The relationship between education and food consumption in the 1995 Australian National Nutrition Survey

How French children food representations and tastes vary according to their social backgrounds: a study of disparities in food habitus

The diet of individuals is influenced by social and cultural factors. Children's food tastes and representations, being principally transmitted by their parents, are likely to depend on their social backgrounds. As it is known that parents' feeding strategies and food education differ depending on their social positions, this study aimed at examining how food representations and tastes vary among children. A qualitative sociological study, using semi-structured interviews, was conducted with 40 children, aged from 9 to 11 years, from four French elementary schools. Results showed that children from disadvantaged social backgrounds mentioned less foods, seemed to have a less varied diet, to consume less vegetables, and to enjoy eating ultra-processed foods more than other children. Different food habitus were found, that can be put into perspective using Bourdieu's distinction theory, including different preoccupations regarding health and necessity among social groups. Disparities in children's food habitus could be theoretically linked with observed and growing social inequalities in health, when taking into consideration the potential practises that these habitus imply, and their probable effects on health. Participatory food education classes at school could aim to reduce such disparities, although some concerns and limits must be acknowledged.

Diet Quality Changes by Educational Level among Adults in Spain from 2017 to 2021

Despite increasing attention on addressing socioeconomic disparities in diet quality, longitudinal studies are scarce. Furthermore, the effects of the COVID-19 pandemic on diet-related outcomes are yet to be fully understood. We examined changes in diet quality by educational level among adults in Madrid, Spain. We used data from recruitment (in 2017) and from 2021. At baseline, our sample included 1358 adults aged 40-75 years who were free of cardiovascular disease and completed a validated diet quality screener. Of them, 931 answered the survey in the follow-up visit in 2021. We used participants' diet quality index scores (range: 18-54; higher scores indicate better diet quality) as the dependent variable. As our independent variable, we assessed participants' educational levels (low, medium, and high). We fitted a multinomial regression using the categories of educational level as the main predictor, adjusting for age, sex, country of origin, and household composition. During the study period, 78.0% of participants sustained their diet quality, 11.6% improved it, and 10.4% moved away from a healthier dietary pattern. In descriptive analyses, we observed an increase in diet quality among less-educated females. Unadjusted multinomial models showed that a lower educational level predicted both increases and decreases in diet quality over the period. Even though the median diet quality scores did not change significantly, we observed heterogeneous changes over the four years. Variability within diet, with some improving and some worsening, seems to have increased among participants with lower educational levels. Future studies should look at the determinants of change in these population subgroups.

Variations in food security status and associated factors: a comparative study across rural-urban interface in north of Bengaluru

The paper makes an attempt to analyze the food consumption pattern, food security status, and factors influencing food security. The study revealed that, among different items of consumption, the use of cereals was higher among the households across the gradients. Rural households derived most of their calorie from cereals. Across rural-urban interface, total consumption was relatively higher in urban area (38.44 kg/CU/month) followed by transition and rural areas. The total energy derived from the consumption of different food items was the highest in urban area (2491.90 Kcal/capita/day) followed by transition (2415.82 Kcal/capita/day) and rural area (2383.28 Kcal/capita/day). The households residing in urban area showed higher Simpson Index of Dietary Diversity (0.81) followed by transition (0.80) and rural (0.77) areas. The percentage of food secure households was highest in urban areas (76.25%) followed by transition (63.75%) and rural (58.75%) areas. Regression analysis revealed that education, monthly income of the sample households, and their localization in urban area were significant determinants of food security. The study concludes the prevalence of food insecurity and suggested the need for strengthening existing food security programmes, besides creating awareness among households to move toward balanced diet by diversifying their production, income, and consumption pattern.

