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Food insecurity is characterized by insufficient access to diverse, nutritious, and safe food and often intensifies in old age. This study was conducted among community-living older persons in Malta to determine their food security based on multiple factors. The specific objectives involved exploring dietary intake, food acquisition methods, perceptions of dietary sufficiency and healthy eating, nutrition information sources, and related challenges. A sequential mixed-methodology strategy was adopted comprising a questionnaire-based survey and focus group discussions. Data from the 264 survey respondents were analyzed for frequencies of different practices, perceptions, knowledge, and concerns regarding food security. Data from the twenty-five focus group participants were analyzed manually in an iterative manner, initially guided by the interview questions; then eventually identifying subthemes emerging from the data itself. The majority of the survey participants were fairly food secure. They consumed varied meals daily and were proficient in food accessibility, with 66% stating that it was easy/very easy to obtain food, 74% purchasing food themselves from near their home, and 50% reporting they were assisted by family members. The majority of the respondents found food affordable (86%) and indicated that they were comfortable with the type and amount of food available at home (96%). Dietary restrictions, living alone, a lack of motivation to cook, impaired physical functionality, and a lack of knowledge to maintain a healthy diet presented obstacles to preferred and nutritious food choices. There was a desire for more education, especially to help manage multiple health conditions. These findings will assist in developing nutrition policies and education interventions to enhance food security among community-living older adults. A key recommendation is to conduct further research to determine nutritional adequacy, solutions to challenges, and nutrition and culinary education needs of non-surveyed persons, especially the very old still living independently, or those experiencing cognitive or financial decline.

While epidemiological research on the protective role of the Mediterranean diet (MD) is highly publicised, little is known about MD education interventions. This exploratory study aimed to provide insight into methodology and effectiveness of the MD as a nutrition education and health promotion tool. Two searches were conducted within PubMed using the terms 'Mediterranean diet' and 'Education' or 'Intervention'. Abstracts yielded were screened for distinct studies in which participants were instructed on the application of MD principles in their diet. Four studies met this criterion. These were further analysed for sample/target population, and intervention design, duration, tools, evaluative measures/tests and outcomes. Interventions targeted both healthy and at-risk populations and lasted between 12 weeks to 1 year, including follow-up. They used individual counselling, tailored computer-based counselling, group education, internet-based education, cookery classes and printed materials. Outcomes were measured using food diaries, FFQ, questionnaires on psychosocial factors and on usage of the educational tools, as well as anthropometrics and biomarkers. Interventions showed statistically significant increases in participants' intake of vegetables, legumes, nuts, fruit, whole grains, seeds, olive oil and dietary PUFA and MUFA, and statistically significant decreases in total cholesterol, ox-LDL-cholesterol, total:HDL-cholesterol ratio, insulin resistance, BMI, body weight and waist circumference. MD education interventions may be cost-effective strategies for helping to protect against and treat a variety of health problems in different populations. Details of such interventions need to be publicised internationally. This introductory review could help inform the design of future targeted MD nutrition education.

The urgent need for transformation of food systems into sustainable healthy food systems (SHFS) is receiving global attention. The crucial involvement of all players in a nation’s food system has been underlined, including the role of higher education institutions as ideal places to train future employees or employers along the food supply-consumption continuum, future professionals who can influence food behaviors in various sectors, and individuals as responsible consumers and advocates. With this backdrop, a two-stage study was conducted that involved a review of key international and national documents to identify SHFS education or training mentions and a preliminary mapping exercise of the programs of different academic entities at the University of Malta (UM) to identify where food, food systems, and/or sustainability are addressed. A synthesizing narrative of the findings of the document review indicates that SHFS are mentioned in different contexts. A content analysis of the course programs and relevant study-unit descriptions shows that the Faculty of Education, the Faculty of Health Sciences, the Institute of Earth Systems, and the Institute of Tourism, Travel and Culture are the four UM entities where multiple aspects of SHFS are addressed. Each entity has its own strength, and areas covered include food, nutrition, health and culture; food science, technology, and production; food policy, regulations, and sustainability issues; and pedagogies for food and sustainability education. Results highlight opportunities for extension, collaboration, and innovation in the UM’s training for potential players in SHFS, and could help inform achievement of the UM’s 2020–2025 Strategic Plan.

This article offers an introduction to the literature on convenience foods as a growing phenomenon within contemporary lifestyles and on the emerging interest and practices in sustainable food consumption. Various factors influence the use of convenience foods, including time availability, values related to health and the natural environment, as well as cooking skills. Some of these factors also feature in choices and behaviours related to sustainable food consumption; although other factors such as knowledge, food labelling and belief in ones own potential positive impact also play a role. The importance of education for sustainable food consumption as a key strategy for improving individual and planetary wellbeing is outlined and the link with Home Economics literacy and particularly food literacy is explained. Building on the literature, and the discipline’s aims and practical application, suggestions are presented on how Home Economics educational initiatives can facilitate convenience in food preparation, whilst keeping in mind principles of sustainable consumption.

