How can packaging change children's eating habits from un-healthy food towards healthier options?

Field Lab: Children consumer behaviour

Your Guide to Healthy Eating Using the Food Pyramid

Do you want to feel good and have more energy? Do you want to maintain a healthy weight and help reduce your risk of becoming ill from high blood pressure, high cholesterol, heart disease, type 2 diabetes, cancer and other chronic diseases?Eating healthy food and being physically active are two of the most importantsteps that you can take to improve your health. To help you do this, follow the Healthy Eating Guidelines, use the Food Pyramid Guide and the Physical Activity Guidelines. Click here to download PDF 540kb FSAI Resource Publication -Healthy Eating and Active Living for Adults, Teenagers and Children over 5 yearsâ?" A Food Guide for Health Professionals and Catering Services:www.fsai.ie/WorkArea/DownloadAsset.aspx?id=11387

Getting a good start: healthy eating from one to five

This booklet outlines advice on many key nutritional issues for children aged one to five. It includes information on how to provide a healthy, balanced diet for this age group, guidance on suitable snacks and drinks, feeding a vegetarian child, vitamin supplements and iron, making the most of mealtimes and how to deal with fussy eaters.

The changing structure of diets in the European Union in relation to healthy eating guidelines

Objective: Our objective in this paper is to assess diets in the European Union (EU) in relation to the recommendations of the recent World Health Organization/Food and Agriculture Organization expert consultation and to show how diets have changed between 1961 and 2001. Data and methods: Computations make use of FAOSTAT data on food availability at country level linked to a food composition database to convert foods to nutrients. We further explore the growing similarity of diets in the EU by making use of a consumption similarity index. The index provides a single number measure of dietary overlap between countries. Results: The data confirm the excessive consumption by almost all countries of saturated fats, cholesterol and sugars, and the convergence of nutrient intakes across the EU. Whereas in 1961 diets in several European countries were more similar to US diets than to those of other European countries, this is no longer the case; moreover, while EU diets have become more homogeneous, the EU as a whole and the USA have become less similar over time. Conclusions: Although the dominant cause of greater similarity in EU diets over the period studied is increased intakes in Mediterranean countries of saturated fats, cholesterol and sugar, also important are reductions in saturated fat and sugar in some Northern European countries. This suggests that healthy eating messages are finally having an impact on diets; a distinctly European diet may also be emerging.

Assessment of evaluations made to healthy eating policies in Europe: a review within the EATWELL Project

Objective: To identify and assess healthy eating policies at national level which have been evaluated in terms of their impact on awareness of healthy eating, food consumption, health outcome or cost/benefit. Design: Review of policy documents and their evaluations when available. Setting: European Member States. Subjects: One hundred and twenty-one policy documents revised, 107 retained. Results: Of the 107 selected interventions, twenty-two had been evaluated for their impact on awareness or knowledge and twenty-seven for their impact on consumption. Furthermore sixteen interventions provided an evaluation of health impact, while three actions specifically measured any cost/benefit ratio. The indicators used in these evaluations were in most cases not comparable. Evaluation was more often found for public information campaigns, regulation of meals at schools/canteens and nutrition education programmes. Conclusions: The study highlights the need not only to develop harmonized and verifiable procedures but also indicators for measuring effectiveness and success and for comparing between interventions and countries. EU policies are recommended to provide a set of indicators that may be measured consistently and regularly in all countries. Furthermore, public information campaigns should be accompanied by other interventions, as evaluations may show an impact on awareness and intention, but rarely on consumption patterns and health outcome.

Should healthy eating programmes incorporate interaction with foods in different sensory modalities? A review of the evidence

Commercial interventions seeking to promote fruit and vegetable consumption by encouraging preschool- and school-aged children to engage with foods with ‘all their senses’ are increasing in number. We review the efficacy of such sensory interaction programmes and consider the components of these that are likely to encourage food acceptance. Repeated exposure to a food's flavour has robust empirical support in terms of its potential to increase food intake. However, children are naturally reluctant to taste new or disliked foods, and parents often struggle to provide sufficient taste opportunities for these foods to be adopted into the child's diet. We therefore explore whether prior exposure to a new food's non-taste sensory properties, such as its smell, sound, appearance or texture, might facilitate the food's introduction into the child's diet, by providing the child with an opportunity to become partially familiar with the food without invoking the distress associated with tasting it. We review the literature pertaining to the benefits associated with exposure to foods through each of the five sensory modalities in turn. We conclude by calling for further research into the potential for familiarisation with the visual, olfactory, somaesthetic and auditory properties of foods to enhance children's willingness to consume a variety of fruits and vegetables.

