Objective: To explore the association between the cognition of Nutrition Facts Panel and prepackaged food purchase behavior among residents in six provinces in China. Methods: Using a multi-stage sampling method, 3 002 adults aged 18-70 were selected from the western region (Sichuan), eastern region (Guangdong, Jiangsu, Beijing), central region (Henan), and northeastern region (Heilongjiang) of China from July 2020 to March 2021. Socio-demographic characteristics of participants and their cognition of Nutrition Facts Panel and prepackaged food purchase behavior were collected through questionnaire. A multivariate binary logistic regression model was used to analyze the association between cognition of Nutrition Facts Panel and prepackaged food purchase behavior. Results: The age of 3 002 subjects was (42.3±13.4) years, among which 63.8% (1 914) were female, 66.7% knew the Nutrition Facts Panel, 49.8% would read it when purchasing, 30.7% could understand it, and 56.6% (1 699) bought prepackaged food more than once a week. The results of multivariate analysis showed that after adjusting for relevant confounding factors, compared with the participants knowing but not reading the Nutrition Facts Panel, the group knowing and reading was more likely to buy 11 types of prepackaged food at least once a week (all P<0.05). Compared with the participants reading but not understanding the Nutrition Facts Panel, the group reading and understanding was less likely to buy 11 types of prepackaged food at least once a week (all P<0.05). Conclusion: There was a correlation between cognition of Nutrition Facts Panel and prepackaged food purchase behavior among residents.
Adult ; Female ; Humans ; Male ; Food Labeling/methods* ; Food ; Nutritional Status ; Surveys and Questionnaires ; China ; Health Knowledge, Attitudes, Practice

Antimicrobial resistance (AMR) is increasingly becoming a threat to global public health, not least in low- and middle-income countries (LMICs) where it is contributing to longer treatment for illnesses, use of higher generation drugs, more expenditure on antimicrobials, and increased deaths attributed to what should be treatable diseases. Some of the known causes of AMR include misuse and overuse of antimicrobials in both humans and animals, unnecessary use of antimicrobials in animals as growth promoters, and lack of awareness among the public on how to protect antimicrobials. As a result, resistant organisms are circulating in the wider environment, and there is a need to consider the One Health approach to minimise the continuing development of AMR. Environmental Health, specifically water, sanitation and hygiene (WASH), waste management, and food hygiene and safety, are key components of One Health needed to prevent the spread of antimicrobial-resistant microorganisms particularly in LMICs and reduce the AMR threat to global public health. The key Environmental Health practices in the prevention of AMR include: (1) adequate WASH through access and consumption of safe water; suitable containment, treatment and disposal of human excreta and other wastewater including from health facilities; good personal hygiene practices such as washing hands with soap at critical times to prevent the spread of resistant microorganisms, and contraction of illnesses which may require antimicrobial treatment; (2) proper disposal of solid waste, including the disposal of unused and expired antimicrobials to prevent their unnecessary exposure to microorganisms in the environment; and (3) ensuring proper food hygiene and safety practices, such as sale and consumption of animal products in which adequate antimicrobial withdrawal periods have been observed, and growing vegetables on unpolluted soil. Environmental Health is therefore crucial in the prevention of infectious diseases that would require antimicrobials, reducing the spread of resistant organisms, and exposure to antimicrobial residues in LMICs. Working with other professionals in One Health, Environmental Health Practitioners have a key role in reducing the spread of AMR including health education and promotion, surveillance, enforcement of legislation, and research.
Developing Countries ; Disease Transmission, Infectious/prevention & control* ; Drug Resistance, Microbial ; Environmental Health/standards* ; Food Safety ; Health Personnel/standards* ; Humans ; Hygiene/standards* ; Role ; Sanitation/standards* ; Waste Management/standards*

