The Mediterranean diet (MD) and Western diet (WD) are poles apart as dietary patterns. Despite the availability of epidemiological tools to estimate the adherence to MD, to date, there is a lack of combined scores. We developed MEDOC, a food frequency questionnaire (FFQ) designed to calculate a combined adherence score for both diets and validated it on 213 subjects. The test-retest reliability revealed all frequency questions falling within the acceptable range of 0.5 to 0.7 (Pearson correlation coefficient) in younger (<30 years old) subjects, while 1 question out of 39 fell below the range in older (>30 years old) participants. The reproducibility for portion size was less satisfying, with, respectively, 38.2% and 70.5% of questions falling below 0.5 (Cohen\'s Kappa index) for younger and older subjects. The good correlation (R = 0.63, p < 0.0001 for subjects younger than 30 years and R = 0.54, p < 0.0001 for subjects older than 30 years, Pearson\'s correlation coefficient) between the MEDOC score and the MediDietScore (MDS) confirmed the validity of the MEDOC score in identifying patients who adhere to the MD. Harnessing the capabilities of this innovative tool, we aim to broaden the existing perspective to study complex dietary patterns in nutritional epidemiology studies.

The prevalence of non-communicable diseases still represents a public health concern in South Africa, of which eating habits are some of the main risk factors. A modern diet consisting of the consumption of highly processed foods high in fat, salt and caloric sweeteners and low in fibre is recognised as unhealthy. This study was conducted to assess the penchant of the population for these types of foods rather than traditional indigenous foods known to be healthier. This research was undertaken in the Gauteng region, which is the most urbanized province in the country. This study consisted of a quantitative research survey conducted in 2019 with 1527 participants (Asians, Black, Coloured, Indians and White) aged 18 and above who had lived in the province for at least two years. The results revealed that 30-40 % were neutral on the issue. Despite half (54.4 %) indicating that it was good to mix traditional and modern foods, a clear preference for modern food was noticed for 35.7 % of respondents, with 32.2 % reporting not being concerned that traditional foods have been replaced by modern foods. The traditional indigenous food consumption (TIFC) appeared to depend on monthly total household income, residential area, and settlement category. Participants with specific economic comfort consumed less. Race and number of people in the participants\' households also significantly affected the TIFC (p < 0.05). Participants of white ethnicity and those living in a household of a maximum of 02 people displayed the lowest TIFC. In comparison to those who strongly disagree, participants with a neutral opinion about the idea of mixing eating habits were also the most neutral concerning preference for a modern diet (OR: 10.95, 95 % CI 7.00-17.12) and nutrition transition (OR: 14.66, 95 % CI 9.09-23.64). Sensitisation about healthy eating habits among the identified at-risk and target groups is undoubtedly a need in the region to avoid a resurgence of modern diet-related diseases.

The Mediterranean diet is a well-studied cultural model of healthy eating, yet research on healthy models from other cultures and cuisines has been limited. This perspective article summarizes the components of traditional Latin American, Asian, and African heritage diets, their association with diet quality and markers of health, and implications for nutrition programs and policy. Though these diets differ in specific foods and flavors, we present a common thread that emphasizes healthful plant foods and that is consistent with high dietary quality and low rates of major causes of disability and deaths. In this perspective, we propose that nutrition interventions that incorporate these cultural models of healthy eating show promise, though further research is needed to determine health outcomes and best practices for implementation.

Amazonian Indigenous Peoples are undergoing drastic changes in their ways of life including the quality and availability of food and its impact on their health and well-being. Indigenous populations have their own perspectives and interpretations of dietary changes unfolding in their communities. Based on in-depth interviews, observations and validation workshops we explored the way Awajún describe and problematise the concept of healthy and unhealthy food in the context of the nutrition transition. We learn that the characteristics of \'good food\' are informed by their capacity to give strength, protect health and enable them to be hardworking people. On the contrary, food that comes from the city weakens the body and may result in health problems. For the Awajún, chicken with hormones, fish preserved in cans, and powdered milk negatively affect their health. We argue that the dichotomy \'healthy\' and \'unhealthy\' used to classify food provides information not only about Indigenous conceptualisations of health and die, but is also a critique of broader structural processes affecting their well-being. The terms, explanations and idioms used by the Awajún to talk about food, provide an insight into Indigenous perspectives and knowledge key to informing global health interventions in culturally appropriate ways.

BACKGROUND: The fundamental transformation of food systems and retail environments in low-income countries is influencing consumers\' food choices and dietary habits in unfavourable directions through the consumption of highly processed, energy-dense foods, predominantly manufactured by multinational food corporations. This study aims to identify the principal factors driving consumers\' preference for multinational foods over local foods in the urban Accra region of Ghana.
METHODS: This cross-sectional survey involving a random sample of 200 consumers conducted in March/April 2023 using interviewer-administered questionnaires employed a maximum difference scaling approach to investigate the drivers of urban Ghanaian consumer food choices for multinational food corporations\' products over local foods. The maximum difference scaling modelling analysis utilized in this study identifies the primary drivers of multinational food corporations\' product preferences and the associated trade-offs.
RESULTS: The study discovered that food quality and safe packaging, perceived healthiness, taste and flavour, and nutritional value were the most significant factors driving consumer preference for multinational food corporations\' products over local foods in Ghana. The criterion food quality and safe packaging had the significantly highest utility than all other attributes in terms of consumer preference for products/meals from multinational food corporations over local foods.
CONCLUSIONS: The results of this study provide significant contributions to the existing body of research, as previous studies have not identified these factors as primary drivers of multinational food products. Public health authorities and nutritionists can use the study\'s findings to implement targeted quality assurance measures in local markets and to address the drivers in health education campaigns.

