What does a person's eating identity add to environmental influences on fruit and vegetable intake?

Meat, myself, and I: The role of multiple identities in meat consumption

Excessive consumption of meat challenges global food security and environmental sustainability. In the mounting literature on identity as a motivator of behaviour, meat consumption has been associated with a handful of identities. Identity theory suggests that people hold multiple identities on different levels of abstraction, but how identities at different levels of abstraction interact and possibly co-determine intentions and behaviour remains largely unanswered. Inspired by research on attitudes and goal hierarchies, this study investigates a hierarchical model of meat-related identities and their relation to intentions to consume red meat. By means of a survey of Danish consumers (N = 1001), we identified identities related to the consumption of red meat (e.g., flexitarian identity), using confirmatory factor analysis and structural equation modelling. We also controlled for the most important additional antecedents identified in prior research. Evidence was found that more abstract identities (e.g., national identity, environmental identity) mostly influence intentions to eat meat indirectly, meditated through more behaviour-specific identities (e.g., flexitarian identity). However, some higher-order identities also appear to have a direct impact on intentions to eat meat after controlling for more behaviour-specific identities, which suggests a less hierarchical structure manifesting itself, possibly due to the behaviour being instrumental at reaching different, functionally unrelated goals that are related to different identities. Policy recommendations towards reducing meat consumption are proposed.

You Are What You Eat… But Do You Eat What You Are? The Role of Identity in Eating Behaviors—A Scoping Review

Background: Identity is a major construct in the fields of psychology and anthropology that can relate to both the maintenance of eating behaviors and cultural sensitivity. However, there has not been any systematic effort to understand the role of identity in eating behaviors and the maintenance of eating behaviors, or to address multiple aspects of identity within an individual across scientific disciplines. This scoping review aims to understand and describe existing research relating identity to eating behaviors and to detail the measurement of identity. Methods: We conducted a systematic search of Ovid, PsychINFO, Embase, and Web of Science for articles on identity and eating behaviors published between January 1946 and March 2022. We utilized the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist, and search methods were developed with the assistance of a research librarian. We rated articles from 1 to 5 based on the depth, complexity, and multi-dimensionality of the identity measurement conducted. Scoring criteria included a review of the number of items directly querying or evaluating identity and the extent of measurement of identity domains. Results: In total, 100 articles were included, examining 10 different identities, 8 identity constructs, 11 eating behaviors, and construct contributions from 26 theories. The mean score of all articles was 2.9 on the scale from 1 to 5. A total of 10 studies scored a “1”; 30 scored a “2”, indicating the use of 1–2 basic questions about identity; 31 received a “3” for use of a common but non-complex identity instrument; 19 received a “4”, meaning they contained strong evaluation and included multiple types of identity but were lacking in terms of depth of measure and/or the comparison of identity effects to constructs; and 10 scored a “5” for their strong, in-depth measure of identity and inclusion of multiple types. Identity was found to be significantly related to eating behaviors in all but one study. Conclusion: Identity measurements seldom accounted for complexities such as multiple identities and identity shifting over time. Nonetheless, our findings indicate that multiple aspects of identity reciprocally reinforce behavior and that change maintenance is associated with identity salience and centrality. Identity is underutilized and heterogeneously applied in eating behavior research. The inclusion of identity assessments may lead to better outcomes being obtained within differing cultural, normative, and environmental scenarios.

Associations of Eating Identities With Self-Reported Dietary Behaviors and Body Mass Index

Objective:

To inform dietary interventions, it is important to understand antecedents of recommended (henceforth: healthy) dietary behaviors, beyond dietary beliefs and self-efficacy. We used the validated “Eating Identity Type Inventory” to assess the extent to which participants identified as healthy eaters, meat eaters, emotional eaters or picky eaters. We examined correlations between participants' race/ethnicity and other socio-demographic characteristics and affinity with these eating identities, how affinity with these eating identities correlated with self-reports of dietary beliefs, self-efficacy, dietary behaviors and Body Mass Index (BMI), and how well affinity with these eating identities predicted self-reported dietary behaviors and BMI, as compared to self-reported dietary beliefs and self-efficacy.

Methods

In an online survey, a diverse sample of 340 Los Angeles County adults reported eating identities, dietary beliefs, and self-efficacy, dietary behaviors and BMI.