A Comparison of Dietary Patterns and Factors Influencing Food Choice among Ethnic Groups Living in One Locality: A Systematic Review

Globally, the number of minority ethnic groups in high-income countries is increasing. However, despite this demographic change, most national food consumption surveys are not representative of ethnically diverse populations. In consequence, many ethnic minorities' dietary intakes are underreported, meaning that accurate analysis of food intake and nutrient status among these groups is not possible. This systematic review aims to address these gaps and understand differences in dietary intakes and influencers of dietary habits of ethnic groups worldwide. A systematic search was conducted through three databases (Pubmed, Web of Science and Scopus) and manual searches, generating n = 56,647 results. A final search of these databases was completed on 13 September 2021, resulting in a total of 49 studies being included in this review. Overall, food group intakes-particularly fruit, vegetable and fish intake-and diet quality scores were seen to differ between ethnicities. Overall Black/African American groups were reported to be among the poorest consumers of fruit and vegetables, whilst Asian groups achieved high diet quality scores due to higher fish intakes and lower fat intakes compared to other groups. Limited data investigated how nutrient intakes, dietary and meal patterns compared between groups, meaning that not all aspects of dietary intake could be compared. Socioeconomic status and food availability appeared to be associated with food choice of ethnic groups, however, confounding factors should be considered more closely. Future work should focus on comparing nutrient intakes and meal patterns between ethnicities and investigate potential targeted interventions which may support adherence to food-based dietary guidelines by all ethnic groups.

Nutrition-related knowledge, practice, and weight status of patients with chronic diseases attending a district hospital in Nigeria

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Australians' experience, barriers and willingness towards consuming edible insects as an emerging protein source

Increasing global populations and limitations on the natural resources required in food production such as land and water will place further pressure on an already strained food production system. To meet the future food production requirements, it is essential to find viable alternatives to current food sources, without the high resource challenges. Protein production is of particular concern and insects are a nutritious and sustainable source yet, despite a rich history in parts of the world, Australians have been reluctant to adopt the practice as a societal norm. This study aimed to explore Australian consumers' experiences with edible insects, identify barriers to consumption, and explore possible factors that may motivate Australians to consume insects. A total of 601 participants (23.8% male, 76.2% female), completed an online survey using a variety of open-ended questions; 5- or 7-point Likert scales and check-all-that-apply questions. Consumer willingness was measured through self-reporting willingness-to-try insects or insect-based foods. Results indicated 35.4% of participants had previously consumed insects, with Orthoptera (crickets, grasshoppers) the most commonly consumed order (60.1%). Participants with no previous experience consuming insects cited 'lack of opportunity' as the main reason (57.2%). 'Increased accessibility' (56.6%) and 'increased nutrition knowledge' (56.6%) were identified as major factors that may increase the likelihood of future insect consumption. Participants reporting that they were willing to try insects were most likely to accept 'insect-based flour' (65.6%) and 'chocolate-covered ants' (52.1%). By providing increased opportunity, accessibility and education of insect-based food products, a higher proportion of Australians may be willing to eat insects, particularly if presented in indistinguishable forms (i.e. flour). This may lead to a greater acceptance of insects as an alternative, more sustainable protein source than previously anticipated.

A policy construction for sustainable rice food sovereignty in Indonesia

As an agricultural country with large natural resources, Indonesia still has considerable problems in managing food security. This is evidenced by the lack of agricultural land and human resources that can support people's food needs so that the government still imports food from other countries. These issues as; it are feared that population growth and high food consumption power, social exclusion (marginalization of agricultural laborers and agricultural land) will cause food security vulnerability in the future. This Mixed method quantitative and qualitative method by statistical and in-depth interview study involving 169 respondents from many stakeholders such as politicians, academicians, farmers, and students to determine policy construction for sustainable rice food sovereignty in Indonesia. The statistical study shows the rice consumption in Indonesia is correlated to education than the age and gender of the respondents. The study indicating problems such as; the welfare of farmers, the application of price limits for staple goods, and improving the quality of agriculture both natural resources, human resources and the provision of agricultural equipment assistance have not been resolved properly. To build food security, it should be balanced with the application of the concept of food sovereignty which is realized by aligning and maximizing competence between political resources, environmental resources capacity, and environmental diplomacy.