Rising incomes across low-and middle-income countries (LMIC) lead to a lower consumption of starchy staples and create a growing demand for high-quality animal protein, an observation referred to as Bennett\'s law. This dietary shift from plant-sourced to animal-sourced proteins has also been referred to as the LMIC protein transition. At this time, there are rising concerns that current livestock production is highly resource intensive and may not meet the growing global demand for high-quality protein. Alternative plant-based proteins, derived from new technologies and often fortified with micronutrients, are intended to close the LMIC nutrient gap. However, data from LMIC suggest that the income-driven selection of animal proteins is aspirational and varies by stage of economic development. Food balance sheets from higher-income countries indicate that meat consumption peaks only at very high incomes. Will plant-based alternative proteins satisfy the growing LMIC demand for animal-sourced foods, thereby negating Bennett\'s law? Current evidence suggests otherwise.

OBJECTIVE: The prevalence of metabolic syndrome (MetS) is on the rise in an increasingly urbanized world. The study aimed to review the association between urbanization and MetS in low- and middle-income countries (LMICs).
RESULTS: A comprehensive search of five databases (MEDLINE, Web of Science, Scopus, EMBASE, and CENTRAL) was performed in January 2022 and updated in October 2022. Peer-reviewed studies that met the eligibility selection criteria were included. Search terms were used for the main concepts which are MetS, dietary patterns, and urbanization in LMICs. Study selection was done in two stages and in duplicate. Random effects models were used to calculate the overall pooled prevalence and main study-level characteristics. Out of 9,773 identified studies, nineteen were included in the systematic review and meta-analysis. The studies were done on 313,644 participants (149,616 urban and 164,028 rural). The pooled risk ratio (RR, 95% confidence interval) of MetS between urban and rural dwellers was RR = 1.24; 95%CI [1.15, 1.34] (I2 = 96.0%, P < 0.0001). A relatively higher prevalence of MetS among urban than rural residents has been observed, especially with the International Diabetes Federation criteria (RR = 1.54; 95%CI [1.21, 1.96]; I2 = 65.0%), and in the population in India (RR = 2.19; 95%CI = 1.24, 3.88, I2 = 85%). Overall, the role of dietary patterns in the development of MetS was inconsistent, and few studies showed a lower risk of MetS with adherence to recommended healthy dietary patterns.
CONCLUSIONS: There was an association between urbanization and the high prevalence of MetS. Interventions and policies to reduce the risk of MetS are needed.

Human food foraging in community forests offers extensive and expandable sources of food and high-quality nutrition that support chronic disease prevention and management and are underrepresented in US diets. Despite severe gaps in non-commercial \"wild food\" data, research in Syracuse, NY, identified substantial amounts of five key antioxidant phytochemicals in locally available, forageable foods with the potential to augment local dietary diversity and quality. Findings endorse the need for micro- and macro-nutrient research on an expanded range of forageable foods, community nutrition education on those foods, an expanded study on antioxidant phytochemical function, and the inclusion of forageables in the food system definition.

Irritable bowel syndrome (IBS), a gastrointestinal disease, is a global phenomenon correlated with industrialization. We propose that an evolutionary medicine approach is useful to understand this disease from an ultimate perspective and conducted a scoping literature review to synthesize the IBS literature within this framework. Our review suggests five potential evolutionary hypotheses for the cause of IBS, including (a) a dietary mismatch accompanying a nutritional transition, (b) an early hygienic life environment leading to the immune system and microbiotic changes, (c) an outcome of decreased physical activity, (d) a response to changes in environmental light-dark cycles, and (e) an artifact of an evolved fight or flight response. We find key limitations in the available data needed to understand early life, nutritional, and socioeconomic experiences that would allow us to understand evolutionarily relevant risk factors and identify a need for further empirical research to distinguish potential causes and test evolutionary hypotheses.

OBJECTIVE: To examine trends in the intake of key food groups among Iranian adults between 2005 and 2016, overall, and according to sociodemographic characteristics.
METHODS: Repeat cross-sectional data from the Iran-STEPwise approach to risk factor surveillance (Iran-WHO STEPS) 2005-2016 were analysed. Regression analyses were used to evaluate trends in the frequency of fruits, vegetables and fish intake and type of oil used over time. Interactions by sex, age and area of residence were examined.
METHODS: Iran.
METHODS: 225 221 Iranian adults.
RESULTS: The frequency of vegetables (β: -0·03; 95 % CI (-0·06, -0·00); P-trend = 0·030) and fish (β: -0·09; 95 % CI (-0·10, -0·08); P-trend < 0·001) intake and use of solid fat (OR: 0·70; 95 % CI (0·70, 0·72); P-trend < 0·001) declined, whilst the frequency of fruit intake (β-Coeff: 0·03, 95 % CI (0·01, 0·05); P-trend = 0·014) and liquid oil use (OR: 1·40; 95 % CI (1·3, 1·4); P-trend<0·001) rose. Rising trends in fruit intake were larger in mid-aged (40-60 years) and older (>60 years) adults (P-interaction < 0·001), whilst declines in vegetable (P-interaction < 0·001) and fish intake (P-interaction = 0·001) were larger in older adults. The declining use of solid fat was strongest in middle-aged and older adults (P-interaction = 0·035), while the increasing use of liquid oil was strongest in rural areas (P-interaction = 0·011).
CONCLUSIONS: During the nutrition transition, liquid oil use and the frequency of fruit intake rose, while the frequency of vegetables and fish intake declined. Nonetheless, the fatty acid composition and cooking methods are important considerations. The changes observed are concerning from a public health perspective and demonstrate the need for interventions and possible targets for tailored strategies.