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Background Obesity epidemic is one of the most serious public health challenges of the twenty-first century. Alcohol has been studied as a possible risk factor for obesity, but the evidence is discordant. This study examined the association between alcohol consumption and obesity in a sample of the Irish adult population. Method An analytical cross-sectional study was conducted using secondary data from the 2017 Healthy Ireland Survey. The primary survey recruited patients using a two-stage probability-based technique and a face-to-face-administered questionnaire to collect data. Descriptive and comparative data were analysed to identify associations between alcohol-related variables with waist circumference (WC) and body mass index (BMI). Regression analysis was performed to examine the associations between harmful alcohol consumption (AUDIT-C score ≥ 5) (exposure variable) and obesity indicators (WC and BMI), the primary outcomes of interest. Adjustments were made for sociodemographic, health-related, and other alcohol-related variables. Results Total of 6864 participants, aged 25 and older, took part in this survey (response rate = 60.4%). Most of the participants (81.9%) were alcohol drinkers, with the majority drinking less than three times per week (76.3%); 47.7% were considered harmful drinkers (AUDIT-C score ≥ 5). After controlling for possible confounders, positive associations of harmful alcohol consumption with WC (β = 1.72, 95% CI: 0.25, 3.19) and BMI (OR = 1.47, 95% CI: 1.10, 1.96) were observed. Binge drinking was positively associated with WC (β = 1.71, 95% CI: 0.50, 2.91), while alcohol consumption frequency was significantly and inversely associated with BMI (OR = 0.59, 95% CI: 0.44, 0.78). Conclusion Harmful alcohol consumption was associated with obesity (high BMI, large WC) after controlling for possible confounders. Frequent binge drinkers were more likely to have a large WC, while frequent alcohol consumers were less likely to have obesity. Further longitudinal studies to examine the exact association between alcohol consumption and obesity are warranted.

Objective:This paper aims to summarise the frameworks currently used to analyse food policymaking processes and to critically assess whether those frameworks can be applied to the analysis of integrated, ‘systems’ approaches to policymaking.Design:Two electronic databases were searched to identify publications analysing food policymaking processes. Data from the publications were charted using an iterative coding process, and details of the underlying analytical frameworks were recorded. Identified frameworks were evaluated using theories of systems approaches to food policy development.Setting:Governmental food policy at the supranational, national and local levels.Results:The search process yielded 532 results. After screening, a final forty-three publications and twenty-four frameworks were identified. In the studies, frameworks were used to analyse agenda-setting, stakeholder networks, policy coherence and development of national food and nutrition policies. All twenty-four frameworks allowed for analysis of actors and context in policymaking processes, while space for considering policy coherence featured less (n 11).Conclusions:Three frameworks were highlighted as particularly applicable to the context of food systems approaches to policymaking. The application of analytical frameworks for policymaking processes is limited in food policy research. However, this review demonstrates that there are considerable benefits to using such frameworks to understand the ideas, knowledge, power and decision-making that lead to food policy development. This is particularly useful in understanding the complex stakeholder networks and policy coherence necessary for successful policies for sustainable food systems.

To review research on the influence of parent-related factors on children's dairy products consumption. A search of electronic databases and a narrative synthesis of the literature were conducted. English-language articles were included if they reported data relating to parental influences on children's consumption of dairy products and if statistical significance was reported. Studies were carried out in the USA ( 8) and in a range of countries across Europe ( 12) and Asia ( 5). The subjects of this research were children aged between 2 and 12 years of age, from a range of geographical locations. Twenty-five studies met the inclusion criteria. The studies examined children's dairy products consumption in relation to parental socio-economic status (education level and income) ( 12), home availability ( 2), home food environment ( 3), parental dairy products consumption ( 4), parent feeding practices ( 3), parents' beliefs and attitudes ( 3) and parental nutrition knowledge ( 3). Results on the association between socio-economic status and children's dairy products consumption varied; however, studies reporting a significant association generally observed a positive relationship. Fifteen studies reported children's total dairy products intake as an outcome measure, with the remaining studies reporting intake of milk or other dairy products as individual foods. This review identified literature exploring a range of parental factors in relation to children's dairy products intake. However, there were limited numbers of studies published within each category of modifiable factors. Further research on the parent-related determinants of dairy products consumption in children is required in order to identify potential intervention targets in this age group.

