Abstract Legumes are a nutrient dense food group that can offer considerable health and sustainability benefits. Despite a long history in agricultural production and diverse dietary patterns, legume intake in the UK is chronically low. This narrative review proposes that the implementation of interventions to promote greater acceptability, access, and intake of legumes in the UK is a worthy endeavour to promote population and planetary health. The health and environmental impacts of legume intake are summarised, and existing barriers to consumption—taste, texture, cooking skills, time, convenience, familiarity, digestive concerns and allergenicity—are outlined. The Nuffield Council on Bioethics Intervention Ladder is adopted to frame and review intervention options that can be adopted to increase legume intake through proportionate population level action. Intervention strategies are identified in a narrative synthesis, mapped to intervention ladder levels, and appraised for feasibility, impact, and proportionality. We identify ‘anchor institutions’ and retail environments as high leverage settings. Progress requires coordinated policy and practice beyond the provision of information and the level of personal responsibility for food choice. Target interventions include: changes to choice architecture in public and retail food environments; increased availability of legumes (e.g., reformulation of familiar foods to incorporate legumes); harnessing public procurement (e.g., schools and the NHS) to increase exposure and normalise legume‐based options; and deployment of incentive measures to promote access. The introduction of interventions across a number of ‘levels’ may offer an efficacious approach to support increased acceptance and consumption of legumes.

Hydroponic horticulture will play a key role in future food production as the growing global population becomes increasingly urbanised. Tomato (Solanum lycopersicum) is a widely grown and consumed crop that is already cultivated hydroponically in glasshouses in areas of the world with cooler climates, such as Northern Europe. Hydroponic growing systems enable high yields but can enhance disease susceptibility which increases the risk of devastating yield losses. Manipulation of the hydroponic microbiome has been proposed as a strategy to protect plants against disease. However, this hypothesis remains largely untested. We examined whether introducing synthetic communities of plant-beneficial microbes (SynComs) could offer a sustainable disease protection solution for hydroponic tomato production. We identified individual microbes and in turn two SynComs that induce systemic disease resistance during the vulnerable early stages of development. The two SynComs were evaluated further in a commercial-scale greenhouse trial. Although both SynComs reduced early growth, they had no adverse effects on yield or fruit quality. Strikingly, while only one SynCom strain consistently persisted in the hydroponic stone wool substrate throughout the six-month trial, the introduction of disease-suppressive SynComs at sowing had significant and similar impacts on bacterial community structure six months later. Our findings demonstrate that microbial SynComs can reduce disease susceptibility of hydroponically grown tomato without compromising yield, offering a viable and sustainable approach for crop protection in controlled environment agriculture.

Introduction The double burden of malnutrition (DBM) is a global public health challenge. This study examined the prevalence of population-level DBM, its demographic and socioeconomic determinants as well as the associations between anthropometric indicators of undernutrition and overnutrition, and micronutrient deficiencies (MNDs), among Vietnamese children, using the data from the nationally representative General Nutrition Survey 2020.Methods Data on anthropometric parameters, micronutrient biomarkers, demographic and socioeconomic indicators for 7289 children aged 6 months to 9 years were analysed. Determinants of malnutrition were assessed using logistic regressions, reported as OR with 95% CIs.Results At national level, 12.7%, 10.5% and 4.7% of children were stunted, underweight and wasted/thin, while 7.3% and 7.1% were overweight and obese, respectively. Low serum zinc, anaemia and iron deficiency were the common MNDs observed, affecting 53.1%, 15.2% and 13.9% of the study participants. Older children aged 2–4 years (OR (95% CI) 1.43 (1.20, 1.72)), ethnic minorities (5.94 (3.78, 9.36)) and those living in mountainous areas (5.06 (1.18, 14.42)) had increased odds of stunting, whereas reduced odds were found in children from the richest quintile (0.13 (0.05, 0.32)). Similar determinants were associated with underweight and MNDs. Males (1.43 (1.16, 1.76)), children aged 5–9 years (10.02 (6.71, 14.97) and children from the richest quintile (2.91 (1.20, 7.05)) had increased odds of overweight. Children with anaemia, low serum retinol and low serum zinc had increased odds of stunting and underweight than non-micronutrient-deficient children (adjusted OR=1.43–1.71). Compared with children without MNDs, those with ≥3 MNDs had almost double the odds of stunting and underweight, whereas those with ≤3 MNDs had reduced odds of overweight (adjusted OR=0.38–0.60).Conclusions Significant demographic variation and socioeconomic inequalities in child malnutrition were identified. National policies and programmes in Vietnam should address age-specific, sex-specific, geographical and socioeconomic disparities to accelerate progress in reducing child malnutrition.

