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Tantimahanon A, Sipiyaruk K, Tantipoj C. Determinants of dietary behaviors among dental professionals: insights across educational levels. BMC Oral Health 2024; 24:724. [PMID: 38914973 PMCID: PMC11197208 DOI: 10.1186/s12903-024-04502-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 06/17/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Healthy dietary behaviors are fundamental for maintaining optimal health. Understanding the dietary behaviors of dentists is vital for designing effective interventions to foster healthier behaviors. However, investigations into dietary behaviors and their associations among dental professionals have been limited. OBJECTIVE To investigate the dietary behaviors of dental professionals, along with the associated factors influencing their dietary options. MATERIALS AND METHODS A self-administered online questionnaire was constructed to collect data from three groups of dental professionals: undergraduates (UG), postgraduates (PG), and practicing dentists (DT). The questionnaire encompassed inquiries regarding demographic characteristics, knowledge assessment, evaluation of attitudes, and examination of dietary behaviors. Data analysis procedures included descriptive statistics, Spearman's rank correlation, and multiple linear regression. RESULTS A total of 842 individuals participated in the study (UG: 264, PG: 247, DT: 331). Attitude emerged as the strongest association of healthy dietary behaviors across all groups (UG: ß=0.370, PG: ß=0.512, DT: ß=0.642; P < 0.001), while alcohol consumption showed a negative correlation with healthy dietary behaviors (UG: ß=-0.135, PG: ß=-0.220, DT: ß=-0.216; P < 0.001). CONCLUSION Significant variations in dietary behaviors across diverse educational levels of dental professionals were observed. Attitude emerged as the predominant factor influencing dietary behaviors, while knowledge was found to have a weak association. Tailored interventions addressing individual challenges at different career stages should be considered to enhance dietary behaviors and overall well-being in dental practice settings.
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Affiliation(s)
- Athikom Tantimahanon
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, 6 Yothi Road, Ratchathewi, Bangkok, 10400, Thailand
| | - Kawin Sipiyaruk
- Department of Orthodontics, Faculty of Dentistry, Mahidol University, 6 Yothi Road, Ratchathewi, Bangkok, 10400, Thailand
| | - Chanita Tantipoj
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, 6 Yothi Road, Ratchathewi, Bangkok, 10400, Thailand.
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Willits-Smith A, Taillie LS, Jaacks LM, Frank SM, Grummon AH. Effects of red meat taxes and warning labels on food groups selected in a randomized controlled trial. Int J Behav Nutr Phys Act 2024; 21:39. [PMID: 38622655 PMCID: PMC11020801 DOI: 10.1186/s12966-024-01584-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 03/15/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND High consumption of red and processed meat contributes to both health and environmental harms. Warning labels and taxes for red meat reduce selection of red meat overall, but little is known about how these potential policies affect purchases of subcategories of red meat (e.g., processed versus unprocessed) or of non-red-meat foods (e.g., cheese, pulses) relevant to health and environmental outcomes. This study examined consumer responses to warning labels and taxes for red meat in a randomized controlled trial. METHODS In October 2021, we recruited 3,518 US adults to complete a shopping task in a naturalistic online grocery store. Participants were randomly assigned to one of four arms: control (no warning labels or tax), warning labels only (health and environmental warning labels appeared next to products containing red meat), tax only (prices of products containing red meat were increased 30%) or combined warning labels + tax. Participants selected items to hypothetically purchase, which we categorized into food groups based on the presence of animal- and plant-source ingredients (e.g., beef, eggs, pulses), meat processing level (e.g., processed pork versus unprocessed pork), and meat species (e.g., beef versus pork). We assessed the effects of the warning labels and tax on selections from each food group. RESULTS Compared to control, all three interventions led participants to select fewer items with processed meat (driven by reductions in processed pork) and (for the tax and warning labels + tax interventions only) fewer items with unprocessed meat (driven by reductions in unprocessed beef). All three interventions also led participants to select more items containing cheese, while only the combined warning labels + tax intervention led participants to select more items containing processed poultry. Except for an increase in selection of pulses in the tax arm, the interventions did not affect selections of fish or seafood (processed or unprocessed), eggs, or plant-based items (pulses, nuts & seeds, tofu, meat mimics, grains & potatoes, vegetables). CONCLUSIONS Policies to reduce red meat consumption are also likely to affect consumption of other types of foods that are relevant to both health and environmental outcomes. TRIAL REGISTRATION NCT04716010 on www. CLINICALTRIALS gov .
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Affiliation(s)
- Amelia Willits-Smith
- Carolina Population Center, University of North Carolina at Chapel Hill, 27516, Chapel Hill, NC, USA
| | - Lindsey Smith Taillie
- Carolina Population Center, University of North Carolina at Chapel Hill, 27516, Chapel Hill, NC, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 27516, Chapel Hill, NC, USA
| | - Lindsay M Jaacks
- Global Academy of Agriculture and Food Systems, The University of Edinburgh, Midlothian, UK
| | - Sarah M Frank
- Global Academy of Agriculture and Food Systems, The University of Edinburgh, Midlothian, UK
| | - Anna H Grummon
- Department of Pediatrics, Stanford University School of Medicine, 3145 Porter Drive, A103, 94034, Palo Alto, CA, USA.
- Department of Health Policy, Stanford University School of Medicine, 94305, Stanford, CA, USA.
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Deeb N, Naja F, Nasreddine L, Kharroubi S, Darwiche N, Hwalla N. Nutrition Knowledge, Attitudes, and Lifestyle Practices That May Lead to Breast Cancer Risk Reduction among Female University Students in Lebanon. Nutrients 2024; 16:1095. [PMID: 38613128 PMCID: PMC11013092 DOI: 10.3390/nu16071095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/13/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
Research has identified both nonmodifiable and modifiable risk factors for breast cancer (BC), with accumulating evidence showing that adopting adequate dietary practices could decrease the risk of this disease. This study aimed to assess nutrition knowledge, attitudes, and lifestyle practices (KAP) that may lead to BC risk reduction among female university students in Lebanon and examine the determinants of their practices. A cross-sectional survey was conducted using a convenience sampling method, comprising 356 (response rate: 71.2%) female students at the American University of Beirut aged 18 to 25 years with no history of BC. Participants completed a pre-tested questionnaire addressing the objectives of the study. The modified Bloom's cut-off of 75% was used to categorize knowledge and practice scores as poor or good and attitudes as negative or positive. Large proportions of students had poor knowledge (68.3%), negative attitudes (65.4%), and poor practices (98.0%) scores. Pursuing a health-related major and having a higher GPA were associated with better knowledge and attitudes while being older and having a lower degree of stress were associated with positive attitudes only. Having a lower body mass index (BMI) was associated with better practice scores. Better knowledge significantly predicted higher intake of fruits and vegetables. Overall knowledge and attitudes were significantly correlated with each other, but neither was significantly correlated with overall practice. These findings underscore the importance of implementing public health programs geared towards improving nutrition KAP that may lead to BC risk reduction.
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Affiliation(s)
- Nour Deeb
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, Beirut 1107 2020, Lebanon; (N.D.); (L.N.); (S.K.)
| | - Farah Naja
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical & Health Sciences (RIMHS), University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates;
- Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, Beirut 1107 2020, Lebanon
| | - Lara Nasreddine
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, Beirut 1107 2020, Lebanon; (N.D.); (L.N.); (S.K.)
| | - Samer Kharroubi
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, Beirut 1107 2020, Lebanon; (N.D.); (L.N.); (S.K.)
| | - Nadine Darwiche
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, P.O. Box 11-0236, Riad El Solh, Beirut 1107 2020, Lebanon;
| | - Nahla Hwalla
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, Beirut 1107 2020, Lebanon; (N.D.); (L.N.); (S.K.)
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Armas AJM, Aranda JAE, Arcos HS, Arellano FL, Arguelles CBL, Arreza AMM, Arriza MAG, Ascan CKA, Torres GCS. Assessing Dietary Salt Intake and Pilot-Testing a Home-Based Intervention to Lower Salt Intake Among Filipino College Students. J Community Health Nurs 2024; 41:57-72. [PMID: 37943282 DOI: 10.1080/07370016.2023.2277839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
PURPOSE To assess the knowledge, attitude, and behaviors related to dietary salt intake and develop a home-based intervention that helps lower salt intake among Filipino college students. DESIGN Two-phase program development study utilizing descriptive and quasi-experimental design. METHODS Phase 1 determined the knowledge, attitude, and behaviors alongside the frequency of dietary salt intake of a consecutive sample (n = 118). Phase 2 involved the development and pilot-testing of a home-based intervention wherein a random sample (n = 35) selected from Phase 1 joined for pilot-testing. The study was conducted from October - November 2021 and utilized valid and reliable measures to test the knowledge, attitude, and behavior of the participants. FINDINGS Initial assessment showed knowledge regarding health risks of high salt intake and positive attitude toward health-promoting behaviors. Post-intervention showed improvement in attitude (p = 0.0004) and behavior (p = 0.001) related to dietary salt intake alongside health literacy (p = 0.036). There was no significant change in knowledge (p = 0.054). CONCLUSION The home-based intervention involving the use of health education materials is successful in improving dietary salt intake patterns. CLINICAL EVIDENCE Community health nurses may utilize home-based interventions to help develop health-promoting behaviors among young adults.
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Caballero-Gonzalez A, López-Cepero A, Mattei J. Deep-Structure Attitudes and Reasons Toward Healthy Eating and Self-Rated Diet and Health in Ethnically Diverse U.S.-Hispanics/Latinos. Health Promot Pract 2023:15248399231214968. [PMID: 38102803 DOI: 10.1177/15248399231214968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
Little is known about deep-structure (i.e., embedded) cultural attitudes toward healthy eating among Hispanics/Latinos in the United States. This study aimed to identify ethnic-specific dietary attitudes of Latino adults and evaluate their associations with self-rated diet and health. Participants (n = 200) were community-based Latinos (25-65 y/o) living in the Boston, Massachusetts metro area who completed a survey assessing agreement with 20 statements on attitudes toward healthy eating (eight positive and 12 negative) and 15 statements on reasons for healthy eating across seven constructs. Multinomial logistic regression models tested the association of sum scores of positive or negative attitudes and reasons for healthy eating with self-rated diet or self-rated health for participants of Caribbean versus Non-Caribbean backgrounds. Most participants of both backgrounds agreed that healthy eating would keep them healthy and make them look good, and that families should eat together. Differences by background were noted in statements regarding eating at special occasions, cost of healthy foods, self-efficacy (i.e., cravings), and cultural beliefs. Negative attitudes were associated with lower odds of better self-rated health for Caribbean, but not for non-Caribbean, participants. Positive attitudes were associated with 1.85 (95% CI [1.10, 3.12]) odds of better self-rated diet for Caribbean participants and 3.13 (95% CI [1.26, 7.81]) for non-Caribbean participants. Non-Caribbean participants were more likely to self-rate very good/excellent diet with higher reasons for healthy eating. Latinos have shared and ethnic-specific deep-structure attitudes toward healthy eating related to their perceived diet quality and health. Programs promoting healthy eating for Latino adults should be deeply tailored by ethnicity.
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Ma Z, Yang H, Meng G, Zhang Q, Liu L, Wu H, Gu Y, Zhang S, Wang X, Zhang J, Sun S, Wang X, Zhou M, Jia Q, Song K, Niu K. Anti-inflammatory dietary pattern is associated with handgrip strength decline: a prospective cohort study. Eur J Nutr 2023; 62:3207-3216. [PMID: 37548698 DOI: 10.1007/s00394-023-03225-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 07/27/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND AND AIMS Skeletal muscle strength decline is strongly associated with inflammation. While previous research has confirmed that diet can modulate chronic inflammation, little is known about the relationship between an anti-inflammatory dietary pattern and muscle strength. The aim of this study was to investigate the association between an anti-inflammatory dietary pattern and handgrip strength decline in a large-scale adult population. METHODS During a median follow-up period of 3 years, this prospective cohort study was carried out between 2013 and 2018 and included 2840 participants (60.2% men). Dietary intake was assessed using a validated food frequency questionnaire at baseline, and handgrip strength was measured annually with a handheld digital dynamometer. The dietary inflammatory potential score was calculated using white blood cell count and hypersensitive C-reactive protein as inflammatory markers, and was determined using reduced rank regression and stepwise linear regression. Multivariable linear regression models were used to estimate the association between the dietary inflammatory potential score and the annualized change in handgrip strength and weight-adjusted handgrip strength. RESULTS After adjusting for multiple confounding factors, significant associations between the dietary inflammatory potential score and the annualized change in handgrip strength and weight-adjusted handgrip strength in women, with values of - 0.8322 kg (95% confidence interval [CI] - 1.6405, - 0.0238; P < 0.0408) and - 0.0171 kg/kg (95% CI - 0.0310, - 0.0032; P < 0.0158), respectively. However, no significant differences were observed between the dietary inflammatory potential score and the annualized change in handgrip strength and weight-adjusted handgrip strength in men, with values of 0.1578 kg (95% CI - 0.6107, 0.9261; P < 0.6874) and - 0.0014 kg/kg (95% CI - 0.0115, 0.0088; P < 0.7933), respectively. CONCLUSION Our findings suggest that consuming an anti-inflammatory dietary pattern could be a protective strategy against the decline in skeletal muscle strength in women.
