherine L Ford

Carlota Basualdo-Hammond

Roseann Nasser

Melita Avdagovska

Heather Keller

Ainsley Malone

Judy D Bauer

M Isabel T D Correia

Diana Cardenas

Leah Gramlich

BMJ Nutrition Prevention & Health

Health policy to address disease-related malnutrition: a scoping review

解决疾病相关营养不良的健康政策：范围综述

Background A healthier diet is associated with lower chronic disease burden, but the impact of neighbourhood food environments on disability and death in older adults is not known. Methods In the Cardiovascular Health Study, a cohort study of adults aged 65+, we calculated study years until death (years of life (YOL)), study years without activities of daily living (ADL) difficulty (years of able life; YoAL) and percent of study years without ADL difficulty (compression of disability). Linear regression quantified associations of food establishments within 5 km of baseline home address (as a z-score) with each outcome, adjusted for sociodemographic characteristics. Sensitivity analyses considered adjustment for risk factors and comorbidities, multiple imputation, alternate neighbourhood definitions (1-km radial buffer, census tract) and restriction on residential stability. Results We included 4298 participants followed for up to 26 years. All food retail establishments were associated with 6 months higher YoAL per SD in the main model (beta, 0.50 years; 95% CI 0.01, 0.98; p=0.046), with similar findings across sensitivity analyses except when restricting on residential stability. Supermarkets and produce markets were associated with compression of disability (beta, 2.31; 95% CI, 0.04, 4.57) and when using 1-km buffers with YOL (beta, 0.23 years; 95% CI 0.03, 0.43) and YoAL (beta, 0.21 years; 95% CI 0.01, 0.41). Non-supermarket food stores were associated with YoAL (beta, 0.67 years; 95% CI, 0.07, 1.27) and compression of disability (beta, 3.03; 95% CI 0.44, 5.62), but significance was not consistent across sensitivity analyses. Fast-food restaurants did not reach statistical significance in any model. Conclusion All food retail was associated with YOL without impairment. Neighbourhood food retail access and type may both have roles in extending YOL and years of able life among older adults, but the findings were sensitive to decisions made during measurement and modelling.

Roma Bhatia

Mark A Hernandez

Jonathan Platt

Anne B Newman

David S Siscovick

Kenneth J Mukamal

Gina S Lovasi

Associations of neighbourhood food retail with disability and death in older adults: Cardiovascular Health Study

邻里食品零售与老年人残疾和死亡的关联：心血管健康研究

Rony Abou-Khalil

Elissar El-Hayek

Comprehensive clarification of statistical and data concerns on the effects of apple cider vinegar on weight loss

苹果醋对减肥效果的统计与数据问题全面澄清

Background Inadequate energy intake among athletes can lead to low energy availability (LEA) which in turn can result in negative effects on athletic performance and physical and psychological health. This syndrome is known as relative energy deficiency in sports (REDs). Objective To map perceived changes in overall food intake among adolescent athletes during the previous year, as well as weekly changes during a 3-month period and to examine how these changes are associated with mental health, physical load and sex. Methods A total of 168 high school athletes from eight different sports participated. A baseline questionnaire examined changes in training habits and food intake in the past year, mental health (short version of the Warwick-Edinburgh Mental Well-being Scale (SWEMWBS)), injury history and previous periods of poor psychological health. Weekly digital questionnaires for 3 months tracked weekly physical and mental load and changes in food intake. Comparative and correlation analyses were performed with p&lt;0.05 considered significant. Results A decreased food intake during the previous year was reported more often among athletes experiencing periods of poor mental health than those without such periods (10% vs 2%; p=0.034). Athletes who decreased their food intake reported lower mental well-being than athletes who increased their food intake (mean difference in SWEMWBS=4.69±1.57; p=0.021). Over a 3-month period, most athletes did not change their food intake, yet fluctuations in physical load were reported. Conclusion This study showed that athletes experiencing lower mental health or period(s) of poor mental health reported decreased food intake more often than those with better mental health or those without period(s) of poor mental health. In addition, the mismatch found between perceived weekly changes in overall food intake and changes in physical load during the same time period could potentially result in an increased risk for LEA.