BACKGROUND: Food safety and hygiene are currently a global health apprehension especially in unindustrialized countries as a result of increasing food-borne diseases (FBDs) and accompanying deaths. This study aimed at assessing knowledge, attitude, and hygiene practices (KAP) of food safety among street-cooked food handlers (SCFHs) in North Dayi District, Ghana. METHODS: This was a descriptive cross-sectional study conducted on 407 SCFHs in North Dayi District, Ghana. The World Health Organization's Five Keys to Safer Food for food handlers and a pretested structured questionnaire were adapted for data collection among stationary SCFHs along principal streets. Significant parameters such as educational status, average monthly income, registered SCFHs, and food safety training course were used in bivariate and multivariate logistic regression models to calculate the power of the relationships observed. RESULTS: The majority 84.3% of SCFHs were female and 56.0% had not attended a food safety training course. This study showed that 67.3%, 58.2%, and 62.9% of SCFHs had good levels of KAP of food safety, respectively. About 87.2% showed a good attitude of separating uncooked and prepared meal before storage. Good knowledge of food safety was 2 times higher among registered SCFHs compared to unregistered [cOR=1.64, p=0.032]. SCFHs with secondary education were 4 times good at hygiene practices of food safety likened to no education [aOR=4.06, p=0.003]. Above GHc1500 average monthly income earners were 5 times good at hygiene practices of food safety compared to below GHc500 [aOR=4.89, p=0.006]. Registered SCFHs were 8 times good at hygiene practice of food safety compared to unregistered [aOR=7.50, p<0.001]. The odd for good hygiene practice of food safety was 6 times found among SCFHs who had training on food safety courses likened to those who had not [aOR=5.97, p<0.001]. CONCLUSIONS Over half of the SCFHs had good levels of KAP of food safety. Registering as SCFH was significantly associated with good knowledge and hygiene practices of food safety. Therefore, our results may present an imperative foundation for design to increase food safety and hygiene practice in the district, region, and beyond.
Adult ; Attitude ; Cooking/methods* ; Cross-Sectional Studies ; Female ; Food Safety ; Ghana ; Health Knowledge, Attitudes, Practice ; Humans ; Hygiene ; Male ; Middle Aged ; Socioeconomic Factors ; Young Adult

BACKGROUND: Food handlers can play a vital role into reducing foodborne diseases by adopting appropriate food handling and sanitation practices in working plants. This study aimed to assess the factors associated with food safety knowledge and practices among meat handlers who work at butcher shops in Bangladesh. METHODS: A cross-sectional study was conducted among 300 meat handlers from January to March, 2021. Data were collected through in-person interviews using a structured questionnaire. The questionnaire consisted of three parts; socio-demographic characteristics, assessments of food safety knowledge, and food safety practices. A multiple logistic regression model was used to identify the factors associated with food safety knowledge and practices. RESULTS: Only 20% [95% confidence interval, (CI) 15.7-24.7] and 16.3% (95% CI 12.3-20.7) of the respondents demonstrated good levels of food safety knowledge and practices, respectively. The factors associated with good levels of food safety knowledge were: having a higher secondary education [adjusted odds ratio (AOR) = 4.57, 95% CI 1.11-18.76], income above 25,000 BDT/month (AOR = 10.52, 95% CI 3.43-32.26), work experience of > 10 years (AOR = 9.31, 95% CI 1.92-45.09), ≥ 8 h per day of work (AOR = 6.14, 95% CI 2.69-13.10), employed on a daily basis (AOR = 4.05, 95% CI 1.16-14.14), and having food safety training (AOR = 8.98 95% CI 2.16-37.32). Good food safety knowledge (AOR = 5.68, 95% CI 2.33-13.87) and working ≥ 8 h per day (AOR = 8.44, 95% CI 3.11-22.91) were significantly associated with a good level of food safety practice. CONCLUSIONS Poor knowledge and practices regarding food safety were found among Bangladeshi meat handlers. Findings may help public health professionals and practitioners develop targeted strategies to improve food safety knowledge and practices among this population. Such strategies may include education and sensitization on good food safety practices.
Adolescent ; Adult ; Aged ; Bangladesh ; Female ; Food Handling/statistics & numerical data* ; Food Safety/methods* ; Health Knowledge, Attitudes, Practice ; Humans ; Meat ; Middle Aged ; Young Adult