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Affiliation(s)
- Zheng Ma
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, China
- School of Public Health of Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, China
- School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Honghao Yang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, China
- School of Public Health of Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, China
| | - Ge Meng
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, China.
- Department of Toxicology and Health Inspection and Quarantine, School of Public Health, Tianjin Medical University, Tianjin, China.
| | - Qing Zhang
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Li Liu
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Hongmei Wu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, China
- School of Public Health of Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, China
| | - Yeqing Gu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, China
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Shunming Zhang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, China
- School of Public Health of Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, China
| | - Xuena Wang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, China
- School of Public Health of Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, China
| | - Juanjuan Zhang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, China
- School of Public Health of Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, China
| | - Shaomei Sun
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Xing Wang
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Ming Zhou
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Qiyu Jia
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Kun Song
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Kaijun Niu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, China.
- School of Public Health of Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, China.
- School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China.
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China.
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Pierguidi L, Spinelli S, Prescott J, Monteleone E, Dinnella C. Responsiveness to warning sensations and anxiety-related psychological traits modulate individual differences in preference for vegetable foods with varied sensory properties. Food Res Int 2023; 173:113342. [PMID: 37803693 DOI: 10.1016/j.foodres.2023.113342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/03/2023] [Accepted: 07/31/2023] [Indexed: 10/08/2023]
Abstract
The innate aversion to warning sensations is an important barrier to the acceptance of vegetable food often characterized by bitter and sour tastes, and astringency. Large individual variations exist in preference for this food category. The present study aimed at exploring differences in demographics, anthropometrics, taste responsiveness, personality traits and attitudes in consumers differing in their preference for vegetable food with varied levels of warning sensations. A panel of Italian consumers (n = 718; 53.6% women, age 18-74 years) self-reported familiarity with, preference for and choice of vegetables with high and low levels of warning sensations. Two clusters were identified: High Warning-Vegetable Consumers (HWVC, n = 464) and Low-Warning Vegetable Consumers (LWVC, n = 254). HWVC showed higher familiarity with and preference for vegetables as a whole and higher choice of vegetables characterized by warning sensations than LWVC. HWVC were more represented by older and normal weight individuals as compared to LWVC. Differences among clusters in liking for and perception of a phenol-enriched plant-based food model specifically developed to induce different levels of bitterness, sourness and astringency were found. HWVC rated bitterness, sourness, and astringency lower and liking higher than LWVC. Scores in anxiety-related psychological traits were lower while attitudes to healthy and high-quality food choice were higher in HWVC than in LWVC. The results of the present study depicted a coherent interplay among several person-related dimensions in modulating preference for vegetable foods. Higher responsiveness to warning sensations, higher level of anxiety-related traits, lower importance assigned to food healthy/quality aspects and younger age all acted as barriers to exposure and acceptance of vegetable food and call for a multidimensional approach to promote the consumption of this food category.
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Affiliation(s)
- L Pierguidi
- Department of Agriculture, Food, Environment and Forestry (DAGRI), University of Florence, Italy.
| | - S Spinelli
- Department of Agriculture, Food, Environment and Forestry (DAGRI), University of Florence, Italy
| | - J Prescott
- Department of Agriculture, Food, Environment and Forestry (DAGRI), University of Florence, Italy; TasteMatters Research & Consulting, Sydney, Australia
| | - E Monteleone
- Department of Agriculture, Food, Environment and Forestry (DAGRI), University of Florence, Italy
| | - C Dinnella
- Department of Agriculture, Food, Environment and Forestry (DAGRI), University of Florence, Italy
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Taillie LS, Bercholz M, Prestemon CE, Higgins ICA, Grummon AH, Hall MG, Jaacks LM. Impact of taxes and warning labels on red meat purchases among US consumers: A randomized controlled trial. PLoS Med 2023; 20:e1004284. [PMID: 37721952 PMCID: PMC10545115 DOI: 10.1371/journal.pmed.1004284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 10/02/2023] [Accepted: 08/22/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND Policies to reduce red meat intake are important for mitigating climate change and improving public health. We tested the impact of taxes and warning labels on red meat purchases in the United States. The main study question was, will taxes and warning labels reduce red meat purchases? METHODS AND FINDINGS We recruited 3,518 US adults to participate in a shopping task in a naturalistic online grocery store from October 18, 2021 to October 28, 2021. Participants were randomized to one of 4 conditions: control (no tax or warning labels, n = 887), warning labels (health and environmental warning labels appeared next to products containing red meat, n = 891), tax (products containing red meat were subject to a 30% price increase, n = 874), or combined warning labels + tax (n = 866). We used fractional probit and Poisson regression models to assess the co-primary outcomes, percent, and count of red meat purchases, and linear regression to assess the secondary outcomes of nutrients purchased. Most participants identified as women, consumed red meat 2 or more times per week, and reported doing all of their household's grocery shopping. The warning, tax, and combined conditions led to lower percent of red meat-containing items purchased, with 39% (95% confidence interval (CI) [38%, 40%]) of control participants' purchases containing red meat, compared to 36% (95% CI [35%, 37%], p = 0.001) of warning participants, 34% (95% CI [33%, 35%], p < 0.001) of tax participants, and 31% (95% CI [30%, 32%], p < 0.001) of combined participants. A similar pattern was observed for count of red meat items. Compared to the control, the combined condition reduced calories purchased (-312.0 kcals, 95% CI [-590.3 kcals, -33.6 kcals], p = 0.027), while the tax (-10.4 g, 95% CI [-18.2 g, -2.5 g], p = 0.01) and combined (-12.8 g, 95% CI [-20.7 g, -4.9 g], p = 0.001) conditions reduced saturated fat purchases; no condition affected sodium purchases. Warning labels decreased the perceived healthfulness and environmental sustainability of red meat, while taxes increased perceived cost. The main limitations were that the study differed in sociodemographic characteristics from the US population, and only about 30% to 40% of the US population shops for groceries online. CONCLUSIONS Warning labels and taxes reduced red meat purchases in a naturalistic online grocery store. Trial Registration: http://www.clinicaltrials.gov/ NCT04716010.
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Affiliation(s)
- Lindsey Smith Taillie
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, United States of America
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Maxime Bercholz
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Carmen E. Prestemon
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Isabella C. A. Higgins
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, United States of America
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Anna H. Grummon
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, United States of America
| | - Marissa G. Hall
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, United States of America
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Lindsay M. Jaacks
- Global Academy of Agriculture and Food Systems, University of Edinburgh, Midlothian, United Kingdom
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Song D, Wang X, Ma Y, Liu NN, Wang H. Beneficial insights into postbiotics against colorectal cancer. Front Nutr 2023; 10:1111872. [PMID: 36969804 PMCID: PMC10036377 DOI: 10.3389/fnut.2023.1111872] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 02/21/2023] [Indexed: 03/12/2023] Open
Abstract
Colorectal cancer (CRC) is one of the most prevalent and life-threatening cancer types with limited therapeutic options worldwide. Gut microbiota has been recognized as the pivotal determinant in maintaining gastrointestinal (GI) tract homeostasis, while dysbiosis of gut microbiota contributes to CRC development. Recently, the beneficial role of postbiotics, a new concept in describing microorganism derived substances, in CRC has been uncovered by various studies. However, a comprehensive characterization of the molecular identity, mechanism of action, or routes of administration of postbiotics, particularly their role in CRC, is still lacking. In this review, we outline the current state of research toward the beneficial effects of gut microbiota derived postbiotics against CRC, which will represent the key elements of future precision-medicine approaches in the development of novel therapeutic strategies targeting gut microbiota to improve treatment outcomes in CRC.
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Affiliation(s)
| | | | | | - Ning-Ning Liu
- State Key Laboratory of Oncogenes and Related Genes, Center for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Wang
- State Key Laboratory of Oncogenes and Related Genes, Center for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Zhou W, Lin H, Ren Y, Lin H, Liang Y, Chen Y, Zhang S. Mental health and self-management in glaucoma patients during the COVID-19 pandemic: a cross-sectional study in China. BMC Ophthalmol 2022; 22:474. [PMID: 36474185 PMCID: PMC9727872 DOI: 10.1186/s12886-022-02695-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To investigate mental health and self-management in glaucoma patients during the COVID-19 pandemic in China and to describe the correlation between anxiety, depression, glaucoma, and self-management. METHODS This cross-sectional study included glaucoma patients who enrolled in the case management platform and completed an online survey. The survey included the Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9), and Glaucoma Self-Management Questionnaire (GSMQ). RESULTS Among 109 glaucoma patients enrolled in this study, the proportions of patients suffering from depression and anxiety during the COVID-19 pandemic were 26.6% and 20.2%, respectively. A statistical association was found between depression and self-management behaviour in these glaucoma patients (r = -0.247, P = 0.010). The self-management scores in patients less than 35 years were lower than those in patients aged 35-60 years (P = 0.046). The scores of body function promotion in men were lower than those in women (P = 0.048). Patients with primary school education and below had lower scores in the medical management of disease than those with either middle school education (P = 0.032) or community college education or higher (P = 0.022). CONCLUSION A high proportion of anxiety and depression was found in glaucoma patients during the COVID-19 pandemic. Better self-management behaviour was associated with stronger mental health regulation. It is important to help glaucoma patients improve their self-management behaviours, especially for young men with low educational levels.
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Affiliation(s)
- Wenzhe Zhou
- grid.268099.c0000 0001 0348 3990The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027 Zhejiang Province China
| | - Haishuang Lin
- grid.268099.c0000 0001 0348 3990The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027 Zhejiang Province China ,grid.268099.c0000 0001 0348 3990Wenzhou Medical University, Wenzhou, 325027 Zhejiang Province China
| | - Yanhan Ren
- grid.168645.80000 0001 0742 0364University of Massachusetts Medical School, Worcester, USA
| | - Hao Lin
- grid.268099.c0000 0001 0348 3990The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027 Zhejiang Province China
| | - Youping Liang
- grid.268099.c0000 0001 0348 3990The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027 Zhejiang Province China
| | - Yanyan Chen
- grid.268099.c0000 0001 0348 3990The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027 Zhejiang Province China
| | - Shaodan Zhang
- grid.268099.c0000 0001 0348 3990The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027 Zhejiang Province China
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Hammond LD, Farrington AP, Sivan M. Verification of the Integrative Model of Adjustment to Chronic Conditions by Mapping it Onto the World Health Organization's International Classification of Function, Disability and Health. Rehabil Process Outcome 2022; 11:11795727221126891. [PMID: 36278118 PMCID: PMC9583227 DOI: 10.1177/11795727221126891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 08/31/2022] [Indexed: 11/05/2022] Open
Abstract
Purpose Literature regarding the WHO's International Classification of Function, Disability and Health (ICF) has called for research into psychosocial adjustment processes. This project aims to establish the relevance of the Integrative Model of Adjustment to Chronic Conditions (IMACC) as a framework for research and a clinical tool in rehabilitation by linking it with the ICF. Methods The study employed secondary analysis of data from the original IMACC grounded theory study, where 8 women and 2 men with type 2 diabetes mellitus participated. IMACC consists of 3 interconnected parts comprising a total of 13 components. Datasets used for the study consisted of the qualitative data underpinning each IMACC component. Meaningful concepts from each dataset were linked to ICF categories using the updated ICF linking rules. Results Results showed that all 13 IMACC components accommodate ICF category codes from all health and health related ICF components in patterns consistent with the theoretical conceptualisation of each separate IMACC component. Conclusion IMACC maps comprehensively to the ICF framework and provides a framework that may be useful for future ICF related research into biopsychosocial processes in psychosocial adjustment. IMACC provides a clinically applicable intervention for people with psychosocial adjustment difficulties consistent with the ICF framework.