Background/objectivesMaternal adherence to healthy lifestyle behaviors during pregnancy has been associated with reduced risk of obesity in the offspring. Our objective is to examine associations between a composite healthy lifestyle score (HLS) in expectant mothers and adverse offspring birth outcomes and childhood obesity.Subjects/methodsThe Lifeways Study comprises 665 mother–child pairs. A composite HLS (scored 0–5) based on high dietary quality (top 40% of the Healthy Eating Index (HEI)-2015), moderate to vigorous physical activity (MVPA), healthy pre-pregnancy BMI (18.5–24.9 kg/m2), never smoker, and no/moderate alcohol intake was calculated. Birth outcomes were abstracted from hospital records. Offspring waist circumference (WC) and BMI was determined at age 5 and 9. Logistic regression tested HLS associations with offspring outcomes.ResultsOffspring birth weight, length, and head circumference were positively associated with the maternal HLS (p < 0.001), whereas child BMI and incidence of overweight/obesity at age 5 and 9 were negatively associated (p < 0.05). In multivariable models, a lower maternal HLS was associated with increased risk of low birth weight (LBW) (P trend = 0.04) and lower likelihood of macrosomia (P trend = 0.03). Examined individually, poor maternal dietary quality, smoking, and alcohol intake were associated with higher risk of LBW (p < 0.04). Likelihood of macrosomia and combined overweight/obesity at age 5 and 9 years were greater among mothers with a pre-pregnancy BMI in the range with obesity (p < 0.04). Smoking during pregnancy was also linked to greater risk of childhood overweight/obesity (OR:1.91, 95% CI:1.01–3.61, p = 0.04 at age 5 and OR: 2.14, 95% CI:1.01–4.11, p = 0.03 at age 9).ConclusionsOur findings suggest that maternal adherence to a healthy lifestyle during pregnancy, in particular having a good quality diet, not smoking, and no/low alcohol intake in combination with a healthy pre-pregnancy BMI, is associated with reduced risk of adverse offspring birth outcomes and childhood obesity.

Background Evidence available on the determinants of vegetable intake in young populations is inconsistent. Vegetable intake is particularly low in adolescents from less-affluent backgrounds, yet no systematic review of qualitative studies investigating determinants for vegetable intake specifically has been conducted to date in this group. This systematic review aimed to identify determinants of vegetable intake in adolescents from socioeconomically disadvantaged urban areas located in very high-income countries reported in qualitative studies. Methods Five electronic databases (PubMed, Web of Science, CINAHL, PsycINFO and ERIC) were searched until August 2022. The search strategy used combinations of synonyms for vegetable intake, adolescents, and qualitative methodologies. Main inclusion criteria were studies exploring views and experiences of motivators and barriers to vegetable intake in a sample of adolescents aged 12–18 years from socioeconomically disadvantaged urban areas in very high income countries. Study quality assessment was conducted using criteria established in a previous review. Results Sixteen studies were included out of the 984 screened citations and 63 full texts. The synthesis of findings identified the following determinants of vegetable intake: sensory attributes of vegetables; psychosocial factors (nutrition knowledge, preferences/liking, self-efficacy, motivation); lifestyle factors (cost/price, time, convenience); fast food properties (taste, cost, satiety); home environment and parental influence; friends’ influence; school food environment, nutrition education and teachers’ support; and availability and accessibility of vegetables in the community and community nutrition practices. Studies attained between 18 and 49 out of 61 quality points, with eleven of 16 studies reaching ≥ 40 points. One main reason for lower scores was lack of data validation. Conclusion Multiple determinants of vegetable intake were identified complementing those investigated in quantitative studies. Future large scale quantitative studies should attempt to examine the relative importance of these determinants in order to guide the development of successful interventions in adolescents from socioeconomically disadvantaged backgrounds.