Omega-3 fatty acid intake and decreased risk of skin cancer in organ transplant recipients

PURPOSE

Organ transplant recipients have over 100-fold higher risk of developing skin cancer than the general population and are in need of further preventive strategies. We assessed the possible preventive effects of omega-3 polyunsaturated fatty acid (PUFA) intake from food on the two main skin cancers, squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) in kidney and liver transplant recipients.

METHODS

Adult kidney or liver transplant recipients transplanted for at least 1 year and at high risk of skin cancer were recruited from the main transplant hospital in Queensland, 2012-2014 and followed until mid-2016. We estimated their dietary total long-chain omega-3 PUFAs and α-linolenic acid intakes at baseline using a food frequency questionnaire and ranked PUFA intakes as low, medium, or high. Relative risks (RRs_adj) of skin cancer adjusted for confounding factors with 95% confidence intervals (CIs) were calculated.

RESULTS

There were 449 transplant recipients (mean age, 55 years; 286 (64%) male). During follow-up, 149 (33%) patients developed SCC (median 2/person; range 1-40) and 134 (30%), BCC. Transplant recipients with high total long-chain omega-3 PUFA compared with low intakes showed substantially reduced SCC tumour risk (RR_adj 0.33, 95% CI 0.18-0.60), and those with high α-linolenic acid intakes experienced significantly fewer BCCs (RR_adj 0.40, 95% CI 0.22-0.74). No other significant associations were seen.

CONCLUSION

Among organ transplant recipients, relatively high intakes of long-chain omega-3 PUFAs and of α-linolenic acid may reduce risks of SCC and BCC, respectively.

Dietary inequity? A systematic scoping review of dietary intake in low socio-economic groups compared with high socio-economic groups in Australia

OBJECTIVE

Low socio-economic groups (SEG) in Australia suffer poorer diet-related health than the rest of the population. Therefore, it is expected that low SEG are less likely to consume diets conforming to Australian Dietary Guidelines (ADG) than higher SEG. However, dietary intake of low SEG in Australia has not been synthesised methodically. This systematic scoping review aims to explore detailed dietary intake of low SEG in Australia in comparison to higher SEG.

DESIGN

A systematic search of peer-reviewed literature and websites, since 1999. Data were extracted, synthesised and analysed in relation to study populations, dietary assessment methods, food groups studied, socio-economic measures and dietary intake.

SETTING

Australia.

PARTICIPANTS

Persons of any age and gender, differentiated by a socio-economic measure.

RESULTS

Results from thirty-three included studies confirmed that overall dietary nutritional value/quality tended to be lower in low SEG than higher SEG in Australia. However, findings were inconsistent across studies for all food groups or all socio-economic measures. Large variations were found between study metrics, definitions, dietary assessment methods, granularity of results and conclusions. Quantitative intakes of all ADG food groups by SEG were not reported in most studies and, where reported, were not comparable.

CONCLUSION

The review showed detailed dietary data are lacking to inform policy and practice and help develop targeted interventions to improve diet-related health of Australian low SEG. There is urgent need for regular, granular assessment of population dietary data to enable comparison of intake between SEG in the context of national food-based dietary guidelines in Australia.