Background/Objectives: Optimal infant and young child feeding (IYCF) practices are crucial to addressing the double burden of malnutrition (DBM), encompassing undernutrition (including micronutrient deficiencies) and overnutrition. This study examined the demographic and socioeconomic determinants of IYCF practices, and their impacts on the DBM among 2039 Vietnamese children aged 6–23 months from the General Nutrition Survey 2020. Methods: Thirteen IYCF indicators recommended by the WHO/UNICEF were evaluated. Associations between IYCF indicators and outcome variables were assessed using logistic regressions. Results: The prevalence of stunting, underweight, and overweight subjects was 10.9%, 5.6%, and 3.1%, respectively. Low serum zinc affected 56.7% of children, while 14.3% had low serum retinol, 31.2% had anemia, and 34.6% had iron deficiency (ID). Only 36.7% of children achieved minimum dietary diversity (MDD), and 29.0% achieved the minimum acceptable diet (MAD). Children from the younger age group (6–11 months), ethnic minorities, those living in rural/mountainous regions, and poorer wealth quintiles had reduced odds of meeting IYCF criteria, including MDD and MAD. Infants meeting MDD had reduced odds of stunting [adjusted odds ratio (95% confidence intervals): 0.61 (0.41, 0.92)], and ID [0.69 (0.54, 0.88)]. Children meeting MAD had reduced odds of anemia [0.72 (0.57, 0.91)], ID [0.66 (0.52, 0.84)], and low serum retinol [0.63 (0.41, 0.99)]. Continued breastfeeding (12–23 months) reduced the odds of being underweight [0.50 (0.27, 0.92)] and of having low serum zinc [0.70 (0.52, 0.96)]. Adequate minimum milk feeding frequency had increased odds of being overweight [3.33 (1.01, 11.09)]. Conclusions: Suboptimal IYCF practices were significant predictors of the DBM among Vietnamese children, with evident age-specific, geographical, and socioeconomic disparities.

Late evening eating is a potential risk factor for overconsumption and weight gain. However, there is limited qualitative research investigating the complex factors that influence late evening eating in adults living with obesity. Identifying the factors that influence late evening eating can inform interventions to reduce late evening eating and associated health risks. Therefore, this study aimed to: i) explore factors that contribute to eating late, and ii) apply the Capability, Opportunity, and Motivation Behaviour (COM-B) model to understand the barriers and enablers to changing to earlier food intake timings in UK adults who report eating late. Semi-structured interviews with seventeen participants [32.47 ± 6.65 years; 34.68 ± 7.10 kg/m2; 71% female (n = 12); 41% White (n = 7)] investigated reasons for late evening eating and the potential barriers and enablers to changing to earlier eating patterns. Thematic analysis identified four main contributors to late evening eating: 1) internal signals (e.g., feeling hungry in the evening); 2) external and situational factors (e.g., work schedules and the food-rich environment); 3) social factors (e.g., interactions with family) and 4) behavioural and emotional factors (e.g., personal preferences and negative feelings in the evening). Time constraints and work schedules were identified as main barriers to changing to earlier eating patterns. Whereas, having high motivation (e.g., contentment with eating earlier in the evening) and interpersonal support were identified as main enablers to eating earlier. This study provides in-depth insights into the psychological, social, and environmental factors contributing to late evening eating. The findings highlight potential targets for future interventions to facilitate earlier eating times in individuals at risk of overweight and obesity.

