Associations between breakfast frequency and adiposity indicators in children from 12 countries
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Evidence on the age-dependent association between adiposity and risk of dementia in the Chinese population is unclear. We aim to disentangle the association of mid- and late- life adiposity with subsequent dementia risk in Chinese adults and compare ageing trajectories of adiposity between those with/out dementia.
Governance and resilience as entry points for transforming food systems in the countdown to 2030
Due to complex interactions, changes in any one area of food systems are likely to impact—and possibly depend on—changes in other areas. Here we present the first annual monitoring update of the indicator framework proposed by the Food Systems Countdown Initiative, with new qualitative analysis elucidating interactions across indicators. Since 2000, we find that 20 of 42 indicators with time series have been trending in a desirable direction, indicating modest positive change. Qualitative expert elicitation assessed governance and resilience indicators to be most connected to other indicators across themes, highlighting entry points for action—particularly governance action. Literature review and country case studies add context to the assessed interactions across diets, environment, livelihoods, governance and resilience indicators, helping different actors understand and navigate food systems towards desirable change.
Trust in scientists and their role in society across 68 countries
Science is crucial for evidence-based decision-making. Public trust in scientists can help decision makers act on the basis of the best available evidence, especially during crises. However, in recent years the epistemic authority of science has been challenged, causing concerns about low public trust in scientists. We interrogated these concerns with a preregistered 68-country survey of 71,922 respondents and found that in most countries, most people trust scientists and agree that scientists should engage more in society and policymaking. We found variations between and within countries, which we explain with individual- and country-level variables, including political orientation. While there is no widespread lack of trust in scientists, we cannot discount the concern that lack of trust in scientists by even a small minority may affect considerations of scientific evidence in policymaking. These findings have implications for scientists and policymakers seeking to maintain and increase trust in scientists.
Development of quality indicators for hypertension management at the primary health care level in South Africa
Despite many quality initiatives at the primary health care (PHC) level, little is known about the actual quality of care of patients diagnosed with hypertension in South Africa. This study aimed to develop quality indicators for hypertension management at the PHC level to improve the quality of care and patient outcomes. The RAND/UCLA Appropriateness Method, comprising two rounds, was used to develop clear, appropriate, and feasible evidence-based quality indicators for hypertension. In Round 1, a 9-point scale was used by a panel of 11 members to rate clarity and appropriateness of 102 hypertension quality indicator statements, grouped under 9 dimensions of quality hypertension management, using an online MS Excel® spreadsheet. In Round 2, 9 of the same panellists discussed all indicators and rated their appropriateness and feasibility during a remote online, interactive face-to-face MS Teams® meeting. Statements rated ≥7–9 with agreement were defined as either appropriate or feasible. The panel rated 46 hypertension quality indicator statements ≥7–9 with agreement for the appropriate and feasible measurement of the management of hypertension: monitoring (n = 16), review (n = 5), lifestyle advice (n = 9), tests (n = 7), intermediate outcomes (n = 6), referrals (n = 2) and practice/facility structures (n = 1). No indicator statements were rated both appropriate and feasible for measuring blood pressure levels and treatment. If applied, these indicators would improve monitoring and management of patients with hypertension, patient outcomes, and data quality in South Africa and result in more efficient use of scarce resources. This study can be replicable for improving care of other non-communicable diseases across Africa.
Global food retail environments are increasingly dominated by large chains and linked to the rising prevalence of obesity
Retail food environments influence food purchasing and dietary patterns. A global analysis of the food retail landscape allowing comparisons across geographical regions is therefore needed to tackle diet-related non-communicable diseases. Here we examine trends in retail food environments from 2009 to 2023 across 97 countries, exploring associations with changes in obesity prevalence. Increases were observed in the density of chain outlets, grocery sales from chain retailers, unhealthy food sales per capita and digital grocery sales; non-chain outlet density and the ratio of non-chain to chain outlets declined over time. South Asia and low- and middle-income countries overall experienced the most rapid transformation. Changes in retail environments and the prevalence of obesity were found to be positively correlated. As retail environments become increasingly digital and dominated by large chains, important implications for diets and health should be expected, particularly in lower-income countries.
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