Nutrition knowledge and body mass index

Interventions based on sensory-hedonic strategies and on nudging to facilitate vegetable and pulses consumption in the school environment

Childhood and adolescence shape lifelong taste preferences and dietary habits, making them crucial periods for promoting healthy and sustainable eating. As students consume up to half of their daily energy intake at school, school interventions can have a significant impact on promoting plant-based diets. Although the benefits of promoting plant-based diets on children's and adolescents' health and environmental sustainability are well established and various studies report promising effects of interventions based on sensory-hedonic strategies and on nudging in promoting vegetables and pulses in schools, a comprehensive collection of those reports is lacking. Therefore, this systematic review aims to collect published literature on the above interventions in schools that focus on promoting the consumption of vegetables and pulses to children and adolescents. Three databases-PubMed, Scopus, and Web of Science-were searched over all years until March 2022 using pre-specified terms. From the 10.488 studies identified, a total of 57 studies reporting sensory-hedonic (e.g., manipulating food sensory properties or their hedonic value) or nudging (e.g., changing the presentation) interventions targeting children and/or adolescents in schools and aiming at promoting vegetables and/or pulses were included. Overall, interventions based on sensory-hedonic strategies (either enhancing the perception of well-accepted flavor and texture or manipulating their hedonic value) and on nudging (through incentives and prompts) are effective in promoting vegetables and pulses. A gap in the literature was identified for interventions targeting adolescents and promoting pulses. Finally, multicomponent interventions, rather than using one strategy alone, could be more successful.

Obesity-Related Knowledge and Practice Among the Healthcare Professions Students in Saudi Arabia

Objective

The objectives of this study are to identify the prevalence and the factors behind overweight and obesity among the healthcare profession's students.

Methods

A well-structured and validated questionnaire was distributed to a heterogeneous purposive sample of the healthcare profession's students in Saudi Arabia.

Results

About 21.0% and 15.5% were overweight and obese, respectively. The average knowledge score was 70.6% and increased with age and among obese participants. The average attitude score was 74.8% with no variation within age, body mass index (BMI), and gender. The average practice score was only 36.7%. There was a significant variation of the practice within the different age groups (P = 0.021). There was a significant association between the participant's knowledge and attitude, and practice.

Conclusion

The average practice score was poor. Despite their good knowledge and positive attitude, the students are exposed to heavy junk food marketing, which encourages overconsumption by instilling positive emotional associations with the junk food. They are mostly physically inactive, anxious and sleep deprived, which can lead to poor eating habits. For this group, various strategies and motivators will likely be needed.

Dietary behaviors of rural residents in northeastern China: implications for designing intervention information and targeting high-risk population

Background

Dietary behavior is a pivotal modifiable determinant in reducing the occurrence of obesity/overweight and chronic non-communicable diseases. Improving the dietary behavior of rural residents in China is imminent due to the poor performance of their dietary behavior. Nutrition knowledge and health literacy are considered as elements that are linked intimately to healthy dietary behaviors but lack research in the Chinese setting.

Purpose

The study is designed to explore the relationship between nutritional knowledge, health literacy and dietary behaviors and to analyze the performance under different demographic characteristics.

Methods

A face-to-face survey of 400 rural residents on their nutrition knowledge, functional health literacy and dietary intake of five food categories consisting of 32 items was conducted based on a validated questionnaire. Descriptive analysis, difference test including ANOVA, t-test and non-parametric test, and multivariate linear regression were used for data analysis.

Results

The results indicate that declarative nutrition knowledge, individuals' information application capacity, and dietary behaviors, especially the intake of fruits, dairy and beans, and vegetable are not ideal and requires improvement. Male, elder, low-income, unmarried, and low-education populations performed significantly worse and were the high-risk group. Procedural nutrition knowledge, information access capacity, information understanding capacity, and information application capacity have remarkable effects on better dietary behavior.

Conclusion

This study provides evidence-based guidance for prioritizing information and populations for healthy dietary interventions.