health of the mother and child, and thus proper monitoring and management are essential. Mobile healthcare services have been applied to manage some diseases, particularly chronic diseases. We aimed to evaluate the utility of a mobile application in nutritional intervention by observing cases of a mobile application in a series of patients with GDM. We provided a mobile-based intervention to GDM patients and collected biochemical and nutritional information. The mobile-based nutritional intervention was effective in controlling carbohydrate intake and improving blood glucose level for patients with GDM.]]>
Blood Glucose ; Child ; Chronic Disease ; Delivery of Health Care ; Diabetes, Gestational ; Diet Therapy ; Diet, Food, and Nutrition ; Female ; Humans ; Mobile Applications ; Mothers ; Pregnancy ; Prevalence

Food allergy is a growing global public health concern. As treatment strategies are currently limited to allergen avoidance and emergency interventions, there is an increasing demand for appropriate models of food allergy for the development of new therapeutics. Many models of food allergy rely heavily on the use of animals, and while useful, many are unable to accurately reflect the human system. In order to bridge the gap between in vivo animal models and clinical trials with human patients, human models of food allergy are of great importance. This review will summarize the commonly used human ex vivo and in vitro models of food allergy and highlight their advantages and limitations regarding how accurately they represent the human in vivo system. We will cover biopsy-based systems, precision cut organ slices, and coculture systems as well as organoids and organ-on-a-chip. The availability of appropriate experimental models will allow us to move forward in the field of food allergy research, to search for effective treatment options and to further explore the cause and progression of this disorder.
Allergens ; Anaphylaxis ; Animals ; Biological Phenomena ; Coculture Techniques ; Emergencies ; Food Hypersensitivity ; Humans ; In Vitro Techniques ; Models, Animal ; Models, Theoretical ; Organoids ; Public Health

BACKGROUND: In Asian countries, including Korea, lead poisoning caused by traditional herbal medicines is often observed in the clinic. However, there have been no reports thus far of lead poisoning caused by drugs that were approved by the Korea Food and Drug Administration (KFDA). Here, we describe seven patients who ingested a problematic natural product-derived drug (NPD). CASE PRESENTATION: In July 2018, seven patients visited a university hospital after ingesting an NPD, S. capsules. These patients complained of various symptoms, and their blood lead levels (BLLs) were elevated relative to those of the general population (arithmetic mean: 19.5 ± 11.6 µg/dL, range: 6.28–35.25 µg/dL). The total doses and BLLs were directly proportional to each other among the patients (r = 0.943, p = 0.001). After the patients discontinued drug intake, their BLLs decreased gradually. The capsule was confirmed to contain lead above the standard value (arithmetic mean: 2,547 ± 1,821.9 ppm). CONCLUSION: This incident highlights the need to strengthen standards for the management of NPD ingredients in Korea. NPDs are more likely to be contaminated than other drugs. Thorough management by the KFDA is essential to prevent a recurrence. Moreover, systematic health care is needed for many patients who have taken problematic NPDs.
Asian Continental Ancestry Group ; Capsules ; Delivery of Health Care ; Humans ; Korea ; Lead Poisoning ; Recurrence ; United States Food and Drug Administration