Associations between healthy eating patterns and indicators of metabolic risk in postmenopausal women

Background: Since human diets contain many components that may work synergistically to prevent or promote disease, assessing diet quality may be informative. The purpose of this study was to investigate the association between quality diet, by using Healthy Eating Index (HEI), and metabolic risk indicators in postmenopausal women.Methods: This cross-sectional study included a total of 173 Brazilian women, aged 45-75 years, seeking healthcare at a public outpatient center. Food consumption assessed by 24 h-recall food inquiry was used to calculate HEI scores: >80 implied diet good, 80-51 diet needed improvement, and <51 diet poor. Anthropometric data included: body mass index (BMI = weight/height(2)), waist-circumference (WC), body fat (%BF) and lean mass (%LM). Data on total cholesterol (TC), high density lipoprotein cholesterol (HDLC), low density lipoprotein cholesterol (LDLC), and triglycerides (TG) were also collected. Fisher's Exact test, and logistic regression method (to determine odds ratio, OR) were used in the statistical analysis.Results: Overweight and obesity were observed in 75.7% of the participants. Excessive %BF (> 35%) was observed in 56.1%, while %LM was reduced (<70%) in 78.1%. WC was elevated (= 88 cm) in 72.3%. Based on HEI values, diet quality was good in 3% (5/173), needed improvement in 48.5% (84/173), and was poor in 48.5% (84/173) of the cases. In this group, 75% of women had high intakes of lipids (> 35%), predominantly saturated and monounsaturated fat. on average, plasma TC, LDLC, and TG levels were higher than recommended in 57.2%, 79.2% and 45.1% of the women, respectively, while HDLC was low in 50.8%. There was association between HEI scores and the %BF that it was higher among women with HEI score < 80 (p = 0.021). There were not observed significant risk associations between HEI and lipid profile.Conclusion: Among the Brazilian postmenopausal women attending a public outpatient clinic, diet was considered to need improvement or to be of poor quality, attributed to high saturated fat ingestion, which probably caused a negative impact on metabolic risk indicators, namely body composition.

Intervention Based Exclusively on Stage- Matched Printed EducationalMaterials Regarding Healthy Eating Does Not Result in Changes to Adolescents' Dietary Behavior

Purpose. To assess the impact of a six-month stage-based intervention on fruit and vegetable intake, regarding perceived benefits and barriers, and self-efficacy among adolescents. Design. Randomized treatment-control, pre-post design. Subjects/ Setting. Schools were randomized between control and experimental groups. 860 adolescents from ten public schools in Bras ' ilia, Federal District, Brazil were evaluated at baseline; 771 (81%) completed the study. Intervention. Experimental group received monthly magazines and newsletters aimed at promotion of healthy eating. Measures. Self-reported fruit and vegetable intake, stages of change, self-efficacy and decisional balance scores were evaluated at baseline and post-intervention in both groups. Analysis. The effectiveness of the intervention was evaluated using the analysis of covariance model (ANCOVA) and repeated measurement analysis by means of weighted least squares. Comparison between the proportions of adolescents who advanced through the stages during the intervention was performed using the Mantel-Haenszel chi-square test. Results. After adjusting for sex and age, study variables showed no modifications through the proposed intervention. There was no statistical difference in participant mobility in the intervention and control groups between the stages of change, throughout the study. Conclusion. A nutritional intervention based exclusively on distribution of stage-matched printed educational materials was insufficient to change adolescents' dietary behavior.