This aim of this study was to explore the various influences on the food choices and behaviours of Maltese primary schoolchildren. Using an ecological framework and following sociological theory of consumption it sought to uncover any group differences in food perceptions, beliefs, preferences and intake, as well as identify any culture-cuisine orientations of foods consumed in different settings. A multi-method grounded approach was adopted, where results from each stage of the research informed the focus of subsequent stages. A culture-sensitive research tool was developed for exploring children’s food consumption and preferences in ten different home-based and non-home-based settings. Data was collected via a large-scale survey with a stratified sample of 7-8-year-old children (N=1088) and their parents (N=932). Follow-up focus group interviews with children (N=16 groups) and telephone interviews with parents (N=30) were also conducted in order to obtain more detail on influences on food intake. Analysis based on gender, household level of schooling, school type, region and access to cable TV showed that Maltese children’s overall food intake was fairly similar across groups, though some specific patterns did emerge. Girls seemed to prefer and consume ‘lighter’ more ‘feminine’ foods and boys ‘heavier’ more ‘masculine’ foods. Children attending independent (fee-paying) schools tended to exhibit more ‘modern’ food practices based on novel and processed foods. They also tended to eat weekday supper with their family less frequently than other groups. Children attending state schools tended to consume more meat-based meals, milk and traditional Maltese foods. Children from the rural island of Gozo seemed to place greater value on balance, quality and freshness of food and ate their weekday supper with their family more frequently. A pronounced Westernisation of Maltese children’s diet was evident. Traditional Maltese foods were only predominant in home-based snacks. Grandparents emerged as having an important role in exposing children to traditional cuisine. Mothers’ provision of food for children was based primarily on hedonic and health motives. Strategies used to promote consumption of healthy food included controlling availability, information-giving and being prescriptive rather than restrictive. In general, both children and parents acknowledged the value of school food rules, although attitudes differed with regard to extent of imposition. Parents also felt that TV food portrayal was a strong influence on their children’s food requests, as was to a lesser extent modelling of food behaviours by peers. Children’s knowledge of the health value of food was good, though a few misperceptions existed and certain food associations were barriers to intake. Taste, texture, convenience and healthfulness were key attributes which attracted children to food. Local health promotion initiatives and nutrition education interventions need to target the different influences on Maltese children’s food intake functioning at the different ecological levels. These include the children’s own food perceptions, beliefs and valuations, as well as the different routes of influence of the mother, grandparents, the school and television.

The overall purpose of this study was to assess the short term impact of a television series about heart health entitled 'The Rhythm of Health'. The major objective was to measure changes in the heart health-related knowledge, attitudes, and current and intended behaviours of a selected group of adult workers. The quantitative findings from the study revealed that, within a relatively well-educated group of people, mainly women between the ages of 31-59 years, working in diverse occupational fields, and who where fairly healthy, active and light television viewers, there was an overall improvement in the scores measuring heart health-related knowledge, attitudes and current and intended behaviour, after exposure to the television series. From the qualitative data collected, it emerged that message content and delivery features most frequently identified as possibly enhancing the impact of health education T.V. series were credibility, lucidity, and supportiveness of the spokespersons; sensitivity to the audience's socio-economic and cultural background; the use of demonstrations or mini-interviews with respected or ordinary people from the community; and clarity, conciseness, and flow in the quality of the production. (Abstract shortened by UMI.)

Fetal growth restriction (FGR) is a common complication of pregnancy, resulting in a fetus that fails to reach its genetically determined growth potential. Whilst the fetal cardiovascular response to acute hypoxia is well established, the fetal defence to chronic hypoxia is not well understood due to experiment constraints. Growth restriction results primarily from reduced oxygen and nutrient supply to the developing fetus, resulting in chronic hypoxia. The fetus adapts to chronic hypoxia by redistributing cardiac output via brain sparing in an attempt to preserve function in the developing brain. This review highlights the impact of brain sparing on the developing fetal cardiovascular and cerebrovascular systems, as well as emerging long-term effects in offspring that were growth restricted at birth. Here, we explore the pathogenesis associated with brain sparing within the cerebrovascular system. An increased understanding of the mechanistic pathways will be critical to preventing neuropathological outcomes, including motor dysfunction such as cerebral palsy, or behaviour dysfunctions including autism and attention-deficit/hyperactivity disorder (ADHD).

Fetal growth restriction (FGR) arises from chronic hypoxia and increases the risk of cardiovascular dysfunction following perinatal asphyxia, although the underlying mechanisms are unknown. We investigated whether FGR lambs have altered cardiovascular responses to perinatal asphyxia compared to control lambs, and whether impairments in α1 and β1 adrenergic receptor function underlie these responses. Single or twin-bearing ewes underwent sterile fetal surgery at 89 days gestation (dGA; term=148d) to induce FGR (single umbilical artery ligation) or sham surgery (Control). At 126dGA, lambs were delivered via caesarean section, instrumented and randomised to immediate ventilation (ControlVENT n=6; FGRVENT n=6), or asphyxia (ControlASPHYXIA n=12; FGRASPHYXIA n=11) induced by umbilical cord occlusion while withholding resuscitation until diastolic blood pressure (BP) decreased to 10mmHg. Lambs were ventilated for 8 hours before baseline ex vivo cardiac function was assessed via Langendorff perfusion to measure left ventricular developed pressure (LVDP), heart rate (HR) and coronary perfusion pressure (CPP). Ex vivo α1 and β1 adrenergic responses were assessed via phenylephrine (10−5 to 10−2 mmol/L) and dobutamine (10−7 to 10−4) administration, respectively. FGRASPHYXIA lambs had lower BP during asphyxia (p<0.05 vs ControlASPHYXIA) and took longer to reach a diastolic BP of 10mmHg (14.5 ± 0.8 min vs. 19.2 ± 1.3 min; p=0.005). FGRASPHYXIA lambs had lower BP in the first 5 minutes after return of spontaneous circulation (p<0.05) due to impaired vascular contractility, with reduced Tau, dP/dtmax and dP/dtmin (p<0.03 vs ControlASPHYXIA). Baseline LVDP, HR and CPP were similar between groups, however FGRASPHYXIA lambs had increased LVDP responses to phenylephrine and dobutamine (p<0.05 vs ControlASPHYXIA), without significant changes to HR or CPP. FGR lambs have altered physiological responses to perinatal asphyxia due to impaired vascular contractility and dysregulated cardiac α1 and β1 adrenergic receptor function, which may increase susceptibility to cardiovascular dysfunction in the neonatal period.