Exploring the Dunning-Kruger Effect in Health Communication: How Perceived Food and Media Literacy and Actual Knowledge Drift Apart When Evaluating Misleading Food Advertising

Marketers often advertise products high in sugar, fat or calories as healthy products. With this potentially misleading information, they can influence eating decisions with negative consequences for human health. Consumers need the ability to uncover misleading food advertising. However, individuals' perceived knowledge and their actual objective abilities often drift apart - a phenomenon which has come to be known as the Dunning-Kruger Effect. Thus, this study set out to uncover the phenomenon's potential existence in health communication, more precisely in the area of food and media literacy. In a quantitative survey representative of the Austrian population (n = 1000) the Dunning-Kruger Effect (DKE) could be detected: Individuals who were most knowledgeable underestimated their food and media literacy, but - on the positive side - they acted as opinion leaders. Individuals who were least knowledgeable about advertising strategies used to market an unhealthy product as healthy and about the actual nutrition score of the advertised product were most likely to overestimate their own food and media literacy. Worryingly, further concerning consequences emerged, especially for least knowledgeable individuals. The study's results provide important implications for public health campaigns.

Theory-based behavioral change interventions to improve periodontal health

Periodontal disease is a significant global health burden affecting half of the world's population. Given that plaque and inflammation control are essential to the attainment of periodontal health, recent trends in preventive dentistry have focused on the use of behavioral models to understand patient psychology and promote self-care and treatment compliance. In addition to their uses in classifying, explaining and predicting oral hygiene practices, behavioral models have been adopted in the design of oral hygiene interventions from individual to population levels. Despite the growing focus on behavioral modification in dentistry, the currently available evidence in the field of periodontology is scarce, and interventions have primarily measured changes in patient beliefs or performance in oral hygiene behaviors. Few studies have measured their impact on clinical outcomes, such as plaque levels, gingival bleeding and periodontal pocket reduction, which serve as indicators of the patient's disease status and quality of oral self-care. The present narrative review aims to summarize selected literature on the use of behavioral models to improve periodontal outcomes. A search was performed on existing behavioral models used to guide dental interventions to identify their use in interventions measuring periodontal parameters. The main models were identified and subsequently grouped by their underlying theoretical area of focus: patient beliefs (health belief model and cognitive behavioral principles); stages of readiness to change (precaution adoption process model and transtheoretical model); planning behavioral change (health action process approach model, theory of planned behavior and client self-care commitment model); and self-monitoring (self-regulation theory). Key constructs of each model and the findings of associated interventions were described. The COM-B model, a newer behavioral change system that has been increasingly used to guide interventions and policy changes, is discussed with reference to its use in oral health settings. Within the limitations of the available evidence, interventions addressing patient beliefs, motivation, intention and self-regulation could lead to improved outcomes in periodontal health. Direct comparisons between interventions could not be made due to differences in protocol design, research populations and follow-up periods. The conclusions of this review assist clinicians with implementing psychological interventions for oral hygiene promotion and highlight the need for additional studies on the clinical effects of behavioral model-based interventions.

Association between dietary knowledge and overweight and obesity in Chinese children and adolescents: Evidence from the China Health and Nutrition Survey in 2004-2015

OBJECTIVE

To assess whether dietary knowledge of Chinese children and adolescents and their mothers was associated with childhood and adolescent overweight and obesity.

METHODS

This cross-sectional study obtained data from the China Health and Nutrition Survey (CHNS) between 2004 and 2015. Dietary knowledge of children and adolescents and their mothers was assessed by asking questions and statements on diets, and clustered by K-means clustering. Body mass index (BMI) and waist circumference (WC) were used to evaluate overweight and obesity among children and adolescents. The association of dietary knowledge with childhood and adolescent overweight and obesity was evaluated by multivariate regression analysis, with odds ratios (ORs) and 95% confidence intervals (CIs) calculated.