The Portuguese National Programme for the Promotion of Healthy Eating: 2012–2015

This paper describes the first 4-year period (2012–2015) of implementation of the Portuguese National Programme for the Promotion of Healthy Eating (PNPAS). PNPAS was approved in 2012 and emerged as a preventive programme for noncommunicable diseases, aiming to improve the nutritional status of the population; it represents the first national strategy in Portugal for the promotion of healthy eating. To accomplish its mission, and taking into account its overall principles, PNPAS has five main goals: (i) to increase knowledge about the food intake of the Portuguese population and about its determinants and consequences; (ii) to modify the availability of certain foods (high in sugar, salt and fat), in schools, workplaces and public spaces; (iii) to inform and empower the population for the purchase, preparation and storage of healthy food, especially the most vulnerable groups; (iv) to identify and promote crosssectoral actions that encourage the consumption of foods of good nutritional quality in an articulate and integrated way with other sectors, namely agriculture, sport, environment, education, social security and local authorities; and (v) to improve the qualifications and conduct of the different professionals who, owing to their roles, may influence nutritional knowledge, attitudes and behaviours. The design of PNPAS followed the latest strategic lines suggested by WHO and the European Commission, proposing a crosssectoral mix of interventions to ensure physical and economic access to healthy eating by creating healthy environments and empowering individuals and communities. Several actions were implemented at different levels during the first 4-year period of implementation of PNPAS; two were especially relevant. The first concerned the empowerment of citizens regarding healthy eating, where the most important aspect was introduction of a digital strategy through development of a website and a blog dedicated to healthy eating. The second concerned the development of documents for health care and other professionals, including several guidelines in new areas, such as anthropometric measures and intervention in preobesity. Process and output indicators were defined to monitor and evaluate the programme. Among those considered as output indicators were the evaluation of childhood obesity, salt consumption and intake of breakfast by school-aged children.

Using a combined motivational and volitional intervention to promote exercise and healthy dietary behaviour among undergraduates

Aims: This study tested the impact of combining a motivational intervention based on protection motivation theory (PMT, Rogers, 1983 [18]) plus a volitional intervention based on action planning and coping planning, as a way to promote the prevention of type 2 diabetes among UK undergraduates. Methods: Eighty-four participants were randomly assigned to either a control group or one of three experimental conditions: motivational intervention (PMT), volitional intervention (APCP), or combined motivational and volitional intervention (PMT&APCP). PMT variables, dietary and exercise behaviours were measured at three time-points over a four-week period. Results: The motivational intervention significantly changed PMT variables. The combined motivational and volitional intervention significantly decreased fat intake and increased the frequency of exercise relative to all other groups, and significantly increased the amount of fruit and vegetables consumed relative to control and volitional intervention groups. Conclusions: These results suggest that motivational intervention is effective at changing cognitions but changing behaviour requires an intervention based on both motivation and volition.

The use of motivational interviews by nurses to promote health behaviors in adolescents: a scoping review protocol