Diets deficient in fibre are reported globally. The associated health risks of insufficient dietary fibre are sufficiently grave to necessitate large-scale interventions to increase population intake levels. The Danish Whole Grain Partnership (DWP) is a public-private enterprise model that successfully augmented whole-grain intake in the Danish population. The potential transferability of the DWP model to Slovenia, Romania and Bosnia-Herzegovina has recently been explored. Here, we outline the feasibility of adopting the approach in the UK. Drawing on the collaborative experience of DWP partners, academics from the Healthy Soil, Healthy Food, Healthy People (H3) project and food industry representatives (Food and Drink Federation), this article examines the transferability of the DWP approach to increase whole grain and/or fibre intake in the UK. Specific consideration is given to the UK's political, regulatory and socio-economic context. We note key political, regulatory, social and cultural challenges to transferring the success of DWP to the UK, highlighting the particular challenge of increasing fibre consumption among low socio-economic status groups - which were also most resistant to interventions in Denmark. Wholesale transfer of the DWP model to the UK is considered unlikely given the absence of the key 'success factors' present in Denmark. However, the DWP provides a template against which a UK-centric approach can be developed. In the absence of a clear regulatory context for whole grain in the UK, fibre should be prioritised and public-private partnerships supported to increase the availability and acceptability of fibre-rich foods.

The triple burden of malnutrition (TBM) is a growing public health issue worldwide. This study examined the prevalence and association between undernutrition, overnutrition and micronutrient deficiencies (MNDs), and the key demographic and socioeconomic determinants, among Vietnamese children, using the nationally representative General Nutrition Survey (GNS) 2020(1).The GNS 2020 was reviewed and approved by the Ethical Committee of the National Institute of Nutrition, Vietnam. Written informed consent was obtained from each participant and/or their parents prior to data collection. Data on anthropometric parameters, micronutrients biomarkers, demographic and socioeconomic indicators for 7,289 children aged 6 months to 9 years old were analysed(1). All analyses were weighted and accounted for complex survey design using svyset commands in STATA. Age-specific and region-specific prevalence of malnutrition were examined. Determinants of malnutrition were assessed using bivariate and multivariate logistic regressions, crude or adjusted odds ratio (OR/AOR) and respective 95% confidence intervals (CI) were reported.Overall, the prevalence of stunting, underweight and wasting/thinness of children was 12.7%, 10.5%, and 4.7%, respectively, in 2020. This finding underscores that child stunting reduction in Vietnam is on track towards the target of 40% reduction by 2025 set by the Global Nutrition Targets(2) (<20%). Meanwhile overweight and obesity among school aged children is off track the target(2), with the prevalence in urban areas increasing from 8.5% in 2010 to 31% in 2020. Low serum zinc, anaemia and iron deficiency (ID) were the common MNDs observed, affecting 53.1%, 15.2%, and 13.9% of children. Prevalence of low serum retinol was relatively low (<7%). In the bivariate regressions, older child (2-4 years old) [OR (95% CI): 1.43 (1.20, 1.72)], ethnic minorities [5.94 (3.78, 9.36)], and living in mountainous areas [5.06 (1.18, 14.42)] had increased odds of stunting, whereas reduced odds were found in children from the richest quintile [0.13 (0.05, 0.32)]. Similar determinants were found to be associated with underweight and MNDs. Males [1.43 (1.16, 1.76)], older children (5-9 years old) [10.02 (6.71, 14.97), and children from the richest quintile [2.91 (1.20, 7.05)] had increased odds of overweight. After adjusting for covariates including age, sex, region, wealth index and inflammation, children with anaemia, low serum retinol and low serum zinc had increased odds of stunting and underweight than non-micronutrient deficient children (AOR = 1.43-1.71). Compared to children without MNDs, those with ≥3 MNDs had almost double the odds of stunting and underweight, whereas those with ≤3 MNDs had reduced odds of overweight (AOR = 0.38−0.60).TBM is becoming a major public health concern for Vietnamese children, and significant demographic variation and socioeconomic inequalities in malnutrition were observed. These findings suggest that national policies and programmes in Vietnam should address age-specific, sex-specific, geographical and socioeconomic disparities to accelerate progress in reducing child malnutrition.