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Affiliation(s)
| | - Alexander Paul Farrington
- Psychology Department, School of Social
Sciences, Humanities and Law, Teesside University, Middlesbrough, Tees Valley,
UK
| | - Manoj Sivan
- Academic Department of Rehabilitation
Medicine (ADRM), University of Leeds, Leeds, UK
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Marinac Pupavac S, Kenðel Jovanović G, Linšak Ž, Glad M, Traven L, Pavičić Žeželj S. The influence on fish and seafood consumption, and the attitudes and reasons for its consumption in the Croatian population. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2022. [DOI: 10.3389/fsufs.2022.945186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Fish makes an important part of the Mediterranean diet, which has been scientifically proven to help preserve human health by protecting against major chronic and inflammatory diseases. Eating fish and seafood is very important, not only for its proven health benefits but also for its positive impact on the environment. Due to many fish and seafood significant positive effects on human health, this study aimed to investigate the socio-demographic factors associated with the consumption of fish and seafood in the population of Primorsko-goranska County in Croatia. Another aim was to determine people's attitudes, choices, and reasons for the consumption of fish and seafood. Self-reported data from 2,910 participants were used. According to the European dietary recommendations for fish consumption, the participants were divided into two groups; the very low to low fish consumption group and the moderate to high fish consumption group, in order to examine the differences in socio-demographic and lifestyle variables, and their attitudes, opinions, and reasons for fish and seafood consumption. More fish and seafood were consumed by women, the elderly, the more educated, non-smokers, and more physically active participants. Age, the highest level of education, and a diet even moderately adherent to the Mediterranean diet was found to significantly increase the likelihood of recommended fish consumption. Participants considered the best reasons to consume more fish lower prices, buy much more locally produced fishery products, and prefer to eat wild-caught fish rather than farmed fish. The study has found a slight increase in fish consumption, although still lower than the European average. It also showed significant socio-demographic associations, also the reasons and attitudes toward higher fish and seafood consumption of the Croatian population. The obtained research data are valuable for planning future public health programs in Croatia aimed at greater consumption of fish and seafood, as well as their promotion as an important part of a sustainable diet.
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Voss ML, Currie CL. Sleep Quality and the Importance Women Place on Healthy Eating Interact to Influence Psychological Resilience. Am J Health Behav 2022; 46:285-293. [PMID: 35794754 DOI: 10.5993/ajhb.46.3.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objectives: The impact women's daily habits may have on psychological resilience is not well understood. This cross-sectional analysis examined: (1) the impact of sleep quality on resilience, and (2) whether this association was modified by the importance women place on healthy eating. Methods: We collected data from 64 women (aged 18-67 years). The Pittsburgh Sleep Quality Index and Connor-Davidson Resilience Scale-10 assessed sleep quality and resilience, respectively, with lower scores indicating reduced resilience. One item assessed attitudes towards healthy eating. Linear regression models and 95% confidence intervals examined associations adjusted for age and income. Results: Reduced sleep quality was associated with a decreased resilience score (B=0.55, 95% CI: -1.06, -0.04, p=.04) when adjusted for age and income. After stratification, sleep quality and resilience were not associated among women who indicated healthy eating was very important. Among women who indicated healthy eating was less than very important, reduced sleep quality was associated with decreased psychological resilience (B=0.85, 95% CI: -1.55, -0.15, p=.02). Conclusions: Poor sleep quality was associated with reduced resilience among women. Placing a strong emphasis on healthy eating helped buffer the impact of poor sleep quality on women's psychological resilience.
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Affiliation(s)
- M L Voss
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada
| | - C L Currie
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada;,
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14
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Lord A, Chiang Y, Cheng Y, Chang Y, Chen H, Huang Y, Pan W. Participation effects of workplace promoting activities on healthy eating behavior. PUBLIC HEALTH IN PRACTICE 2022; 4:100286. [PMID: 36570393 PMCID: PMC9773043 DOI: 10.1016/j.puhip.2022.100286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 05/24/2022] [Accepted: 06/19/2022] [Indexed: 12/27/2022] Open
Abstract
Objective The study intends to examine the effect of participating healthy eating related games or activities in workplace on changes of employee's self-reported behavioral stage for adopting healthy eating. Study design A quasi-experimental study. Methods A multi-strategic intervention for 8-month was designed and implemented in a main staff canteen area within a non-profit academic organization. The initial event included exhibition of custom-made dining plates filled with correct portions of food models for three caloric levels and provision of user-friendly online resources, which were followed by three promotion activities (long-term exhibition of my balanced plates, matching games for six food groups, and do-it-yourself healthy plate) in the 8 months. Results A total of 86 adult participants (males = 37, female = 49) who had completed pre- and post-surveys were included in the analysis. Participants who participated all three promotion activities presented greater advancement in stage of healthy eating behaviors (HEB) than those who did not participate any activity (β= 1.118, 95% CI = 0.428-1.808, P = 0.001 among male participants; β = 0.740, 95% CI = 0.145-1.336, P = 0.015 among all participants). Adjustment has been made for significantly-associated covariates including types of promotion activities, initial-HEB and gender. Conclusions A multi-strategic intervention providing balanced food plates and online resources followed by consecutive promotion activities are effective in advancing HEB for the workplace adults. Differential impacts of promotion activities and gender should also be considered for designing workplace interventions.
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Affiliation(s)
- A.Y.Z. Lord
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Y.T. Chiang
- College of Life Science, National Taiwan University, Taipei, Taiwan
| | - Y.Y. Cheng
- Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Y.P. Chang
- Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - H.J. Chen
- Department of Public Health & Medical Humanities, Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Y.C. Huang
- Department of Nutrition, College of Health Care, China Medical University, Taichung City, Taiwan
| | - W.H. Pan
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan,Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan,Corresponding author. FAHA, 128 Sec. 2, Academia Rd. Nankang, Taipei, 115, Taiwan, ROC.
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Di Vita G, Zanchini R, Spina D, Maesano G, La Via G, D'Amico M. Exploring Purchasing Determinants for a Low Fat Content Salami: Are Consumers Willing to Pay for an Additional Premium? FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2022. [DOI: 10.3389/fsufs.2022.794533] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Consumers today are increasingly moving toward healthier lifestyles and food purchasing habits. This new awareness has also prompted the meat industry, usually indicted for the use of harmful compounds and ingredients such as additives, salt, and fat, to introduce innovative measures to meet demand. This study aims to assess consumer willingness to pay an additional price premium (APP) for a healthy salami by identifying which factors are more likely to have an effect on the willingness to purchase, such as socio-demographic and product and market-related attributes. An Ordered Logit model has been applied to define factors influencing consumers' willingness to pay for a low-fat salami. Results show a favorable consumer acceptance of reduced-fat salami conveyed by the willingness of consumers to pay an additional price for this product and confirm that the health awareness of consumers is an important driving force in cured meat marketing strategies.
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Relationship between perceived healthy eating behaviours and dietary, lifestyle and sociodemographic factors: results from a national cross-sectional study. Proc Nutr Soc 2022. [DOI: 10.1017/s0029665122001471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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17
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Association of eating motives with anthropometry, body composition, and dietary intake in healthy German adults. Appetite 2021; 170:105865. [PMID: 34921914 DOI: 10.1016/j.appet.2021.105865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 12/08/2021] [Accepted: 12/10/2021] [Indexed: 11/24/2022]
Abstract
Effective policies to address poor food choices and dietary patterns need to consider the complex set of motives affecting eating behavior. This study examined how different eating motives are associated with anthropometry, body composition, and dietary intake. Our analysis is based on a cross-sectional sample with 429 healthy adults in three different age groups collected in Germany from 2016 to 2018. Dietary intake, Body Mass Index (BMI), waist circumference (WC), and fat-free mass (FFM) were measured by standardized methods. Eating motives were measured using The Eating Motivation Scale (TEMS). Regressing dietary intakes and anthropometric indicators on TEMS motives, we identify the main sources of variation in diet and nutritional status separately for men and women. Results indicated the Health motive to be positively associated with FFM (B±SE=1.72±0.44) and negatively with WC (B±SE=-3.23±0.81) for men. For women, the Need & Hunger motive was positively associated with FFM (B±SE=1.63±0.44) and negatively with WC (B±SE=-2.46±0.81). While Liking and Habits were the most frequently stated eating motives, we did not find them to be significantly related to the nutritional status. Other motives were associated with dietary intake but not anthropometry or body composition. The Price motive was positively and the Convenience motive was negatively associated with energy (B±SE=63.77±19.98;B±SE=-46.96±17.12) and carbohydrate intake (B±SE=7.15±2.65;B±SE=-5.98±2.27) for men. The results highlight the need for more differentiated analyses of eating motives, beyond comparing the relative importance of motives based on mean values, towards the association of motives with dietary intake and nutritional status.
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Dutriaux L, Papies EK, Fallon J, Garcia-Marques L, Barsalou LW. Incidental exposure to hedonic and healthy food features affects food preferences one day later. Cogn Res Princ Implic 2021; 6:78. [PMID: 34894322 PMCID: PMC8665956 DOI: 10.1186/s41235-021-00338-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 10/18/2021] [Indexed: 11/10/2022] Open
Abstract
AbstractMemories acquired incidentally from exposure to food information in the environment may often become active to later affect food preferences. Because conscious use of these memories is not requested or required, these incidental learning effects constitute a form of indirect memory. In an experiment using a novel food preference paradigm (n = 617), we found that brief incidental exposure to hedonic versus healthy food features indirectly affected food preferences a day later, explaining approximately 10% of the variance in preferences for tasty versus healthy foods. It follows that brief incidental exposure to food information can affect food preferences indirectly for at least a day. When hedonic and health exposure were each compared to a no-exposure baseline, a general effect of hedonic exposure emerged across individuals, whereas health exposure only affected food preferences for high-BMI individuals. This pattern suggests that focusing attention on hedonic food features engages common affective processes across the general population, whereas focusing attention on healthy food features engages eating restraint goals associated with high BMI. Additionally, incidental exposure to food features primarily changed preferences for infrequently consumed foods, having less impact on habitually consumed foods. These findings offer insight into how hedonic information in the obesogenic food environment contributes to unhealthy eating behavior that leads to overweight and obesity. These findings further motivate the development of interventions that counteract the effects of exposure to hedonic food information and that broaden the effects of exposure to healthy food information.
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Selani MM, Ramos PHB, Patinho I, França F, Harada-Padermo SDS, Contreras-Castillo CJ, Saldaña E. Consumer's perception and expected liking of labels of burgers with sodium reduction and addition of mushroom flavor enhancer. Meat Sci 2021; 185:108720. [PMID: 34896872 DOI: 10.1016/j.meatsci.2021.108720] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 11/04/2021] [Accepted: 11/23/2021] [Indexed: 10/19/2022]
Abstract
This study investigated consumers' perception of labels of burgers with sodium reduction and/or addition of mushroom flavor enhancer. Six visual stimuli were created using a factorial design with sodium content (regular, sodium-reduced, and sodium-reduced plus health claim) and flavor enhancer (monosodium glutamate (MSG) and mushroom extract) as factors. Consumers answered an attitudinal questionnaire and evaluated the stimuli through expected liking and check-all-that-apply (CATA) questions. Three consumers' clusters were identified, which associated positive attributes to labels of burgers with mushroom flavor enhancer and negative attributes to labels of MSG-burgers, regardless of sodium content. The main positive drivers of liking were "I would buy", "attractive", "innovative", "tasty", and "contain fewer additives", which were associated with burgers with mushroom flavor enhancer, while "contain additives", "processed", "artificial", "unhealthy", and "not attractive" were the negative drivers of liking that should be modified in a reformulation to increase liking. This study provides valuable information for the development of healthier burgers and their positioning in the market.