RESULTS

A total of 2,338 children and adolescents were included. Children and adolescents with low dietary knowledge were demonstrated to have significantly higher risks of BMI-defined overweight or obesity (OR = 1.66, 95%CI = 1.21-2.28, P = 0.002), and WC-defined obesity (OR = 1.52, 95%CI = 1.12-2.06, P = 0.007) than those with high dietary knowledge. Compared with high dietary knowledge in mothers, low dietary knowledge was associated with significantly elevated risks of BMI-defined overweight or obesity (OR = 1.48, 95%CI = 1.08-2.02, P = 0.014), and WC-defined obesity (OR = 1.59, 95%CI = 1.18-2.16, P = 0.003). Furthermore, significantly increased odds of BMI-defined overweight or obesity and WC-defined non-obesity in children and adolescents were related to low dietary knowledge versus high dietary knowledge of children and adolescents (OR = 1.72, 95%CI = 1.08-2.74, P = 0.023), while there was no association of BMI-defined non-overweight and non-obesity and WC-defined obesity with dietary knowledge among children and adolescents (OR = 1.35, 95%CI = 0.89-2.04, P = 0.161). Additionally, no association was found between dietary knowledge of mothers and BMI-defined overweight or obesity and WC-defined non-obesity among children and adolescents (OR = 1.39, 95%CI = 0.89-2.17, P = 0.155), while low dietary knowledge of mothers was associated with increased odds of BMI-defined non-overweight and non-obesity and WC-defined obesity in children and adolescents (OR = 1.58, 95%CI = 1.03-2.43, P = 0.036).

CONCLUSION

Dietary knowledge of children and adolescents and their mothers was associated with childhood and adolescent overweight and obesity. Dietary knowledge of children and adolescents negatively related to the risk of BMI-defined overweight or obesity, and dietary knowledge of mothers to odds of WC-defined obesity.

The relation between prenatal stress, overweight and obesity in children diagnosed according to BMI and percentage fat tissue

BACKGROUND

One of the environmental factors contributing to abnormal weight changes in children may be maternal exposure to adverse environmental factors during pregnancy, which in previous studies led to inconclusive results showing both overweight or obesity and underweight in children. The aim of the study was to assess the influence of prenatal stress on the BMI status and cut-off points for the percentage of fat content.

METHODS

The cohort study included 254 girls and 276 boys. Information on prenatal stress was collected retrospectively with a questionnaire on objective adverse events completed by a parent/guardian of a 6-12-year-old child. We examined the body weight of children and performed an electrical bioimpedance analysis of their body composition. We assessed the BMI status according to the International Obesity Task Force (IOTF) criterion and on the basis of body fat according to McCarthy criterion.

RESULTS

The results of our study show that the prenatal stress was related to increased risk of overweight (OR 2.14, 95% CI: 1.25-3.65) diagnosed on the basis of body fat cut-off points, but not when the BMI was a diagnostic criterion (OR 1.03, 95% CI: 0.58-1.83).

CONCLUSION

The method of diagnosis based on the fat content appears to be an indicator of the occurrence of abnormalities in body composition due to prenatal stress more sensitive than that based on the BMI.

LEVEL OF EVIDENCE

Level III evidence obtained from well-designed cohort or case-control analytic studies.

Association of Vitamin D Knowledge, Behavior and Attitude with BMI Status among Arab Adults

