During an outbreak of hepatitis A predominantly among men who have sex with men (MSM) in Copenhagen, Denmark, in 2004, we did a case-control study to determine risk factors for infection. A case was an MSM >17 years, living in Copenhagen, with IgM positive hepatitis A infection diagnosed between June and August 2004, and without a household contact with a hepatitis A case before onset of illness. Controls were selected at the Copenhagen Pride Festival. The study included 18 cases and 64 controls. Sixteen of 18 cases and 36/63 controls had sex with casual partners (ORMH 5.6, 95% CI 1.2-26.9). Eleven of 18 cases and 14/62 controls had sex in gay saunas (ORMH 4.2, 95% CI 1.5-11.5). Sex at private homes appeared to be protective (ORMH 0.2, 95% CI 0.1-0.7). Casual sex including sex in gay saunas was an important risk factor for the spread of HAV among MSM in Copenhagen. The results are in accordance with findings in other European outbreaks. As the general immunity to hepatitis A decreases and the outbreak potential increases, we recommend health education and hepatitis A vaccination to all MSM not living in monogamous relationships, especially if they visit gay saunas or other places with frequent partner change. To stop spread of hepatitis A among MSM in Europe, a European consensus on prevention and control measures may be required.

Objective: To examine the direction and magnitude of the relationship between family meal frequency and dietary and family functioning outcomes in children (2-18 years).Design: Systematic literature review with meta-analysis.Methods: Independent electronic searches, one for each outcome of interest, were conducted across five databases PubMed, CINAHL, Web of Science, Scopus and PsycINFO. Studies were included if peer-reviewed and published in English in the US through December 2018.Main Outcome Measures: Diet and family functioning.Results: Dietary outcomes showed some evidence of a positive association between family meal frequency and fruits, vegetables, fruits and vegetables, sugar-sweetened beverages, and the Healthy Eating Index. There is less clear evidence of this relationship in snacks, fast food and desserts. A positive association was found between family meal frequency or dinner family meal 3 frequency and family functioning outcomes. All studies included had cross-sectional and longitudinal study designs. Conclusions and Implications:There is some evidence to show a positive relationship between family meal frequency and dietary outcomes. There is stronger evidence for the relationship with family functioning outcomes. The majority of articles included in the systematic reviews were excluded from meta-analysis due to inadequate data and high methodological diversity across exposure and outcome variables.

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Background: Older adults report low fruit and vegetable (FV) intake. The lack of objective, field-based assessments of FV intake is a limitation when assessing the effectiveness of interventions. Aim: To examine if self-reported FV intake was correlated with Veggie Meter® scores among low-income older adults. The Veggie Meter® is a portable tool that uses pressure-mediated reflection spectroscopy to estimate skin carotenoid measurements. Methods: A cross-sectional assessment of FV intake, food security, and Veggie Meter® score in low-income older adults was conducted. Bivariate analyses quantified the association between FV intake and Veggie Meter® score. Results: Participants ( n = 154) were mostly female (69.3%), non-white (66.2%) and at risk for food insecurity (65.6%). Mean Veggie Meter® score was 172.3 ± 77.2 and had a small significant positive correlation with FV intake (r= 0.192, p = 0.018). Conclusion: The Veggie Meter® may objectively indicate FV intake. Research to validate the Veggie Meter® in older, diverse populations is needed.