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Affiliation(s)
- Miriam Mabel Selani
- Centro de Ciências da Natureza, Campus Lagoa do Sino, Universidade Federal de São Carlos, Rod. Lauri Simões de Barros, Km 12, 18290-000 Buri, SP, Brazil.
| | - Paulo Henrique Bertucci Ramos
- Faculdade de Economia, Administração de Contabilidade (FEA), Universidade de São Paulo (USP), Av. Prof. Luciano Gualberto, 908, 05508-010 São Paulo, SP, Brazil
| | - Iliani Patinho
- Departamento de Agroindústria, Alimentos e Nutrição (LAN), Escola Superior de Agricultura "Luiz de Queiroz" (ESALQ), Universidade de São Paulo (USP), Av. Pádua Dias 11, CP 9, 13418-900 Piracicaba, SP, Brazil
| | - Fabiana França
- Centro de Ciências da Natureza, Campus Lagoa do Sino, Universidade Federal de São Carlos, Rod. Lauri Simões de Barros, Km 12, 18290-000 Buri, SP, Brazil
| | - Samara Dos Santos Harada-Padermo
- Departamento de Agroindústria, Alimentos e Nutrição (LAN), Escola Superior de Agricultura "Luiz de Queiroz" (ESALQ), Universidade de São Paulo (USP), Av. Pádua Dias 11, CP 9, 13418-900 Piracicaba, SP, Brazil
| | - Carmen J Contreras-Castillo
- Departamento de Agroindústria, Alimentos e Nutrição (LAN), Escola Superior de Agricultura "Luiz de Queiroz" (ESALQ), Universidade de São Paulo (USP), Av. Pádua Dias 11, CP 9, 13418-900 Piracicaba, SP, Brazil
| | - Erick Saldaña
- Escuela Profesional de Ingeniería Agroindustrial, Universidad Nacional de Moquegua, Prolongación calle Ancash s/n, Moquegua 18001, Peru
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20
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A school-based nutrition education program involving children and their guardians in Japan: facilitation of guardian-child communication and reduction of nutrition knowledge disparity. Nutr J 2021; 20:92. [PMID: 34794453 PMCID: PMC8600693 DOI: 10.1186/s12937-021-00751-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 11/09/2021] [Indexed: 11/21/2022] Open
Abstract
Background Since the risk of noncommunicable diseases is closely associated with dietary intake, it is important to establish healthy dietary habits in childhood. Although several dietary education programs for children have been attempted, their implementation at school was often difficult due to overcrowded study curricula. We developed a new program which included homework for children and guardians, and evaluated its effect. Determinants of the effect were also investigated. Methods The school-based nutrition education program including a 45-min lecture, a series of homework assignments involving children and guardians, and two handouts was implemented in 14 public primary schools in Japan. Seven schools each underwent the intervention in an alternating manner. Nutrition knowledge (percentage (%) of correct answers in the nutrition knowledge questionnaire) and attitude/behavior toward diet was evaluated three times (May (baseline), October, February) as outcomes. These factors and their changes following the intervention were assessed by linear mixed models to adjust for individual factors, with consideration to clustering of the participants and repeated measurements. Results In total, 2227 children aged 10–12 years and their guardians participated. All schools completed the program. Children’s nutrition knowledge level was significantly increased (8.7%, 95% confidence interval [7.7–9.7]) following the intervention. Communication between children and their guardians, which was positively related with nutrition knowledge, was facilitated by the intervention. The increase in nutrition knowledge was greater among children with a lower knowledge level at baseline. Conclusions This school-based nutrition education program was effective and feasible. Appropriate teaching materials for homework can reduce the burden on schools and facilitate communication between children and guardians. Public schools can be crucial venues for decreasing disparities in nutrition knowledge. Trial registration This study was registered as an intervention study in the UMIN Clinical Trials Registry (trial ID: UMIN000029252) on Sep 22, 2017. Supplementary Information The online version contains supplementary material available at 10.1186/s12937-021-00751-z.
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Perception of the Health Threats Related to the Consumption of Wild Animal Meat-Is Eating Game Risky? Foods 2021; 10:foods10071544. [PMID: 34359415 PMCID: PMC8303633 DOI: 10.3390/foods10071544] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/30/2021] [Accepted: 06/30/2021] [Indexed: 02/07/2023] Open
Abstract
Consumer interest in game meat has increased in recent years. Consumers appreciate its nutritional value but still have many concerns. Based on data from a quantitative study conducted in the group of 450 purposively selected Polish respondents declaring to consume the game meat, consumers were segmented concerning the perception of health risks associated with its consumption. Three separate clusters were identified using hierarchical cluster analysis: Indifferent (42%), Fearful (30%), and Selective (28%). The clusters differed significantly in the perception of the role of game in their lives and taking actions to mitigate the health risks associated with its consumption. In addition, their socioeconomic profiles were significantly different. The Indifferent segment-significantly more often than the other segments-believes that game has a positive impact on health, and the way to counteract the health risks is to not eat raw meat. The Selective segment attaches great importance to the choice of consumption place as a warranty of access to safe meat. The Fearful segment is willing to pay more for good quality meat and search for information. The results proved that the game consumers are not a homogenous group. Recognizing the differences can indicate a path for the traders to efficiently meet the consumers' expectations and needs.
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Dickinson DL, Kakoschke N. Seeking confirmation? Biased information search and deliberation in the food domain. Food Qual Prefer 2021. [DOI: 10.1016/j.foodqual.2021.104189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Calvert S, Dempsey RC, Povey R. Normative misperceptions of unhealthy snacking amongst 11- to 12-year-old secondary school students. Appetite 2021; 166:105462. [PMID: 34119560 DOI: 10.1016/j.appet.2021.105462] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/28/2021] [Accepted: 06/08/2021] [Indexed: 10/21/2022]
Abstract
Younger adolescents are at an age where they have increasing control of their diet, and where peers become an important social reference for acceptable and normative dietary behaviours. These normative perceptions are often inaccurate and can lead to the development of unhealthy eating practices; although, the role of normative misperceptions of peers' unhealthy snacking behaviours in younger adolescents' personal snacking behaviours is not clear. The current study was a cross-sectional analysis of baseline data from a social norms-based healthy eating intervention sampling two secondary schools in deprived areas of England. Students aged 11-12 years (n = 252) completed self-report measures of their demographic characteristics and personal behaviours, attitudes, intentions, and normative perceptions (descriptive and injunctive norms), relating to unhealthy snacking. Results indicated students overestimated peers' daily unhealthy snacks consumption by approximately 3.2 portions, misperceived peers to have more positive attitudes towards unhealthy snacking and more negative attitudes towards reducing snacking. The greater these misperceptions of peers' behaviours and attitudes, the more likely students were to consume unhealthy snacks and have positive attitudes about unhealthy snacking. Girls had a stronger intention to reduce their snacking behaviours if they had more positive attitudes to reducing snacking behaviours and misperceived peers to also have a positive attitude. In summary, 11- to 12-year-olds misperceive the snacking behaviour and attitudes of their peers, and such normative misperceptions are associated with students' own snacking behaviours and attitudes. Interventions which challenge these misperceptions may assist in reducing the social acceptability of unhealthy snacking and in reducing unhealthy snacking amongst young adolescents.
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Affiliation(s)
- Sian Calvert
- The Staffordshire Centre for Psychological Research, Staffordshire University, Stoke-on-Trent, ST4 2DF, UK.
| | - Robert C Dempsey
- Department of Psychology, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, M15 6GX, UK
| | - Rachel Povey
- The Staffordshire Centre for Psychological Research, Staffordshire University, Stoke-on-Trent, ST4 2DF, UK
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Song MW, Kim KT, Paik HD. Probiotics as a Functional Health Supplement in Infant Formulas for the Improvement of Intestinal Microflora and Immunity. FOOD REVIEWS INTERNATIONAL 2021. [DOI: 10.1080/87559129.2021.1928178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Myung Wook Song
- Department of Food Science and Biotechnology of Animal Resources, Konkuk University, Seoul, Republic of Korea
| | - Kee-Tae Kim
- Department of Food Science and Biotechnology of Animal Resources, Konkuk University, Seoul, Republic of Korea
| | - Hyun-Dong Paik
- Department of Food Science and Biotechnology of Animal Resources, Konkuk University, Seoul, Republic of Korea
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Risk factors of overweight/obesity-related lifestyles in university students: Results from the EHU12/24 study. Br J Nutr 2021; 127:914-926. [PMID: 33955337 PMCID: PMC8908003 DOI: 10.1017/s0007114521001483] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
This paper investigates the prevalence and interaction of overweight/obesity-related lifestyles (specifically, examining whether subjects meet the recommended criteria), in a representative sample of university students. This study is part of the project EHU12/24, an observational cross-sectional study, designed to assess the prevalence of excess body fat (BF) and major risk of developing overweight/obesity, according to a standardised protocol. In a cohort of 603 students, aged between 18 and 28 years, of the University of the Basque Country, information about meal patterns, diet quality, physical activity, sitting time, sleeping time, toxic habits and anthropometric measurements were collected. Sampling took place from February 2014 to May 2017. Binary logistic regression models adjusted for the covariates were utilised to test the association between lifestyles and risk of excess adiposity. The prevalence of overweight/obesity, according to BF percentage, was 14·4 %. The variables analysed related to meal pattern were associated with diet quality, and less healthy food habits were associated with other less health-related behaviours. Among men, moderate/low physical activity, breakfast skipping, non-adequate breakfast duration, number of eating occasions and eating breakfast alone/depending on the occasion were associated with excess BF, while among women, low MedDietScore, moderate/high alcohol consumption, non-adequate sleep duration, eating breakfast and lunch alone/depending on the occasion. Results suggest that certain unhealthy lifestyle behaviours coexist, interact with one another and increase the risk of overweight/obesity in this population. Sex-specific differences in risk factors of obesity have implications for interventions for primary prevention of obesity within this environment.
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Psychometric validity of the motivation for healthy eating scale (MHES), short version in Japanese. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01469-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Tsiampalis T, Faka A, Kouvari M, Psaltopoulou T, Pitsavos C, Chalkias C, Panagiotakos DB. The impact of socioeconomic and environmental determinants on Mediterranean diet adherence: a municipal-level spatial analysis in Athens metropolitan area, Greece. Int J Food Sci Nutr 2021; 72:259-270. [PMID: 32657627 DOI: 10.1080/09637486.2020.1791057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The aim of this study was to identify the geographical variability, the socio-economic and the environmental determinants of adherence to the Mediterranean diet in a general population sample. Level of adherence to the Mediterranean diet was estimated by the ATTICA epidemiological study for 2,749 participants, while socio-economic, demographic, and environmental characteristics were provided by official national and international databases. Higher adherence to the Mediterranean diet was detected in areas with a greater proportion of females and older people, with lower unemployment rate and immigrant population, as well as, in areas covered at a greater extent by green and with higher frequency of supermarkets and street markets. The present findings provide evidence for policy makers to better understand how layers of influence intersect to shape individuals' eating habits, while they may also contribute in identifying areas of emerging interventions needed.
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Affiliation(s)
- Thomas Tsiampalis
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Antigoni Faka
- Department of Geography, School of Environment, Geography and Applied Economics, Harokopio University, Athens, Greece
| | - Matina Kouvari
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Theodora Psaltopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Athens, Greece
| | | | - Christos Chalkias
- Department of Geography, School of Environment, Geography and Applied Economics, Harokopio University, Athens, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
- Faculty of Health, University of Canberra, Canberra, Australia
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Chen Y, Lin B, Mancino L, Ver Ploeg M, Zhen C. Nutritional quality of retail food purchases is not associated with participation in the Supplemental Nutrition Assistance Program for nutrition-oriented households. PLoS One 2020; 15:e0240263. [PMID: 33338058 PMCID: PMC7748149 DOI: 10.1371/journal.pone.0240263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/22/2020] [Indexed: 11/23/2022] Open
Abstract
The Supplemental Nutrition Assistance Program (SNAP) provides millions of low-income Americans food benefits and other forms of nutrition assistance. Evidence indicates that SNAP reduces food insecurity. However, there is a concern that the food benefit may increase the demand for less healthy foods more than healthier foods, thereby reducing the overall nutritional quality of the participant's food basket. This paper aims to examine the association of SNAP participation with the nutritional quality of food-at-home purchases of low-income households and to investigate the potential heterogeneity among consumers with different levels of nutrition attitude. This analysis used food purchase data from the USDA National Household Food Acquisition and Purchase Survey (FoodAPS). Our study sample included 2,218 low-income households, of which 1,184 are SNAP participants, and 1,034 are income-eligible nonparticipants. Multivariate regressions were performed to explore the SNAP-nutritional quality association. A household's nutrition attitude was measured using its response to a question on whether the household searched for nutrition information online in the last 2 months. Households that affirmed they had an online nutrition search were treated as nutrition-oriented households (21.2% of the low-income sample), and households that did not were considered less nutrition-oriented households (78.8%). For robustness, we also created an alternative nutrition attitude measure based on reported use of the nutrition facts label. We found that among less nutrition-oriented households, SNAP participants had a statistically significant 0.097 points (p = 0.018) lower Guiding Stars rating than low-income nonparticipants. However, there was no significant SNAP-nutritional quality association among nutrition-oriented households. In conclusion, SNAP participation was associated with lower nutritional quality of food purchases among less nutrition-oriented households, but not among nutrition-oriented households. The results suggest that the intended nutritional benefits of restrictions on purchases of healthy foods may not reach the subgroup of nutrition-oriented SNAP participants.