This study aims to investigate the association of vitamin D (VD) knowledge, behavior, and attitude with BMI status among Saudi adults. This cross-sectional online survey included a total of 774 participants (M/F: 239/535). Knowledge about the overall sources of VD was highest in OB participants in correctly identifying sunlight (95.1%; p < 0.001) while significantly more OW participants answered food (83.1%; p = 0.04) and fortified food (66.5%; p = 0.02). However, 18.9% of OB participants also wrongly identified air as a VD source and this was significantly higher than in other groups (p = 0.03). OW participants were 50% less likely to identify salmon and fish oil (odds ratio, OR 0.5 (95% Confidence interval, CI 0.4-0.7); p < 0.01) and 40% more likely to identify chicken (OR 1.4 (1.0-1.9); p < 0.05) as dietary sources of VD than controls. On the other hand, OB participants were almost three times more likely to know that sunlight exposure is the main source of VD than controls (OR 2.65 (1.2-6.0); p < 0.05). In conclusion, while VD knowledge overall was apparently high in Saudi adults regardless of BMI status, the quality of knowledge among OB and OW individuals appear inconsistent, particularly in terms of identifying the right VD sources. Public health awareness campaigns should include the correction of VD misconceptions so that high-risk populations are able to make well-informed decisions in achieving optimal VD levels.

Correlates of Self-Reported and Functional Understanding of Nutrition Labels across 5 Countries in the 2018 International Food Policy Study

BACKGROUND

Nutrition labels on prepackaged foods are an important source of nutrition information; however, differences in comprehension of varying label formats can limit their use and effectiveness.

OBJECTIVES

This study examined levels and correlates of consumers' self-reported understanding of Nutrition Facts tables (NFts) and front-of-package (FOP) labels, as well as functional NFt understanding.

METHODS

Adults (≥18 y) in Australia (n = 3901), Canada (n = 4107), Mexico (n = 4012), the United Kingdom (n = 5121), and the United States (n = 4445) completed online surveys in November/December 2018. Descriptive statistics summarized sample profiles by country. Linear regression models examined the association between label understanding (self-reported NFt and FOP, functional NFt) and consumer dietary behaviors, functional nutrition knowledge, and sociodemographic characteristics. NFt understanding was measured in all countries, with FOP labeling assessed only in Mexico, Australia, and the United Kingdom.

RESULTS

Self-reported and functional NFt understanding was significantly higher in the United States and Canada (P < 0.0001). In adjusted analyses, functional NFt understanding was significantly higher among women compared to men (P < 0.0001); respondents from the "majority" ethnic group in their respective countries compared with minority ethnic groups (P < 0.0001); those with higher education levels (P < 0.0001) and functional nutrition knowledge compared with their lower education and nutrition knowledge counterparts (P < 0.0001), respectively; and those making efforts to consume less sodium, sugar, or fat compared with those not reporting dietary efforts (P < 0.0001). Self-reported FOP label understanding was significantly higher for interpretive labeling systems in Australia (health star ratings) and the United Kingdom (traffic lights) compared with Mexico's Guideline Daily Amounts (GDAs) (P < 0.0001).

CONCLUSIONS

Nutrition labels requiring greater numeracy skills (i.e., NFts, GDAs) were more difficult for consumers to understand than interpretive FOP labels (i.e., traffic lights). Differences in NFt and FOP label understanding by income adequacy and education suggest potential disparities in labeling policy effects among vulnerable subgroups.

Pregnant mothers' knowledge, attitude, practice and its predictors towards nutrition in public hospitals of Southern Ethiopia: A multicenter cross-sectional study

Objectives:

Insufficient nutrition can predisposes women to infection, pregnancy losses, preeclampsia and anaemia as well birth of underweight baby whose survival is threatened. Therefore, this study was aimed to assess pregnant mothers’ nutrition knowledge, attitude, practice and associated factors.

Methods:

A multicenter cross-sectional study was conducted among 378 participants who were selected using a systematic random sampling technique. Quantitative data were collected using a structured and interviewer-administered questionnaire, which consisted of questions on sociodemographic features, obstetrics characteristics and pregnant women’s nutrition knowledge, attitude and practice. Data entry and analysis were done using Statistical Package for the Social Sciences statistical version 23. Binary logistic regression analysis was done to identify associated factors. All variables with p-value of < 0.23 in bivariate analysis were included in multivariate analysis, and finally, statistical significance was declared at p-value < 0.05 with 95% confidence interval.