Background/objectives:The role of smoking from the paternal line during the pre-conception period on grand-child’s overweight/obesity and associated underlying pathways are uncertain. We examined whether the smoking status from the paternal line was associated with the grand-child’s higher weight at birth, and overweight or obesity at 5 and 9 years of age. The grandparental smoking effect from the maternal line was also explored.Subjects/methods:Participants were fathers and grandparents and grand-children from the Lifeways Cross Generational Cohort (N = 1021 for the analysis at birth; N = 562 and N = 284 for the analysis at 5 and 9 years, respectively). Paternal and grandparental smoking was defined as smoking versus non-smoking. Children’s weight categories compared were high versus normal weight at birth, and overweight/obesity versus normal weight (based on BMI and waist circumference) at age of five and nine years. Logistic regression models were used to estimate the crude and adjusted associations.Results:After adjustment for several child and parental factors, at age five there was an association between paternal smoking and offspring’s overweight/obesity based on BMI (Adjusted Odds Ratio (AOR), and 95%CI: 1.76, 1.14–2.71, p-value: 0.010), most marked for boys (AOR: 2.05, 1.06–3.96, p-value: 0.032). These associations remained when confined to the children sample with biological fathers only (overall sample, AOR: 1.92, 1.22–3.02, p-value: 0.005; son, AOR: 2.09, 1.06–4.11, p-value: 0.033). At age 9, the paternal grandmothers’ smoking was positively associated with their grandchild’s overweight/obesity status based on waist circumference (AOR: 3.29, 1.29–8.37), and especially with that of her granddaughter (AOR: 3.44, 1.11–10.69). These associations remained when analysing only the children sample with biological fathers (overall sample, AOR: 3.22,1.25–8.29, p-value: 0.016; granddaughter, AOR: 3.55, 1.13–11.15, p-value: 0.030).Conclusion:The smoking habit from the paternal line is associated with grand-children’s adiposity measures during their early childhood, which might be epigenetically transmitted through male-germline cells.

Background Obesity and its measure of body mass index are strongly determined by parental body size. Debate continues as to whether both parents contribute equally to offspring body mass which is key to understanding the aetiology of the disease. The aim of this study was to use cohort data from three generations of one family to examine the relative maternal and paternal associations with offspring body mass index and how these associations compare with family height to demonstrate evidence of genetic or environmental cross-generational transmission. Methods 669 of 1082 families were followed up in 2007/8 as part of the Lifeways study, a prospective observational cross-generation linkage cohort. Height and weight were measured in 529 Irish children aged 5 to 7 years and were self-reported by parents and grandparents. All adults provided information on self-rated health, education status, and indicators of income, diet and physical activity. Associations between the weight, height, and body mass index of family members were examined with mixed models and heritability estimates computed using linear regression analysis. Results Self-rated health was associated with lower BMI for all family members, as was age for children. When these effects were accounted for evidence of familial associations of BMI from one generation to the next was more apparent in the maternal line. Heritability estimates were higher (h 2 = 0.40) for mother-offspring pairs compared to father-offspring pairs (h 2 = 0.22). In the previous generation, estimates were higher between mothers-parents (h 2 = 0.54-0.60) but not between fathers-parents (h 2 = -0.04-0.17). Correlations between mother and offspring across two generations remained significant when modelled with fixed variables of socioeconomic status, health, and lifestyle. A similar analysis of height showed strong familial associations from maternal and paternal lines across each generation. Conclusions This is the first family cohort study to report an enduring association between mother and offspring BMI over three generations. The evidence of BMI transmission over three generations through the maternal line in an observational study corroborates the findings of animal studies. A more detailed analysis of geno and phenotypic data over three generations is warranted to understand the nature of this maternal-offspring relationship.

