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Kenney E, Adebiyi VO, Seligman HK, Ehmke MD, Guthrie JF, Coleman-Jensen A, Frongillo EA. Assessing and Monitoring Nutrition Security in the United States: A Narrative Review of Current Measures and Instruments. Curr Nutr Rep 2024; 13:639-667. [PMID: 38916806 PMCID: PMC11327197 DOI: 10.1007/s13668-024-00547-7] [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] [Accepted: 05/01/2024] [Indexed: 06/26/2024]
Abstract
PURPOSE OF REVIEW Because nutrition plays a crucial role in the development of chronic diseases, ensuring nutrition security is important for promoting population health. Nutrition security is defined as having consistent and equitable access to healthy, safe, affordable foods essential to optimal health and well-being. Distinguished from food security, nutrition security consists of two constructs: healthy diets and nutritional status. The study aimed to identify population measures that reflect the important constructs of nutrition security (i.e., healthy diets and nutritional status) to inform U.S. nutrition security assessment and monitoring. RECENT FINDINGS Through a narrative review conducted across multiple databases, associations between subconstructs of healthy diets and nutritional status were identified. Of the six subconstructs that constitute healthy diets, nutrient adequacy and moderation were most often used to assess and monitor healthfulness of U.S. population diets and were associated with health outcomes. There is little evidence of an association between health outcomes and macronutrient balance or diversity in the U.S. Thirteen instruments were identified as potentially suitable for measuring at least one subconstruct of healthy diet in the population. This review highlights the importance of nutrition security in addressing population health challenges. It emphasizes the potential use of multiple instruments and measures to comprehensively monitor population nutrition security and inform intervention strategies. Identifying feasible and practical measures for assessing and monitoring nutrition security is imperative for advancing population health and mitigating the burden of chronic diseases.
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Affiliation(s)
- Emma Kenney
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Discovery I Building, 915 Greene Street, Columbia, SC, 29208, USA.
| | - Victoria O Adebiyi
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Discovery I Building, 915 Greene Street, Columbia, SC, 29208, USA
| | - Hilary K Seligman
- Division of General Internal Medicine and Center for Vulnerable Populations, University of California, San Francisco, CA, USA
| | - Mariah D Ehmke
- United States Department of Agriculture, Economic Research Service, Washington, DC, USA
| | - Joanne F Guthrie
- United States Department of Agriculture, Economic Research Service, Washington, DC, USA
| | - Alisha Coleman-Jensen
- United States Department of Agriculture, Economic Research Service, Washington, DC, USA
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Discovery I Building, 915 Greene Street, Columbia, SC, 29208, USA
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2
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Castro K, Frye RE, Silva E, Vasconcelos C, Hoffmann L, Riesgo R, Vaz J. Feeding-Related Early Signs of Autism Spectrum Disorder: A Narrative Review. J Pers Med 2024; 14:823. [PMID: 39202014 PMCID: PMC11355084 DOI: 10.3390/jpm14080823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Revised: 07/17/2024] [Accepted: 07/25/2024] [Indexed: 09/03/2024] Open
Abstract
Feeding difficulties are prevalent among individuals with autism spectrum disorder (ASD). Nevertheless, the knowledge about the association between feeding-related early signs and child development remains limited. This review aimed to describe the signs and symptoms related to feeding during child development and to explore their relevance to the diagnosis of ASD. Specialists in nutrition and/or ASD conducted a search of MEDLINE, PsycINFO, and Web of Science databases. Although studies in typically developing children demonstrate age-related variations in hunger and satiety cues, the literature about early feeding indicators in ASD is scarce. Challenges such as shortened breastfeeding duration, difficulties in introducing solid foods, and atypical mealtime behaviors are frequently observed in children with ASD. The eating difficulties experienced during childhood raise concerns for caregivers who base their feeding practices on their perceptions of food acceptance or refusal. Considering the observed associations between feeding difficulties and ASD, the importance of recognizing feeding-related signs according to developmental milestones is emphasized to alert medical professionals that deviation in the formation of feeding habits and skills could indicate the need for ASD diagnostic investigation.
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Affiliation(s)
- Kamila Castro
- Serviço de Neuropediatria do Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, RS, Brazil;
- Programa de Pós Graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul, Porto Alegre 90610-000, RS, Brazil;
- Programa de Pós-Graduação em Nutrição e Alimentos, Universidade Federal de Pelotas, Pelotas 96010-610, RS, Brazil; (E.S.); (L.H.); (J.V.)
| | - Richard E Frye
- Autism Discovery and Treatment Foundation and Rossignol Medical Center, 4045 E Union Hills Rd, Phoenix, AZ 85050, USA;
| | - Eduarda Silva
- Programa de Pós-Graduação em Nutrição e Alimentos, Universidade Federal de Pelotas, Pelotas 96010-610, RS, Brazil; (E.S.); (L.H.); (J.V.)
| | - Cristiane Vasconcelos
- Programa de Pós Graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul, Porto Alegre 90610-000, RS, Brazil;
| | - Laura Hoffmann
- Programa de Pós-Graduação em Nutrição e Alimentos, Universidade Federal de Pelotas, Pelotas 96010-610, RS, Brazil; (E.S.); (L.H.); (J.V.)
| | - Rudimar Riesgo
- Serviço de Neuropediatria do Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, RS, Brazil;
- Programa de Pós Graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul, Porto Alegre 90610-000, RS, Brazil;
| | - Juliana Vaz
- Programa de Pós-Graduação em Nutrição e Alimentos, Universidade Federal de Pelotas, Pelotas 96010-610, RS, Brazil; (E.S.); (L.H.); (J.V.)
- Faculdade de Nutrição, Universidade Federal de Pelotas, Pelotas 96010-610, RS, Brazil
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Cabezas MF, Nazar G. A scoping review of food and nutrition literacy programs. Health Promot Int 2023; 38:daad090. [PMID: 37676303 DOI: 10.1093/heapro/daad090] [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] [Indexed: 09/08/2023] Open
Abstract
The impact of food literacy (FL) and nutrition literacy (NL) programs on lifestyles and health is recognized in the literature, yet few studies systematize it. This study aims to deepen the understanding of FL/NL from the characterization of programs in terms of (i) theoretical foundations, conceptualization and measuring instruments; (ii) characterization of the FL/NL programs and results and (iii) limitations and future directions declared. A scoping review of original articles addressing FL/NL programs from the Web of Science, Scopus and PubMed databases published between 2015 and 2023. There was a somewhat restricted view of the construct and the absence of a clear boundary between FL and NL. Half of the studies reported theoretical foundations. The most used model was Social Cognitive Learning Theory. More significant development of programs was observed in Australia, using quasi-experimental designs. Most of the studies informed positive results. Limitations of the studies related to the sampling process, absence of a control group and lack of follow-up. It is suggested that long-term interventions consider economic, social and cultural factors. Despite that theoretical and empirical aspects should be revised, FL/NL programs are a suitable strategy to mitigate the social and health effects of inadequate nutrition.
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Affiliation(s)
| | - Gabriela Nazar
- Departamento de Psicología, Universidad de Concepción, Concepción, Chile
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Qin Y, Rivera RL, Zhang Y, Wang Q, Tooze JA, Abbott AR, Maulding MK, Craig BA, Bailey RL, Eicher-Miller HA. A Randomized Intervention of Supplemental Nutrition Assistance Program-Education Did Not Improve Dietary Outcomes Except for Vitamin D Among Lower-Income Women in Indiana. J Acad Nutr Diet 2023; 123:284-298.e2. [PMID: 35781080 DOI: 10.1016/j.jand.2022.06.030] [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: 07/26/2021] [Revised: 06/23/2022] [Accepted: 06/28/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND The goal of US Department of Agriculture Supplemental Nutrition Assistance Program-Education (SNAP-Ed) is to improve the likelihood that those eligible for SNAP will make healthy choices aligned with the Dietary Guidelines for Americans, 2020-2025. OBJECTIVE The objective of the study was to evaluate the long-term effects of a direct SNAP-Ed intervention in which participants actively engage in learning with educator instruction about dietary quality and usual intake of key nutrient and food groups among Indiana SNAP-Ed-eligible women participants as an example sample in the context of no similar existing evaluation. DESIGN The study design was a parallel-arm, randomized controlled, nutrition education intervention, with follow-up at 1 year. PARTICIPANTS/SETTING Participants (18 years and older; n = 97 women) eligible for SNAP-Ed and interested in receiving nutrition education lessons were recruited from 31 Indiana counties from August 2015 to May 2016 and randomized to an intervention (n = 53) or control (n = 44) group. INTERVENTION The intervention comprised core lessons of Indiana SNAP-Ed delivered between 4 and 10 weeks after baseline assessment. Each participant completed a baseline and 1-year follow-up assessment. Dietary intake was assessed using repeated 24-hour dietary recalls (up to 2). MAIN OUTCOME MEASURES Mean usual nutrient, food group intake, diet quality (ie, Healthy Eating Index-2010 scores), and proportion of intervention and control groups meeting Dietary Guidelines for Americans, 2020-2025 recommendations and Dietary Reference Intake indicators of requirement or adequacy, were determined using the National Cancer Institute method and the simple Healthy Eating Index-2010 scoring algorithm method. Dietary changes between intervention and control groups were examined over time using mixed linear models. STATISTICAL ANALYSES PERFORMED Bonferroni-corrected significance levels were applied to the results of the mixed linear models for comparisons of usual intake of nutrients and foods. RESULTS No differences in diet quality, intake of food group components, food group intake, or nutrients were observed at 1-year follow-up, except that vitamin D intake was higher among those who received SNAP-Ed compared with the control group. CONCLUSIONS A direct SNAP-Ed intervention did not improve diet quality, food group intake, or key nutrient intake, except for vitamin D, among Indiana SNAP-Ed-eligible women up to 1 year after the nutrition education.
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Affiliation(s)
- Yue Qin
- Department of Nutrition Science, Purdue University, West Lafayette, IN
| | - Rebecca L Rivera
- Department of Nutrition Science, Purdue University, West Lafayette, IN
| | - Yumin Zhang
- Department of Statistics, Purdue University, West Lafayette, IN
| | - Qi Wang
- Department of Statistics, Purdue University, West Lafayette, IN
| | - Janet A Tooze
- School of Medicine, Wake Forest University, Winston-Salem, NC
| | - Angela R Abbott
- Health and Human Sciences Extension, Purdue University, West Lafayette, IN
| | - Melissa K Maulding
- Department of Nutrition and Dietetics, Eastern Illinois University, Charleston
| | - Bruce A Craig
- Department of Statistics, Purdue University, West Lafayette, IN
| | - Regan L Bailey
- Department of Nutrition Science, Purdue University, West Lafayette, IN
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Gray HL, Buro AW, Sinha S. Associations Among Parents' Eating Behaviors, Feeding Practices, and Children's Eating Behaviors. Matern Child Health J 2023; 27:202-209. [PMID: 36609937 DOI: 10.1007/s10995-022-03572-6] [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: 09/08/2021] [Revised: 12/13/2022] [Accepted: 12/20/2022] [Indexed: 01/09/2023]
Abstract
Parental feeding practices influence children's eating behaviors, yet it is not well-understood whether parents' own eating behaviors are associated with their feeding practices. The purpose of this study was to examine associations among parents' eating behaviors, parental feeding practices, and children's eating behaviors. A cross-sectional study was conducted with 76 parents of children from an elementary school in Tampa, FL. Parents completed three questionnaires with topics related to parent eating behaviors, parental feeding practices, and children's eating behaviors. Multiple regression analysis was performed, controlling for demographic covariates. Parents who reported to eat more fruits per day (β = 0.15), eat more than one kind of fruit each day (β = 0.33), eat more than one kind of vegetable each day (β = 0.29), eat 2 or more vegetables at the main meal (β = 0.36), plan meals (β = 0.19), and keep vegetables ready for the child to eat (β = 0.25) indicated that they use more positive reinforcement feeding practices (all p ≤ 0.001). There were significantly positive associations between positive reinforcement and children's eating fruits or vegetables like apples, bananas or carrots as snacks (β = 1.03) and eating more than one kind of vegetable a day (β = 1.03; all p < 0.001). No other variables had any significant associations. Findings of this study indicate that there are potential associations among parent's own eating behaviors, feeding practices, and children's eating behaviors. Further research is needed to determine the mechanism of these relationships. Targeting these parental factors may be an effective way to maximize the impact of nutrition interventions on children's dietary behavior changes.