Adolescents - defined as young people between 10 and 19 years of age1 - are, in general, a relatively healthy segment of the population.2 However, the developmental changes that take place during adolescence may affect their subsequent risk for diseases and for a variety of health-related behaviors. In fact, early onset of preventable health problems (e.g. obesity, malnutrition, STDs) and the engagement in health risk behaviors (e.g., sedentary life style, excessive alcohol consumption, unprotected sex) during adolescence, are likely to put them at greater risk for physical and mental health problems at a later stage in life. Moreover, health related problems and health risk behaviors may disrupt adolescents' physical and cognitive development and therefore may affect their ability to think and act in relation to decisions about their health in the future.1 In summary, health-related behaviors in adolescence, apart from their influence on the continuum of "health-disease", they also have the potential to influence future behaviors. In fact, several studies have shown that past behaviors are good predictors of future behaviors .3,4 Thus, promoting healthy practices during adolescence and taking measures to better protect young people from health risks are essential for the prevention of health problems in adulthood.5 According to the World Health Organization, the main problems affecting young people include mental health problems (such as behavioral disorders, eating disorders, suicide, anxiety or depression), the use of substances (illegal substances, alcohol and tobacco), interpersonal violence, nutrition (a proper nutrition consists of healthy eating habits and physical exercise), unintentional injuries (which are a leading cause of death and disability among young people, with road traffic injuries accounting for about 700 deaths per day), sexual and reproductive health (for example, risky sexual behaviors, early pregnancy and childbirth) and HIV (resulting from sexual transmission and drug injection).5,6 On the other hand, the number of children and youth with chronic health conditions has increased dramatically in the past four decades7 as larger numbers of chronically ill children survive beyond the age of 10.8 Despite the lack of data on adolescents' health making it difficult to determine the prevalence of chronic illnesses in this age group9, it is known that one in ten adolescents suffers from a chronic condition worldwide.10 In fact, national population based studies from Western countries show that 20-30% of teenagers have a chronic illness, defined as one that lasts longer than six months.8 The most prevalent chronic illness among adolescents is asthma and the one with the highest incidence is diabetes mellitus, particularly type II.9 Traditionally, healthcare professionals have been mainly investing in health education activities, through the transmission of knowledge with a view to creating habits, customs and behaviors, and promoting healthy lifestyles. However, empowering people does not only consist of giving them the right information11 , i.e. good information is not enough to cause people to make changes.12 The motivation or desire to change unhealthy behaviors and habits depends on many factors, namely intrinsic motivation, control over personal decisions, self-confidence and perception of effectiveness, personal ambivalence, and individualized assistance.12 Many professionals assume that supplying knowledge is sufficient for behavioral changes; however, even very good advice often fails to generate behavioral change. After all, people continue to engage in unhealthy behaviors despite clearly knowing what they should do and how to change. "What is lacking is the motivation to apply that knowledge".13, p.1233 In fact, behavioral change is a complex phenomenon with multiple determinants that also includes motivational variables. It is associated with ambivalent processes expressed in the dilemma between keeping the current status and moving on to new ways of acting. For example, telling adolescents that if they keep on engaging in a certain behavior, they are increasing the risk of developing a long-term condition such as cardiovascular disease, stroke or diabetes is rarely enough to trigger the desired behavioral change; people are more likely to change when they believe that the change is really effective and that they are able to implement it.12 Therefore, it is essential to provide specific training for "healthcare professionals to master motivational techniques, avoid confrontation with the users, and facilitate behavioral changes".14 In this context, motivating patients to make behavioral changes is also an important nursing task where change in lifestyle is a major element of patients' treatment and preventive interventions.15 One of the nurse's goals is to help improve a patient's health or help them to manage existing health conditions. Once nurses are in a position where they have to focus on accomplishing tasks and telling patients what needs to be accomplished16, the role of the nurse is expanding even more into the use of motivational strategies.17 MI is bringing nurses back to therapeutic communication and moving them closer to successful health promotion and disease management, by promoting behavior change and empowering their patients. As the nursing profession evolves, MI is seen as a challenge and the basis of nurse's interactions with individuals, families and communities.16, 17 In the same way, MI may be taken as an essential tool in the provision of nursing care to adolescents, being itself a workspace with possible therapeutic effects regarding problems, clarification of doubts, and development of skills.18 In fact, MI may be particularly applicable in work with adolescents because of their specific developmental stage. Adolescents attempt to establish their own autonomy and identity while struggling with social interactions and moral issues, which leads to ambivalence.19 Consistent with the developmental challenges during adolescence, "MI explicitly honors autonomy, people's right and irrevocable ability to decide about their own behavior"20 while allowing the person to explore possibilities for change of risky or maladaptive behaviours.19 MI can be defined as a directive, client-centred counselling style for eliciting behavior change by helping clients to explore and resolve ambivalence. It is most centrally defined not by technique but by its spirit as a facilitative style of interpersonal relationship.21 It is a set of strategies and techniques widely used in clinical practice based on the transtheoretical model of change. The Stages of Change model describes five stages of readiness—precontemplation, contemplation, preparation, action, and maintenance—and provides a framework for understanding behavior change.22 The MI has been widely tested and applied in different areas, such as modification of addictive behaviors, interventions with offenders in the context of justice, eating disorders, promotion of therapeutic adherence among chronic patients, promotion of learning in school settings or intervention with adolescents at risk.18,23 In general, clinical practice has been adopting the perspective of motivation as something relatively immutable, i.e., the adolescent is either motivated for change/treatment and, in these conditions, the professional's role is to help him/her, or the adolescent is not motivated and then change/treatment is not feasible. Alternatively the theoretical model underlying the MI technique postulates that the individual's adherence to change/treatment depends on his/her motivation, which can change throughout the therapeutic intervention. As several studies found positive results for effects of MI24-26 and its use by health professionals is encouraged23,27 nurses may play an important role in patients' process of change. As nurses have a crucial role in clinical contexts, they can facilitate the process of ending risk behaviors and/or adopting positive health behaviors through some motivational techniques, namely with adolescents. A considerable number of systematic reviews about MI already exist pointing to some benefits of its use in the treatment of a broad range of behavioral problems and diseases.13,28,29 Some of the current reviews focus on examining the effectiveness of MI for adolescents with diverse health risks/problems 30-32. However, to date there are no reviews that present and assess the evidence for the use of nurse-led MI in adolescents. Therefore, we have little knowledge of what works for whom (which adolescent subpopulation) under what circumstances (in which setting, for what problem) in relation to motivational interviewing by nurses. There is a clear need for scoping or mapping the use of MI by nurses with adolescents to identify evidence gaps and to inform opportunities for future development in nursing practice. On the other hand, information regarding nurse-led implemented and evaluated interventions, techniques and/or strategies used, contexts of application and adolescents subpopulation groups is dispersed in the literature33-36 which impedes the formulation of precise questions about the effectiveness of those interventions conducted by nurses and therefore the realization of a systematic review. In other words, it is known that different kind of motivational interventions have been implemented in different contexts by nurses, however does not exist a map about all the motivational techniques and/or strategies used. Furthermore the literature does not clarify which is the role of nurses at cross professional motivational intervention implemented programs and finally the outcomes and evaluation of interventions are unclear. Thus, the practical implication of this mapping will be clarifying all these aspects. Without this clarification is not possible to proceed to the realization of a systematic review about the effectiveness of the use of motivational interviews by nurses to promote health behaviors in adolescents, in a particular context and/or health risk behavior; or regarding the effectiveness of certain technique and/or strategy of MI. Consequently, there are important questions about the nature of the evidence in this area that need to be answered before formulating a precise question of effectiveness. This scoping review aims to respond to these questions. An initial search of the JBI Database of Systematic Reviews & Implementation Reports, Cochrane Database of Systematic Reviews, , Database of promoting health effectiveness reviews (DoPHER), The Campbell Library, Medline and CINAHL, has revealed that currently there is no Scoping Review (published or in progress) on the subject. In this context, this scoping review will examine and map the published and unpublished research around the use of MI by nurses implemented and evaluated to promote health behaviors in adolescents; to establish its current extent, range and nature and identify its feasibility, outcomes and gaps in the evidence defining research priorities in this field. This scoping review will be informed by the JBI methodology37 that suggests a five stage methodological framework for conducting scoping reviews which includes: identifying the research question, searching for relevant studies, selecting studies, charting data, collating, summarizing and reporting the results.