BACKGROUND: The purpose of this study was to evaluate the effectiveness and the level of self-management support on the Metabolic Syndrome Management Program at public health centers in Seoul metropolitan city. METHODS: The effectiveness on the Metabolic Syndrome Management Program were analyzed using secondary data from 1,312 community residents who were receiving program. The level of self-management support on Metabolic Syndrome Management Program was evaluated using an ‘Assessment of Primary Care Resources and Supports for Chronic Disease Self-Management’ from four public health centers. RESULTS: The effectiveness on the Metabolic Syndrome Management Program was showed that decreased smoking (p=0.044) and drinking (p<0.001), and increased healthy dietary habit (p<0.001) in health behaviors. It was showed that decreased triglyceride (p=0.002) and increased high-density lipoprotein cholesterol (p<0.001) in clinical indicators. The level of self-management support on Metabolic Syndrome Management Program was 98.1 points and it meaned that implementation is done in an organized and consistent manner using a team approach. There was difference in the level of self-management support by public health centers (p=0.003). CONCLUSION: The Metabolic Syndrome Management Program in public health centers was effective, and level of self-management support was done as organizational level, but patient input and mental health were insufficient.
Cholesterol ; Chronic Disease ; Drinking ; Food Habits ; Health Behavior ; Humans ; Lipoproteins ; Mental Health ; Primary Health Care ; Public Health ; Self Care ; Seoul ; Smoke ; Smoking ; Triglycerides

BACKGROUND: The food and food service influence the quality of life and the general health condition of older persons living in long-term care (LTC) facilities. Purchasing good food materials is a ground of good food service. In Korea, the residents in LTC facilities should pay for the cost of food materials and ingredients out of their pocket because it is not covered by LTC insurance. This study explored what factors affect the cost of food materials paid by LTC facility residents and which factor affects most. METHODS: We used data from the study on out-of-pocket payment on national LTC insurance, which surveyed 1,552 family caregivers of older residents in LTC facilities. We applied conditional multi-level model, of which the first level represents the characteristics of care receivers and caregivers and its second level reflects those of LTC facilities. RESULTS: We found that the facility residents with college-graduated family caregivers paid 11,545 Korean won more than those with less than elementary-graduated ones. However, the income level of family caregivers did not significantly affect the amount of the food material cost of the residents. The residents in privately owned, large, metropolitan-located facilities were likely to pay more than those in other types of facilities. The amount of the food material cost of the residents was mainly decided by the facility level factors rather than the characteristics of care recipients and their family caregivers (intra-class correlation=82%). CONCLUSION: These findings suggest that it might be effective to design a policy targeting facilities rather than residents in order to manage the cost of food materials of residents in LTC facilities. Setting a standard price for food materials in LTC facilities, like Japan, could be suggested as a feasible policy option. It needs to inform the choice of LTC users by providing comparable food material cost information. The staffing requirement of nutritionist also needs to be reviewed.
Caregivers ; Food Services ; Health Expenditures ; Humans ; Insurance ; Insurance, Long-Term Care ; Japan ; Korea ; Long-Term Care ; Nutritionists ; Quality of Life

PURPOSE: To understand awareness, attitude and knowledge levels of muscle health of adults over 18 years old. METHODS: This study was a cross-sectional study using questionnaires. A total of 401 questionnaires were included for final analysis. Mean and standard deviation of the continuous variables were analyzed and frequency analysis of categorical variables was performed. To identify differences according to general characteristics, t-test was used. RESULTS: Awareness scores about the importance of muscle health and exercises were 8.3 and 13.0, respectively. Attitude score and knowledge score were 12.4 and 15.0, respectively. There were differences in attitude toward muscle health according to gender, age, physical activity, and diet habits. However, there was no difference in attitude toward muscle health according to educational level, smoking, drinking, or sleeping. CONCLUSION: It is necessary to seek a strategy to improve awareness and attitude toward muscle health based on knowledge, not merely to raise knowledge level about muscle health. Since nurses play a central role in health promotion and disease prevention, they should also play an important role in strategic development and application of intervention.
Adult ; Cross-Sectional Studies ; Drinking ; Exercise ; Food Habits ; Health Promotion ; Humans ; Motor Activity ; Muscles ; Smoke ; Smoking