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Affiliation(s)
- Yu Chen
- Formerly with Department of Agricultural and Applied Economics, University of Georgia, Athens, GA, United States of America
| | - Biing‐Hwan Lin
- Formerly with Economic Research Service, U.S. Department of Agriculture, Washington, DC, United States of America
| | - Lisa Mancino
- Formerly with Economic Research Service, U.S. Department of Agriculture, Washington, DC, United States of America
| | - Michele Ver Ploeg
- Food and Health Policy Institute, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States of America
| | - Chen Zhen
- Department of Agricultural and Applied Economics, University of Georgia, Athens, GA, United States of America
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Kibr G, Mulugeta A, Bosha T. Socio-economic Variables Associated with Motivational Barriers of Food Choice among Lactating Women from Central Ethiopia: A Cross-sectional Study. Ecol Food Nutr 2020; 60:276-303. [PMID: 33280419 DOI: 10.1080/03670244.2020.1845164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Understanding the drivers of food choice is essential to guide the nutrition interventions and tailor nutrition counseling messages. There is strong evidence from a published study, which demonstrate attention for the need to consider the wide range of drivers during food choice. Due to the large variety of food products on the market, consumers make a multitude of food choice daily. The study aimed to assess major motivational drivers of food choice among randomly selected lactating women aged 15-49 years (423) from Debrebirhan Town using face to face interview. Logistic regression analysis was used to find association b/socio-economic variables and motivational drivers of food choice using SPSS version 20. Candidate variables were selected and transferred using the P- a value of less than 0.25, and AOR was reported. Variables with a P-value less than 0.05 on multiple variable logistic regressions were taken as significant variables. Influences of religion, price, preparation convenience, health value and taste during food choice were responded by above half of women. From logistic regression, 15-25 years' age and self-employed were linked to religious influence in food choice with AOR (95%CI) of 0.09(0.01-0.48) and 4.13(1.4-12.24). Age (15-25 and 26-35 years), education (no, primary and secondary) and being housewife were associated to choosing of foods for their health value with AOR (95%CI) of 0.26(0.12-0.6), 0.37(0.18-0.76), 0.14(0.04-0.42), 0.25(0.13-0.54), 0.33(0.17-0.66) and 2.5(1.23-5). Only family size (2-4 vs.>4 persons) was associated with price concern in food choice with AOR (95%CI) of 0.39(0.21-0.71). Being divorced, husband headed, 7-12 and13-18 month lactation period, 15-25 and 26-35 years' age were related to preparation convenience of foods with AOR (95%CI) of 5.94(1.13-31.33), 0.42(0.18-0.96), 3.26(1.34-7.93), 4.4(1.81-10.72), 0.16(0.05-0.47) and 0.25(0.11-0.59). Self-management approaches by nutrition education and promotion to change eating behaviors of women, increasing supply and price regulation toward healthy foods are recommended.
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Affiliation(s)
- Gesessew Kibr
- Department of Food Science and Nutrition, Wollega University, Shambu Campus, Ethiopia
| | - Afework Mulugeta
- Department of Public Health, Mekelle University, Mekelle, Ethiopia
| | - Tafese Bosha
- School of Nutrition, Food Science and Technology, Hawassa University, Hawassa, Ethiopia
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Chow EJ, Doody DR, Di C, Armenian SH, Baker KS, Bricker JB, Gopal AK, Hagen AM, Ketterl TG, Lee SJ, Reding KW, Schenk JM, Syrjala KL, Taylor SA, Wang G, Neuhouser ML, Mendoza JA. Feasibility of a behavioral intervention using mobile health applications to reduce cardiovascular risk factors in cancer survivors: a pilot randomized controlled trial. J Cancer Surviv 2020; 15:554-563. [PMID: 33037989 DOI: 10.1007/s11764-020-00949-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 09/28/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE Determine the feasibility of a remotely delivered mobile health (mHealth)-supported intervention to improve diet and physical activity in hematologic malignancy survivors. METHODS Pilot randomized controlled trial of a 16-week intervention for improving diet and physical activity: individualized goal-setting (daily steps, sodium, saturated fat, added sugar intake) per feedback from mHealth trackers (Fitbit for activity; Healthwatch360 for diet), supplemented by a Facebook peer support group. Controls accessed the trackers without goal-setting or peer support. Everyone received standardized survivorship counseling with tailored advice from a clinician. Actigraphy and food frequency questionnaires assessed activity and diet at baseline and follow-up. RESULTS Forty-one participants (51.2% male; median age 45.1 years; 7.0 years from treatment) were randomized (24 intervention; 17 control). Fitbit and Healthwatch360 use were more common among intervention versus control participants (75.0% versus 70.6% and 50.0% versus 17.7% of eligible days, respectively). Most intervention participants (66.7%) engaged with Facebook; overall, 91.7% interacted with the study's mHealth applications. While no comparisons in activity or dietary outcomes between intervention versus control group met statistical significance, the intervention was associated with greater reductions in the targeted dietary factors and improvements in Healthy Eating Index-2015 score, moderate-vigorous physical activity time, and daily steps. Participant retention at 6 months was 90.2%. CONCLUSIONS An intervention for cardiovascular risk reduction based on individualized goal-setting enhanced by mHealth and social media peer support was feasible and acceptable among cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS Effective and easily disseminated strategies that improve diet and physical activity in this population are needed. TRIAL REGISTRATION Registered in ClinicalTrials.gov (NCT03574012) on June 29, 2018.
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Affiliation(s)
- Eric J Chow
- Fred Hutchinson Cancer Research Center, PO Box 19024, Mailstop M4-C308, Seattle, WA, 98109, USA.
- Department of Pediatrics, University of Washington, Seattle, WA, USA.
| | - David R Doody
- Fred Hutchinson Cancer Research Center, PO Box 19024, Mailstop M4-C308, Seattle, WA, 98109, USA
| | - Chongzhi Di
- Fred Hutchinson Cancer Research Center, PO Box 19024, Mailstop M4-C308, Seattle, WA, 98109, USA
| | | | - K Scott Baker
- Fred Hutchinson Cancer Research Center, PO Box 19024, Mailstop M4-C308, Seattle, WA, 98109, USA
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Jonathan B Bricker
- Fred Hutchinson Cancer Research Center, PO Box 19024, Mailstop M4-C308, Seattle, WA, 98109, USA
| | - Ajay K Gopal
- Fred Hutchinson Cancer Research Center, PO Box 19024, Mailstop M4-C308, Seattle, WA, 98109, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Anna M Hagen
- Fred Hutchinson Cancer Research Center, PO Box 19024, Mailstop M4-C308, Seattle, WA, 98109, USA
| | - Tyler G Ketterl
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Stephanie J Lee
- Fred Hutchinson Cancer Research Center, PO Box 19024, Mailstop M4-C308, Seattle, WA, 98109, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Kerryn W Reding
- Fred Hutchinson Cancer Research Center, PO Box 19024, Mailstop M4-C308, Seattle, WA, 98109, USA
- School of Nursing, University of Washington, Seattle, WA, USA
| | - Jeannette M Schenk
- Fred Hutchinson Cancer Research Center, PO Box 19024, Mailstop M4-C308, Seattle, WA, 98109, USA
| | - Karen L Syrjala
- Fred Hutchinson Cancer Research Center, PO Box 19024, Mailstop M4-C308, Seattle, WA, 98109, USA
| | - Sarah A Taylor
- Fred Hutchinson Cancer Research Center, PO Box 19024, Mailstop M4-C308, Seattle, WA, 98109, USA
| | - Guangxing Wang
- Fred Hutchinson Cancer Research Center, PO Box 19024, Mailstop M4-C308, Seattle, WA, 98109, USA
| | - Marian L Neuhouser
- Fred Hutchinson Cancer Research Center, PO Box 19024, Mailstop M4-C308, Seattle, WA, 98109, USA
| | - Jason A Mendoza
- Fred Hutchinson Cancer Research Center, PO Box 19024, Mailstop M4-C308, Seattle, WA, 98109, USA
- Department of Pediatrics, University of Washington, Seattle, WA, USA
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Xie Z, Liu K, Or C, Chen J, Yan M, Wang H. An examination of the socio-demographic correlates of patient adherence to self-management behaviors and the mediating roles of health attitudes and self-efficacy among patients with coexisting type 2 diabetes and hypertension. BMC Public Health 2020; 20:1227. [PMID: 32787809 PMCID: PMC7424981 DOI: 10.1186/s12889-020-09274-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 07/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patients with coexisting type 2 diabetes and hypertension generally exhibit poor adherence to self-management, which adversely affects their disease control. Therefore, identification of the factors related to patient adherence is warranted. In this study, we aimed to examine (i) the socio-demographic correlates of patient adherence to a set of self-management behaviors relevant to type 2 diabetes and hypertension, namely, medication therapy, diet therapy, exercise, tobacco and alcohol avoidance, stress reduction, and self-monitoring/self-care, and (ii) whether health attitudes and self-efficacy in performing self-management mediated the associations between socio-demographic characteristics and adherence. METHODS We performed a secondary analysis of data collected in a randomized controlled trial. The sample comprised 148 patients with coexisting type 2 diabetes mellitus and hypertension. Data were collected by a questionnaire and analyzed using logistic regression. RESULTS Female patients were found to be less likely to exercise regularly (odds ratio [OR] = 0.49, P = 0.03) and more likely to avoid tobacco and alcohol (OR = 9.87, P < 0.001) than male patients. Older patients were found to be more likely to adhere to diet therapy (OR = 2.21, P = 0.01) and self-monitoring/self-care (OR = 2.17, P = 0.02). Patients living with family or others (e.g., caregivers) were found to be more likely to exercise regularly (OR = 3.44, P = 0.02) and less likely to avoid tobacco and alcohol (OR = 0.10, P = 0.04) than those living alone. Patients with better perceived health status were found to be more likely to adhere to medication therapy (OR = 2.02, P = 0.03). Patients with longer diabetes duration (OR = 2.33, P = 0.01) were found to be more likely to adhere to self-monitoring/self-care. Self-efficacy was found to mediate the association between older age and better adherence to diet therapy, while no significant mediating effects were found for health attitudes. CONCLUSIONS Adherence to self-management was found to be associated with socio-demographic characteristics (sex, age, living status, perceived health status, and diabetes duration). Self-efficacy was an important mediator in some of these associations, suggesting that patient adherence may be improved by increasing patients' self-management efficacy, such as by patient empowerment, collaborative care, or enhanced patient-physician interactions.
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Affiliation(s)
- Zhenzhen Xie
- Department of Industrial and Manufacturing Systems Engineering, The University of Hong Kong, Hong Kong, China
| | - Kaifeng Liu
- Department of Industrial and Manufacturing Systems Engineering, The University of Hong Kong, Hong Kong, China
| | - Calvin Or
- Department of Industrial and Manufacturing Systems Engineering, The University of Hong Kong, Hong Kong, China.
| | - Jiayin Chen
- Department of Industrial and Manufacturing Systems Engineering, The University of Hong Kong, Hong Kong, China
| | - Mian Yan
- School of Intelligent Systems Science and Engineering, Jinan University, Zhuhai, China
| | - Hailiang Wang
- Department of Systems Engineering and Engineering Management, City University of Hong Kong, Hong Kong, China
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Djekic I, Ilic J, Guiné RPF, Tomasevic I. Can we understand food oral processing using Kano model? Case study with confectionery products. J Texture Stud 2020; 51:861-869. [DOI: 10.1111/jtxs.12550] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/25/2020] [Accepted: 07/02/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Ilija Djekic
- Faculty of Agriculture Institute of Food Technology and Biochemistry, University of Belgrade Belgrade Republic of Serbia
| | - Jovan Ilic
- Faculty of Agriculture Institute of Food Technology and Biochemistry, University of Belgrade Belgrade Republic of Serbia
| | - Raquel P. F. Guiné
- CERNAS‐IPV Research Centre Polytechnic Institute of Viseu Viseu Portugal
| | - Igor Tomasevic
- Department of Animal Origin Products Technology Faculty of Agriculture, University of Belgrade Belgrade Republic of Serbia
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Londerée AM, Wagner DD. The orbitofrontal cortex spontaneously encodes food health and contains more distinct representations for foods highest in tastiness. Soc Cogn Affect Neurosci 2020; 16:816-826. [PMID: 32613228 PMCID: PMC8521750 DOI: 10.1093/scan/nsaa083] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 03/28/2020] [Accepted: 06/15/2020] [Indexed: 11/29/2022] Open
Abstract
The human orbitofrontal cortex (OFC) has long been associated with food reward processing and is thought to represent modality-independent signals of value. Food tastiness and health are core attributes of many models of food choice and dietary self-control. Here we used functional neuroimaging to examine the neural representation of tastiness and health for a set of 28 food categories selected to be orthogonal with respect to both dimensions. Using representational similarity analysis, in conjunction with linear mixed-effects modeling, we demonstrate that the OFC spontaneously encodes food health, whereas tastiness was associated with greater neural dissimilarity. Subsequent analyses using model dissimilarity matrices that encode overall tastiness magnitude demonstrated that the neural representation of foods grows more distinct with increasing tastiness but not with increasing health. In a separate study, we use lexical analysis of natural language descriptions of food to show that food tastiness is associated with more elaborate descriptions of food. Together these data show not only that the OFC spontaneously encodes the dimensions of health and tastiness when viewing appetitive food cues, but also that the neural and cognitive representations of food categories that are the highest in tastiness are more refined than those lower in tastiness.