Results

Pearson correlations revealed that identifying more as a healthy eater was positively associated with self-reports of being non-Hispanic White, non-Hispanic mixed race, older, and college-educated, while identifying more as a meat eater was positively associated with self-reports of being non-Hispanic Black, younger, and male (α = 0.05). Pearson correlations also showed that healthy eaters had more accurate dietary beliefs and self-efficacy, and emotional eaters had lower self-efficacy (α = 0.05). In linear regressions, identifying more as a healthy eater was associated with self-reporting healthier dietary behaviors and lower BMI, and identifying more as a meat eater and emotional eater was associated with reporting less healthy dietary behaviors and higher BMI, even after accounting for correlations with socio-demographics, dietary beliefs, and self-efficacy (α = 0.05).

Conclusions

Our findings highlight the importance of eating identities in understanding dietary behaviors and outcomes, with implications for dietary interventions.

Measures of Perceived Neighborhood Food Environments and Dietary Habits: A Systematic Review of Methods and Associations

Access to healthy food is a necessity for all people. However, there is still a lack of reviews on the assessment of respondent-based measures of neighborhood food environments (perceived food environments). The aim of this systematic review was to evaluate the measurement tools for perceived food environments by five dimensions of food access and to obtain the overview of their associations with dietary habits among people aged 18 years and older in middle- and high-income countries. Observational studies using perceived food environment measures were identified through a systematic review based on two databases for original studies published from 2010 to 2020. A total of 19 final studies were extracted from totally 2926 studies. Pertaining to the five dimensions of food access, 12 studies dealt with accessibility, 13 with availability, 6 with affordability, 10 with acceptability, 2 with accommodation, and 8 with a combination of two or more dimensions. Perceived healthy food environments were positively associated with healthy dietary habits in 17 studies, but 8 of them indicated statistically insignificant associations. In conclusion, this review found accessibility and availability to be major dimensions of perceived food environments. The relationship between healthy food environments and healthy diets is presumably positive and weak.

Examining demographic characteristics and food access indicators from the location of vegan soul food restaurants in the south

Objective: There have been a number of soul food restaurants serving exclusively vegan meals opening up across the country to appeal to African Americans and others interested in eating healthier soul foods. This study determined the number of restaurants serving vegan soul foods in the South and identified the locations of these restaurants in order to understand the characteristics of the surrounding communities that they serve.Design: Two reviewers identified restaurants using standardized search criteria for menu items in the 16 states (and the District of Columbia) that are categorized as being in the South from the Census Bureau. Mean percentage of African Americans, poverty rates, and obesity rates by county where restaurants were located were collected via census data. Restaurants were classified as being in or out of a food desert zone using the United States Department of Agriculture's (USDA) food atlas map (0.5- and 1.0-mile radius). T-tests were conducted to test for differences in the census data between the restaurants that were considered to be in and out of a food desert zone.Results: Overall, 45 restaurants met the inclusion criteria. Counties where restaurants were located had a mean African American population of 36.5 ± 18.5%, mean poverty rate of 15.5 ± 3.85% and mean obesity rate of 26.8 ± 4.8%. More than one third (n = 18, 40.0%) of the restaurants were considered to be in a food desert zone. There were no significant differences in the mean population, obesity, and poverty rates between restaurants classified in a food desert zone and restaurants not located in a food desert zone.Conclusion: A significant number of restaurants were classified in food desert zones, implying their potential to provide healthier meals by serving vegan soul foods to residents in the surrounding neighborhoods. Future work should assess how these restaurants might influence healthier eating habits in their communities.

More Frequent Food Shopping May Promote Fruit and Vegetable Intake: A Systematic Review

BACKGROUND

Food shopping frequency may be an important modifiable factor related to increasing fruit and vegetable (FV) intake. Because of mixed findings of individual studies of shopping frequency, a systematic review is needed to examine findings across studies and store types.

OBJECTIVE

To conduct a systematic review of articles examining the relationship between frequency of food shopping and FV intake including examination of participation in federal nutrition assistance programs on FV intake, if reported.

METHODS

A search, guided by the Preferred Reported Items for Systematic Reviews and Metanalyses, using terms related to FV consumption and food shopping across 4 online databases, was conducted. Studies conducted in the US and published through October, 2020, included adults, and had a cross-sectional, longitudinal, cohort, or randomized study design were eligible for inclusion.