Does Eating Addiction Favor a More Varied Diet or Contribute to Obesity?-The Case of Polish Adults

The rapidly increasing prevalence of overweight and obesity indicates a need to search for their main causes. Addictive-like eating and associated eating patterns might result in overconsumption, leading to weight gain. The aim of the study was to identify the main determinants of food intake variety (FIV) within eating addiction (EA), other lifestyle components, and sociodemographic characteristics. The data for the study were collected from a sample of 898 Polish adults through a cross-sectional survey in 2019. The questionnaire used in the study included Food Intake Variety Questionnaire (FIVeQ), Eating Preoccupation Scale (EPS), and questions regarding lifestyle and sociodemographic factors. High eating addiction was found in more than half of the people with obesity (54.2%). In the study sample, physical activity at leisure time explained FIV in the greatest manner, followed by the EPS factor: eating to provide pleasure and mood improvement. In the group of people with obesity, the score for this EPS factor was the best predictor of FIV, in that a higher score was conducive to a greater variety of food intake. Sociodemographic characteristics differentiated FIV only within groups with normal body weight (age) and with overweight (education). In conclusion, food intake variety (FIV) was associated with physical activity at leisure time, and then with EPS factor “Eating to provide pleasure and mood improvement”, whereas sociodemographic characteristics were predictors of FIV only within groups identified by body mass index (BMI). Nevertheless, our observations regarding the eating to provide pleasure and mood improvement factor and its associations with food intake variety indicate a need for further research in this area. Future studies should also use other tools to explicitly explain this correlation.

Mediators and moderators of nutrition intervention effects in remote Indigenous Australia

We conducted a longitudinal dietary intervention study to assess the impact of a store-based intervention on mediators and moderators and consequent dietary behaviour in Indigenous communities in remote Australia. We assessed dietary intake of fruit, vegetable, water and sweetened soft drink, mediators and moderators among 148, eighty-five and seventy-three adult participants (92 % women) at baseline (T1), end of intervention (T2) and at 24 weeks post intervention (T3), respectively. Mediators included perceived affordability and self-efficacy. Moderators were barriers to eat more fruit and vegetables and food security. Mixed-effects models were used to determine changes in mediators and moderators with time and associations between these and each dietary outcome. Perceived vegetable affordability increased from T1 (19 %; 95 % CI 11, 27) to T2 (38 %; 95 % CI 25, 51) (P=0·004) and returned to baseline levels at T3. High self-efficacy to eat more fruit and vegetables and to drink less soft drink decreased from T1 to T3. A reduction in soft drink intake of 27 % (95 % CI −44, −4; P=0·02) was reported at T3 compared with T1; no changes with time were observed for all other outcome measures. Regardless of time, vegetable intake was positively associated with self-efficacy to cook and try new vegetables, no barriers and food security. The dietary intervention went someway to improving perceived affordability of vegetables but was probably not strong enough to overcome other mediators and moderators constraining behaviour change. Meaningful dietary improvement in this context will be difficult to achieve without addressing underlying constraints to behaviour change.

Are dietary inequalities among Australian adults changing? a nationally representative analysis of dietary change according to socioeconomic position between 1995 and 2011-13

BACKGROUND

Increasing inequalities in rates of obesity and chronic disease may be partly fuelled by increasing dietary inequalities, however very few nationally representative analyses of socioeconomic trends in dietary inequalities exist. The release of the 2011-13 Australian National Nutrition and Physical Activity Survey data allows investigation of change in dietary intake according to socioeconomic position (SEP) in Australia using a large, nationally representative sample, compared to the previous national survey in 1995. This study examined change in dietary intakes of energy, macronutrients, fiber, fruits and vegetables among Australian adults between 1995 and 2011-13, according to SEP.

METHODS

Cross-sectional data were obtained from the 1995 National Nutrition Survey, and the 2011-13 National Nutrition and Physical Activity Survey. Dietary intake data were collected via a 24-h dietary recall (n = 17,484 adults) and a dietary questionnaire (n = 15,287 adults). SEP was assessed according to educational level, equivalized household income, and area-level disadvantage. Survey-weighted linear and logistic regression models, adjusted for age, sex/gender and smoking status, examined change in dietary intakes over time.