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Affiliation(s)
- Allison M Londerée
- Department of Psychology, The Ohio State University, Columbus, OH 43202, USA
| | - Dylan D Wagner
- Department of Psychology, The Ohio State University, Columbus, OH 43202, USA
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Yoon SR, Fogleman SK, Kim H, Lee KE, Kim OY. Breakfast Intake Effect on the Association between Fast-Food Consumption and the Risk of Obesity and Dyslipidemia in Korean Adults Aged 20-39 Years Based on the Korea National Health and Nutrition Examination Survey IV 2013-2014. Clin Nutr Res 2020; 9:107-121. [PMID: 32395441 PMCID: PMC7192669 DOI: 10.7762/cnr.2020.9.2.107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 04/16/2020] [Accepted: 04/17/2020] [Indexed: 11/19/2022] Open
Abstract
We investigated the association between fast-food (FF) consumptions and the risk of overweight/obesity and dyslipidemia in Korean adults (20-39 years) based on the Korea National Health and Nutrition Examination Survey (2013-2014). We also examined the effect of breakfast intake on the risk of overweight/obesity and dyslipidemia according to their frequencies of FF consumption. FF consumption was categorized into 3 groups: < 1 time/month (n = 79); 1-3 times/month (n = 1,173); and ≥ 1 time/week (n = 474). People consuming FF ≥ 1 time/week had unhealthy lifestyles, higher intake of total calorie, fat, and protein, and higher levels of blood pressure, total cholesterol (TC) and low-density lipoprotein (LDL)-cholesterol than those consuming FF < 1 time/month. Logistic regression analysis showed higher risk of overweight/obesity in people consuming FF 1-3 times/month (odds ratio [OR], 2.525; confidence intervals [CIs], 1.169-5.452; p = 0.018) and ≥ 1 time/week (OR, 2.646; CIs, 1.128-6.208; p = 0.025) than those consuming FF < 1 time/month after the adjustment. The risk of dyslipidemia was also higher in people consuming FF ≥ 1 time/week than those consuming FF < 1 time/month after the adjustment (OR, 2.444; CIs, 1.047-5.704; p = 0.039). Furthermore, among people consuming FF ≥ 1 time/week, irregular breakfast consumers (≤ 2 times/week, n = 215) had significantly higher levels of triglyceride, TC, and LDL-C than regular breakfast consumers (5-6 times/week, n=180). Irregular breakfast consumers also showed a higher risk of dyslipidemia than regular breakfast consumers after the adjustment (OR, 2.913; CIs, 1.463-5.801; p = 0.002). In conclusion, frequent FF consumption increases the risk of obesity and dyslipidemia in Korean adults aged 20-39 years. Particularly among the frequent FF consumers, irregular breakfast intake may contribute to the increased risk of dyslipidemia. It may provide an evidence for proper dietary education to reduce the risk of overweight/obesity and dyslipidemia in Koreans adults aged 20-39 years.
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Affiliation(s)
- So Ra Yoon
- Department of Food Science and Nutrition, Dong-A University, Busan 49315, Korea
- Center for Silver-targeted Biomaterials, Brain Busan 21 Plus Program, Dong A University, Busan 49315, Korea
- Institute of Health Insurance and Clinical Research, National Health Insurance Service Ilsan Hospital, Goyang 10444, Korea
| | - Sockju K. Fogleman
- Department of Food and Nutrition, Meredith College, Raleigh, NC 27607-5298, USA
| | - Hyunyoung Kim
- Department of Food Science and Nutrition, Dong-A University, Busan 49315, Korea
- Center for Silver-targeted Biomaterials, Brain Busan 21 Plus Program, Dong A University, Busan 49315, Korea
| | - Kyung Eun Lee
- Divison of Applied Food System, College of Natural Sciences, Seoul Women's University, Seoul 01797, Korea
| | - Oh Yoen Kim
- Department of Food Science and Nutrition, Dong-A University, Busan 49315, Korea
- Center for Silver-targeted Biomaterials, Brain Busan 21 Plus Program, Dong A University, Busan 49315, Korea
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Rempe HM, Sproesser G, Hannink A, Skurk T, Brandl B, Hauner H, Renner B, Volkert D, Sieber CC, Freiberger E, Kiesswetter E. The Relationship Between Healthy Eating Motivation and Protein Intake in Community-Dwelling Older Adults With Varying Functional Status. Nutrients 2020; 12:nu12030662. [PMID: 32121298 PMCID: PMC7146591 DOI: 10.3390/nu12030662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 02/24/2020] [Accepted: 02/26/2020] [Indexed: 11/19/2022] Open
Abstract
In older adults, the relationship between healthy eating motivation (HEM) and protein intake as key component of a healthy diet is poorly understood. Therefore, we investigate the association of HEM with (1) total protein intake and (2) intake of different protein sources in older adults with varying functional status. In this cross-sectional study including 250 adults (≥70 years), we assessed HEM with “The Eating Motivation Survey” and protein intake by 7-day food records. In addition, gender, age, Body Mass Index (BMI), energy intake and functional status were considered. Regression analyses revealed that HEM was neither related to total (β = −0.02; p = 0.723) nor to relative protein intake (β = 0.04; p = 0.370). Notwithstanding this, participants with stronger HEM showed lower intake of protein from meat and meat products (β = −0.14; p = 0.018), higher intake of overall plant-based protein (β = 0.11; p = 0.032), protein from fruit and vegetables (β = 0.20; p = 0.002) and from pulses, nuts an seeds (β = 0.16; p = 0.016). Our findings suggest HEM as a valuable indicator for intake of distinct protein sources. However, since HEM is not related to total protein intake, the importance of sufficient protein consumption should be emphasized by promoting healthy eating, regardless of self-perceived HEM.
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Affiliation(s)
- Hanna M. Rempe
- Institute for Biomedicine of Aging, Friedrich-Alexander-University of Erlangen-Nürnberg, Kobergerstraße 60, 90408 Nürnberg, Germany; (A.H.); (D.V.); (C.C.S.); (E.F.); (E.K.)
- Correspondence: ; Tel.: +49 911 5302-96163
| | - Gudrun Sproesser
- Psychological Assessment and Health Psychology, University of Konstanz, Box 47, 78457 Konstanz, Germany; (G.S.); (B.R.)
| | - Anne Hannink
- Institute for Biomedicine of Aging, Friedrich-Alexander-University of Erlangen-Nürnberg, Kobergerstraße 60, 90408 Nürnberg, Germany; (A.H.); (D.V.); (C.C.S.); (E.F.); (E.K.)
| | - Thomas Skurk
- Else-Kröner-Fresenius-Center for Nutritional Medicine, Technical University of Munich, Gregor-Mendel-Straße, 85354 Freising-Weihenstephan, Germany; (T.S.); (H.H.)
- ZIEL Institute for Food and Health, Core Facility Human Studies, Technical University of Munich, Gregor-Mendel-Str. 2, 85354 Freising, Germany;
| | - Beate Brandl
- ZIEL Institute for Food and Health, Core Facility Human Studies, Technical University of Munich, Gregor-Mendel-Str. 2, 85354 Freising, Germany;
| | - Hans Hauner
- Else-Kröner-Fresenius-Center for Nutritional Medicine, Technical University of Munich, Gregor-Mendel-Straße, 85354 Freising-Weihenstephan, Germany; (T.S.); (H.H.)
- Klinikum Rechts der Isar, Institute of Nutritional Medicine, Technical University of Munich, Georg-Brauchle-Ring 62, 80992 Munich, Germany
| | - Britta Renner
- Psychological Assessment and Health Psychology, University of Konstanz, Box 47, 78457 Konstanz, Germany; (G.S.); (B.R.)
| | - Dorothee Volkert
- Institute for Biomedicine of Aging, Friedrich-Alexander-University of Erlangen-Nürnberg, Kobergerstraße 60, 90408 Nürnberg, Germany; (A.H.); (D.V.); (C.C.S.); (E.F.); (E.K.)
| | - Cornel C. Sieber
- Institute for Biomedicine of Aging, Friedrich-Alexander-University of Erlangen-Nürnberg, Kobergerstraße 60, 90408 Nürnberg, Germany; (A.H.); (D.V.); (C.C.S.); (E.F.); (E.K.)
- Department of Medicine, Kantonsspital Winterthur, Brauerstraße 15, 8400 Winterthur, Switzerland
| | - Ellen Freiberger
- Institute for Biomedicine of Aging, Friedrich-Alexander-University of Erlangen-Nürnberg, Kobergerstraße 60, 90408 Nürnberg, Germany; (A.H.); (D.V.); (C.C.S.); (E.F.); (E.K.)
| | - Eva Kiesswetter
- Institute for Biomedicine of Aging, Friedrich-Alexander-University of Erlangen-Nürnberg, Kobergerstraße 60, 90408 Nürnberg, Germany; (A.H.); (D.V.); (C.C.S.); (E.F.); (E.K.)
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The Choice of Bread: The Association between Consumers' Awareness of Dietary Fiber and Declared Intentions to Eat. Nutrients 2020; 12:nu12020360. [PMID: 32019124 PMCID: PMC7071172 DOI: 10.3390/nu12020360] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 01/22/2020] [Accepted: 01/28/2020] [Indexed: 11/16/2022] Open
Abstract
The objective of the study was to find whether consumers declare an intention to eat bread enriched with fiber in the situation of availability of a plain bread and plain bread with grains, and how these intentions are related to their awareness of fiber in bread. The data were collected in a cross-sectional survey among 1014 Polish adults. Based on three pictures of rolls: plain wheat roll (CR), roll enriched with 12% fiber (RF), and roll topped with sunflower seeds (RSS), the participants' perception regarding fiber content and its impact on intentions to eat were assessed. The respondents were not informed about the differences in composition of the rolls. Although RSS contained only slightly more fiber (0.98 g) than CR (0.81 g), and much less than RF (3.08 g), most of the respondents indicated RSS as containing the most fiber (50.8%) and declared their intention to eat it (39.0%). Respondents who pointed out the importance of fiber, and grains or wholemeal flour addition when making purchase decision, were more likely to declare an intention to eat RSS compared with CR. The low interest in fiber content in a diet increased the chances of declaring an intention to eat CR and RF. People less educated and with low incomes were more likely to declare an intention to eat CR rather than RSS. While people from rural areas were more likely to choose RSS compared with CR and RF. In conclusion, there is interest in bread enriched with fiber, but consumers experience difficulties in recognizing it. Declared intentions to eat each rolls were determined to the greatest extent by the perception of the roll as source of fiber. Thus, educational activities should be focused on consumers' perception of fiber-rich products and their skills related to the selection of high-fiber foods.
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Bergström M, Håkansson A, Blücher A, Andersson HS. From carbohydrates to fat: Trends in food intake among Swedish nutrition students from 2002 to 2017. PLoS One 2020; 15:e0228200. [PMID: 31990946 PMCID: PMC6986719 DOI: 10.1371/journal.pone.0228200] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 01/09/2020] [Indexed: 01/22/2023] Open
Abstract
Earlier studies have implied a change in dietary habits of the Swedish population towards a low carbohydrate, high fat diet. Questions have been raised about the development in recent years and potential health effects. We have investigated the dietary intake of Swedish female students enrolled in a university nutrition course between 2002 and 2017. The students carried out self-reporting of all food and drink intake over one weekday and one weekend day. Intake of macronutrients (E%) and micronutrients were calculated for the whole period while statistical analysis was performed for changes between 2009 and 2017 (729 women). Results showed significant changes in carbohydrate intake (from 47.0 to 41.4 E%) and fat intake (from 31.7 to 37.5 E%). Carbohydrate intake was significantly lower than the Nordic Nutrition Recommendations (45–60 E%). However, daily fiber intake remains high (3.0 g/MJ) in a national context, and intake of vitamin D and folate appears to increase during the period. The results suggest that the observed national transition from carbohydrate to fat intake persists, and that it might be especially evident among individuals interested in food and nutrition. Considering the fiber and micronutrient intake, the change is not necessarily unfavorable for this particular group.