The triple burden of malnutrition (TBM) is increasing globally, but significant evidence gaps exist regarding its burden and drivers among children in Southeast Asian (SEA) countries. We systematically searched four databases (PROSPERO-CRD42023420129) and Google Scholar through February 2024. We assessed stunting and overweight prevalence among children aged 0-18 years old across four SEA countries (Indonesia, Malaysia, Thailand, and Vietnam) from recent national surveys. We conducted random-effect meta-analyses to estimate the pooled prevalence of micronutrient deficiencies, and the pooled odds ratio for TBM-associated determinants using an adapted socio-ecological framework. 176 studies were included for systematic review, with 132 studies eligible for meta-analysis. Our findings illustrate significant variation in TBM across countries, dependent on region, age, and sex. Pooled prevalence [95% CI] of anemia, iron, vitamin A, and D deficiencies were 25% [22, 29], 14% [10, 18], 6% [4, 8], and 40% [32, 48], respectively (I2>90%). Determinants of the TBM included child-individual factors, poor early-life nutrition, and family household characteristics including maternal nutrition and education, socioeconomic, family size, sanitation, and food security. However, macro-level environmental impacts were less documented. Our findings emphasize the need for robust, timely monitoring of TBM data, including micronutrient biomarkers, and targeted policy intervention in SEA countries.

The risk of DEB is more prevalent in girls, particularly during adolescence. The onset of DEB can be triggered by many inter-related factors, including biological, social, parental, and psychosocial. To date, very little is known about the determinants of DEBs in Saudi adolescent girls. Using a qualitative analysis, this study explored potential determinants of DEB among adolescent girls in Riyadh. Eighteen semi-structured interviews were carried out with adolescent girls (mean age = 14.06, SD = 0.87) who reported a high risk of DEB (EAT-26 ≥ 20) in intermediate and secondary schools in Riyadh. The mean weight was 51 kg (SD = 11.8) with BMI ranging from 14.18 kg/m2 to 27.51 kg/m2. EAT-26 scores ranged from 21 to 42 (M = 26.8, SD = 5.6). Data were transcribed and revised, then themes and sub-themes were assigned using MAXQDA 24. The most common DEBs reported were dieting and binging, followed by induced vomiting. Major themes were related to negative cognitions, conscious imitation/copying behaviours, bullying, comparisons, and negative comments. Some participants identified the possibility of biological and familial factors in increasing the likelihood of DEB. Our findings provide a framework that could be used to increase understanding of DEB and inform the development of interventions to address underlying causes of DEB in Saudi adolescent girls.

Biofortification (increasing the micronutrient content of food before harvest) has been successfully used to nutritionally improve staple foods in low- and middle-income countries. This approach could also help address micronutrient shortfalls in at-risk populations in high-income countries (HICs), however, the potential of biofortification interventions in this context is not well understood. The aim of this scoping review is to assess the nature and extent of available research evidence on biofortified foods in relation to human consumption in HICs. Literature searches were conducted in MEDLINE, WoS, ProQuest, CINAHL, AGRIS and Epistemonikos. Forty-six peer-reviewed articles were included. Most research was conducted in the USA (n = 15) and Italy (n = 11), on cereal crops (n = 14) and vegetables (n = 11), and on selenium (n = 12) and provitamin A (n = 11). Seven research domains were identified in the literature: bioavailability (n = 17); nutrient stability (n = 11); opinions and attitudes (n = 9); functionality (n = 9); sensory properties (n = 2); safety (n = 1); and modeling (n = 1). Evidence from HICs in each domain is limited. There is a need for more research particularly in areas sensitive to the cultural and socio-economic context.