RESULTS

Dietary intakes remained poor across the SEP spectrum in both surveys, as evidenced by high consumption of saturated fat and total sugars, and low fiber, fruit and vegetable intakes. There was consistent evidence (i.e. according to ≥2 SEP measures) of more favorable changes in dietary intakes of carbohydrate, polyunsaturated and monounsaturated fat in higher, relative to lower SEP groups, particularly in women. Intakes of energy, total fat, saturated fat and fruit differed over time according to a single SEP measure (i.e. educational level, household income, or area-level disadvantage). There were no changes in intake of total sugars, protein, fiber or vegetables according to any SEP measures.

CONCLUSIONS

There were few changes in dietary intakes of energy, most macronutrients, fiber, fruits and vegetables in Australian adults between 1995 and 2011-13 according to SEP. For carbohydrate, polyunsaturated and monounsaturated fat, more favorable changes in intakes occurred in higher SEP groups. Despite the persistence of suboptimal dietary intakes, limited evidence of widening dietary inequalities is positive from a public health perspective.

TRIAL REGISTRATION

Clinical trials registration: ACTRN12617001045303 .

Social determinants of household food expenditure in Australia: the role of education, income, geography and time

OBJECTIVE

To examine socio-economic status (SES) and time-related factors associated with less healthy food purchases in Australia.

DESIGN

Data were from the 2009/10 Household Expenditure Survey (HES) conducted by the Australian Bureau of Statistics. Regression analysis was used to examine the associations between the proportion of the household food budget spent on various food types (processed and unprocessed foods, foods purchased from takeaways and restaurants) and SES and time constraint variables.

SETTING

Australia, 2009-2010.

SUBJECTS

Nationally representative sample of Australian households.

RESULTS

Household income seems to be the most important correlate with food expenditure patterns once other SES indicators are controlled for. Time constraints appear to explain some, but not all, of the adjusted SES gradients in food expenditure. Comparing home food consumption categories (processed and unprocessed foods) with foods purchased away from home (takeaway and restaurant foods) shows that wealthier, more highly educated and least disadvantaged households spend relatively less of their total food budget on processed and unprocessed foods prepared at home and more on foods purchased away from home at restaurants.

CONCLUSIONS

Simple SES gradients in dietary behaviour are influenced by correlations between different SES indicators and between SES and time constraints. Examining these factors separately obscures some of the possible causal effects of disadvantage on healthy eating. When formulating policy responses to unhealthy diets, policy makers should consider alternative sources of disadvantage, including time pressure.

Innovative approaches to estimate individual usual dietary intake in large-scale epidemiological studies

Valid estimation of usual dietary intake in epidemiological studies is a topic of present interest. The aim of the present paper is to review recent literature on innovative approaches focussing on: (1) the requirements to assess usual intake and (2) the application in large-scale settings. Recently, a number of technology-based self-administered tools have been developed, including short-term instruments such as web-based 24-h recalls, mobile food records or simple closed-ended questionnaires that assess the food intake of the previous 24 h. Due to their advantages in terms of feasibility and cost-effectiveness these tools may be superior to conventional assessment methods in large-scale settings. New statistical methods have been developed to combine dietary information from repeated 24-h dietary recalls and FFQ. Conceptually, these statistical methods presume that the usual food intake of a subject equals the probability of consuming a food on a given day, multiplied by the average amount of intake of that food on a typical consumption day. Repeated 24-h recalls from the same individual provide information on consumption probability and amount. In addition, the FFQ can add information on intake frequency of rarely consumed foods. It has been suggested that this combined approach may provide high-quality dietary information. A promising direction for estimation of usual intake in large-scale settings is the integration of both statistical methods and new technologies. Studies are warranted to assess the validity of estimated usual intake in comparison with biomarkers.