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Affiliation(s)
- Heewon L Gray
- College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, MDC 56, 33612, Tampa, FL, USA.
| | - Acadia W Buro
- H. Lee Moffitt Cancer Center and Research Institute, 12902 USF Magnolia Drive, 33612, Tampa, FL, USA
| | - Sweta Sinha
- Cedar Sinai Medical Center, 8700 Beverly Blvd, 90048, California, LA, USA
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Taniguchi T, Haslam A, Sun W, Sisk M, Hayman J, Jernigan VBB. Impact of a Farm-to-School Nutrition and Gardening Intervention for Native American Families from the FRESH Study: A Randomized Wait-List Controlled Trial. Nutrients 2022; 14:nu14132601. [PMID: 35807781 PMCID: PMC9268191 DOI: 10.3390/nu14132601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/21/2022] [Accepted: 06/21/2022] [Indexed: 02/08/2023] Open
Abstract
Establishing healthy eating habits during childhood is critical to prevent chronic diseases that develop in adulthood. Tribally owned Early Childhood and Education (ECE) programs signify fundamental influence in childhood obesity disparities. A strategy to improve diet is the use of school gardens; however, few studies have used rigorous methods to assess diet and health outcomes. The purpose of this manuscript is to describe results from the six-month Food Resource Equity for Sustainable Health (FRESH) study among Native American families. We aimed to recruit 176 families of children attending Osage Nation ECE programs in four communities. Two communities received the intervention and two served as wait-list controls. Outcomes included change in dietary intake, body mass index, health status, systolic blood pressure (adults only), and food insecurity in children and parents. There were 193 children (n = 106 intervention; n = 87 control) and 170 adults (n = 93 intervention; n = 77 control) enrolled. Vegetable intake significantly increased in intervention children compared to controls for squash (p = 0.0007) and beans (p = 0.0002). Willingness to try scores increased for beans in intervention children (p = 0.049) and tomatoes in both groups (p = 0.01). FRESH is the first study to implement a farm-to-school intervention in rural, tribally owned ECEs. Future interventions that target healthy dietary intake among children should incorporate a comprehensive parent component in order to support healthy eating for all household members.
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Affiliation(s)
- Tori Taniguchi
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK 74135, USA;
- Correspondence:
| | - Alyson Haslam
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA 94143, USA;
| | - Wenjie Sun
- Department of Rural Health, Oklahoma State University Center for Health Sciences, Tulsa, OK 74135, USA;
| | - Margaret Sisk
- Osage Nation, Harvest Land, Pawhuska, OK 74056, USA; (M.S.); (J.H.)
| | - Jann Hayman
- Osage Nation, Harvest Land, Pawhuska, OK 74056, USA; (M.S.); (J.H.)
| | - Valarie Blue Bird Jernigan
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK 74135, USA;
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Blue Bird Jernigan V, Taniguchi T, Haslam A, Williams MB, Maudrie TL, Nikolaus CJ, Wetherill MS, Jacob T, Love CV, Sisson S. Design and Methods of a Participatory Healthy Eating Intervention for Indigenous Children: The FRESH Study. Front Public Health 2022; 10:790008. [PMID: 35296044 PMCID: PMC8920553 DOI: 10.3389/fpubh.2022.790008] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 01/26/2022] [Indexed: 12/23/2022] Open
Abstract
Objective To increase vegetable and fruit intake, reduce body mass index (BMI), and improve parental blood pressure among American Indian families. Design Randomized, wait-list controlled trial testing a multi-level (environmental, community, family, and individual) multi-component intervention with data collection at baseline and 6 months post-intervention. Setting Tribally owned and operated Early Childhood Education (ECE) programs in the Osage Nation in Oklahoma. Participants American Indian families (at least one adult and one child in a ECE program). A sample size of 168 per group will provide power to detect differences in fruit and vegetable intake. Intervention The 6-month intervention consisted of a (1) ECE-based nutrition and gardening curriculum; (2) nutrition education and food sovereignty curriculum for adults; and (3) ECE program menu modifications. Main Outcome Measures The primary outcome is increase in fruit and vegetable intake, assessed with a 24-h recall for adults and plate weight assessments for children. Secondary outcomes included objective measures of BMI among adults and children and blood pressure among adults.
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Affiliation(s)
- Valarie Blue Bird Jernigan
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States,*Correspondence: Valarie Blue Bird Jernigan
| | - Tori Taniguchi
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Alyson Haslam
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
| | - Mary B. Williams
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Tulsa, OK, United States
| | - Tara L. Maudrie
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Cassandra J. Nikolaus
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, United States
| | - Marianna S. Wetherill
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Tulsa, OK, United States
| | - Tvli Jacob
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Charlotte V. Love
- School of Health Care Administration, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Susan Sisson
- Department of Nutritional Sciences, University of Oklahoma College of Allied Health, Oklahoma City, OK, United States
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Paynter E, Begley A, Butcher LM, Dhaliwal SS. The Validation and Improvement of a Food Literacy Behavior Checklist for Food Literacy Programs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413282. [PMID: 34948890 PMCID: PMC8701925 DOI: 10.3390/ijerph182413282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 12/02/2021] [Accepted: 12/02/2021] [Indexed: 12/03/2022]
Abstract
Food literacy is a multidimensional construct required to achieve diet quality. The Food Sensations® for Adults (FSA) program aims to improve the food literacy of low to middle-income adults living in Western Australia and is funded by the Western Australian Department of Health. The original published behavior checklist used to measure change in food literacy has been revised based on experience of the facilitators and the iterative development of the program. This research sought to assess the validity and reliability of the improved food literacy behavior checklist. A total of 1,359 participants completed the checklist over an 18-month period. Content, face, and construct validity were considered in the re-development of the checklist. An exploratory factor analysis of the checklist identified three factors: (1) Plan and Manage, (2) Selection, and (3) Preparation. Cronbach’s alpha coefficients of 0.883, 0.760, and 0.868 were found for each of the three factors respectively. These coefficients indicated good internal consistency and were higher than those found in the original checklist analysis. An external validation was undertaken with the original food literacy behavior checklist, and a strong positive relationship between the two tools was found. In addition to being used to evaluate FSA, this revised and extensively validated tool could provide guidance to others evaluating similar food literacy programs and contribute to international measurement research.
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Affiliation(s)
- Ellen Paynter
- School of Population Health, Curtin University, Bentley 6102, Australia;
| | - Andrea Begley
- School of Population Health, Curtin University, Bentley 6102, Australia;
- Correspondence: ; Tel.: +61-89266-2773
| | | | - Satvinder S. Dhaliwal
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley 6102, Australia;
- Duke-NUS Medical School, National University of Singapore, Singapore 169857, Singapore
- Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands 6009, Australia
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, Minden 11800, Malaysia
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Malinowska AM. Easy Diet Screener: A quick and easy tool for determining dietary patterns associated with lipid profile and body adiposity. J Hum Nutr Diet 2021; 35:590-604. [PMID: 34841622 DOI: 10.1111/jhn.12973] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 11/05/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is a lack of simple tools that could allow members of the general population to estimate their own dietary patterns and to associate them with unfavourable health outcomes. The present study aimed to develop and validate a simple self-administered tool, called the Easy Diet Screener (EDS), that would identify healthy and unhealthy dietary patterns and evaluate their association with unfavourable blood and anthropometric parameters (i.e. values outside the recommended values). METHODS In total, 259 adult people (31-50 years of age) participated in this observational study. They filled out an online version of the EDS questionnaire; those who scored highly were assigned to the healthy dietary pattern (HDP) group, whereas those with a low score were assigned to the western dietary pattern (WDP) group. The dietary records, anthropometric and biochemical parameters were evaluated in a subset of 200 participants who obtained similar score in the repeated EDS (paper version). RESULTS People assigned to HDP on the basis of EDS had significantly better diet quality than those assigned to WDP, with values of the Healthy Eating Index being 76.9 ± 9.2 and 58.7 ± 10.5, respectively. People classed as WDP had a higher risk of too high serum low-density lipoproteins [odds ratio (OR) = 2.65], triglycerides (OR = 3.67), body mass index (OR = 2.87) and percentage of fat tissue (OR = 3.98) than did people in the HDP. CONCLUSIONS EDS is an easy tool for quickly identifying healthy and western dietary patterns that are associated with lipid profile and body adiposity.
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Affiliation(s)
- Anna M Malinowska
- Department of Human Nutrition and Dietetics, Poznań University of Life Sciences, Poznań, Poland
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10
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Ranjit N, Macias S, Hoelscher D. Factors related to poor diet quality in food insecure populations. Transl Behav Med 2021; 10:1297-1305. [PMID: 33421089 PMCID: PMC7796710 DOI: 10.1093/tbm/ibaa028] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
It is well-known that consumption of nutrient-rich foods, especially fruits and vegetables, are low among food insecure populations. While cost is an important reason for these inadequate diets, underlying factors such as poor food purchase and management behaviors, and low levels of psychosocial factors that motivate dietary improvements, may exacerbate food insufficiency among the food-insecure. In this analysis, we examine these underlying factors across food-secure and food-insecure populations in Texas. Data on self-reported food insecurity, dietary practices, behaviors related to food purchase and management, and psychosocial factors related to food were obtained from a survey administered to a convenience sample of SNAP-eligible adults (n = 1,171) ages 18 and older, drawn from multiple low-income areas across the state of Texas in 2018 over two survey rounds. Mixed linear regression models adjusting for zip code as a random effect were used to compare mediators of diet across food-insecure and food-secure participants. Using the binary categories defined by the U.S. Household Food Security Survey Module scale 753 participants (64.3% of the sample collected) were classified as food insecure. Food insecure participants had notably unhealthier diet profiles, with significantly lower (p < .001) frequency and average serving size of fruit and vegetable consumption. They were also less likely to use food labels to make food choices (p < .001), and to cook a meal at home (p = .008). In contrast, differences across food secure and food insecure households in planning meals before going shopping, and making lists were much smaller. Finally, levels of various psychosocial precursors of healthy eating were also lower among food insecure participants, including self-efficacy for healthy eating (p = .014), self-efficacy to plan meals with vegetables (p = .048), and stage of change of fruit and vegetable consumption (p < .001). Overall, eating habits, specific food procurement and preparation practices, and levels of psychosocial precursors of healthy eating are significantly poorer among food insecure populations compared with food-secure low-income participants. Our results point to specific behaviors that can be targeted in educational and skill building interventions seeking to address poor dietary practices among the food insecure.
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Affiliation(s)
- Nalini Ranjit
- School of Public Health in Austin, The University of Texas Health Science Center at Houston, Austin, TX.,Michael and Susan Dell Center for Healthy Living, Austin, TX
| | - Sarah Macias
- School of Public Health in Austin, The University of Texas Health Science Center at Houston, Austin, TX.,Michael and Susan Dell Center for Healthy Living, Austin, TX
| | - Deanna Hoelscher
- School of Public Health in Austin, The University of Texas Health Science Center at Houston, Austin, TX.,Michael and Susan Dell Center for Healthy Living, Austin, TX
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11
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Fultz AK, Rex SM, Mazelin A, McGarry C, Brewer B, Patterson F, Robson S. Examining fruit and vegetable intake in low-income older adults using the Veggie Meter®. Nutr Health 2021; 28:13-17. [PMID: 34100662 DOI: 10.1177/02601060211022275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Older adults report low fruit and vegetable (FV) intake. The lack of objective, field-based assessments of FV intake is a limitation when assessing the effectiveness of interventions. AIM To examine if self-reported FV intake was correlated with Veggie Meter® scores among low-income older adults. The Veggie Meter® is a portable tool that uses pressure-mediated reflection spectroscopy to estimate skin carotenoid measurements. METHODS A cross-sectional assessment of FV intake, food security, and Veggie Meter® score in low-income older adults was conducted. Bivariate analyses quantified the association between FV intake and Veggie Meter® score. RESULTS Participants (n = 154) were mostly female (69.3%), non-white (66.2%) and at risk for food insecurity (65.6%). Mean Veggie Meter® score was 172.3 ± 77.2 and had a small significant positive correlation with FV intake (r= 0.192, p = 0.018). CONCLUSION The Veggie Meter® may objectively indicate FV intake. Research to validate the Veggie Meter® in older, diverse populations is needed.