Rates of non-communicable diseases, including cardiovascular disease and type 2 diabetes, and mental health problems, such as anxiety and depression, are high and rising in the urbanising world. Gardening could improve both mental and physical health and help prevent a range of conditions by increasing fruit and vegetable (F V) consumption, promoting physical activity, and reducing stress. However, good quality quantitative research in the area is scarce, and our understanding of the role of allotments and home gardens, and the effects of the level of engagement in gardening and involvement with food production has thus far been limited. We quantitatively assess the relationship between home and allotment gardening and various indicators and predictors of health and well-being using an online survey of gardeners (n = 203) and non-gardeners (n = 71) in the UK. The survey was composed of multiple validated questionnaires (including the Short Form Food Frequency Questionnaire (SFFFQ), the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), the Physical Health Questionnaire (PHQ) and the Self-Rated Health question (SRH)) and self-defined questions relating to participants’ involvement with gardening and food production, and relevant demographic and lifestyle factors. Data were analysed using a series of hierarchical logistic and multiple linear regression models adjusting for socio-demographic variables. After adjusting for relevant socio-demographic factors, gardening related variables were associated with better self-rated health, higher mental well-being, increased F V consumption. Higher F V intake was in turn also associated with better self-rated health and decreased odds of obesity. Thus, gardening had a positive association with four different aspects of health and well-being, directly or indirectly via increased F V consumption. Our results suggest that gardening in UK allotments and domestic gardens may promote different aspects of health and well-being via multiple mechanisms. Improving access to growing space and promoting regular gardening could provide a range of benefits to public health. More research on how socio-economic factors influence the health and well-being benefits of gardening will help policymakers devise strategies to maximise these benefits.

Introduction The triple burden of malnutrition (TBM) is a growing public health issue worldwide. This study examined the prevalence and association between undernutrition, overnutrition and micronutrient deficiencies (MNDs), and the associated demographic and socioeconomic determinants, among Vietnamese children, using the nationally representative General Nutrition Survey 2020. Methods Data on anthropometric parameters, micronutrients biomarkers, demographic and socioeconomic indicators for 7,289 children aged 6 months to 9 years old were analysed. Determinants of malnutrition were assessed using logistic regressions and reported as odds ratio (OR) [95% confidence intervals (CI)]. Results Overall, 12.7%, 10.5% and 4.7% of children were stunted, underweight and wasted/thin; while 7.3% and 7.1% were living with overweight and obesity, respectively. Low serum zinc, anaemia and iron deficiency (ID) were the common MNDs observed, affecting 53.1%, 15.2% and 13.9% of the study participants. Older children aged 2-4 years old [OR (95% CI): 1.43 (1.20, 1.72)], ethnic minorities [5.94 (3.78, 9.36)] and living in mountainous areas [5.06 (1.18, 14.42)] had increased odds of stunting, whereas reduced odds were found in children from the richest quintile [0.13 (0.05, 0.32)]. Similar determinants were found to be associated with underweight and MNDs. Males [1.43 (1.16, 1.76)], children aged 5-9 years old [10.02 (6.71, 14.97) and children from the richest quintile [2.91 (1.20, 7.05)] had increased odds of overweight. Children with anaemia, low serum retinol and low serum zinc had increased odds of stunting and underweight than non-micronutrient deficient children (adjusted OR=1.43-1.71). Compared to children without MNDs, those with ≥3 MNDs had almost double the odds of stunting and underweight, whereas those with ≤3 MNDs had reduced odds of overweight (adjusted OR=0.38-0.60). Conclusions Significant demographic variation and socioeconomic inequalities in child malnutrition were identified. National policies and programmes in Vietnam should address age-specific, sex-specific, geographical and socioeconomic disparities to accelerate progress in reducing child malnutrition. What is already known on this topic? summarise the state of scientific knowledge on this subject before you did your study and why this study needed to be done What this study adds? summarise what we now know as a result of this study that we did not know before How this study might affect research, practice or policy? summarise the implications of this study ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This work was undertaken as part of the project entitled Addressing micronutrient deficiencies associated with the double burden of childhood malnutrition in China, a combined food system framework, which funded by UK Biotechnology and Biological Sciences Research Council (BBSRC) (Grant number: BB/T008989/1). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The GNS 2020 was reviewed and approved by the Ethical Committee of the National Institute of Nutrition (NIN), Ministry of Health, Vietnam. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes

AbstractBody weight regulation may be influenced by the timing of food intake. The relationship between children’s BMI and their daily pattern of energy consumption was investigated using data from the UK National Diet and Nutrition Survey 2008–2019. The sample included 6281 children aged 4–18 years. Linear and logistic regression models investigated the timing of energy intake (103kJ) as a predictor of BMI (kg/m2) and healthy weight status. The models showed that children aged 4–10 years who consume more energy content after 20:00, in comparison with less energy content, had a significantly higher BMI (young girls:β= 0·159; 95 % CI 0·003, 0·315;P= 0·05; young boys:β= 0·166; 95 % CI 0·028, 0·304;P= 0·02). Similar findings were also present for boys aged 11–18 years (β= 0·091; 95 % CI 0·003, 0·180;P= 0·04), though logistic regression findings were contradictory (OR = 0·9566; 95 % CI 0·926, 0·989;P =0·009). However, older girls who consumed more energy content in the morning had a significantly lower BMI (β =–0·464; 95 % CI –0·655, –0·273;P< 0·001) and a lower probability of non-healthy weight (OR = 0·901; 95 % CI 0·826, 0·982;P= 0·02). Physical activity reduced the likelihood of unhealthy weight status. The data suggest that food consumption later in the day in childhood and into adolescence may increase the risk of a higher BMI, especially for less active children. Developing guidance on appropriate meal timings and recommended energy distribution throughout the day could promote healthier lifestyles. Doing so may help increase parental awareness of timing of food intake and its potential impact on BMI.

Abstract Background Given the high rates globally of Type 2 Diabetes Mellitus (T2DM), there is a clear need to target health behaviours through person-centred interventions. Health coaching is one strategy that has been widely recognised as a tool to foster positive behaviour change. However, it has been used inconsistently and has produced mixed results. This systematic review sought to explore the use of behaviour change techniques (BCTs) in health coaching interventions and identify which BCTs are linked with increased effectiveness in relation to HbA1C reductions. Methods In line with the PICO framework, the review focused on people with T2DM, who received health coaching and were compared with a usual care or active control group on HbA1c levels. Studies were systematically identified through different databases including Medline, Web of science, and PsycINFO searches for relevant randomised controlled trials (RCTs) in papers published between January 1950 and April 2022. The Cochrane collaboration tool was used to evaluate the quality of the studies. Included papers were screened on the reported use of BCTs based on the BCT taxonomy. The effect sizes obtained in included interventions were assessed by using Cohen’s d and meta-analysis was used to estimate sample-weighted average effect sizes (Hedges’ g). Results Twenty RCTs with a total sample size of 3222 were identified. Random effects meta-analysis estimated a small-sized statistically significant effect of health coaching interventions on HbA1c reduction (g + = 0.29, 95% CI: 0.18 to 0.40). A clinically significant HbA1c decrease of ≥5 mmol/mol was seen in eight studies. Twenty-three unique BCTs were identified in the reported interventions, with a mean of 4.5 (SD = 2.4) BCTs used in each study. Of these, Goal setting (behaviour) and Problem solving were the most frequently identified BCTs. The number of BCTs used was not related to intervention effectiveness. In addition, there was little evidence to link the use of specific BCTs to larger reductions in HbA1c across the studies included in the review; instead, the use of Credible source and Social reward in interventions were associated with smaller reductions in HbA1c. Conclusion A relatively small number of BCTs have been used in RCTs of health coaching interventions for T2DM. Inadequate, imprecise descriptions of interventions and the lack of theory were the main limitations of the studies included in this review. Moreover, other possible BCTs directly related to the theoretical underpinnings of health coaching were absent. It is recommended that key BCTs are identified at an early stage of intervention development, although further research is needed to examine the most effective BCTs to use in health coaching interventions. Trial registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021228567 .