Determinants of consumption-day amounts applicable for the estimation of usual dietary intake with a short 24-h food list

Next to the information on frequency of food consumption, information on consumption-day amounts is important to estimate usual dietary intake in epidemiological studies. Our objective was to identify determinants of consumption-day amounts to derive person-specific standard consumption-day amounts applicable for the estimation of usual dietary intake using separate sources to assesss information on consumption probability and amount consumed. 24-h Dietary recall data from the German National Nutrition Survey II (n = 8522; aged 20–80 years) conducted between 2005 and 2007 were analysed for determinants of consumption-day amounts of thirty-eight food and beverage groups using LASSO variable selection for linear mixed-effects models. Determinants included sex, age, BMI, smoking status, years of education, household net income, living status and employment status. Most often, sex, age and smoking status were selected as predictors for consumption-day amounts across thirty-eight food groups. In contrast, living with a partner, employment status and household net income were less frequently chosen. Overall, different determinants were of relevance for different food groups. The number of selected determinants ranged from eight for coffee and juice to zero for cabbage, tea, root vegetables, leafy vegetables, fruit vegetables, legumes, offal, vegetable oils, and other fats. For the estimation of usual dietary intake in a combined approach with a 24-h food list, person-specific standard consumption-day amounts could be used. Sex, age and smoking status were shown to be the most relevant predictors in our analysis. Their impact on the estimation of usual dietary intake needs to be evaluated in future studies.

The association between socio-economic position and diet quality in Australian adults

OBJECTIVE

We aimed to investigate the association between multiple measures of socio-economic position (SEP) and diet quality, using a diet quality index representing current national dietary guidelines, in the Australian adult population.

DESIGN

Cross-sectional study. Linear regression analyses were used to estimate the association between indicators of SEP (educational attainment, level of income and area-level disadvantage) and diet quality (measured using the Dietary Guideline Index (DGI)) in the total sample and stratified by sex and age (≤55 years and >55 years).

SETTING

A large randomly selected sample of the Australian adult population.

SUBJECTS

Australian adults (n 9296; aged ≥25 years) from the Australian Diabetes, Obesity and Lifestyle Study.

RESULTS

A higher level of educational attainment and income and a lower level of area-level disadvantage were significantly associated with a higher DGI score, across the gradient of SEP. The association between indicators of SEP and DGI score was consistently stronger among those aged ≤55 years compared with their older counterparts. The most disadvantaged group had a DGI score between 2 and 5 units lower (depending on the marker of SEP) compared with the group with the least disadvantage.

CONCLUSIONS

A higher level of SEP was consistently associated with a higher level of diet quality for all indicators of SEP examined. In order to reduce socio-economic inequalities in diet quality, healthy eating initiatives need to act across the gradient of socio-economic disadvantage with a proportionate focus on those with greater socio-economic disadvantage.

Who uses herbs and spices?

Purpose

– This paper aims to examine the usage patterns of herbs and spices among Australians and to identify how herbs and spices were consumed by respondents from different social backgrounds.

Design/methodology/approach

– In all, 1,023 adult Australians completed an online survey and ranked the frequencies of use of 21 herbs and spices and provided details of their demographics, cooking intentions and household types.

Findings

– Latent class analysis was applied and three types of usage patterns were identified, including high use, moderate use and low use of herbs and spices. The usage patterns were associated differentially with several covariates. For example, the chance of being in the high-usage group was positively associated with age, number of adults living in the household and cooking evening meals from scratch, but negatively related to levels of education and possession of cooking or culinary qualifications. Moreover, respondents who cooked their evening meals from scratch and who were not interested in receiving information or advice about making inexpensive but tasty meals were more likely to be in the moderate- rather than the low-usage group.

Originality/value

– The identification of groups of users of herbs and spices would enable health communications to be tailored to enhance the use of herbs and spices and reduce the use of other flavouring agent including fat, sugar and salt.

Healthy eating norms and food consumption

BACKGROUND/OBJECTIVES

Beliefs about what people think they ought to eat to be healthy ('healthy eating norms (HENs)') may be important influences on food consumption. The purpose of this study was to examine the predictive roles of normative expectations and demographics, personal values, substance use behaviours and body weight on reported food consumption among middle-aged Australians.