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Affiliation(s)
- Maria Bergström
- Department of Chemistry and Biomedical Sciences, Linnaeus University, Kalmar, Sweden
| | - Andreas Håkansson
- Department of Food Technology, Engineering and Nutrition, Lund University, Lund, Sweden
| | - Anna Blücher
- Department of Chemistry and Biomedical Sciences, Linnaeus University, Kalmar, Sweden
| | - Håkan S Andersson
- Department of Chemistry and Biomedical Sciences, Linnaeus University, Kalmar, Sweden
- Department of Medical Biochemistry and Biophysics, Karolinska Institute, Solna, Sweden
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Liu D, Juanchich M, Sirota M, Orbell S. People overestimate verbal quantities of nutrients on nutrition labels. Food Qual Prefer 2019. [DOI: 10.1016/j.foodqual.2019.103739] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Krumreich FD, Seifert M, Santos RB, Gularte MA. Consumers' Impression of Minimally Processed Gala Apples Using Word Association. J Food Sci 2019; 84:2955-2960. [PMID: 31509251 DOI: 10.1111/1750-3841.14779] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 07/02/2019] [Accepted: 07/25/2019] [Indexed: 02/01/2023]
Abstract
This study aimed to identify consumers' preferences and impressions of minimally processed "Gala" cultivar apples, using preference tests and word associations. The study was conducted online via the Google Docs tool and sent out via social networks. The participants were 607 individuals, mostly women, mainly between the ages of 18 and 45, with education up to undergraduate and postgraduate level. As regards the preference for minimally processed apples, the profile of the consumer did not influence the choice. The profiles analyzed were gender and education. For the word association test, 11-word categories were formed, and among these, the most important aspect was appearance, followed by taste and texture, which was confirmed by correspondence analysis. Sample A (0 days-no storage) was the most preferred one, differing significantly from the other samples, whereas sample B (3 days of storage) and sample C (6 days of storage) were associated with characteristics for choice of product. The word association methodology revealed the consumer's impressions of the product, in addition to demonstrating simplicity, low cost, speed, and an exploratory character. PRACTICAL APPLICATION: Gender and level of schooling did not influence the choice of minimally processed apples. Appearance was the most cited word in the word association test. Word association is a simple, fast, inexpensive, and projective technique.
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Affiliation(s)
- F D Krumreich
- Post Graduate Program of Food Science and Technology, Faculty of Agronomy Eliseu Maciel, Federal Univ. of Pelotas, Pelotas, Rio Grande do Sul, 96010-900, Brazil
| | - M Seifert
- Post Graduate Program of Food Science and Technology, Faculty of Agronomy Eliseu Maciel, Federal Univ. of Pelotas, Pelotas, Rio Grande do Sul, 96010-900, Brazil
| | - R B Santos
- Post Graduate Program of Nutrition and Food, Faculty of Nutrition, Federal Univ. of Pelotas, Pelotas, Rio Grande do Sul, 96010-610, Brazil
| | - M A Gularte
- Post Graduate Program of Food Science and Technology, Faculty of Agronomy Eliseu Maciel, Federal Univ. of Pelotas, Pelotas, Rio Grande do Sul, 96010-900, Brazil.,Post Graduate Program of Nutrition and Food, Faculty of Nutrition, Federal Univ. of Pelotas, Pelotas, Rio Grande do Sul, 96010-610, Brazil
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Howard Wilsher S, Fearne A, Panagiotaki G. "That is an Awful Lot of Fruit and Veg to Be Eating". Focus Group Study on Motivations for the Consumption of 5 a Day in British Young Men. Nutrients 2019; 11:nu11081893. [PMID: 31416148 PMCID: PMC6723209 DOI: 10.3390/nu11081893] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 07/31/2019] [Accepted: 08/05/2019] [Indexed: 12/20/2022] Open
Abstract
Young men do not consume enough fruit and vegetables, increasing their risk for future ill health. To understand what motivates their food choice, a novel conceptual framework that included key concepts from the theory of planned behavior and risk theory was developed. Thirty-four British men (18-24 years) took part in focus groups, where innovative visual qualitative methods provided insight into participants' motivations for fruit and vegetable consumption. Based on information from food diaries, participants were described as high (4+ portions) or low (up to 3 portions) consumers. Interviews were coded thematically into concepts and characteristics of the conceptual framework. Young men were generally unaware of the UK government's recommendation to consume 5 portions of fruit and vegetable a day and chronic health risks associated with low consumption. High consumers were motivated by perceived risk, perceived behavioral control, and health-conscious self-identity. They held internalized, holistic beliefs about diet and health, whereas low consumers' beliefs were externalized, based on physical appearances. Low consumers were driven by social influences to consume cheap, easily available convenience foods. The conceptual framework differentiated levels of fruit and vegetable consumption between the two groups and provided new information about young men's motivations for fruit and vegetable consumption.
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Affiliation(s)
| | - Andrew Fearne
- Norwich Business School, University of East Anglia, Norwich NR4 7TJ, UK
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Rempe HM, Sproesser G, Gingrich A, Spiegel A, Skurk T, Brandl B, Hauner H, Renner B, Volkert D, Sieber CC, Freiberger E, Kiesswetter E. Measuring eating motives in older adults with and without functional impairments with The Eating Motivation Survey (TEMS). Appetite 2019; 137:1-20. [PMID: 30776395 DOI: 10.1016/j.appet.2019.01.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 01/24/2019] [Accepted: 01/28/2019] [Indexed: 02/09/2023]
Abstract
Gaining a better understanding which motives play a role in daily eating is crucial in order to develop personalized interventions promoting adequate diet. The Eating Motivation Survey (TEMS) is a comprehensive tool to assess manifold reasons for eating but has not been specifically applied in an older sample including very old persons and persons differing in functional status. Therefore, the first step of the study was to investigate whether the basic motives of TEMS are consistent in an older sample and comparable across older adults with and without functional impairments. Second, the study aimed at describing which motives underlie eating behavior in older age most often as well as to analyze the relationship between eating motives and functional status. 376 community-dwelling older persons aged 70 years and older filled in the brief survey version (15 motives à 3 items) of TEMS. The sample comprises 149 unimpaired and 227 impaired participants in terms of physical function. Confirmatory factor analysis yielded good model fit with RMSEA 0.036 and SRMR 0.048. Furthermore, multi-group analysis revealed a generally invariant factor structure across participants with and without functional impairments. Liking was rated to underlie eating behavior most often, followed by Health and Natural Concerns. Considering gender, age and BMI, significant associations between functional status and the motive Sociability emerged. Since the results suggest that the fifteen basic eating motives are generalizable in older age and across different functional states, TEMS might be a valuable tool in nutrition-related health promotion to developing individualized approaches considering health aspects as well as hedonistic factors.
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Affiliation(s)
- Hanna M Rempe
- Friedrich-Alexander-University of Erlangen-Nürnberg, Institute for Biomedicine of Aging, Kobergerstraße 60, 90408, Nürnberg, Germany.
| | - Gudrun Sproesser
- University of Konstanz, Psychological Assessment and Health Psychology, Box 47, 78457, Konstanz, Germany
| | - Anne Gingrich
- Friedrich-Alexander-University of Erlangen-Nürnberg, Institute for Biomedicine of Aging, Kobergerstraße 60, 90408, Nürnberg, Germany
| | - Alexandra Spiegel
- Friedrich-Alexander-University of Erlangen-Nürnberg, Institute for Biomedicine of Aging, Kobergerstraße 60, 90408, Nürnberg, Germany
| | - Thomas Skurk
- Else-Kröner-Fresenius-Center for Nutritional Medicine, Technical University of Munich, Gregor-Mendel-Straße, 85354, Freising, Weihenstephan, Germany; Technical University of Munich, ZIEL Institute for Food and Health, Core Facility Human Studies, Gregor-Mendel-Str. 2, 85354, Freising, Germany
| | - Beate Brandl
- Else-Kröner-Fresenius-Center for Nutritional Medicine, Technical University of Munich, Gregor-Mendel-Straße, 85354, Freising, Weihenstephan, Germany; Technical University of Munich, ZIEL Institute for Food and Health, Core Facility Human Studies, Gregor-Mendel-Str. 2, 85354, Freising, Germany
| | - Hans Hauner
- Technical University of Munich, ZIEL Institute for Food and Health, Core Facility Human Studies, Gregor-Mendel-Str. 2, 85354, Freising, Germany; Technical University of Munich, Klinikum rechts der Isar, Institute of Nutritional Medicine, Georg-Brauchle-Ring 62, 80992, Munich, Germany
| | - Britta Renner
- University of Konstanz, Psychological Assessment and Health Psychology, Box 47, 78457, Konstanz, Germany
| | - Dorothee Volkert
- Friedrich-Alexander-University of Erlangen-Nürnberg, Institute for Biomedicine of Aging, Kobergerstraße 60, 90408, Nürnberg, Germany
| | - Cornel C Sieber
- Friedrich-Alexander-University of Erlangen-Nürnberg, Institute for Biomedicine of Aging, Kobergerstraße 60, 90408, Nürnberg, Germany; Krankenhaus Barmherzige Brüder Regensburg, Prüfeninger Straße 86, 93049, Regensburg, Germany
| | - Ellen Freiberger
- Friedrich-Alexander-University of Erlangen-Nürnberg, Institute for Biomedicine of Aging, Kobergerstraße 60, 90408, Nürnberg, Germany
| | - Eva Kiesswetter
- Friedrich-Alexander-University of Erlangen-Nürnberg, Institute for Biomedicine of Aging, Kobergerstraße 60, 90408, Nürnberg, Germany
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Raji Lahiji M, Dehdari T, Shokouhi Shoormasti R, Hosseini AF, Navaei M, Zarrati M. Nutrition knowledge, attitudes, and practice towards breast cancer prevention among the female population of Iran University of medical science students. Nutr Cancer 2019; 71:1355-1364. [PMID: 31058553 DOI: 10.1080/01635581.2019.1607410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Diet plays a measurable role in breast cancer (BC) prevention. The aims of this study were to assess nutrition-related BC prevention Knowledge, attitudes and practice (KAP) of female university students and to examine the relationship between demographic characteristics of students and their KAP. We conducted a cross-sectional study among 500 female students from Iran University of Medical Science (IUMS). A pretested self-administered questionnaires were used to assess the participants' nutrition-related BC prevention KAP. A total of 500 students completed the survey. Students' knowledge with the mean score of 16.97, significantly varied by age (P= 0.03), the field of study (P= 0.001) and family history of BC (P= 0.01). The mean score of attitudes and practice toward nutrition-related BC prevention factors were 24.86 and 39.39, respectively. A significant relationship was observed between nutrition knowledge and attitude (r = 0.27, P < 0.001). Also, Nutrition-related attitudes were positively correlated with the BC prevention dietary practices (r = 0.23, P < 0.001). Nutrition KAP about BC prevention factors was found to be influenced by individual factors such as age, field of study, familial history of BC, job and residency status. Together, our findings confirm that increasing nutrition knowledge is not sufficient for dietary behavior change, but is necessary.
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Affiliation(s)
- Mahsa Raji Lahiji
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences , Tehran , Iran
| | - Tahereh Dehdari
- Department of Health Education and Health Promotion, School of Public Health, Iran University of Medical Science , Tehran , Iran
| | | | - Agha Fatemeh Hosseini
- Department of Biostatistics, School of Public Health, Iran University of Medical Science , Tehran , Iran
| | - Mehraban Navaei
- Department of Nutrition, Student Research Committee, School of Public Health, Iran University of Medical Sciences , Tehran , Iran
| | - Mitra Zarrati
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences , Tehran , Iran
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Saba A, Sinesio F, Moneta E, Dinnella C, Laureati M, Torri L, Peparaio M, Saggia Civitelli E, Endrizzi I, Gasperi F, Bendini A, Gallina Toschi T, Predieri S, Abbà S, Bailetti L, Proserpio C, Spinelli S. Measuring consumers attitudes towards health and taste and their association with food-related life-styles and preferences. Food Qual Prefer 2019. [DOI: 10.1016/j.foodqual.2018.11.017] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Schwedhelm C, Knüppel S, Schwingshackl L, Boeing H, Iqbal K. Meal and habitual dietary networks identified through Semiparametric Gaussian Copula Graphical Models in a German adult population. PLoS One 2018; 13:e0202936. [PMID: 30142191 PMCID: PMC6108519 DOI: 10.1371/journal.pone.0202936] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 08/10/2018] [Indexed: 12/17/2022] Open
Abstract
Gaussian graphical models (GGMs) are exploratory methods that can be applied to construct networks of food intake. Such networks were constructed for meal-structured data, elucidating how foods are consumed in relation to each other at meal level. Meal-specific networks were compared with habitual dietary networks using data from an EPIC-Potsdam sub-cohort study. Three 24-hour dietary recalls were collected cross-sectionally from 815 adults in 2010-2012. Food intake was averaged to obtain the habitual intake. GGMs were applied to four main meals and habitual intakes of 39 food groups to generate meal-specific and habitual dietary networks, respectively. Communities and centrality were detected in the dietary networks to facilitate interpretation. The breakfast network revealed five communities of food groups with other vegetables, sauces, bread, margarine, and sugar & confectionery as central food groups. The lunch and afternoon snacks networks showed higher variability in food consumption and six communities were detected in each of these meal networks. Among the central food groups detected in both of these meal networks were potatoes, red meat, other vegetables, and bread. Two dinner networks were identified with five communities and other vegetables as a central food group. Partial correlations at meals were stronger than on the habitual level. The meal-specific dietary networks were only partly reflected in the habitual dietary network with a decreasing percentage: 64.3% for dinner, 50.0% for breakfast, 36.2% for lunch, and 33.3% for afternoon snack. The method of GGM yielded dietary networks that describe combinations of foods at the respective meals. Analysing food consumption on the habitual level did not exactly reflect meal level intake. Therefore, interpretation of habitual networks should be done carefully. Meal networks can help understand dietary habits, however, GGMs warrant validation in other populations.