It is unclear how dietary, physical activity and sedentary behaviors co-occur in school-aged children. We investigated the clustering of energy balance-related behaviors and whether the identified clusters were associated with weight status. Participants were 6- to 9-year-old children (n = 63,215, 49.9% girls) from 19 countries participating in the fourth round (2015/2017) of the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative. Energy balance-related behaviors were parentally reported. Weight and height were objectively measured. We performed cluster analysis separately per group of countries (North Europe, East Europe, South Europe/Mediterranean countries and West-Central Asia). Seven clusters were identified in each group. Healthier clusters were common across groups. The pattern of distribution of healthy and unhealthy behaviors within each cluster was group specific. Associations between the clustering of energy balance-related behaviors and weight status varied per group. In South Europe/Mediterranean countries and East Europe, all or most of the cluster solutions were associated with higher risk of overweight/obesity when compared with the cluster ‘Physically active and healthy diet’. Few or no associations were observed in North Europe and West-Central Asia, respectively. These findings support the hypothesis that unfavorable weight status is associated with a particular combination of energy balance-related behavior patterns, but only in some groups of countries.

Maternal dietary quality during pregnancy is associated with offspring outcomes. These associations have not been examined in three-generation families. We investigated associations between parental and grandparental dietary quality, determined by healthy eating index (HEI)-2015, and offspring birth outcomes and weight status at age 5. The Lifeways cohort study in the Republic of Ireland comprises 1082 index-child’s mothers, 333 index-child’s fathers, and 707 grandparents. HEI-2015 scores were generated for all adults from prenatal dietary information collected using a validated food frequency questionnaire. In an adjusted model, greater adherence to the maternal HEI was associated with lower likelihood of low birth weight (LBW) (OR: 0.72, 95% CI: 0.50–0.99, p = 0.04). Similarly, maternal grandmothers (MGM) with higher HEI scores were less likely to have grandchildren with LBW (OR: 0.87, 95% CI: 0.61–0.96, p = 0.04) and more likely to have macrosomia (OR: 1.10, 95% CI: 1.01–1.22, p = 0.03). Higher paternal and paternal grandmothers (PGM) HEI scores were associated with lower likelihood of childhood obesity (OR: 0.89, 95% CI: 0.30–0.94, p = 0.03) and overweight (OR: 0.83, 95% CI: 0.22–0.99, p = 0.04), respectively. Mediation analysis showed significant direct relationship of MGM and PGM HEI scores on grandchildren’s birthweight and obesity, respectively. In conclusion, maternal line dietary quality appears to influence fetal growth whereas paternal line dietary quality appears to influence postnatal growth.

Background/Objectives To prospectively investigate the predictors of overweight/obesity and of body mass index (BMI) change in schoolchildren. Subjects/Methods A cohort of 2755 Irish children (53.7% girls), aged 6−10 years at baseline, participating in the Childhood Obesity Surveillance Initiative were included. Height and weight were objectively measured and BMI was calculated. Overweight/obesity were defined according to the International Obesity Task Force cut-offs. Prevalence of overweight/obesity at baseline and follow-up, incidence of overweight/obesity and changes in BMI over time were computed. Lifestyle indicators were parentally reported with a questionnaire. Predictors of overweight/obesity were investigated by multivariate mixed logistic regression models. Results Baseline BMI (OR = 6.46, 95% CI = 4.56−9.17) and school socioeconomic level (OR = 2.12, 95% CI = 1.16−3.86) were associated with higher risk of becoming overweight/obese. Children with no savoury snacks consumption (OR = 0.22, 95% CI = 0.07−0.69), or with frequent sports/dancing clubs attendance (OR = 0.41, 95% CI = 0.19−0.88) had lower odds of overweight/obesity at follow-up. Poor fruit intake was associated with higher risk of overweight/obesity (OR = 2.16, 95% CI = 1.23−3.78). Conclusions Initial BMI was the main predictor of subsequent overweight/obesity in schoolchildren, followed, to a lesser extent, by school socioeconomic status. Although lifestyle behaviours appeared to have lower effect as compared with prior BMI, children with healthier lifestyle behaviours were at reduced risk of overweight/obesity at follow-up. Programmes that aim at preventing the onset of overweight and obesity need to be a priority given the existing difficulties to reverse this condition later in life.