RESULTS

Twenty-four articles were included. The majority of studies found at least 1 positive finding between the frequency of food shopping and FV intake, indicating that as the frequency of food shopping increased, FV intake increased. In studies with 100% participation in government/federal nutrition assistance programs, participation was associated with FV intake. Studies that included participation as a subset found participation not associated with FV intake.

IMPLICATIONS FOR FUTURE RESEARCH AND PRACTICE

The frequency of shopping may be modifiable to increase FV intake. Experimental research is needed to test the directionality and causality of the relationship. Federal nutrition assistance programs may be a logical place to test the relationship through the adjustment of fund disbursements.

Food Shopping Frequency of Rural Tennessee Adults With Comparisons by Federal Nutrition Assistance Participation

OBJECTIVE

To describe food shopping frequency across 7 store types in a rural context and compare food shopping frequency between federal nutrition assistance recipients and nonrecipients.

METHODS

This cross-sectional study was conducted at county fairs in rural Tennessee.

RESULTS

Reported overall mean food shopping frequency was 18.4 (SD, 13.9) times in the past 30 days. A mean of 3.1 (SD, 1.2) store types were visited, with supermarkets, convenience stores, and dollar stores the most frequented stores. Federal nutrition assistance program recipients shopped significantly less frequently than nonrecipients for overall shopping frequency (P = 0.02), supermarkets (P = 0.02), and farmers' markets (P = 0.04).

CONCLUSIONS AND IMPLICATIONS

Educating and counseling individuals on how food shopping frequency may promote nutrition and health may be important. Federal nutrition assistance programs that distribute benefits monthly may impact food shopping frequency.

Food Acquisition and Shopping Patterns in the United States: Characteristics and Relation to Body Mass Index in the US Food Acquisition and Purchase Survey

BACKGROUND

Previous studies examined the association between shopping distance, frequency, and store type separately.

OBJECTIVES

The objective is to explore food acquisition and shopping habits using multidimensional measures and examine its association with body mass index (BMI).

DESIGN

A cross-sectional study was conducted.

PARTICIPANTS/SETTING

Four thousand four hundred sixty-six households from the US Food Acquisition and Purchase Survey during April 2012 to January 2013 were included in this analysis.

MAIN OUTCOMES MEASURES

Both continuous BMI and categorical BMI were used.

STATISTICAL ANALYSES

Latent class analysis was used to identify the latent profiles using travel distance and perceived travel time between residential location and primary store, store type, transportation mode, and farmers' market utilization. Multivariable linear regression and multinomial logistic regression were used to assess the association between the identified patterns and continuous and categorical BMI. All analyses were stratified by urbanicity.

RESULTS

Overall, 65% (weighted percentage) of households were located in an urban tract. Thirty-seven percent were categorized as Class 1 (households that shopped more proximally, used their own vehicle, and shopped at a farmers' market), 50% as Class 2 (households that shopped more distally, used their own vehicle, and shopped at a farmers' market), and 14% as Class 3 (households that shopped proximally but perceived longer travel time, used someone else's vehicle, and did not shop at a farmers' market). Among rural households, 54% were Class 1 and 46% were Class 2 (Class 3 was not identified). Socioeconomic status characteristics, proximity, and store food price concerns were associated with the identified patterns. However, no significant association was found between the identified patterns and BMI.

CONCLUSIONS

Food acquisition and shopping patterns were not associated with BMI in this national sample. However, future studies should also investigate the role of economic factors, such as food prices, in relation to shopping patterns and BMI.

Conceptual Models of Food Choice: Influential Factors Related to Foods, Individual Differences, and Society

Understanding individual food choices is critical for transforming the current food system to ensure healthiness of people and sustainability of the planet. Throughout the years, researchers from different fields have proposed conceptual models addressing factors influencing the food choice, recognized as a key leverage to improve planetary and human health. However, a multidisciplinary approach is needed to better understand how different factors are involved and interact with each other in the decision-making process. The present paper reviews and analyzes existing models, providing an intact point-of-view by integrating key elements into a bigger framework. Key determinants of general food choice are identified and categorized, including food-internal factor (sensory and perceptual features), food-external factors (information, social environment, physical environment), personal-state factors (biological features and physiological needs, psychological components, habits and experiences), cognitive factors (knowledge and skills, attitude, liking and preference, anticipated consequences, and personal identity), as well as sociocultural factors (culture, economic variables, political elements). Moreover, possible directions of influence among the factors towards final food choice were discussed. The need of multidisciplinary impulses across research field with the support of empirical data are crucial for understanding factors influencing food choice as well as for enriching existing conceptual models. The framework proposed here would serve as a roadmap for facilitating communications and collaborations between research fields in a structural and systematic way.