Result:

From 378 women participated, a total of 231 (61.1%) respondents were in age range of 25–34 years. About 148 (39.1%) of women were not knowledgeable, 153 (40.5%) had an unfavourable attitude, and 47.7% had poor dietary practice. Knowledge (adjusted odds ratio = 4.5; 95% confidence interval: 2.88, 10.06, p = 0.03), attitude (adjusted odds ratio = 3.6; 95% confidence interval: 2.43, 6.66, p = 0.04) and practice (adjusted odds ratio = 3.6; 95% confidence interval: 2.43, 6.66, p = 0.036) were all significantly associated with maternal education. Regarding their occupation, merchant women were seven times (adjusted odds ratio = 7.02; 95% confidence interval: 2.88, 17.09, p = 0.01) more likely to have knowledge and government employees were six times (adjusted odds ratio = 6.05; 95% confidence interval: 3.58, 13.05, p = 0.04) more likely to be knowable than housewives. Moreover, multiparous women were 4.77 times (adjusted odds ratio = 4.77; 95% confidence interval: 1.15, 8.66, p = 0.002) more likely to be knowledgeable compared to primigravida women. Monthly income was also associated to attitude (adjusted odds ratio = 0.45, 95% confidence interval: 0.10, 1.66, p = 0.03). Women who had a favourable attitude were five times (adjusted odds ratio = 5.25; 95% confidence interval: 2.36, 9.62, p = 0.04) more likely to have good nutritional practices during pregnancy.

Conclusion:

Pregnant women’s knowledge, attitude and practice towards nutrition in this area were low. The educational status of women was associated with knowledge; attitude and practice. Likewise, occupation and parity were associated with knowledge; and attitude was also found to be a determinant factor of nutritional practice. Therefore, community nutritional education and antenatal nutritional counselling need to be strengthened in the area.

The Impact of Dietary Knowledge on Health: Evidence from the China Health and Nutrition Survey

Promoting a healthy diet through education is part of the Healthy China 2030 action plan. However, studies examining how dietary knowledge affects public health in China are sparse. This study employs multiple waves of the China Health and Nutrition Survey (CHNS) data to examine the impacts of dietary knowledge on Chinese adults' health, with a particular emphasis on how the impacts of dietary knowledge vary across different demographic groups. Moreover, we contribute to the literature by incorporating the spouse's dietary knowledge into the analysis framework to inspect the relationship between a spouse's dietary knowledge and an individual's health. Our results indicate that dietary knowledge significantly improves an individual's health status. However, there is no evidence that an individual's health is influenced by his/her spouse's dietary knowledge. Moreover, we find that individuals with a lower level of education and rural residents benefit more from increasing dietary knowledge. Policy implications of this study are also discussed.

Nutrition Knowledge among College of Basic Education Students in Kuwait: A Cross-Sectional Study

Lack of nutrition knowledge may contribute to poor dietary practices. Schools are an ideal environment to address this issue and to start the process of nutrition education. Therefore, teachers should be equipped with adequate nutrition knowledge. This study was designed to evaluate the level of general nutrition knowledge and demographic variations in knowledge in a sample of students attending the College of Basic Education in Kuwait. A cross-sectional study was conducted using a modified and validated revised version of the General Nutrition Knowledge Questionnaire (GNKQ-R) for UK adults. Univariate and multivariate analyses were performed to determine the association between various factors and nutrition knowledge score. A total of five hundred and ninety-seven students completed the questionnaire. Most respondents (84.1%) had a poor level of nutrition knowledge using original Bloom's cutoff points. Sex, BMI, cooking habits, and who is responsible for preparing food in the household were the main determinants of nutrition knowledge score at p < 0.05. The mean score of the students was 40.06 ± 9.89 out of 84 points. Females scored significantly higher than males, at 41.10 ± 9.29 and 38.72 ± 10.48, respectively (p = 0.007). Students with a BMI of ≥30 achieved significantly greater scores (mean 42.30 ± 9.41) than those who were underweight, normal, or overweight (p < 0.001). Students who stated that they always cook their own food achieved significantly greater scores (mean 43.69 ± 9.58) than those who did not (p = 0.025). Students who stated that they depend on the housekeeper for food preparation achieved significantly lower scores (mean 38.86 ± 10.13) than those who prepare their own food or depend on their relatives to prepare food (p = 0.042). Poor nutrition knowledge was found among prospective teachers studying in the College of Basic Education. This must be rectified for the effective implementation of nutrition education programs in schools.