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Affiliation(s)
| | - Samantha M Rex
- University of Delaware, Department of Behavioral Health and Nutrition, USA.,Johns Hopkins University, Department of International Health, USA
| | - Audrey Mazelin
- University of Delaware, Department of Behavioral Health and Nutrition, USA
| | | | - Ben Brewer
- University of Delaware, College of Health Sciences, USA
| | - Freda Patterson
- University of Delaware, Department of Behavioral Health and Nutrition, USA
| | - Shannon Robson
- University of Delaware, Department of Behavioral Health and Nutrition, USA
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Cortés YI, Berry DC, Perreira KM, Stuebe A, Stoner L, Giscombé CW, Crandell J, Santíago L, Harris LK, Duran M. A multi-component, community-engaged intervention to reduce cardiovascular disease risk in perimenopausal Latinas: pilot study protocol. Pilot Feasibility Stud 2021; 7:10. [PMID: 33407947 PMCID: PMC7786946 DOI: 10.1186/s40814-020-00756-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 12/16/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) risk increases substantially during perimenopause. Latinas have a significantly worse CVD risk factor profile than non-Hispanic White women, potentially due to multiple sociocultural and environmental factors. To date, interdisciplinary interventions have not focused on improving nutrition, physical activity, stress management, and biologic CVD risk in perimenopausal Latinas. The purpose of this study is to examine the feasibility and initial efficacy of a multi-component intervention to reduce CVD risk in perimenopausal Latinas. METHODS This is a two-group, repeated measures experimental study. Eighty perimenopausal Latinas (age 40-55 years) from two community groups will be randomized: one group will complete the intervention; the other will be a wait-list control. The intervention consists of 12-weekly sessions (education, physical activity, stress management, coping skills training), followed by 3 months of continued support, and 6 months of skill maintenance on their own. The primary outcomes include arterial stiffness, blood pressure, lipids, and blood glucose. Secondary outcomes are health behaviors (nutrition, physical activity, sleep, coping strategies), self-efficacy, and other biological factors related to CVD risk (adiposity, C-reactive protein, hair cortisol, vasomotor symptoms). We will assess changes in outcomes from Time 1 (baseline) to Time 2 (6 months) and Time 3 (12 months) using general linear mixed models to test the hypotheses. We will also evaluate the feasibility of the intervention by assessing enrollment and retention rates, barriers, and facilitators to enrollment, intervention fidelity, the suitability of study procedures, and participant satisfaction with the intervention and study protocol. We hypothesize the intervention group will decrease biologic CVD risk and improve health behaviors and self-efficacy significantly more than the wait-list control. DISCUSSION Results from this study will contribute to knowledge on the feasibility of behavioral interventions, including stress management and coping skills training, which could reduce CVD burden among perimenopausal Latinas. Because Hispanic/Latinos are the largest ethnic minority in the United States (US), progress regarding CVD risk among perimenopausal Latinas may lead to significant improvement in the overall CVD burden in the US. TRIAL REGISTRATION Prospectively registered, NCT04313751 (03/19/2020), Protocol version 1.0.
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Affiliation(s)
- Yamnia I. Cortés
- School of Nursing, The University of North Carolina at Chapel Hill, Campus Box 7460, Chapel Hill, NC 27599-7460 USA
| | - Diane C. Berry
- School of Nursing, The University of North Carolina at Chapel Hill, Campus Box 7460, Chapel Hill, NC 27599-7460 USA
| | - Krista M. Perreira
- Department of Social Medicine, The University of North Carolina at Chapel Hill, 333 South Columbia Street, MacNider Hall, Campus Box 7240, Chapel Hill, NC 27599-7240 USA
| | - Alison Stuebe
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, The University of North Carolina at Chapel Hill, 3010 Old Clinic Building, Campus Box 7516, Chapel Hill, NC 27599-7516 USA
| | - Lee Stoner
- Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill, 306 Woollen Gym, Campus Box 8605, Chapel Hill, NC 27599-8605 USA
| | - Cheryl Woods Giscombé
- School of Nursing, The University of North Carolina at Chapel Hill, Campus Box 7460, Chapel Hill, NC 27599-7460 USA
| | - Jamie Crandell
- Department of Biostatistics, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Campus Box 7460, Chapel Hill, NC 27599-7460 USA
| | - Lymarí Santíago
- School of Nursing, The University of North Carolina at Chapel Hill, Campus Box 7460, Chapel Hill, NC 27599-7460 USA
| | - Latesha K. Harris
- School of Nursing, The University of North Carolina at Chapel Hill, Campus Box 7460, Chapel Hill, NC 27599-7460 USA
| | - Mayra Duran
- School of Nursing, The University of North Carolina at Chapel Hill, Campus Box 7460, Chapel Hill, NC 27599-7460 USA
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Murray EK, Baker SS, Betts NM, Hess A, Auld G. Development of a National Dietary Behaviors Questionnaire for EFNEP Adult Participants. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:1088-1099. [PMID: 32763052 DOI: 10.1016/j.jneb.2020.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 06/03/2020] [Accepted: 06/09/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Develop and establish the reliability and validity of dietary behavior evaluation questions for the Expanded Food and Nutrition Education Program (EFNEP). DESIGN A mixed-methods study using cognitive interviews, expert panels, test/retest reliability, and pretests/posttests. SETTING 14 states across the US. PARTICIPANTS A convenience sample of low-income EFNEP or EFNEP-eligible participants for cognitive interviews (n = 111), reliability testing (n = 181), and sensitivity to change testing (n = 382). MAIN OUTCOMES MEASURES Indicators of face and content validity, temporal reliability, and sensitivity to change. ANALYSIS Questions interpreted as intended in cognitive interviews, intraclass correlation coefficient and Spearman rank-order correlation for reliability testing; paired t tests or Wilcoxon signed-rank tests for sensitivity to change; and exploratory factor analyses to identify possible scales. RESULTS Cognitive interviews resulted in 3 rounds of question revisions; reliability value ranges were 0.48-0.77 for intraclass correlation coefficient and 0.43-0.77 for Spearman rank-order correlation. For sensitivity to change, 9 items had evidence of change (P < 0.05) between pretests and posttests, whereas 5 items had evidence for change after removing those with little room to change. Two scales were identified: diet quality and non-cheese dairy. CONCLUSIONS AND IMPLICATIONS The EFNEP's new dietary behavior evaluation questions demonstrated face and content validity, moderate to strong reliability, and sensitivity to detect self-reported behavior changes among low-income, diverse populations (culturally, racially/ethnically, and level of education) across 14 states. Nutrition education programs targeting similar behaviors with English speaking clients could consider this dietary behavior questionnaire.
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Affiliation(s)
- Erin K Murray
- Department of Nutrition, Metropolitan State University of Denver, Denver, CO
| | - Susan S Baker
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO.
| | - Nancy M Betts
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK
| | - Ann Hess
- Department of Statistics, Colorado State University, Fort Collins, CO
| | - Garry Auld
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
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14
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Steeves S, Acciai F, Tasevska N, DeWeese RS, Yedidia MJ, Ohri-Vachaspati P. The Special Supplemental Nutrition Program for Women, Infants, and Children Spillover Effect: Do Siblings Reap the Benefits? J Acad Nutr Diet 2020; 120:1288-1294. [PMID: 32402760 DOI: 10.1016/j.jand.2020.02.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 02/21/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Participation in the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC) among 0- to 5-year-old children is associated with healthier diets. Extension of dietary benefits to older, age-ineligible children (5-18 years old) residing in WIC households has not been fully investigated. OBJECTIVE Examine the association between household WIC participation and dietary behaviors of age-ineligible children. DESIGN Cross-sectional secondary analysis of data collected from 2 independent panels (2009-2010 and 2014) of the New Jersey Child Health Study, using household surveys. Questions derived from national surveys assessed consumption frequency of specific foods among 5- to 18-year-old children. PARTICIPANTS/SETTING The analytic sample included 616 age-ineligible children from households with incomes below 200% of the federal poverty level, 398 of whom were from WIC-participating households. MAIN OUTCOME MEASURES Eating behaviors were measured as frequency of daily consumption of fruit, vegetables, 100% juice, sugar-sweetened beverages, and sweet and salty snacks. STATISTICAL ANALYSIS Multivariable negative binomial models examined the association between eating behaviors and household WIC participation status adjusting for child's age, sex, and race; mother's education; city of residence; household size; and panel. Results are expressed as incidence rate ratios (IRRs). RESULTS Household WIC participation was not associated with dietary behaviors among age-ineligible children (5-18 years old) in the overall sample. However, healthier dietary patterns were observed for specific demographic groups. Compared with age-ineligible children in non-WIC households, age-ineligible children in WIC households had (1) a higher frequency of vegetable consumption among 12- to 18-year-old children (IRR = 1.29; 95% confidence interval [CI] 1.05-1.58; P = .015); (2) a marginally significant higher frequency of 100% juice consumption among females (IRR = 1.27; 95% CI 1.00-1.62; P = .053); and (3) a lower frequency of sugar-sweetened beverages consumption among Hispanic children (IRR = 0.61; 95% CI 0.43-0.86; P = .004). CONCLUSIONS Household WIC participation may positively influence dietary behaviors of age-ineligible children, suggesting a possible WIC spillover effect. Revisions to WIC package composition should consider the possible dietary implications for all children in the household.
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15
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Holmes H, Almeida VA, Boushey C, Banna J. Use of Technology for Dietary Assessment in Immigrant Populations. Am J Lifestyle Med 2020; 14:118-121. [PMID: 32231473 DOI: 10.1177/1559827619890948] [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: 11/17/2022] Open
Abstract
To determine the impact of educational programs on immigrant groups in the United States, nutrition educators must have assessment and evaluation tools that use the language and vocabulary of the target population. Filipino Americans exhibit health disparities with regard to several conditions and are an important target for nutrition education. Currently, there are no existing rigorously tested tools in the Tagalog language which also have a low user burden and are designed to measure diet for assessment and evaluation of nutrition education programs. As these programs are generally evaluated using time-intensive dietary assessment tools not tailored specifically to Filipinos, they may not effectively characterize the diet of this population. Given the high adoption rates of mobile phones by populations outside of the United States, mobile apps may represent a best choice for developing tools to assist individuals recently migrating to the United States or speaking English as an additional language. Several tools of this nature have been developed for immigrant groups and hold promise in terms of acceptability. Examples of dietary assessment tools using technology developed for Spanish speakers in the United States are provided. These methods may also be appropriate for addressing the needs of immigrant groups such as Filipinos.
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Affiliation(s)
- Hannah Holmes
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources (HH, VAA, JB), University of Hawaii at Manoa, Honolulu, Hawaii.,University of Hawaii Cancer Center (CB), University of Hawaii at Manoa, Honolulu, Hawaii
| | - Vanessa Araujo Almeida
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources (HH, VAA, JB), University of Hawaii at Manoa, Honolulu, Hawaii.,University of Hawaii Cancer Center (CB), University of Hawaii at Manoa, Honolulu, Hawaii
| | - Carol Boushey
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources (HH, VAA, JB), University of Hawaii at Manoa, Honolulu, Hawaii.,University of Hawaii Cancer Center (CB), University of Hawaii at Manoa, Honolulu, Hawaii
| | - Jinan Banna
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources (HH, VAA, JB), University of Hawaii at Manoa, Honolulu, Hawaii.,University of Hawaii Cancer Center (CB), University of Hawaii at Manoa, Honolulu, Hawaii
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16
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Armstrong B, Trude ACB, Johnson C, Castelo RJ, Zemanick A, Haber-Sage S, Arbaiza R, Black MM. CHAMP: A cluster randomized-control trial to prevent obesity in child care centers. Contemp Clin Trials 2019; 86:105849. [PMID: 31525490 DOI: 10.1016/j.cct.2019.105849] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 09/05/2019] [Accepted: 09/11/2019] [Indexed: 02/06/2023]
Abstract
Foundational elements of lifelong health are formed during the preschool years. Child care attendance has nearly doubled in the past 5 years making child care centers an ideal setting to establish healthy habits that prevent pediatric obesity. Despite the promising evidence of efficacy of child care-based obesity prevention interventions, limited attention has been directed to criteria needed for implementation at scale. There is potential to improve children's dietary and physical activity behaviors in diverse communities through theory-based, culturally appropriate, manualized interventions, delivered by child care staff. CHAMP (Creating Healthy Habits Among Maryland Preschoolers) is a 3-arm cluster randomized controlled childhood obesity prevention trial, aiming to improve motor skills, physical activity and willingness to try new foods among 864 preschoolers (age 3-5 years) enrolled in 54 child care centers in 10 Maryland counties. CHAMP is informed by social-cognitive and bioecological theories and based on an evidence-based program, The Food Friends®. The two intervention arms include: 1) child care-center based lessons (18-week gross motor and 12-week nutrition) administered by trained child care staff, and 2) a web-based intervention for caregivers in addition to center-based lessons. Evaluations are conducted among children, caregivers, and child care staff at fall enrollment, midline, and spring, following intervention completion. Analyses include linear mixed-models, accounting for clustering and repeated measures, incorporating center-arms as moderators. CHAMP will provide evidence-based information to inform wellness guidelines and policies that can be disseminated broadly, to ensure that child care centers provide opportunities for children to develop healthy eating, and physical activity habits. Trial Registration: NCT03111264; https://clinicaltrials.gov/ct2/show/NCT03111264.
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Affiliation(s)
- Bridget Armstrong
- University of Maryland Baltimore School of Medicine, Department of Pediatrics, United States of America
| | - Angela C B Trude
- University of Maryland Baltimore School of Medicine, Department of Pediatrics, United States of America
| | - Candace Johnson
- University of Maryland Baltimore School of Medicine, Department of Pediatrics, United States of America
| | - Romulus J Castelo
- University of Maryland Baltimore School of Medicine, Department of Pediatrics, United States of America
| | - Amy Zemanick
- University of Maryland Baltimore School of Medicine, Department of Pediatrics, United States of America
| | - Sophie Haber-Sage
- University of Maryland Baltimore School of Medicine, Department of Pediatrics, United States of America
| | - Raquel Arbaiza
- University of Maryland Baltimore School of Medicine, Department of Pediatrics, United States of America
| | - Maureen M Black
- University of Maryland Baltimore School of Medicine, Department of Pediatrics, United States of America; RTI International, Department of Pediatrics, United States of America.
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Banna J. Considerations for Evaluation of Fruit and Vegetable Intake in Low-Literate Spanish-Speaking Participants in USDA Food and Nutrition Education Programs. Am J Lifestyle Med 2019; 13:235-238. [PMID: 31105483 DOI: 10.1177/1559827618819414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Rates of obesity and associated chronic disease are high in Hispanics in the United States. Nutrition education interventions promoting dietary change in underserved populations have been shown to have positive effects on behaviors such as fruit and vegetable (FV) intake, thereby reducing the chronic disease burden. Evaluation tools in the Spanish language to assess the dietary behavior changes made in response to the intervention are important in determining the success of such efforts. Currently, there are no Spanish-language tools focused exclusively on FV intake and behaviors that include features to enhance readability for use in low-literacy participants of US Department of Agriculture (USDA) food assistance and education programs. There is a need for such tools to determine the degree to which programs are able to promote behavior change. In designing these tools, researchers should take into account potential issues that may arise when administered. For example, respondents may have difficulty estimating consumption for mixed dishes and vegetables added to food. To address such issues, researchers should employ strategies to assist respondents to understand what constitutes FV and appropriately identify amount consumed. Addition of images to tools or development of accompanying instruction guides may be helpful. Once developed and tested, such scales may be used with Spanish-speaking participants of USDA food assistance and education programs aimed at improving FV behaviors and ultimately, intake.
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Affiliation(s)
- Jinan Banna
- College of Tropical Agriculture and Human Resources, Honolulu, Hawaii
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18
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Rivera RL, Maulding MK, Eicher-Miller HA. Effect of Supplemental Nutrition Assistance Program–Education (SNAP-Ed) on food security and dietary outcomes. Nutr Rev 2019. [DOI: 10.1093/nutrit/nuz013 [doi]] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
AbstractThe Supplemental Nutrition Assistance Program–Education (SNAP-Ed) is the nutrition promotion component of SNAP, formerly known as food stamps. SNAP-Ed assists low-income populations in the United States improve dietary intake and reduce food insecurity through nutrition education. This narrative review summarizes current investigations of SNAP-Ed’s effectiveness at improving food security and dietary outcomes, and it can help inform future policy and implementation of the program. There was stronger evidence for SNAP-Ed as an effective means of improving food security (n = 4 reports) than for its effects on nutrition or dietary outcomes (n = 10 reports). Inconsistency in measurement tools and outcomes and a lack of strong study designs characterized the studies that sought to evaluate the effectiveness of SNAP-Ed at improving nutrition or dietary outcomes. Additional rigorous study designs in diverse population groups are needed to strengthen the evidence. In the face of reduced financial SNAP benefits, SNAP-Ed may play an important role in helping to eliminate food insecurity and improve dietary outcomes and, ultimately, the health of low-income Americans.
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Affiliation(s)
- Rebecca L Rivera
- Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA
| | - Melissa K Maulding
- Family Nutrition Program, Health and Human Sciences Cooperative Extension, Purdue University, West Lafayette, Indiana, USA
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19
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Rivera RL, Maulding MK, Eicher-Miller HA. Effect of Supplemental Nutrition Assistance Program–Education (SNAP-Ed) on food security and dietary outcomes. Nutr Rev 2019; 77:903-921. [PMID: 31077323 DOI: 10.1093/nutrit/nuz013] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AbstractThe Supplemental Nutrition Assistance Program–Education (SNAP-Ed) is the nutrition promotion component of SNAP, formerly known as food stamps. SNAP-Ed assists low-income populations in the United States improve dietary intake and reduce food insecurity through nutrition education. This narrative review summarizes current investigations of SNAP-Ed’s effectiveness at improving food security and dietary outcomes, and it can help inform future policy and implementation of the program. There was stronger evidence for SNAP-Ed as an effective means of improving food security (n = 4 reports) than for its effects on nutrition or dietary outcomes (n = 10 reports). Inconsistency in measurement tools and outcomes and a lack of strong study designs characterized the studies that sought to evaluate the effectiveness of SNAP-Ed at improving nutrition or dietary outcomes. Additional rigorous study designs in diverse population groups are needed to strengthen the evidence. In the face of reduced financial SNAP benefits, SNAP-Ed may play an important role in helping to eliminate food insecurity and improve dietary outcomes and, ultimately, the health of low-income Americans.
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Affiliation(s)
- Rebecca L Rivera
- Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA
| | - Melissa K Maulding
- Family Nutrition Program, Health and Human Sciences Cooperative Extension, Purdue University, West Lafayette, Indiana, USA
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20
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Begley A, Paynter E, Butcher LM, Bobongie V, Dhaliwal SS. Identifying Participants Who Would Benefit the Most from an Adult Food-literacy Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1272. [PMID: 30970671 PMCID: PMC6480264 DOI: 10.3390/ijerph16071272] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 04/04/2019] [Accepted: 04/05/2019] [Indexed: 11/25/2022]
Abstract
Food literacy programs aim to improve behaviours required to achieve a quality diet. The objectives of this study were to assess the demographic, food literacy related and dietary behaviour of participants enrolling in Food Sensations® for Adults, a free four-week food literacy program and identify the subgroup of participants who benefit most. Cross-sectional pre-program questionnaire data (n = 1626) from participants enrolling in the program was used to stratify into low, middle and high food-literacy tertiles. Factor scores from a reliability analysis of food literacy behaviours were then used to produce a composite score). Participants were 80.2% female, 56% aged 26 to 45 years and 73.3% from low to middle socio-economic areas. Demographic characteristics were not a significant predictor of the lowest composite food-literacy group. Those with the lowest composite food-literacy tertile score were more likely to have lower self-rated cooking skills, a negative attitude to the cost of healthy foods, lower intakes of fruits and vegetables and a higher frequency of consuming takeaway food and sugary drinks. Food literacy programs must focus on recruiting those who have low self-rated cooking skills, who consider healthy foods expensive and have poor dietary intakes and will most likely to benefit from such programs.
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Affiliation(s)
- Andrea Begley
- School of Public Health, Curtin University, Perth 6102, Australia; (E.P.); (S.S.D.)
| | - Ellen Paynter
- School of Public Health, Curtin University, Perth 6102, Australia; (E.P.); (S.S.D.)
| | - Lucy M. Butcher
- Foodbank Western Australia, Perth Airport 6105, Australia; (L.M.B.); (V.B.)
| | - Vanessa Bobongie
- Foodbank Western Australia, Perth Airport 6105, Australia; (L.M.B.); (V.B.)
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21
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Begley A, Paynter E, Butcher LM, Dhaliwal SS. Effectiveness of an Adult Food Literacy Program. Nutrients 2019; 11:nu11040797. [PMID: 30959958 PMCID: PMC6520903 DOI: 10.3390/nu11040797] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/01/2019] [Accepted: 04/01/2019] [Indexed: 11/16/2022] Open
Abstract
Nutrition education programs aim to improve food literacy domains covering the planning and management, selection, preparation and cooking and eating of healthy food. Reviews indicate programs are effective but acknowledge challenges with evaluation of community focused delivery. Food Sensations® for Adults (FSA) is a free four-week nutrition and cooking program targeted at low-to-middle income Western Australians who would like to improve their food literacy. The aim of this research was assess how effective FSA is in changing food literacy and selected dietary behaviours. Statistical analysis identified a significant increase in postprogram scores for domains of planning and management, selection and preparation using factor scores (n = 1092). The proportion of the score increase in the postprogram scores compared to the preprogram scores was 10–25%. There was also a significant increase in self-reported fruit and vegetable serve intake, equating to an average increase of ¼ serve/day of fruit and ½ serve/day of vegetables. Of those classified as low food literacy, 61–74% improved postprogram scores in the three domains. FSA is effective in improving food literacy and dietary behaviours and the results add to the evidence base as to how effective these programs can be and for whom they should be targeted for future success.
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Affiliation(s)
- Andrea Begley
- School of Public Health, Curtin University, Perth 6102, Australia.
| | - Ellen Paynter
- School of Public Health, Curtin University, Perth 6102, Australia.
| | - Lucy M Butcher
- Foodbank Western Australia, Perth Airport 6105, Australia.
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22
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Examining the Association between Food Literacy and Food Insecurity. Nutrients 2019; 11:nu11020445. [PMID: 30791670 PMCID: PMC6412525 DOI: 10.3390/nu11020445] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 02/15/2019] [Accepted: 02/15/2019] [Indexed: 11/28/2022] Open
Abstract
Poor food literacy behaviours may contribute to food insecurity in developed countries. The aim of this research was to describe the apparent prevalence of food insecurity in adults at enrolment in a food literacy program and to examine the relationship between food insecurity and a range of independent variables. Individuals attending the Food Sensations® for Adults program in Western Australia from May 2016 to April 2018 completed a pre-program questionnaire (n = 1433) indicating if they had run out of money for food in the past month (food insecurity indicator), frequency of food literacy behaviours, selected dietary behaviours, and demographic characteristics. The level of food insecurity reported by participants (n = 1379) was 40.5%. Results from multiple logistic regression demonstrated that behaviours related to planning and management, shopping, preparation, and cooking were all statistically independently associated with food insecurity, in addition to soft/soda drink consumption, education, employment status, and being born in Australia. The results are salient as they indicate an association between food literacy and food insecurity. The implications are that food insecure participants may respond differently to food literacy programs. It may be necessary to screen people enrolling in programs, tailor program content, and include comprehensive measures in evaluation to determine effect on the impact of food literacy programs on different subgroups.
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23
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Kirkpatrick SI, Guenther PM, Douglass D, Zimmerman T, Kahle LL, Atoloye A, Marcinow M, Savoie-Roskos MR, Dodd KW, Durward C. The Provision of Assistance Does Not Substantially Impact the Accuracy of 24-Hour Dietary Recalls Completed Using the Automated Self-Administered 24-H Dietary Assessment Tool among Women with Low Incomes. J Nutr 2019; 149:114-122. [PMID: 30602015 PMCID: PMC6904414 DOI: 10.1093/jn/nxy207] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 08/07/2018] [Indexed: 11/13/2022] Open
Abstract
Background Evidence is lacking informing the use of the Automated Self-Administered 24-h Dietary Assessment Tool (ASA24) with populations characterized by low income. Objective This study was conducted among women with low incomes to evaluate the accuracy of ASA24 recalls completed independently and with assistance. Methods Three hundred and two women, aged ≥18 y and with incomes below the Supplemental Nutrition Assistance Program thresholds, served themselves from a buffet; amounts taken as well as plate waste were unobtrusively weighed to enable calculation of true intake for 3 meals. The following day, women completed ASA24-2016 independently (n = 148) or with assistance from a trained paraprofessional in a small group (n = 154). Regression modeling examined differences by condition in agreement between true and reported foods; energy, nutrient, and food group intakes; and portion sizes. Results Participants who completed ASA24 independently and those who received assistance reported matches for 71.9% and 73.5% (P = 0.56) of items truly consumed, respectively. Exclusions (consumed but not reported) were highest for lunch (at which participants consumed approximately 2 times the number of distinct foods and beverages compared with breakfast and dinner). Commonly excluded foods were additions to main dishes (e.g., tomatoes in salad). On average, excluded foods contributed 43.6 g (46.2 kcal) and 40.1 g (43.2 kcal) among those in the independent and assisted conditions, respectively. Gaps between true and reported intake were different between conditions for folate and iron. Within conditions, significant gaps were observed for protein, vitamin D, and meat (both conditions); vitamin A, iron, and magnesium (independent); and folate, calcium, and vegetables (assisted). For foods and beverages for which matches were reported, no difference in the gap between true and reported portion sizes was observed by condition (P = 0.22). Conclusions ASA24 performed relatively well among women with low incomes; however, accuracy was somewhat lower than previously observed among adults with a range of incomes. The provision of assistance did not significantly impact accuracy.
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Affiliation(s)
- Sharon I Kirkpatrick
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada,Address correspondence to SIK (e-mail: )
| | - Patricia M Guenther
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT
| | | | | | - Lisa L Kahle
- Information Management Services, Inc., Rockville, MD
| | - Abiodun Atoloye
- Department of Nutrition, Dietetics and Food Sciences, Utah State University, Logan, UT
| | - Michelle Marcinow
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | | | - Kevin W Dodd
- Division of Cancer Prevention, National Cancer Institute, Bethesda, MD
| | - Carrie Durward
- Department of Nutrition, Dietetics and Food Sciences, Utah State University, Logan, UT
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24
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Evaluation Tool Development for Food Literacy Programs. Nutrients 2018; 10:nu10111617. [PMID: 30400130 PMCID: PMC6267114 DOI: 10.3390/nu10111617] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 10/15/2018] [Accepted: 10/23/2018] [Indexed: 11/24/2022] Open
Abstract
Food literacy is described as the behaviours involved in planning, purchasing, preparing, and eating food and is critical for achieving healthy dietary intakes. Food literacy programs require valid and reliable evaluation measures. The aim of this paper is to describe the development and validation of a self-administered questionnaire to measure food literacy behaviours targeted by the Food Sensations® for Adults program in Western Australia. Validity and reliability tests were applied to questionnaire item development commencing with (a) a deductive approach using Australian empirical evidence on food literacy as a construct along with its components and (b) adapting an extensively-tested food behaviour checklist to generate a pool of items for investigation. Then, an iterative process was applied to develop a specific food literacy behaviour checklist for program evaluation including exploratory factor analysis. Content, face, and construct validity resulted in a 14-item food behaviour checklist. Three factors entitled Plan & Manage, Selection, and Preparation were evident, resulting in Cronbach’s alpha 0.79, 0.76, and 0.81, respectively, indicating good reliability of each of these factors. This research has produced a validated questionnaire, is a useful starting point for other food literacy programs, and has applications globally.
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Banna J. Considerations for Evaluation of Diabetes Prevention Programs in Hispanic Adults in the United States. Am J Lifestyle Med 2018; 12:21-24. [PMID: 30202379 DOI: 10.1177/1559827617726503] [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: 11/16/2022] Open
Abstract
Hispanics are at high risk for diabetes. While there have been a number of diabetes prevention programs targeting Hispanics in the United States, not all recent studies focused on evaluating such programs have made use of validated tools to examine behavior change or examined acceptability and feasibility of the intervention. Tools used to assess behavioral outcomes such as diet should be tested to ensure validity and reliability. Acceptability may be examined using qualitative and quantitative measures to obtain feedback on the content of the intervention. Feasibility of the intervention may be evidenced by the enrollment, attendance, and attrition rates, as well as barriers or facilitators to participating in the program. Appropriate and comprehensive evaluation of such programs will allow for continued improvement of prevention efforts to address high rates of diabetes in this at-risk population.
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Affiliation(s)
- Jinan Banna
- Department of Human Nutrition, Food and Animal Sciences, University of Hawaii at Manoa, Honolulu, Hawaii
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Power JM, Bersamin A. A Text Messaging Intervention (Txt4HappyKids) to Promote Fruit and Vegetable Intake Among Families With Young Children: Pilot Study. JMIR Form Res 2018; 2:e13. [PMID: 30684412 PMCID: PMC6334673 DOI: 10.2196/formative.8544] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 03/25/2018] [Accepted: 04/24/2018] [Indexed: 12/02/2022] Open
Abstract
Background Increasing fruit and vegetable intake among low-income populations, especially children, is a priority for United States federal food assistance programs. With over 49 million federal food assistance program recipients, cost-effective and efficient methods are needed to effectively deliver nutrition education to such a large population. Objective The objective of our study was to examine the preliminary efficacy and acceptability of a text messaging intervention, Txt4HappyKids, to promote fruit and vegetable intake among families with young children. Methods The intervention was evaluated using a pre-post study design. Parents (N=72) in Alaska were recruited from venues that serve a predominantly low-income population to participate in an 11-week intervention based on social cognitive theory. Parents received two texts per week promoting child fruit and vegetable intake. Behaviors, self-efficacy, and attitudes related to fruit and vegetable intake were measured at baseline and postintervention. Perceived changes in behaviors and open-ended feedback were also collected postintervention. Results Of all participants, 67.3% (72/107) completed the intervention. We found no changes in behavior (P=.26), self-efficacy (P=.43), or attitudes (P=.35) related to fruit and vegetable intake from pre- to postintervention. Completers reported that since their participation in Txt4HappyKids, 92% (66/72) served more fruits and vegetables to their child because they thought fruits and vegetables were beneficial, 86% (62/72) tried to follow a healthier diet, 85% (61/72) tried different ways of preparing fruits and vegetables, and 81% (58/72) were more aware of the foods their child consumes. Additionally, 79% (57/72) of completers thought that Txt4HappyKids was credible, 71% (51/72) found texts useful, and 82% (59/72) would recommend it to a friend. Conclusions A text messaging intervention was not sufficient to increase fruit and vegetable intake among families with young children. However, parents felt positively impacted by Txt4HappyKids and were receptive to nutrition information, despite the absence of face-to-face contact. High satisfaction among completers indicates that text messaging may be an acceptable complement to budget-constrained nutrition programs. These findings are an important first step in developing larger multi-level interventions utilizing mobile technology; however, a more rigorous evaluation of the Txt4HappyKids intervention is warranted.
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Affiliation(s)
- Julianne Mary Power
- Center for Alaska Native Health Research, Institute of Arctic Biology, University of Alaska Fairbanks, Fairbanks, AK, United States
| | - Andrea Bersamin
- Center for Alaska Native Health Research, Institute of Arctic Biology, University of Alaska Fairbanks, Fairbanks, AK, United States
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Townsend MS, Shilts MK, Styne DM, Drake C, Lanoue L, Ontai L. An Obesity Risk Assessment Tool for Young Children: Validity With BMI and Nutrient Values. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2018; 50:705-717. [PMID: 29567008 DOI: 10.1016/j.jneb.2018.01.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 01/28/2018] [Accepted: 01/29/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Demonstrate validity and reliability for an obesity risk assessment tool for young children targeting families' modifiable home environments. DESIGN Longitudinal design with data collected over 100 weeks. SETTING Head Start and the Special Supplemental Nutrition Program for Women, Infants, and Children. PARTICIPANTS Parent-child pairs (n = 133) provided food behavior assessments; 3 child-modified, 24-hour dietary recalls; 3 ≥ 36-hour activity logs; and measured heights and weights. MAIN OUTCOME MEASURE Five measures of validity and 5 of reliability. RESULTS Validity was excellent for the assessment tool, named Healthy Kids, demonstrating an inverse relationship with child body mass index percentile-for-age (P = .02). Scales were significantly related to hypothesized variables (P ≤ .05): fruit or vegetable cup equivalents; folate; vitamins A, C, and D; β-carotene; calcium; fiber; sugar; screen, sleep, and physical activity minutes; and parent behaviors. Measures of reliability were acceptable. CONCLUSIONS AND IMPLICATIONS Overall, children with higher Healthy Kids scores had a more healthful profile as well as lower body mass index percentiles-for-age 1.5 years later. Healthy Kids has potential for use by nutrition professionals as a screening tool to identify young children most at risk for excess weight gain, as an evaluation to assess intervention impact, and as a counseling tool to tailor intervention efforts. Future research should include validation in other settings and with other populations.
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Affiliation(s)
| | - Mical K Shilts
- Department of Family and Consumer Sciences, California State University at Sacramento, Sacramento, CA
| | - Dennis M Styne
- Department of Pediatrics, University of California at Davis, Davis, CA
| | - Christiana Drake
- Department of Statistics, University of California at Davis, Davis, CA
| | - Louise Lanoue
- Department of Nutrition, University of California at Davis, Davis, CA
| | - Lenna Ontai
- Cooperative Extension, University of California at Davis, Davis, CA
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Morrison EJ, Clark MM, Wieland ML, Weis JA, Hanza MMK, Meiers SJ, Patten CA, Sloan JA, Novotny PJ, Sim LA, Nigon JA, Sia IG. Relationship Between Negative Mood and Health Behaviors in an Immigrant and Refugee Population. J Immigr Minor Health 2018; 19:655-664. [PMID: 27669717 DOI: 10.1007/s10903-016-0506-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Immigrants experience an escalation of negative health behaviors after arrival to the United States. Negative mood is associated with poorer health behaviors in the general population; however, this relationship is understudied in immigrant populations. Adolescent (n = 81) and adult (n = 70) participants completed a health behavior survey for immigrant families using a community-based participatory research approach. Data was collected for mood, nutrition, and physical activity. Adolescents with positive mood drank less regular soda, and demonstrated more minutes, higher levels, and greater social support for physical activity (all ps < .05). Adults with positive mood reported more snacking on fruits/vegetables, greater self-efficacy for physical activity, and better physical well-being (all ps < .05). Negative mood was associated with low physical activity level and poor nutritional habits in adolescent and adult immigrants. Designing community-based programs offering strategies for mood management and healthy lifestyle change may be efficacious for immigrant populations.
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Affiliation(s)
- Eleshia J Morrison
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Matthew M Clark
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Mark L Wieland
- Division of Primary Care Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Jennifer A Weis
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, USA
| | | | - Sonja J Meiers
- Department of Nursing, Winona State University, Rochester, MN, USA
| | - Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Jeff A Sloan
- Division of Biostatistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Paul J Novotny
- Division of Biostatistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Leslie A Sim
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | | | - Irene G Sia
- Division of Infectious Diseases, Mayo Clinic, Rochester, MN, USA.
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Srivastava G, Palmer KD, Ireland KA, McCarthy AC, Donovan KE, Manders AJ, McDougal J, Lenders CM, Apovian CM. Shape-Up and Eat Right Families Pilot Program: Feasibility of a Weight Management Shared Medical Appointment Model in African-Americans With Obesity at an Urban Academic Medical Center. Front Pediatr 2018; 6:101. [PMID: 29707530 PMCID: PMC5906543 DOI: 10.3389/fped.2018.00101] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 03/27/2018] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES Disparities in obesity care exist among African-American children and adults. We sought to test the feasibility of a pilot program, a 1-year family-based intervention for African-American families with obesity [shape up and eat right (SUPER)], adopting the shared medical appointment model (SMA) at an urban safety net hospital. OUTCOMES Primary outcomes: (1) family attendance rate and (2) program satisfaction. Secondary outcomes: change in body mass index (BMI), eating behaviors, and sedentary activity. METHODS Adult parents (BMI ≥ 25 kg/m2) ≥18 years and their child(ren) (BMI ≥ 85th percentile) ages 6-12 years from adult or pediatric weight management clinics were recruited. One group visit per month (n = 12) consisting of a nutrition and exercise component was led by a nurse practitioner and registered dietitian. Height and weight were recorded during each visit. Participants were queried on program satisfaction, food logs and exercise journals, Food Stamp Program's Food Behavior, and the Expanded Food and Nutrition Education Program food checklists. RESULTS Thirteen participants from lower socioeconomic zip codes consented [n = 5 mothers mean age 33 years, BMI of 47.4 kg/m2 (31.4-73.6 kg/m2); n = 8 children; mean age 9 years, BMI of 97.6th percentile (94-99th percentile); 60% enrolled in state Medicaid]. Average individual attendance was 23.4% (14-43%; n = 13); monthly session attendance rates declined from 100 to 40% by program completion; two families completed the program in entirety. Program was rated (n = 5 adults) very satisfactory (40%) and extremely satisfactory (60%). Pre-intervention, families rated their eating habits as fair and reported consuming sugar-sweetened beverages or sports drinks, more so than watching more than 1 h of television (p < 0.002) or video game/computer activity (p < 0.006) and consuming carbonated sodas (p < 0.004). Post-intervention, reducing salt intake was the only statistically significant variable (p < 0.029), while children watched fewer hours of television and spent less time playing video games (from average 2 to 3 h daily; p < 0.03). CONCLUSION Attendance was lower than expected though children seemed to decrease screen time and the program was rated satisfactory. Reported socioeconomic barriers precluded families from attending most sessions. Future reiterations of the intervention could be enhanced with community engagement strategies to increase participant retention.
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Affiliation(s)
- Gitanjali Srivastava
- Nutrition and Weight Management Research Center, Boston Medical Center, Department of Medicine, Section of Endocrinology, Diabetes, Nutrition and Weight Management, Boston University School of Medicine, Boston, MA, United States
| | - Kenya D Palmer
- Nutrition and Weight Management Research Center, Boston Medical Center, Department of Medicine, Section of Endocrinology, Diabetes, Nutrition and Weight Management, Boston University School of Medicine, Boston, MA, United States
| | - Kathy A Ireland
- Nutrition and Fitness for Life Program, Boston Medical Center, Department of Pediatrics, Boston University School of Medicine, Boston, MA, United States
| | - Ashley C McCarthy
- Nutrition and Weight Management Research Center, Boston Medical Center, Department of Medicine, Section of Endocrinology, Diabetes, Nutrition and Weight Management, Boston University School of Medicine, Boston, MA, United States
| | - Kate E Donovan
- Nutrition and Fitness for Life Program, Boston Medical Center, Department of Pediatrics, Boston University School of Medicine, Boston, MA, United States
| | - Aaron J Manders
- Nutrition and Fitness for Life Program, Boston Medical Center, Department of Pediatrics, Boston University School of Medicine, Boston, MA, United States
| | - Juhee McDougal
- Department of Medicine, Section of General Internal Medicine, Boston University School of Medicine, Boston, MA, United States
| | - Carine M Lenders
- Nutrition and Fitness for Life Program, Boston Medical Center, Department of Pediatrics, Boston University School of Medicine, Boston, MA, United States
| | - Caroline M Apovian
- Nutrition and Weight Management Research Center, Boston Medical Center, Department of Medicine, Section of Endocrinology, Diabetes, Nutrition and Weight Management, Boston University School of Medicine, Boston, MA, United States
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Using pre- and post-survey instruments in interventions: determining the random response benchmark and its implications for measuring effectiveness. Public Health Nutr 2017; 21:1043-1047. [PMID: 29262871 DOI: 10.1017/s1368980017003639] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The present communication demonstrates that even if individuals are answering a pre/post survey at random, the percentage of individuals showing improvement from the pre- to the post-survey can be surprisingly high. Some simple formulas and tables are presented that will allow analysts to quickly determine the expected percentage of individuals showing improvement if participants just answered the survey at random. This benchmark percentage, in turn, defines the appropriate null hypothesis for testing if the actual percentage observed is greater than the expected random answering percentage. DESIGN The analysis is demonstrated by testing if actual improvement in a component of the US Department of Agriculture's (USDA) Expanded Food and Nutrition Education Program is significantly different from random answering improvement. SETTING USA. SUBJECTS From 2011 to 2014, 364320 adults completed a standardized pre- and post-survey administered by the USDA. RESULTS For each year, the statement that the actual number of improvements is less than the expected number if the questions were just answered at random cannot be rejected. This does not mean that the pre-/post-test survey instrument is flawed, only that the data are being inappropriately evaluated. CONCLUSIONS Knowing the percentage of individuals showing improvement on a pre/post survey instrument when questions are randomly answered is an important benchmark number to determine in order to draw valid inferences about nutrition interventions. The results presented here should help analysts in determining this benchmark number for some common survey structures and avoid drawing faulty inferences about the effectiveness of an intervention.
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Patterns of food and physical activity environments related to children's food and activity behaviors: A latent class analysis. Health Place 2017; 49:19-29. [PMID: 29156415 DOI: 10.1016/j.healthplace.2017.11.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Revised: 10/09/2017] [Accepted: 11/02/2017] [Indexed: 11/20/2022]
Abstract
Relationships between food and physical activity (PA) environments and children's related behaviors are complex. Latent class analyses derived patterns from proximity to healthy and unhealthy food outlets, PA facilities and parks, and counts of residential dwellings and intersections. Regression analyses examined whether derived classes were related to food consumption, PA, and overweight among 404 low-income children. Compared to children living in Low PA-Low Food environments, children in High Intersection&Parks-Moderate Density&Food, and High Density-Low Parks-High Food environments, had significantly greater sugar-sweetened beverage consumption (ps<0.01) and overweight/obesity (ps<0.001). Children in the High Density-Low Parks-High Food environments were more likely to walk to destinations (p = 0.01) Recognizing and leveraging beneficial aspects of neighborhood patterns may be more effective at positively influencing children's eating and PA behaviors compared to isolating individual aspects of the built environment.
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Suzuki A, Choi SY, Lim E, Tauyan S, Banna JC. Evaluation of Factorial Validity and Reliability of a Food Behavior Checklist for Low-Income Filipinos. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2017; 49:593-598.e1. [PMID: 28689613 PMCID: PMC5612474 DOI: 10.1016/j.jneb.2017.04.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 04/25/2017] [Accepted: 04/26/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To examine factorial validity, test-retest reliability, and internal consistency of a Tagalog-language food behavior checklist (FBC) for a low-income Filipino population. METHODS Participants (n = 160) completed the FBC on 2 occasions 3 weeks apart. Factor structure was examined using principal component analysis. For internal consistency, Cronbach α was calculated. For test-retest reliability, Spearman correlation or intraclass correlation coefficient (ICC) was calculated between scores at the 2 points. RESULTS All but 1 item loaded on 6 factors: fruit and vegetable quantity, fruit and vegetable variety, fast food, sweetened beverage, healthy fat, and diet quality. Cronbach α was .75 for the total scale (range, .39-.76 for subscales). Spearman correlation was 0.78 (ICC, 0.79) for the total scale (range, 0.66-0.80 [ICC, 0.68-0.80] for subscales). CONCLUSIONS AND IMPLICATIONS The FBC demonstrated adequate factorial validity, test-retest reliability, and internal consistency. With additional testing, the FBC may be used to evaluate the US Department of Agriculture's nutrition education programs for Tagalog speakers.
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Affiliation(s)
- Asuka Suzuki
- Department of Human Nutrition, Food, and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa, Honolulu, HI
| | - So Yung Choi
- Biostatistics Core Facility, Department of Complementary & Integrative Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI
| | - Eunjung Lim
- Biostatistics Core Facility, Department of Complementary & Integrative Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI
| | - Socorro Tauyan
- Department of Human Nutrition, Food, and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa, Honolulu, HI
| | - Jinan C Banna
- Department of Human Nutrition, Food, and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa, Honolulu, HI.
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Townsend MS, Shilts MK, Styne DM, Drake C, Lanoue L, Woodhouse L, Allen LH. Vegetable behavioral tool demonstrates validity with MyPlate vegetable cups and carotenoid and inflammatory biomarkers. Appetite 2016; 107:628-638. [DOI: 10.1016/j.appet.2016.09.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 08/09/2016] [Accepted: 09/02/2016] [Indexed: 11/25/2022]
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Bihuniak JD, Ramos A, Huedo-Medina T, Hutchins-Wiese H, Kerstetter JE, Kenny AM. Adherence to a Mediterranean-Style Diet and Its Influence on Cardiovascular Risk Factors in Postmenopausal Women. J Acad Nutr Diet 2016; 116:1767-1775. [PMID: 27568885 DOI: 10.1016/j.jand.2016.06.377] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 06/24/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND A Mediterranean-style diet (MedSD) is associated with positive health outcomes, particularly reduced risk of cardiovascular disease. It is of interest to assess the feasibility of adherence to a MedSD in a subset of older adults in the United States. OBJECTIVE To assess the efficacy of implementing a MedSD intervention in a subset of postmenopausal women living in the United States, and to detect the influence of this dietary pattern on blood lipid levels. DESIGN A partial feeding, nutrition counseling, pilot study with a one-group longitudinal design. PARTICIPANTS Sixteen healthy, postmenopausal, American women living in suburban communities in Farmington, CT, with a mean±standard deviation age of 77±6.8 years and a body mass index of 26.1±3.1. INTERVENTION Participants were counseled by a registered dietitian nutritionist on how to follow a MedSD, which included increased sources of n-3 polyunsaturated fatty acids, fruits, and vegetables, and decreased saturated fat, n-6 polyunsaturated fatty acids, and simple sugars for 12 weeks. To maintain isocaloric conditions, participants were asked to substitute sources of saturated fat and refined carbohydrates for extra virgin olive oil (3 T/day), walnuts (1.5 oz/day), and fatty fish (3 to 5 servings/wk), which were provided at 3-week intervals. MAIN OUTCOME MEASURES Dietary adherence measures included the Mediterranean Diet Score, 3-day diet records, and serum fatty acid and lipid profiles. STATISTICAL ANALYSES Mixed model longitudinal analyses were conducted to assess changes over time (Weeks 0, 12, and 24) in the outcome variables. RESULTS Mediterranean Diet Score increased by 8.9 points (P<0.001) after the MedSD phase. Dietary sugar decreased by 10.8 g (P<0.05), total dietary n-3 increased by 1.6 g (P<0.01), total dietary n-6 increased by 5.5 g (P<0.01), and dietary n-6:n3 ratio decreased by 3.6 units (P<0.01). In serum, 22:6 (n-3), 20:5 (n-3), and 18:3 (n-3) increased (P<0.001, P<0.01, and P<0.001, respectively), and 14:0, 16:0, 17:0, 20:4 (n-6), 22:4 (n-6) declined after the intervention (P<0.01, P<0.001, P<0.01, P<0.01, and P<0.001, respectively), which support a change in dietary intake toward a MedSD. Serum high-density lipoprotein cholesterol levels increased by 3.8 mg/dL (0.098 mmol/L) (P<0.05) and serum triglyceride levels decreased by 11.6 mg/dL (0.131 mmol/L) (P<0.10). CONCLUSIONS A pilot study of a 12-week MedSD intervention with counseling from a registered dietitian nutritionist can favorably influence the dietary pattern and lipid profile of postmenopausal women living in the United States.
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Pojednic R, Peabody S, Carson S, Kennedy M, Bevans K, Phillips EM. The effect of before school physical activity on child development: A study protocol to evaluate the Build Our Kids Success (BOKS) Program. Contemp Clin Trials 2016; 49:103-8. [PMID: 27339866 DOI: 10.1016/j.cct.2016.06.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 06/17/2016] [Accepted: 06/18/2016] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Most childhood physical activity interventions focus on reducing childhood obesity with varying success, indicating that body mass index (BMI) may be a limited marker of health in children. To better understand overall childhood health and wellbeing, this study is investigating BOKS (Build Our Kids Success), an established ongoing before-school physical activity program, to evaluate students' physical health, mental health, cognitive capacity, and academic performance. DESIGN AND METHODS The study is a non-randomized controlled trial with 26 elementary and middle schools in 3 Massachusetts communities, including first through eighth grade (aged 5-14) students, their parents, and teachers. Data collection is occurring during the 2015-2016 school year. Physical fitness is being assessed via 400m run and anthropometrics via height and weight measures (BMI). Psychosocial outcomes are being assessed via student, parent, and teacher survey and include nutrition, daily activities, emotional and relationship scales, bullying and victimization, vitality and energy, student engagement, stress, positive affect, self-efficacy and life satisfaction. Academic performance is reported by grades. Statistical methods include a psychometric evaluation of study measures, Pearson correlations, Student's t-tests, ANOVA/ANCOVA and multivariate linear regression including multilevel modeling analyses to account for the hierarchical organization of the data. DISCUSSION This study is investigating a before school physical activity program on parameters of physical health, mental health, cognitive capacity, and academic performance by employing a novel triad approach, correlating the input of the child, parent, and teacher. Outcomes will evaluate the effectiveness of a before school physical activity program in elementary and middle schools and potentially provide valuable information for schools looking to institute innovative physical activity programs.
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Affiliation(s)
- Rachele Pojednic
- Institute of Lifestyle Medicine, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United States.
| | - Stephanie Peabody
- Institute of Lifestyle Medicine, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United States
| | - Shelley Carson
- Institute of Lifestyle Medicine, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United States
| | - Mary Kennedy
- Institute of Lifestyle Medicine, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United States
| | - Katherine Bevans
- University of Pennsylvania School of Medicine, Philadelphia, PA, United States
| | - Edward M Phillips
- Institute of Lifestyle Medicine, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United States
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Lorts C, Ohri-Vachaspati P. Eating behaviors among low-income obese adults in the United States: Does health care provider's advice carry any weight. Prev Med 2016; 87:89-94. [PMID: 26876632 PMCID: PMC4884458 DOI: 10.1016/j.ypmed.2016.02.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 01/19/2016] [Accepted: 02/06/2016] [Indexed: 10/22/2022]
Abstract
The U.S. Preventive Task Force recommends that all patients be screened for obesity and given appropriate weight loss advice, if needed, as nutrition counseling by primary care physicians is a key objective for Healthy People 2020. This study assesses the association between health care provider's (HCP) advice to lose weight and eating behaviors among obese individuals. Data were collected using a household survey of adults in five New Jersey cities in 2009-10. Analyses presented are limited to 548 obese participants. Negative-binomial regression analysis determined the association of participants' eating behaviors and HCP's advice to lose weight, after adjusting for the participant's attempt to lose weight and demographic variables. Despite being obese, only 48% of the participants received weight loss advice from their HCP while 68% stated they were attempting to lose weight. HCP's advice to lose weight was associated with increased salad and fruit consumption (PR 1.3, 95% CI 1.06-1.61; PR 1.23, 95% CI 1.02-1.48). Attempting to lose weight was positively associated with a higher consumption of fruit (PR 1.39, 95% CI 1.13-1.72), vegetables (PR 1.22, 95% CI 1.07-1.39), and with eating fruits and vegetables as snacks (PR 1.62, 95% CI 1.28-2.05). Attempting to lose weight was negatively associated with consumption of sweet snacks (PR 0.68, 95% CI 0.49-0.94), sugar sweetened beverages (PR 0.71, 95% CI 0.58-0.87) and fast food (PR 0.77, 95% CI 0.62-0.97). There were no significant interactions between HCP's advice and attempts to lose weight. Obese adult's attempt to lose weight, and not HCP's advice to lose weight, was a predictor for healthy eating behaviors. Interventions in medical practices should train HCPs on effective strategies for motivating obese patients to adopt healthier lifestyles.
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Affiliation(s)
- Cori Lorts
- School of Nutrition and Health Promotion, Arizona State University, 550 N. 3rd Street, Phoenix, AZ 85004, United States.
| | - Punam Ohri-Vachaspati
- School of Nutrition and Health Promotion, Arizona State University, 550 N. 3rd Street, Phoenix, AZ 85004, United States.
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Banna JC, Buchthal OV, Tauyan S. Assessing Face Validity of a Food Behavior Checklist for Limited-resource Filipinos. HAWAI'I JOURNAL OF MEDICINE & PUBLIC HEALTH : A JOURNAL OF ASIA PACIFIC MEDICINE & PUBLIC HEALTH 2015; 74:334-40. [PMID: 26535163 PMCID: PMC4610259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Diet-related chronic health conditions are prevalent in the Filipino American community; however, there is a lack of rigorously validated nutrition education evaluation tools in Tagalog for use in this population. This study aimed to develop and evaluate the face validity of a Tagalog-language food behavior checklist (FBC). A multi-step method was used, involving translation of questionnaire text from English to Tagalog by a team of professionals, creation of accompanying color photographs, cognitive testing with the target population, final review by the team of professionals, and assessment of readability. Subjects for cognitive testing were men (n=6) and women (n=14) 18 years or older in Hawai'i who received or were eligible to receive Supplemental Nutrition Assistance Program (SNAP) benefits, self-identified as Filipino, and preferred Tagalog rather than English. Participants were recruited from churches, the Filipino Center, and other community sites. Cognitive interviews revealed several issues with text and photographs, such as preferences for specific terms, and images that did not adequately illustrate the text. Image changes were made to reflect items most commonly consumed. The team of professionals agreed with participant suggestions. Assessment of readability revealed a reading level appropriate for a low-literacy population of grade 5.9. The multi-step process, which allowed members of the target audience to reveal the appropriateness of the questionnaire, yielded a Tagalog-language FBC found to have adequate face validity. After further evaluation of validity and reliability, this tool may be used to evaluate behavior change resulting from the United States Department of Agriculture's (USDA) nutrition education programs.
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Affiliation(s)
- Jinan C Banna
- Department of Human Nutrition, Food, and Animal Sciences, University of Hawai'i at Manoa, Honolulu, HI (JCB, ST)
| | - Opal Vanessa Buchthal
- Department of Human Nutrition, Food, and Animal Sciences, University of Hawai'i at Manoa, Honolulu, HI (JCB, ST)
| | - Socorro Tauyan
- Department of Human Nutrition, Food, and Animal Sciences, University of Hawai'i at Manoa, Honolulu, HI (JCB, ST)
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Murray DW, Mahadevan M, Gatto K, O’Connor K, Fissinger A, Bailey D, Cassara E. Culinary efficacy: an exploratory study of skills, confidence, and healthy cooking competencies among university students. Perspect Public Health 2015; 136:143-51. [DOI: 10.1177/1757913915600195] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims: This study was conducted to determine whether a group of college-age students in New Jersey, USA, had the requisite culinary skills, knowledge, and confidence to take personal control of their meal planning and production. The long-term threat to the public health systems posed by high rates of obesity among young adults in higher education institutions has garnered widespread attention across the world. Studies have shown that assuming personal responsibility over preparing and consuming food can play a key role in addressing the problem of poor nutrient intakes. Methods: Focus groups were conducted with students ( N = 24) who fit the eligibility criteria of not having a university meal plan, and living independently at the time of the study (not with family members). The sessions were recorded, transcribed, and then coded into themes. Two trained research assistants tested the results and inter-rater reliability was confirmed. Results: Content analysis revealed three major themes: Health Perceptions, Life influences, and Barriers to Cooking and Eating Healthy. The students’ comments indicated that while they had a basic knowledge of the key principles of eating a balanced diet, it may not have necessarily translated into actual food choices and cooking practices. Several students reported an overreliance on processed and prepared foods, and they consumed few fruits and vegetables. Conclusions: Factors such as lack of culinary knowledge and skill, financial instability, inadequate access to healthy food options, and other time/lifestyle constraints may have played a significant role in limiting their ability to prepare and consume healthy meals. The findings of this study highlight the importance of designing programmes with effective strategies to motivate and encourage college students to improve their food behaviours and practices.
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Lim SS, Gold A, Gaillard PR, Wey A, Reicks M. Validation of 2 Brief Fruit and Vegetable Assessment Instruments Among Third-Grade Students. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2015; 47:446-51.e1. [PMID: 26153663 DOI: 10.1016/j.jneb.2015.05.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2014] [Revised: 05/21/2015] [Accepted: 05/21/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To evaluate the validity of 2 brief instruments to estimate fruit and vegetable (FV) intake among third-grade children. METHODS Children from an elementary school and a community center (n = 107) completed 2 retrospective questions for FV intake (fruit and vegetable questionnaire [FVQ]) and a food record (A Day in the Life Questionnaire [DILQ]) to estimate FV intake. Agreement between intake based on these instruments and 3 24-hour dietary recalls was determined. RESULTS Disattenuated Pearson correlation coefficients ranged from 0.40 to 0.69 for FV intake; however, the low reliability of multiple 24-hour recalls may have inflated the strength of the correlations. Altman-Bland difference plots suggested that the FVQ overestimated FV intake whereas the DILQ overestimated fruit and underestimated vegetable intake. Limits of agreement were wide for both tools, indicating poor overall agreement. CONCLUSIONS AND IMPLICATIONS The FVQ and DILQ were not valid instruments to evaluate FV consumption under current study conditions. Other assessment methods and instruments should be considered for young children.
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Affiliation(s)
| | - Abby Gold
- Department of Public Health, North Dakota State University, Fargo, ND
| | | | - Andrew Wey
- Biostatistics and Data Management Core, University of Hawaii, Honolulu, HI
| | - Marla Reicks
- Department of Food Science and Nutrition, University of Minnesota, St. Paul, MN
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A systematic review of brief dietary questionnaires suitable for clinical use in the prevention and management of obesity, cardiovascular disease and type 2 diabetes. Eur J Clin Nutr 2015; 69:977-1003. [DOI: 10.1038/ejcn.2015.6] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 12/04/2014] [Accepted: 01/05/2015] [Indexed: 11/08/2022]
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Role modeling as an early childhood obesity prevention strategy: effect of parents and teachers on preschool children's healthy lifestyle habits. J Dev Behav Pediatr 2014; 35:378-87. [PMID: 25007060 DOI: 10.1097/dbp.0000000000000074] [Citation(s) in RCA: 108] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess the effectiveness of a child care center-based parent and teacher healthy lifestyle role-modeling program on child nutrition and physical activity outcomes. METHODS Child care centers (N = 28) serving low-income families were randomized to intervention or control arms. Intervention centers (N = 12) implemented (1) menu modifications, (2) a child's healthy lifestyle curriculum, and (3) an adult (teacher- and parent-focused) healthy lifestyle role-modeling curriculum. Control centers (N = 16) received an attention control safety curriculum. Nutrition and physical activity data were collected at the beginning (T1) and at the end (T2) of the school year. Exploratory factor analysis identified positive and negative nutrition and physical activity practices by children, parents, and teachers. RESULTS Intervention parents' baseline (β = .52, p < .0001) and school year consumption (β = .47, p < .0001) of fruits/vegetables significantly increased their children's consumption of fruits/vegetables from T1 to T2. Intervention parents significantly influenced a decrease in children's junk food consumption (β = -.04, p < .05), whereas control parents significantly influenced an increase in their children's junk food consumption (β = .60, p < .001) from T1 to T2. Control children showed a significant increase in junk food consumption (β = .11, p = .01) and sedentary behavior (β = .09, p < .005) from T1 to T2. Teachers did not significantly influence preschool-age children's nutrition or physical activity patterns from T1 to T2. CONCLUSIONS Parent nutrition and physical activity patterns significantly influence their preschool-age children's consumption of fruits/vegetables, junk food, and level of sedentary behavior. Future obesity prevention intervention efforts targeting this age group should include parents as healthy lifestyle role models for their children.
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Mackey AD, Albrecht D, Oliver J, Williams T, Long AC, Price PT. Plasma carotenoid concentrations of infants are increased by feeding a milk-based infant formula supplemented with carotenoids. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2013; 93:1945-1952. [PMID: 23255208 DOI: 10.1002/jsfa.5996] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2012] [Revised: 10/15/2012] [Accepted: 11/16/2012] [Indexed: 06/01/2023]
Abstract
BACKGROUND Human milk is the gold standard of infant nutrition and is a source of important substances, including carotenoids. Infant formulas are designed to mimic the composition and/or performance of human milk, although currently carotenoids are not routinely added to US infant formulas. The aim of this study was to assess plasma concentrations of β-carotene, lutein and lycopene 56 days after feeding infants milk-based infant formula without (CTRL) or with different concentrations of added carotenoids (L1 and L2). RESULTS Plasma carotenoid concentrations increased in infants fed carotenoid-supplemented formulas as compared with the control formula with no added carotenoids. At study day 56, infants fed the supplemented formulas (L1 and L2) had mean plasma lutein, β-carotene and lycopene concentrations that were within the range of a concurrent group of human milk-fed infants (HM). Anthropometric measurements were comparable among all study groups. CONCLUSION Plasma carotenoid concentrations of infants fed the supplemented formulas were within the range of the HM group and are consistent with reported plasma carotenoid ranges in human milk-fed infants. The experimental formulas were well tolerated and anthropometric measurements were comparable among all study groups.
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Affiliation(s)
- Amy D Mackey
- Abbott Nutrition, Abbott Laboratories, 3300 Stelzer Road, Columbus, OH 43219, USA
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Hunter J, Leeder S. Patient questionnaires for use in the integrative medicine primary care setting—A systematic literature review. Eur J Integr Med 2013. [DOI: 10.1016/j.eujim.2013.02.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Aaron GJ, Keim NL, Drewnowski A, Townsend MS. Estimating dietary costs of low-income women in California: a comparison of 2 approaches. Am J Clin Nutr 2013; 97:835-41. [PMID: 23388658 PMCID: PMC3607657 DOI: 10.3945/ajcn.112.044453] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Currently, no simplified approach to estimating food costs exists for a large, nationally representative sample. OBJECTIVE The objective was to compare 2 approaches for estimating individual daily diet costs in a population of low-income women in California. DESIGN Cost estimates based on time-intensive method 1 (three 24-h recalls and associated food prices on receipts) were compared with estimates made by using less intensive method 2 [a food-frequency questionnaire (FFQ) and store prices]. Low-income participants (n = 121) of USDA nutrition programs were recruited. Mean daily diet costs, both unadjusted and adjusted for energy, were compared by using Pearson correlation coefficients and the Bland-Altman 95% limits of agreement between methods. RESULTS Energy and nutrient intakes derived by the 2 methods were comparable; where differences occurred, the FFQ (method 2) provided higher nutrient values than did the 24-h recall (method 1). The crude daily diet cost was $6.32 by the 24-h recall method and $5.93 by the FFQ method (P = 0.221). The energy-adjusted diet cost was $6.65 by the 24-h recall method and $5.98 by the FFQ method (P < 0.001). CONCLUSIONS Although the agreement between methods was weaker than expected, both approaches may be useful. Additional research is needed to further refine a large national survey approach (method 2) to estimate daily dietary costs with the use of this minimal time-intensive method for the participant and moderate time-intensive method for the researcher.
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Affiliation(s)
- Grant J Aaron
- Program in International and Community Nutrition and the Department of Nutrition, University of California, Davis, CA 95616, USA
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45
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Comparison of a Web-Based vs In-Person Nutrition Education Program for Low-Income Adults. J Acad Nutr Diet 2013; 113:120-6. [DOI: 10.1016/j.jand.2012.07.034] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Accepted: 07/23/2012] [Indexed: 11/21/2022]
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Lee JY, Cho DS, Kim HJ. The effect of salt usage behavior on sodium intake and excretion among Korean women. Nutr Res Pract 2012; 6:232-7. [PMID: 22808348 PMCID: PMC3395789 DOI: 10.4162/nrp.2012.6.3.232] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Revised: 05/29/2012] [Accepted: 05/29/2012] [Indexed: 11/05/2022] Open
Abstract
This study was done to explore the effect of Korean women's salt usage behavior on their sodium intake and excretion according to aging. Dietary sodium intake and salt usage behavior were analyzed to compare the difference between young and middle-aged women. One hundred fifty six young women and 77 middle-aged women without hypertension or any current medication were recruited. Body mass index, waist hip ratio, blood pressure were measured from each subject. Salt usage behaviors were surveyed with questionnaire, sodium intake with 24-hr recall method, and sodium excretion with spot urine. Middle-aged women were more obese than young women according to body mass index and waist hip ratio. Blood pressure was significantly higher for the middle-aged. Young women consumed more fats and middle-aged women more carbohydrates. Middle-aged women consumed more sodium and potassium, and excreted more sodium. Among questionnaire items, kimchi, soup or pot stew, or salted vegetables were found to be related with high sodium diet. Salted vegetables and salted nuts and potato chips were significantly correlated with young women's high sodium diet, while soy sauce on fried food, kimchi, salted vegetables accounted for middle-aged women's high sodium diet. With these results, we concluded that middle-aged women consumed more carbohydrates, less fat, and more sodium and potassium than young women. Middle-aged women frequently choose kimchi, soup or pot stew, or salted vegetables, and they contribute to high sodium intake. We recommend to choose low-salt kimchi, less soup or pot stew, and more fresh vegetables for lower sodium diet.
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Affiliation(s)
- Jeung Yun Lee
- Department of Food and Nutrition, Eulji University, Seongnam 461-713, Korea
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47
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Cornélio ME, Gallani MCBJ, Godin G, Rodrigues RCM, Nadruz W, Mendez RDR. Behavioural determinants of salt consumption among hypertensive individuals. J Hum Nutr Diet 2012; 25:334-44. [DOI: 10.1111/j.1365-277x.2012.01238.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Kim HY, Kwon S, Lee JS, Choi YS, Chung HR, Kwak TK, Park J, Kang MH. Development of a Nutrition Quotient (NQ) equation modeling for children and the evaluation of its construct validity. ACTA ACUST UNITED AC 2012. [DOI: 10.4163/kjn.2012.45.4.390] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Hye-Young Kim
- Department of Food & Nutrition, Yongin University, Yongin 449-714, Korea
| | - Sehyug Kwon
- Department of Statistics, Hannam University, Daejeon 306-791, Korea
| | - Jung-Sug Lee
- FANSA (Food and Nutrition Statistical Analysis), Seoul 153-764, Korea
| | - Young-Sun Choi
- Department of Food & Nutrition, Daegu University, Gyeongsan 712-714, Korea
| | | | - Tong-Kyung Kwak
- Department of Food & Nutrition, Yonsei University, Seoul 120-749, Korea
| | | | - Myung-Hee Kang
- Department of Food & Nutrition, Daeduk Valley Campus, Hannam University, Daejeon 305-811, Korea
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Dickin KL, Lent M, Lu AH, Sequeira J, Dollahite JS. Developing a measure of behavior change in a program to help low-income parents prevent unhealthful weight gain in children. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2012; 44:12-21. [PMID: 21996430 DOI: 10.1016/j.jneb.2011.02.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2010] [Revised: 02/14/2011] [Accepted: 02/21/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To develop and test a brief measure of changes in eating, active play, and parenting practices after an intervention to help parents shape children's choices and home environments. DESIGN Sequential phases of development and testing: expert panel review, cognitive testing interviews, field testing, test-retest study, and assessment of convergence with detailed previously validated instruments. SETTING AND PARTICIPANTS Expanded Food and Nutrition Education Program (EFNEP), New York State. Low-income parents of 3- to 11-year-old children; Cooperative Extension nutrition and parenting educators. MAIN OUTCOME MEASURES Questionnaire reliability, validity, respondent comprehension, and feasibility of use in program contexts. ANALYSIS Qualitative analysis of item comprehension. Correlational analysis of test-retest reliability and convergent validity. RESULTS A behavior checklist was developed to assess change in parent-reported family eating, physical activity, and parenting practices addressed by an intervention. The checklist was feasible for use in EFNEP and questions were understood as intended. Test-retest reliability was good (r = 0.83) and scores correlated significantly (range, 0.25 to -0.60; P < .05) with detailed measures of dietary habits, parental modeling, physical activity, and home environment. CONCLUSIONS AND IMPLICATIONS Development and testing in a program context produced a tool community nutritionists can use to evaluate educational interventions aimed at helping parents promote healthful eating and activity.
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Affiliation(s)
- Katherine L Dickin
- Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA.
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Adedze P, Chapman-Novakofski K, Witz K, Orr R, Donovan S. Knowledge, attitudes, and beliefs about nutrition and childhood overweight among WIC participants. FAMILY & COMMUNITY HEALTH 2011; 34:301-310. [PMID: 21881417 DOI: 10.1097/fch.0b013e31822b53dd] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This study assessed knowledge, attitudes, and beliefs about nutrition, physical activity, and health risks related to childhood overweight among Women, Infants, and Children participants. Most (n = 165) were knowledgeable about causes/health risks of overweight (90%). The belief that "some people are born big or thin . . . " varied by education level (P < 0.05). Concerning activity, many (white non-Hispanic, 53%; African-American 69%) reported their children spending 2 to 3 hours per day watching television and playing video games, with 10% white non-Hispanic and 21% of African-American reporting 4 hours or more (P < 0.05). Beliefs related to the risk of overweight and activity level of the children differed among ethnic groups.
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Affiliation(s)
- Pascasie Adedze
- Division of Nutritional Sciences & Department of Food Science and Human Nutrition, University of Illinois, Urbana-Champaign, Urbana, IL 61801, USA
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