SUBJECTS/METHODS

A questionnaire was administered by mail to a random sample of people aged 40 years and above, drawn from the Electoral Rolls in Victoria, Australia. Part of the questionnaire contained questions about the respondents' beliefs about what should they eat to be healthy, what actually they ate, their personal values, smoking and alcohol use, as well as self-reported heights and weights and demographic characteristics.

RESULTS

Respondents' reported food consumption did not match their HENs. Demographics, smoking, body mass index (BMI) and personal values, and HENs were associated with reported consumption but the relationships differed among men and women. Generally, high energy-dense, nutrition-poor (EDNP) food consumption was negatively associated with age. Fruit and vegetable HEN and consumption was positively linked to universalist values but negatively related to smoking status among men. In contrast in women, fruit and vegetable HENs were positively related to income and education while EDNP HEN was negatively associated with age and income but positively linked to body weight and power values.

CONCLUSIONS

Reported food consumption was associated with HEN, personal values, demographics, smoking and BMI through different pathways among men and women. The implications for nutrition promotion are discussed.

Classification of main meal patterns--a latent class approach

Relatively little examination of the meals that are prepared in households has been conducted, despite their well-defined properties and widespread community interest in their preparation. The purpose of the present study was to identify the patterns of main meal preparation among Australian adult household meal preparers aged 44 years and younger and 45 years and over, and the relationships between these patterns and likely socio-demographic and psychological predictors. An online cross-sectional survey was conducted by Meat and Livestock Australia among a representative sample of people aged 18–65 years in Australia in 2011. A total of 1076 usable questionnaires were obtained, which included categorical information about the main meal dishes that participants had prepared during the previous 6 months along with demographic information, the presence or absence of children at home, confidence in seasonal food knowledge and personal values. Latent class analysis was applied and four types of usage patterns of thirty-three popular dishes were identified for both age groups, namely, high variety, moderate variety, high protein but low beef and low variety. The meal patterns were associated differentially with the covariates between the age groups. For example, younger women were more likely to prepare a high or moderate variety of meals than younger men, while younger people who had higher levels of education were more likely to prepare high-protein but low-beef meals. Moreover, young respondents with higher BMI were less likely to prepare meals with high protein but low beef content. Among the older age group, married people were more likely to prepare a high or moderate variety of meals than people without partners. Older people who held strong universalist values were more likely to prepare a wide variety of meals with high protein but low beef content. For both age groups, people who had children living at home and those with better seasonal food knowledge were more likely to prepare a high variety of dishes. The identification of classes of meal users would enable health communication to be tailored to improve meal patterns. Moreover, the concept of meals may be useful for health promotion, because people may find it easier to change their consumption of meals rather than individual foods.

Optimising women's diets. An examination of factors that promote healthy eating and reduce the likelihood of unhealthy eating

The majority of nutrition promotion research that has examined the determinants of unhealthy or healthy dietary behaviours has focused on factors that promote consumption of these foods, rather than factors that may both promote healthy eating and buffer or protect consumption of unhealthy foods. The purpose of this paper is to identify factors that both promote healthy eating and also reduce the likelihood of eating unhealthily amongst women. A community sample of 1013 Australian women participated in a cross-sectional self-report survey that assessed factors associated with diet and obesity. Multiple logistic regressions were used to examine the associations between a range of individual, social and environmental factors and aspects of both healthy and unhealthy eating, whilst controlling for key covariates. Results indicated that women with high self efficacy for healthy eating, taste preferences for fruit and vegetables, family support for healthy eating and the absence of perceived barriers to healthy eating (time and cost) were more likely to consume components of a healthy diet and less likely to consume components of a unhealthy diet. Optimal benefits in overall diet quality amongst women may be achieved by targeting factors associated with both healthy and unhealthy eating in nutrition promotion efforts.

Investigation of population heterogeneity of diet use among middle-aged Australians

The purpose of the study was to determine patterns of diet use among middle-aged Australian men and women and the relationships between these different usage patterns and demographic characteristics, health status and health habits. A cross-sectional mail survey was conducted among a random sample of 2975 people aged 40-71 years in Victoria, Australia. A total of 1031 usable questionnaires were obtained which included information about the use of diets (e.g. low-fat and low-salt) during the past 3 months along with demographic information, health status and health habits. Based on the responses about the use of thirteen diets for both sexes, latent class analysis was employed to identify the optimal number of use of diets and the assignment of participants to particular groups. Three types of diet uses were identified and provisionally named: diet use, selected diet use and non-diet use. This classification was associated with demographics, health status and health habits, and these associations differed between men and women. The findings suggest that nutrition education programmes should be tailored to the different needs of the diet use groups.

Why women of lower educational attainment struggle to make healthier food choices: the importance of psychological and social factors

Women of lower educational attainment are more likely to eat unhealthy diets than women of higher educational attainment. To identify influences on the food choices of women with lower educational attainment, 11 focus groups (eight with women of lower, and three with women of higher educational attainment) were held. Using a semi-structured discussion guide, environmental, social, historical and psychological factors known to be associated with food choice were explored. Audio recordings were transcribed verbatim and thematically analysed. Compared to women of higher educational attainment, women of lower educational attainment had less control over their families' food choices, less support for attempts to eat healthily, fewer opportunities to observe and learn good food-related practices, more negative affect, more perceived environmental constraints and more ambiguous beliefs about the consequences of eating a nutritious diet. These findings provide a starting point for taking forward the design of an intervention to improve the diets of young women.

Dietary behaviours during pregnancy: findings from first-time mothers in southwest Sydney, Australia

BACKGROUND

Limited prevalence data are available for nutrition related health behaviours during pregnancy. This study aimed to assess dietary behaviours during pregnancy among first-time mothers, and to investigate the relationships between these behaviours and demographic characteristics, so that appropriate dietary intervention strategies for pregnant women can be developed.

METHOD

An analysis of cross-sectional survey was conducted using data from 409 first-time mothers at 26-36 weeks of pregnancy, who participated in the Healthy Beginnings Trial conducted in southwestern Sydney, Australia. Dietary behaviours, including consumption of vegetables, fruit, water, milk, soft drinks, processed meat products, fast foods/take away and chips, were assessed using the New South Wales Health Survey questionnaire through face-to-face interviews. Factors associated with dietary behaviours were determined by logistic regression modeling. Log-binomial regression was used to calculate adjusted risk ratios (ARR).

RESULTS

Only 7% of mothers reported meeting the recommended vegetable consumption and 13% reported meeting the recommended fruit consumption. Mean and median intakes per day were 2.3 (SD 1.3) and 2 serves of vegetables, and 2.1 (SD 1.4) and 2 serves of fruit respectively. About one fifth of mothers (21%) reported drinking 2 cups (500 ml) or more of soft drink per day and 12% reported consuming more than 2 meals or snacks from fast-food or takeaway outlets per week. A small percentage of mothers (5%) had experienced food insecurity over the past 12 months. There were significant inverse associations between water and soft drink consumption (Spearman's rho -0.20, P < 0.001), and between fruit and fast food/takeaway consumption (Spearman's rho -0.16, P = 0.001). The dietary behaviours were associated with a variety of socio-demographic characteristics, but no single factor was associated with all the dietary behaviours.

CONCLUSIONS

There were low reported levels of vegetable and fruit consumption and high reported levels of soft drink and takeaway/fast food consumption among pregnant women. Dietary interventions to prevent adverse health consequences need to be tailored to meet the needs of pregnant women of low socio-economic status in order to improve their own healthy eating behaviors. Increasing water and fruit consumption could lead to reduced consumption of soft drink and takeaway/fast food among pregnant women.

TRIAL REGISTRATION

HBT is registered with the Australian Clinical Trial Registry (ACTRNO12607000168459).