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Affiliation(s)
- Carolina Schwedhelm
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
- NutriAct – Competence Cluster Nutrition Research Berlin-Potsdam, Nuthetal, Germany
| | - Sven Knüppel
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
| | - Lukas Schwingshackl
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
- NutriAct – Competence Cluster Nutrition Research Berlin-Potsdam, Nuthetal, Germany
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
- NutriAct – Competence Cluster Nutrition Research Berlin-Potsdam, Nuthetal, Germany
| | - Khalid Iqbal
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
- NutriAct – Competence Cluster Nutrition Research Berlin-Potsdam, Nuthetal, Germany
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Perceived Barriers to Healthy Eating and Physical Activity Among Participants in a Workplace Obesity Intervention. J Occup Environ Med 2018; 59:746-751. [PMID: 28692017 DOI: 10.1097/jom.0000000000001092] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To characterize barriers to healthy eating (BHE) and physical activity (BPA) among participants in a workplace weight management intervention. METHODS Steps to health participants completed a questionnaire to ascertain barriers to physical activity and healthy eating faced. Exploratory factor analysis was used to determine the factor structure for BPA and BHE. The relationships of these factors with accelerometer data and dietary behaviors were assessed using linear regression. RESULTS Barriers to physical activity included time constraints and lack of interest and motivation, and to healthy eating, lack of self-control and convenience, and lack of access to healthy foods. Higher BHE correlated with higher sugary beverage intake but not fruit and vegetable and fat intake. CONCLUSIONS To improve their effectiveness, workplace weight management programs should consider addressing and reducing barriers to healthy eating and physical activity.
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McKenzie B, Santos JA, Trieu K, Thout SR, Johnson C, Arcand J, Webster J, McLean R. The Science of Salt: A focused review on salt-related knowledge, attitudes and behaviors, and gender differences. J Clin Hypertens (Greenwich) 2018; 20:850-866. [PMID: 29722131 PMCID: PMC8031068 DOI: 10.1111/jch.13289] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 03/21/2018] [Indexed: 12/20/2022]
Abstract
The aim of the current review was to examine the scope of studies published in the Science of Salt Weekly that contained a measure of self-reported knowledge, attitudes, and behavior (KAB) concerning salt. Specific objectives were to examine how KAB measures are used to evaluate salt reduction intervention studies, the questionnaires used, and whether any gender differences exist in self-reported KAB. Studies were reviewed from the commencement of Science of Salt Weekly, June 2013 to the end of August 2017. Seventy-five studies had relevant measures of KAB and were included in this review, 13 of these were salt-reduction intervention-evaluation studies, with the remainder (62) being descriptive KAB studies. The KAB questionnaires used were specific to the populations studied, without evidence of a best practice measure. 40% of studies used KAB alone as the primary outcome measure; the remaining studies used more quantitative measures of salt intake such as 24-hour urine. Only half of the descriptive studies showed KAB outcomes disaggregated by gender, and of those, 73% showed women had more favorable KAB related to salt. None of the salt intervention-evaluation studies showed disaggregated KAB data. Therefore, it is likely important that evaluation studies disaggregate, and are appropriately powered to disaggregate all outcomes by gender to address potential disparities.
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Affiliation(s)
- Briar McKenzie
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Joseph Alvin Santos
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Kathy Trieu
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
- Faculty of Medicine, The University of Sydney, Camperdown, NSW, Australia
| | - Sudhir Raj Thout
- The George Institute for Global Health India, Unit No. 301, Hyderabad, Telangana, India
| | - Claire Johnson
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - JoAnne Arcand
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Jacqui Webster
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
- Faculty of Medicine, The University of Sydney, Camperdown, NSW, Australia
| | - Rachael McLean
- Department of Preventive & Social Medicine, University of Otago, Dunedin, New Zealand
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Barrea L, Muscogiuri G, Di Somma C, Tramontano G, De Luca V, Illario M, Colao A, Savastano S. Association between Mediterranean diet and hand grip strength in older adult women. Clin Nutr 2018; 38:721-729. [PMID: 29643004 DOI: 10.1016/j.clnu.2018.03.012] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 03/07/2018] [Accepted: 03/17/2018] [Indexed: 01/14/2023]
Abstract
BACKGROUND & AIMS Mediterranean Diet (MD) is an eating pattern associated with multiple healthy benefits, including the conservation of skeletal muscle. Frailty is a major geriatric syndrome characterized by low muscle strength. The Hand Grip Strength (HGS) is the most frequently used indicator of muscle functional capacity for clinical purposes. The association between the adherence to the MD and HGS in elderly has not yet fully investigated. The goal of this study was to examine the association between the adherence to the MD and HGS in a not hospitalized elderly who participated in the project PERsonalised ict Supported Services for Independent Living and Active Ageing (PERSSILAA). METHODS Eighty-four elderly women were consecutively enrolled (aged 60-85 years) in this cross-sectional observational study. Anthropometric measures were evaluated. A validated 14-item questionnaire PREDIMED (PREvención con DIeta MEDiterránea) was used for the assessment of adherence to the MD. Dietary data were collected by a 7-day food records. Muscle strength was measured by HGS using a grip strength dynamometer (KERN & SOHN GmbH). RESULTS The majority of participants were overweight (46.4%). An average adherence to the MD was found in 52.4% of participants, while the minority of them showed a low adherence (21.4%). HGS > cut-point of 20 kg were found in 43 subjects (51.2%). According to the adherence to MD, 39% participants with HGS values higher than cut-point presented a high adherence score compared with 14% of those with lower values of HGS (p = 0.018). The participants with HGS > cut-point presented significantly higher PREDIMED score than those with HGS < cut-point (p < 0.001). Based on ROC curves, the most sensitive and specific cut-point for the PREDIMED score to predict HGS categories was ≥8. No evident correlations were observed between HGS and age, while HGS was negatively correlated with hip circumference (r = -0.233, p = 0.033) and BMI (r = -0.219, p = 0.045), and positively correlated with PREDIMED score (r = 0.598, p < 0.001). At binomial logistic regression analysis almost all 14-items of PREDIMED questionnaire were significantly associated with HGS adjusted for BMI. At multinomial logistic regression analysis to assess the association of the three classes of adherence to the MD with the HGS, after adjusting for BMI the lowest adherence to MD was associated with the lowest Odds Ratio of HGS (p < 0.001). CONCLUSIONS This study evidenced a positive association between the adherence to the MD and muscle strength in a sample of active elderly women, stratified according to the HGS > cut-point of 20 kg. Our study highlights the usefulness of the developing health services to detect and prevent age-associated decline in physical performance in elderly subjects by addressing nutritional and physical intervention.
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Affiliation(s)
- Luigi Barrea
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | - Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | | | - Giovanni Tramontano
- Research and Development Unit, Federico II University Hospital, Via Sergio Pansini 5, 80131 Naples, Italy.
| | - Vincenzo De Luca
- Research and Development Unit, Federico II University Hospital, Via Sergio Pansini 5, 80131 Naples, Italy.
| | | | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
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Health- and Taste-Related Attitudes Associated with Dietary Patterns in a Representative Sample of Polish Girls and Young Women: A Cross-Sectional Study (GEBaHealth Project). Nutrients 2018; 10:nu10020254. [PMID: 29473894 PMCID: PMC5852830 DOI: 10.3390/nu10020254] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 02/08/2018] [Accepted: 02/17/2018] [Indexed: 11/17/2022] Open
Abstract
Attitudes can be predictors of certain health-related behaviours. The attitudes of young females towards health and taste have not been yet fully examined and their associations with dietary behaviours remain unclear. The aim of the study was to investigate if attitudes are associated with dietary patterns in a representative sample of Polish girls. The study population consisted of 1107 girls, aged 13-21 and living in Poland. Attitudes were assessed using the Health and Taste Attitudes Scale (HTAS) and categorised as negative, neutral or positive. Dietary data was obtained using a Food Frequency Questionnaire. Dietary patterns (DPs), derived previously with a Principal Component Analysis (PCA), were 'Traditional Polish', 'Fruit and vegetables', 'Fast food and sweets' and 'Dairy and fats'. The associations between attitudes and DPs were assessed using Spearman's correlation coefficients and logistic regression. The reference group were girls with neutral attitudes. Odds ratios (ORs) were adjusted for age, socioeconomic status (SES), and body mass index (BMI). The correlations between attitudes and DPs ranged from -0.28 for attitudes towards health and 'Fast food and sweets' and 'Traditional Polish' DPs to 0.33 for attitudes towards health and the 'Fruit and vegetables' DP (p < 0.05). In the logistic regression analysis, the strongest associations within health-related HTAS subscales were observed between negative attitudes towards natural products and the 'Fast food and sweets' DP (OR: 10.93; 95% CI: 3.32-36.01) and between positive attitudes towards health and the 'Fruit and vegetables' DP (OR: 5.10; 3.11-8.37). The strongest associations within taste-related HTAS subscales were observed between positive attitudes towards craving for sweet foods and the 'Traditional Polish' DP (OR: 1.93; 1.43-2.61) and between positive attitudes towards using food as a reward and the 'Dairy and fats' DP (OR: 2.08; 1.22-3.55) as well as the 'Fast food and sweets' DP (OR: 2.07; 1.14-3.74). Positive attitudes towards health were associated with a pro-healthy dietary pattern characterised by the consumption of fruit and vegetables, while negative attitudes towards natural products as well as a strong craving for sweets and using food as a reward were associated with less healthy dietary patterns. To improve the dietary habits of girls and young women, positive attitudes towards health should be strengthened and supported by emphasizing the sensory values of pro-healthy foods.
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Azizan NA, Thangiah N, Su TT, Majid HA. Does a low-income urban population practise healthy dietary habits? Int Health 2018; 10:108-115. [DOI: 10.1093/inthealth/ihy001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 01/06/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Nurul Ain Azizan
- Centre for Population Health and Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
- Advanced Medical and Dental Institute, Universiti Sains Malaysia, Bertam 13200, Pulau Pinang, Malaysia
| | - Nithiah Thangiah
- Centre for Population Health and Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Tin Tin Su
- Centre for Population Health and Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Hazreen Abdul Majid
- Centre for Population Health and Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
- Harvard Chan School of Public Health, Boston, 02115, MA, USA
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Does Perception of Dietary Fiber Mediate the Impact of Nutrition Knowledge on Eating Fiber-Rich Bread? Nutrients 2017; 9:nu9111255. [PMID: 29144429 PMCID: PMC5707727 DOI: 10.3390/nu9111255] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 11/07/2017] [Accepted: 11/13/2017] [Indexed: 12/16/2022] Open
Abstract
The average daily intake of fiber is still too low in relation to nutritional recommendations, as was found in several studies. Therefore, it is necessary to recommend ways to increase fiber intake in the diet. Increasing the consumption of bread rich in fiber as a substitute of white bread is one of the ways to increase fiber intake. The aim of this study was to find out whether nutrition knowledge and perception of dietary fiber affected the frequency of eating wholemeal bread and white bread fortified with fiber. The data were collected in 2014 through a cross-sectional quantitative survey that was performed under the Bioproduct project among a group of 1013 Polish adults. The associations between variables were investigated using multiple regression analysis. The respondents’ general knowledge on nutrition influenced their knowledge on fiber intake (correlation coefficient r = 0.30). Respondents with a greater knowledge perceived higher benefits of consuming cereal products that were fortified with fiber (r = 0.78), and attached greater importance to the information on the label (r = 0.39) as well. The nutrition knowledge determined the familiarity with fiber-enriched bread and the consumption of this product (r = 0.40) to a greater degree than the frequency of wholemeal bread consumption (r = −0.10). The respondents’ perception of dietary fiber was observed to play a partial mediation role between the knowledge on nutrition and the consumption of both kinds of breads, suggesting that it can be an important predictor of bread consumption. To increase the consumption of bread that is rich in fiber, emphasis should be laid on specific information on fiber, referring to food products as well as on individual’s perception of those products. The said information should be reinforced along with overall communication regarding nutrition to influence the bread-related decisions.
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