Eating disorders (EDs) and disordered eating behaviours (DEBs) are significant health problems related to body image and weight dissatisfaction among adolescents and young adults worldwide. During this stage of sensitive development, these behaviours may hinder the optimal growth process and can consequently lead to wasting, stunting, and micronutrient deficiencies. However, there is a limited amount of literature on DEB among Arab populations, particularly in Saudi Arabia. This review aims to assess the prevalence of EDs/DEB and to develop a clear understanding of the epidemiology of such conditions among adolescents and youth in Saudi Arabia. Five databases were systematically searched and 14 papers met the inclusion criteria. The Eating Attitudes Test (EAT-26) was the predominant tool used for evaluating aberrant eating behaviours, indicating a high prevalence of EDs/DEB ranging from 10.2% to 48.1%. The highest prevalence of EDs/DEB was reported in the eastern region ranging from 29.4% to 65.5%. In terms of age and sex, the prevalence was higher among older students compared to younger school students and males reported more Eds/DEB compared to female students. These disorders are found to be prevalent in Saudi Arabia, and the risk of developing such conditions is high across the whole age range.

Background: Over recent years, the Middle East, and especially Saudi Arabia, has faced multiple changes, including structural-demographic and economic shifts. This has led to massive changes in the population’s lifestyle, including more unhealthy diets and increases in physical inactivity. As a result, accelerating rates of chronic diseases, including type 2 diabetes mellitus (T2DM) are a major public health concern. Current diabetes care in Saudi Arabia focuses on increasing the awareness of patients through various approaches, mainly based on health education, which is found to be suboptimal and ineffective for improving long-term outcomes. This study aims to assess the feasibility and acceptability of using a client-centred approach called health coaching that supports, enables, and engages T2DM patients to take the central role of controlling their own conditions by developing new crucial skills. Methods: A mixed methods randomised controlled feasibility study of health coaching will be used. Participants (n = 30) are adults with T2DM with poorly controlled diabetes (A1C ≥7) who can read and write in Arabic. Eligible participants are randomly allocated to either an intervention or control group for 12 weeks. COM-B model and Behaviour Change Technique Taxonomy version 1 (BCTTv1) guide the intervention curriculum. Predetermined progression criteria will be used to determine whether to proceed to a larger trial or not. Outcomes will be measured at baseline and 3 months. The study’s primary aim is to assess the process of eligibility, recruitment, retention and completion rates, acceptability and suitability of intervention and the time to complete each procedure. The preliminary efficacy of health coaching is the secondary outcome that includes different measurements, such as HbA1c, blood pressure, body mass index (BMI), waist circumference, weight, patients’ self-efficacy, and diabetes self-management. Discussion: This is the first study to explore the feasibility, acceptability, and preliminary efficacy of health coaching that used the Capability, Opportunity, Motivation, Behaviour (COM-B) model and BCTTv1 as guidance to develop the intervention for adults with T2DM in Saudi Arabia. The findings of this study will be used to inform the larger RCT trial if it is shown to be feasible and acceptable.

Sub-Saharan Africa (SSA) is experiencing an increasing prevalence of young children being overweight and obese. Many feeding and physical activity-related behaviours are established at home during preschool years, yet the precise factors that contribute to preschool overweight and obesity have not been fully elucidated. This review aims to identify factors in the home environment associated with overweight and or obesity in preschool children in SSA. Ovid MEDLINE, EMBASE, CINAHL, Scopus, Web of Science, Africa Journals Online (AJOL) and the African Index Medicus databases were systematically searched for qualitative and quantitative studies published between 2000 and 2021. Eleven studies (ten quantitative, one qualitative) met the inclusion criteria. Overall, the results highlight the paucity of studies exploring factors in the home environment associated with overweight and obesity in preschool children in Sub-Saharan Africa. The home food environment and maternal BMI appear to be important factors associated with overweight and obesity in preschool children; however, the information for all other factors explored remains unclear due to the lack of evidence. For successful obesity prevention and treatment interventions to be developed, more research in this area is required to understand how different aspects of the home environment contribute to overweight and obesity in preschool Sub-Saharan African children.