Relationship Between Grocery Shopping Frequency and Home- and Individual-Level Diet Quality Among Low-Income Racial or Ethnic Minority Households With Preschool-Aged Children

BACKGROUND

The home food environment can shape the diets of young children. However, little is known about modifiable factors that influence home food availability and dietary intake.

OBJECTIVE

The purpose of this study was to examine the relationship between grocery shopping frequency with home- and individual-level diet quality.

DESIGN

This was a secondary, cross-sectional analyses of data from the Study on Children's Home Food Availability Using TechNology. Data were collected in the homes of participants from November 2014 through March 2016.

PARTICIPANTS/SETTINGS

A purposive sample of 97 low-income African American and Hispanic or Latinx parent-child dyads residing in Chicago, IL, enrolled in the study.

MAIN OUTCOME MEASURES

The main outcomes were home- and individual-level diet quality. Healthy Eating Index-2010 (HEI-2010) scores were calculated from home food inventory data collected in participants' homes to assess home-level diet quality. To assess individual-level diet quality, HEI-2010 scores were based on multiple 24-hour diet recalls from parent-child dyads.

STATISTICAL ANALYSES

Grocery shopping frequency was examined in relation to diet quality at the home and individual levels. Grocery shopping frequency was defined as the number of times households shopped on a monthly basis (ie, once a month, twice a month, 3 times a month, or 4 times or more a month). Multivariable linear regression analysis, controlling for covariates, tested the relationships between grocery shopping frequency and HEI-2010 total and component scores at the home and individual levels.

RESULTS

Grocery shopping frequency was positively associated with home-level HEI-2010 scores for total diet, whole grains, and empty calories (higher scores reflect better diet quality) and with individual-level HEI-2010 scores for total and whole fruit (parents only), vegetables (children only), and sodium (children only).

CONCLUSIONS

Grocery shopping frequency was associated with multiple dimensions of diet quality at the home and individual levels. These results offer a potential strategy to intervene on home food availability and individual dietary intake.

Food security moderates relationship between perceived food environment and diet quality among adults in communities with low access to healthy food retail

OBJECTIVE

To examine the relationship between food security status, diet quality measured using Healthy Eating Index-2010 (HEI-2010) scores, demographics and the following factors: perceptions of healthy food availability, healthy eating identity and perceived control of healthy eating.

DESIGN

A cross-sectional study in 2016-2017 using three 24-h dietary recalls and one psychosocial survey.

SETTING

Two urban communities in Cleveland and Columbus, Ohio, USA, with low access to healthy food retailers.

PARTICIPANTS

Primary food shoppers living in the targeted geographic areas (N 450).

RESULTS

Our results indicated that high school graduates had lower HEI-2010 scores compared with participants who had some college education or more (β = -2·77, P = 0·02). Participants receiving Supplemental Nutrition Assistance Program (SNAP) benefits had lower HEI-2010 scores (β = -2·69, P = 0·03). Healthy eating identity was associated with higher HEI-2010 scores (β = 1·85, P = 0·004). Food security status moderated the relationship between perception of healthy food availability and HEI-2010 scores. Among participants with very low food security (VLFS), greater perceptions of healthy food availability were associated with higher HEI-2010 scores (β = 3·25, P = 0·03), compared with food secure participants. Only 14 % of VLFS participants used a personal vehicle as transportation to their primary food shopping store.

CONCLUSIONS

Findings offer targets for future intervention development and evaluation to promote community nutrition. These targets include strategies to improve the value of SNAP benefits, promote access to quality education, increase transportation options to healthy food retailers and develop nutrition programming to promote healthy eating identity.