ERICA: prevalence of healthy eating habits among Brazilian adolescents

ABSTRACT OBJECTIVE To describe the prevalence of eating habits considered healthy in adolescents according to sex, age, education level of the mother, school type, session of study, and geographic region. METHODS The assessed data come from the Study of Cardiovascular Risks in Adolescents (ERICA), a cross-sectional, national and school-based study. Adolescents of 1,247 schools of 124 Brazilian municipalities were evaluated using a self-administered questionnaire with a section on aspects related to eating behaviors. The following eating behaviors were considered healthy: consuming breakfast, drinking water, and having meals accompanied by parents or legal guardians. All prevalence estimates were presented proportionally, with their respective 95% confidence intervals. The Chi-square test was used to evaluate the differences in healthy eating habits prevalences according to other variables. The module survey of the Stata program version 13.0 was used to analyze complex data. RESULTS We evaluated 74,589 adolescents (72.9% of the eligible students). Of these, 55.2% were female, average age being 14.6 years (SD = 1.6). Among Brazilian adolescents, approximately half of them showed healthy eating habits when consuming breakfast, drinking five or more glasses of water a day, and having meals with parents or legal guardians. All analyzed healthy eating habits showed statistically significant differences by sex, age, type of school, session of study, or geographic region. CONCLUSIONS We suggest that specific actions of intersectoral approach are implemented for the dissemination of the benefits of healthy eating habits. Older female adolescents (15 to 17 years old) who studied in public schools, resided in the Southeast region, and whose mothers had lower education levels, should be the focus of these actions since they present lower frequencies concerning the evaluated healthy habits.

A communication strategy for Continente: Practical, low priced and healthy eating solutions

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics

Promoting healthy eating standards on children through CSR educational programs: An evaluation of impact on eating preferences, attitude towards the brand and perceived brand reputation

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics

The influence of a fun packaging on children’s sensory evaluation of a healthy product

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics