Estimates of fruit and vegetable intake in childhood and adult dietary behaviors of African American women

Developing and Validating the Preschool Nutrition Education Practices Survey

OBJECTIVE

Validate the Preschool Nutrition Education Practices Survey.

DESIGN

Iterative approach combining design-based research and Standards for Educational and Psychological Testing.

SETTING

Los Angeles, CA and Philadelphia, PA Early Care and Education (ECE) classrooms.

PARTICIPANTS

Expert panel members (n = 7); ECE teachers: interviews (n = 8), pilot survey (n = 31), and final survey (n = 136).

VARIABLES MEASURED

Early care and education nutrition education practices used in the classroom either during class time or mealtime.

ANALYSIS

Qualitative content analysis was implemented for content, response process, and consequences of testing validity evidence. Rasch rating scale analysis was conducted for the response process and internal structure validity and reliability evidence.

RESULTS

Qualitative field-testing produced strong content, response process, and consequences of testing validity evidence to inform survey modifications. Quantitative field-testing generated a psychometrically sound, well-targeted 12-item survey on a 4-point frequency scale with excellent item and person reliability (0.97 and 0.93 respectively) and separation (5.36 and 3.77 respectively); good Rasch Principal Components Analysis findings (60.3%); and productive item fit statistics (0.50-1.50 logits).

CONCLUSIONS AND IMPLICATIONS

Robust validity (content, response process, consequences of testing, internal structure) and reliability evidence were demonstrated for using the Preschool Nutrition Education Practices Survey to assess ECE teachers' use of nutrition education practices. Future research is needed to examine its relationship to other variables, such as nutrition teaching efficacy, and to determine its ability to detect change in ECE nutrition education practices over time and across groups.

Predicting Hawaiian Youth's Physical Activity and Fruit and Vegetable Consumption Behaviors: A 10-Year Cohort Study

Background: Health behaviors in childhood and adolescence are implicated in health behaviors and chronic disease risk in adulthood for the majority of the US population. However, little is known about these relationships in Hawaiian youth. This study investigated the extent to which childhood physical activity (PA) and fruit and vegetable consumption behaviors predicted later behaviors across a 10-year period in Hawaiian youth. Methods: Three cohorts of fourth- to sixth-grade students who participated in an elementary after-school program (Fun 5) provided baseline data (Y1-data collected between 2003 and 2007), 5-year (Y5-data collected between 2008 and 2012), and 10-year (Y10-data collected between 2013 and 2017) follow-up surveys. Demographic, PA, and fruit and vegetable consumption measures were completed at all 3 time points. Bivariate and multiple regressions were computed in 2018. Results: Y1 and Y5 behavior predicted PA in young adulthood. For fruit and vegetable consumption, Y1 behavior predicted Y5 behavior but not Y10 behavior, and Y5 behavior predicted Y10 behaviors. Conclusions: Similar to mainland US youth, it is important to address PA and nutrition early in the life span for Hawaiian youth to increase long-term preventive health behaviors and reduce long-term chronic disease risk.

Increasing vegetable intake in Mexican-American youth: a randomized controlled trial

Despite the health benefits, vegetable intake in youth remains below recommended levels. The purpose of our study was to compare two methods for increasing vegetable consumption. It was hypothesized that participants randomized to both the exposure-only and the pairing condition would increase their vegetable consumption and increase the variety of vegetables consumed. A total of 78 Mexican-American middle school-aged children from a charter school in Houston, TX, were randomized to a pairing condition (n=40) or an exposure-only condition (n=38) during the Spring 2009 semester. Children in the pairing condition were provided a preferred taste (peanut butter) paired with vegetables weekly at school during a nutrition class for 4 months. Children in the exposure-only condition received vegetables weekly during a nutrition class that covered the same material as the pairing condition. After 4 months, the pairing condition participants demonstrated significant increases in vegetable consumption (F=13.40, P<0.001) as well as variety of vegetables eaten (F=13.69, P<0.001) when compared to those in the exposure-only condition. The findings of this study suggest that the pairing of vegetables with a preferred taste, such as peanut butter, may be an effective technique in increasing consumption, especially in children who report being resistant to eating vegetables.

Knowledge of young African American adults about heart disease: a cross-sectional survey

Background

African Americans have higher rates of cardiovascular disease (CVD) mortality than other ethnic groups. Young adults are prime targets for intervention strategies to prevent and reduce disease risk. The study purpose was to determine the level of knowledge of lifestyle risk factors for CVD among young African American adults in Phoenix. The results will be used to guide the development of CVD outreach programs targeted to this population. The Health Belief Model was used as a conceptual framework.

Methods

A convenience sample of 172 African American men and women aged 18-26 years completed a questionnaire adapted from the American Heart Association national surveys. Descriptive statistics were compared by age, gender, education level, and health status variables including BMI, smoking status, and physical activity.

Results

Some aspects of heart-disease were well known among young adult African Americans. Knowledge of certain other important risk factors (menopause) and preventive behaviors (eating fewer animal products), however, was more variable and inconsistent among the respondents. Differences in knowledge of individual variables was greater by education level than by gender overall. Predictors of a summary CVD knowledge score included higher education, female gender, and high self-efficacy (adjusted R² = 0.158, p < .001). Predictors of self-efficacy in changing CVD risk were higher education and perceived low risk of CVD (adjusted R² = 0.064, p < .001), but these characteristics explained only 6% of the variance.

Conclusions

Evaluation of baseline knowledge of CVD is essential before designing and implementing health promotion programs. Existing strengths and weaknesses in knowledge can guide tailoring of programs to be more effective. Further research would help to identify the range of other characteristics that determine knowledge and risk perception.

Which circulating antioxidant vitamins are confounded by socioeconomic deprivation? The MIDSPAN family study

BACKGROUND

Antioxidant vitamins are often described as having "independent" associations with risk of cancer, cardiovascular disease (CVD) and mortality. We aimed to compare to what extent a range of antioxidant vitamins and carotenoids are associated with adulthood and childhood markers of socioeconomic deprivation and to adverse lifestyle factors.

METHODS AND FINDINGS

Socioeconomic and lifestyle measures were available in 1040 men and 1298 women from the MIDSPAN Family Study (30-59 years at baseline) together with circulating levels of vitamins A, C, E, and carotenoids (alpha-carotene, beta-carotene, lutein and lycopene). Markers of socioeconomic deprivation in adulthood were consistently as strongly associated with lower vitamin C and carotenoid levels as markers of adverse lifestyle; the inverse association with overcrowding was particularly consistent (vitamin C and carotenoids range from 19.1% [95% CI 30.3-6.0] to 38.8% [49.9-25.3] lower among those in overcrowded residencies). These associations were consistent after adjusting for month, classical CVD risk factors, body mass index, physical activity, vitamin supplements, dietary fat and fibre intake. Similar, but weaker, associations were seen for childhood markers of deprivation. The association of vitamin A or E were strikingly different; several adult adverse lifestyle factors associated with higher levels of vitamin A and E, including high alcohol intake for vitamin A (9.5% [5.7-13.5]) and waist hip ratio for vitamin E (9.5% [4.8-14.4]), with the latter associations partially explained by classical risk factors, particularly cholesterol levels.

CONCLUSIONS

Plasma vitamin C and carotenoids have strong inverse associations with adulthood markers of social deprivation, whereas vitamin A and E appear positively related to specific adverse lifestyle factors. These findings should help researchers better contextualize blood antioxidant vitamin levels by illustrating the potential limitations associated with making causal inferences without consideration of social deprivation.

Fruit and Vegetable Intake In Canadian Ethnic Populations

Purpose: We explored whether Canada's diverse ethnic population consumes an adequate daily amount of fruit and vegetables. We also examined the association between fruit and vegetable consumption and long-term diseases.

Methods: The Canadian Community Health Survey, Cycle 2.2 (CCHS 2.2), was used to determine the fruit and vegetable intake (FVI) of 13 racial groups, as well as of the entire population. Specifically, we determined median intake and proportions of the group consuming five or more daily servings. Multiple pairwise comparisons among the proportions were performed to detect ethnic groups with significantly low FVI. Logistic regression was also used to describe the risk of longterm diseases associated with FVI and ethnicity.

Results: The percentages of Southeast Asian, Aboriginal (offreserve), and Chinese people who consumed five or more daily servings of fruit and vegetables were significantly lower than percentages in all other ethnic groups surveyed. Aboriginal people with the lowest FVI demonstrated the highest propensity for developing most of the long-term diseases.

Conclusions: The majority of Canada's ethnic groups identified in the CCHS 2.2 fell short of the recommended FVI target. This low-intake status might be a risk factor for common long-term diseases.

Determinants of low-fat eating behaviors among midlife African American women

OBJECTIVE

The purpose of this study was to explore midlife African American women's low-fat eating habits in the context of health attitudes, social support, and food preferences.

DESIGN

A cross-sectional design was used.

SETTINGS

One Midwestern and 1 national African American women's organization were targeted for data collection.

PARTICIPANTS

African American women between the ages of 45 and 64.

MAIN OUTCOME MEASURES

Health Attitudes Scale, Social Support Scale, Eating Behaviors subscale, and Low-Fat Eating subscale.

ANALYSIS

A hierarchical multiple regression analysis was performed.

RESULTS

Highly educated women did not engage in better eating habits than women with less education. Family members provided more criticism and friends provided more encouragement for healthful eating. However, only family encouragement and criticism for healthful eating and food preferences remained predictive of low-fat eating habits in midlife African American women in the final regression model.

CONCLUSIONS AND IMPLICATIONS

Changing attitudes may not influence changes in behaviors. Women experience family support as a significant influence to eating habits. Future nutrition interventions should be inclusive of women at every educational level and have a multidimensional focus that targets family involvement and changing behaviors.

Dietary behaviors and portion sizes of black women who enrolled in SisterTalk and variation by demographic characteristics

OBJECTIVE

To describe the dietary behaviors of black women who enrolled in the SisterTalk weight control study.

DESIGN

Baseline data collected via telephone survey and in-person screening.

SETTING

Boston, Massachusetts and surrounding areas.

PARTICIPANTS

461 black women completed the baseline assessments.

MAIN OUTCOME MEASURES

Measured height and weight; self-reported demographics, risk factors, and dietary variables including fat-related eating behaviors, food portion size, and fruit, vegetable, and beverage intake.

ANALYSIS

Analysis of variance (ANOVA) models with food habits questionnaire (FHQ) scores as the dependent variable and demographic categories as the independent variables; ANOVA models with individual FHQ item scores as the dependent variable and ethnic identification as the independent variable.

RESULTS

More than 60% reported eating < 5 servings of fruits and vegetables/day. Self-reported portion sizes were large for most food items. Older age, being born outside the United States, living without children, and being retired were significantly associated with a higher prevalence of fat-lowering behaviors. The frequency of specific fat-lowering behaviors and portion size also differed by ethnic identification.

CONCLUSIONS AND IMPLICATIONS

The findings support the need for culturally appropriate interventions to improve the dietary intake of black Americans. Further studies should examine the dietary habits, food preparation methods, and portion sizes of diverse groups of black women.

Psychosocial and demographic predictors of fruit, juice and vegetable consumption among 11–14-year-old Boy Scouts

Objective

Psychosocial and demographic correlates of fruit, juice and vegetable (FJV) consumption were investigated to guide how to increase FJV intake.

Design

Hierarchical multiple regression analysis of FJV consumption on demographics and psychosocial variables.

Setting

Houston, Texas, USA.

Subjects

Boys aged 11–14 years (n= 473).

Results

FJV preference and availability were both significant predictors of FJV consumption, controlling for demographics and clustering of Boy Scout troops. Vegetable self-efficacy was associated with vegetable consumption. The interaction of preference by home availability was a significant predictor of FJV. The interaction of self-efficacy by home availability showed a trend towards significantly predicting vegetable consumption. No significant interactions were found between body mass index and the psychosocial variables.

Conclusions

Findings suggest that future interventions emphasising an increase in preference, availability and efficacy may increase consumption of FJV in similar populations.

Types of food aversions: animal, vegetable, and texture

Despite a growing body of research investigating the origins and effects of food aversions, few research instruments have been developed to measure aversions to specific types or categories of food. Undergraduates (N = 209) responded to a series of food aversion questionnaires. The results suggest that people tend to be averse to 2 types of foods (vegetables and meats or fats) and to the texture and taste of certain foods (e.g., oysters). Aversions were slightly more prevalent among women than among men and were correlated with lower educational levels. The authors provide a means of advancing future research on this problem by reliably identifying 3 categories of food aversions. Future researchers should evaluate additional food categories and expand the focus on food aversions beyond the current concern with learned avoidance of specific food items.

An ecological approach to understanding contributions to disparities in diabetes prevention and care

This paper highlights causes of disparities associated with the prevention and treatment of diabetes. An ecological approach is presented that depicts interactions among the social, institutional, and physical environments that may serve to further exacerbate these disparities. Recommendations for change, including enhanced cultural training, participatory involvement of communities to develop solutions, and implementing policies that equalize environmental exposures across populations, are recommended.

Models for nutrition education to increase consumption of calcium and dairy products among African Americans

Calcium and dairy consumption are documented to be low among African Americans and have demonstrated benefits to bone growth, overall nutritional status, and health throughout the life cycle. There is also an emerging relationship to the prevention of obesity. This low consumption has been attributed to both cultural and community/environmental barriers. Using a life course construct and an ecological model of health behavior, this paper will illustrate why nutrition education and food consumption behavior at one stage of the life cycle may influence health status at that stage as well as influence health and consumption of calcium and dairy products at subsequent stages. The life course construct recognizes that both past and present behavior and experiences (in this case food and nutrient intake) are shaped by the wider social, economic, and cultural context and therefore may provide clues to current patterns of health and disease. The ecological model, concerned with constructs of environmental change, behavior, and policies that may help people make choices in their daily life, complements the life course approach when examining the potential influence of nutrition education provided by federally funded food and nutrition programs on calcium and dairy consumption behavior across the life cycle. The "critical period model" within the life course construct is operative for calcium, a nutrient for which adequate intake is critically important during adolescence when peak bone density development, necessary for later protection against osteoporosis, is important.