Maria Larsson

Ida Lindman

Agneta Hörnell

Josefin Abrahamson

Prospective study of food intake changes in adolescent elite athletes

青少年精英运动员饮食摄入变化的前瞻性研究

Background Postprandial lipemia (PPL) has been recognised as a cardiovascular disease risk factor. Appetite and PPL can be influenced by the length of saturated fatty acids (FAs). Thus, this study aims to investigate if different FA chain lengths have different impacts on appetite and PPL in healthy volunteers. Methods This is a randomised crossover single-blinded intervention study of 20 healthy adults. Coconut oil and palm oil were consumed in the form of biscuits. Blood serum samples were withdrawn after an overnight fast and 1, 2, 4 and 6 hours after eating the test meals and examined for blood lipid profile (total cholesterol (TC), high-density lipoprotein (HDL) and triglycerides (TG)), while Friedewald’s equation was used to calculate low-density lipoprotein (LDL). Visual analogue scales were used by participants to rate their appetites, and an ad libitum meal was weighed to determine the energy intake. Results The net area under the curve of TG and TC following the coconut oil were significantly lower than following the palm oil ( P value ≤0.05). In the mean of the change in TC, LDL and HDL from the baseline, a significant difference was found after 6 hours of eating the biscuits ( P value ≤0.05). The perceptions of hunger and fullness did not significantly differ between the two types of FAs. Also, the energy and macronutrient intakes were not significantly different after the two types of oil, neither at the ad libitum meal nor on the day following the treatments. Conclusion The selection of FA chain length may influence PPL, and thus cardiovascular disease risk in a way that is functionally significant. However, this study detected no influence of FA chain length on appetite up to 40 hours post-treatment. Trial registration number NCT05539742 .

Ruaa Jadallah

Shatha S Hammad

Comparison of the effect of medium-chain fatty acids and long-chain fatty acids on postprandial appetite and lipemia: a randomised crossover trial

中链脂肪酸与长链脂肪酸对餐后食欲和脂血症影响的比较：一项随机交叉试验

Background Several modifiable risk factors, including dietary habits, are linked to cardiovascular disease (CVD) progression. However, lifestyle changes remain notoriously challenging, perhaps due to psychosocial factors. This pilot study aims to investigate the relationship between adherence to a healthy diet, CVD risk factors, psychological factors and sociodemographic variables among middle-aged adults in Sweden. Methods Data were collected from March to December 2012 in the SCAPIS diet sub-study, where a total of 200 participants aged 50–64 years were enrolled. Dietary intake was assessed using the MiniMeal-Q food frequency questionnaire, and adherence to healthy eating patterns was evaluated using the Diet Quality Index-Swedish Nutrition Recommendations (DQI-SNR). Psychological factors, stress and sleep patterns were assessed through a comprehensive questionnaire. Statistical analyses included t-tests, analysis of variance, X 2 tests and logistic regression to identify predictors of unfavourable apolipoprotein (Apo) B/Apo A1 ratios. Results Out of 200 participants, 182 had complete and reliable dietary data. The majority exhibited intermediate adherence to a healthy diet, with women showing better adherence to dietary fibre intake compared with men. Women with high dietary quality had better cardiovascular profiles, including higher levels of Apo A1 and high-density lipoprotein cholesterol, lower Apo B/Apo A1 ratios and higher plasma carotenoids. Significant predictors of unfavourable Apo B/Apo A1 ratios included low socioeconomic status (SES), higher body mass index, larger waist circumference and smoking. Stratified adjusted analyses revealed distinct predictors based on SES, with depression increasing the OR of an unfavourable lipid profile by 6.41 times (p=0.019) in low SES areas. Conclusions This study highlights the potential of tailored recommendations considering socioeconomic and psychological factors. Addressing mental health and promoting physical activity may be crucial for CVD risk reduction, particularly in low SES areas. Further research is needed to confirm these findings in larger cohorts and to develop targeted interventions for diverse population groups.

Sanna Nybacka

Mireille Ryden

Anneli Peolsson

Per Leanderson

Diet quality, psychological factors and their associations with risk factors of cardiovascular disease: a cross-sectional pilot study

饮食质量、心理因素及其与心血管疾病风险因素的关联：一项横断面初步研究

Abbreviation	BMJNPH
Journal Impact	3.24
Quartiles(Global)	NUTRITION & DIETETICS(Q2)

ISSN	2516-5542
h-index	15

Publication Information	Publisher: BMJ Publishing Group，Publishing cycle: ，Journal Type: journal，Open Access Journals: Yes
Basic data	Year of publication: 2019，Proportion of original research papers: ，Self Citation Rate:， Gold OA Rate:
Journal Fees	$Details
Average review cycle	12 weeks

BMJ Nutrition, Prevention and Health

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Share Submission Experience

Health policy to address disease-related malnutrition: a scoping review

Associations of neighbourhood food retail with disability and death in older adults: Cardiovascular Health Study

Comprehensive clarification of statistical and data concerns on the effects of apple cider vinegar on weight loss

Prospective study of food intake changes in adolescent elite athletes

Comparison of the effect of medium-chain fatty acids and long-chain fatty acids on postprandial appetite and lipemia: a randomised crossover trial

Diet quality, psychological factors and their associations with risk factors of cardiovascular disease: a cross-sectional pilot study

Prospective study of food intake changes in adolescent elite athletes

Comparison of the effect of medium-chain fatty acids and long-chain fatty acids on postprandial appetite and lipemia: a randomised crossover trial

Comprehensive clarification of statistical and data concerns on the effects of apple cider vinegar on weight loss

Health policy to address disease-related malnutrition: a scoping review