The influence of identity on the prevalence and persistence of disordered eating and weight control behaviors in Mexican American college women

Disordered eating behaviors are prevalent in Mexican-American college-enrolled women and contribute to compromised physical and psychological health. Although disordered eating behaviors are multi-determined, few studies have examined individual difference factors that contribute to disordered eating behaviors in Mexican women beyond acculturation. Evidence suggests that individual differences in the constellation of identities may be an important factor influencing the disordered eating behaviors. We hypothesized that individual differences in the collection of identities (self-schemas) increases susceptibility to defining oneself as fat (fat self-schema) and contribute to disordered eating behaviors over time in Mexican American college women. A 12-month longitudinal design was used to measure the level of disordered eating behaviors at 5 points over 12 months in 477 Mexican American women. Identity properties (i.e., positive self-schemas, negative self-schemas, fat self-schema) were measured at baseline. Controlling for relevant covariates, latent growth curve models showed that Mexican American women with few positive and many negative self-schemas were more likely to define themselves as fat, which in turn, predicted purging and fasting/restricting behaviors across the year. However, identity properties were not predictive of binge eating and excessive exercise episodes. Interventions focused on development of positive self-schemas that reflect areas of interest and competence and the revision of negative self-schemas may protect against purging and fasting/restricting in Mexican American college-enrolled women.

Socioecological Path Analytic Model of Diet Quality among Residents in Two Urban Food Deserts

BACKGROUND

Diet is critical to chronic disease prevention, yet there are persistent disparities in diet quality among Americans. The socioecological model suggests multiple factors, operating at multiple levels, influence diet quality.

OBJECTIVE

The goal was to model direct and indirect relationships among healthy eating identity, perceived control of healthy eating, social support for healthy eating, food retail choice block scores, perceptions of healthy food availability, and food shopping behaviors and diet quality measured using Healthy Eating Index-2010 scores (HEI-2010) for residents living in two urban communities defined as food deserts.

DESIGN

A cross-sectional design was used including data collected via self-reported surveys, 24-dietary recalls, and through objective observations of food retail environments.

PARTICIPANTS/SETTING

Data collection occurred in 2015-2016 in two low-income communities in Cleveland (n=243) and Columbus (n=244), OH.

MAIN OUTCOME MEASURE

HEI-2010 scores were calculated based on the average of three 24-hour dietary recalls using the Nutrition Data System for Research.

ANALYSIS

Separate path models, controlled for income, were run for each community. Analysis was guided by a conceptual model with 15 hypothesized direct and indirect effects on HEI-2010 scores. Associations were considered statistically significant at P<0.05 and P<0.10 because of modest sample sizes in each community.

RESULTS

Across both models, significant direct effects on HEI-2010 scores included healthy eating identity (β=.295, Cleveland; β=.297, Columbus, P<0.05) and distance traveled to primary food store (β=.111, Cleveland, P<0.10; β=.175, Columbus, P<0.05). Perceptions of healthy food availability had a significant, inverse effect in the Columbus model (β=-.125, P<0.05). The models explained greater variance in HEI-2010 scores for the Columbus community compared with Cleveland (R²=.282 and R²=.152, respectively).

CONCLUSIONS

Findings highlight the need for tailored dietary intervention approaches even within demographically comparable communities. Interventions aimed at improving diet quality among residents living in food deserts may need to focus on enhancing healthy eating identity using culturally relevant approaches while at the same time addressing the need for transportation supports to access healthy food retailers located farther away.

Maternal and child dietary intake: The role of maternal healthy-eater self-schema

BACKGROUND

Mothers play a key role in shaping the dietary intake of their young children through their own dietary intake and the foods they make available at home. Therefore, understanding the mechanisms underlying maternal food choices is crucial. Cognitions about the self as a healthy eater, referred to as healthy-eater self-schema (HESS), predict dietary intake in diverse samples, but the linkage has not been investigated in mothers and their feeding behaviors. This study examined the relationship between a maternal HESS, maternal and child intake of fruits, vegetables, saturated fat, and added sugar, and home food availability.

METHODS

A cross-sectional, descriptive design was used with mothers and their 2-5 year old children (N = 124 dyads). Kendzierski's Healthy-Eater Self-Schema questionnaire was used to measure HESS. Block Food Frequency Screeners were used to measure diets (mother and child) and the Home Environment Survey was used to measure home availability of fruits/vegetables and fats/sweets. Multiple regression and multiple mediation analyses were performed.

RESULTS

Maternal HESS was positively associated with maternal intake of fruits and vegetables, and negatively associated with intake of added sugar. Maternal HESS was not directly associated with child dietary intake, but was indirectly associated with child intake of fruits, vegetables, and added sugar through maternal intake of the same foods. Home food availability was not significantly associated with HESS.

CONCLUSION

This study found that a mother's HESS was positively associated with her diet, which was subsequently associated with aspects of her child's diet. Interventions to foster development of HESS in mothers may be an effective means to promote healthy dietary intake in mothers and their young children.