Nutrition Literacy of Portuguese Adults-A Pilot Study

Nutrition is an essential factor in the prevention and treatment of some chronic diseases. For this reason, the population must know about nutrition, healthy food, and dietetics so that the promotion of healthier eating habits can lead to a consequent decrease in chronic disease incidence. That said, the present study aimed to assess nutrition literacy in the Portuguese population. Three hundred thirty participants aged between 18 and 65 years old were included in an observational, quantitative, and cross-sectional research. After the analysis, it was found that the vast majority of the study population (65.2%) had a good level of nutrition literacy. The participants having upper educational qualifications, following a specific diet, presenting an adequate BMI, having family members trained in the field of nutrition, and those who studied or worked in the field of health sciences reported a higher level of nutrition literacy. In conclusion, it seems to be essential to identify the population groups with the lowest nutrition knowledge so that it would be possible to apply personalized measures and to promote better literacy, reducing the prevalence and incidence of diseases and improving quality of life.

Obesity-related knowledge and body mass index: a national survey in Portugal

PURPOSE

Obesity-related knowledge predicts weight control but previous studies only comprise individuals with excessive weight and assess very specific aspects of knowledge. This study aims to evaluate several domains of obesity-related knowledge according to the body mass index (BMI) in a representative sample of Portuguese-speaking dwellers in mainland Portugal.

METHODS

A sample of 1624 participants aged 16-79 years was analyzed. Eighteen questions comprising eight obesity domains were asked: prevalence, physical activity, number of calories, adiposity location, causes, diagnosis, treatment and consequences; each one was dichotomized into correct/incorrect knowledge.

RESULTS

The majority of Portuguese-speaking dwellers recognized the benefits of physical activity, the risks of abdominal obesity and most consequences of excessive weight, independently of their BMI. However, knowledge gaps were identified regarding prevalence, calories and BMI diagnosis. BMI influenced specific obesity-related knowledge: participants with a normal BMI knew the BMI formula more often, identified 22 as normal BMI more frequently and had the highest proportion of correct knowledge regarding the number of calories an adult should eat; obese individuals identified natural products as not being good treatments for obesity more often. After adjusting for age, sex and educational level, obese individuals identified natural products and supplements as not being good obesity treatments more often.

CONCLUSIONS

Obesity-related knowledge gaps (prevalence, calories, and diagnosis) were identified among Portuguese adults. Moreover, correct knowledge does not necessarily translate into a healthier BMI. Besides the dissemination of accurate information, public health interventions should focus on the transfer of knowledge to behaviors that will guarantee better weight management.

EVIDENCE-BASED MEDICINE RANKINGS

Level V: Opinions of respected authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.

Psychometric Validation of a Nutrition Knowledge Questionnaire among Parents of 3-6-Year-Old Asian Indian Children in East Barddhaman District, West Bengal, India

Background:

In India, virtually, no study was aimed to develop a psychometrically valid and reliable questionnaire to assess the nutrition knowledge and practice among parents of children aged between 3 and 6 years.

Objective:

The present study describes an evaluation of validity and reliability measures in a questionnaire designed for the assessment of nutrition knowledge among parents of children participating in a study finding relationship between physical growth and development and nonverbal intelligence quotient development being undertaken in a semi-urban area.

Design:

This was a cross-sectional school-based reliability and validity study.

Setting:

This study was conducted in seven primary schools within the limits of Purba (East) Barddhaman district legislation, West Bengal, India.

Participants:

One hundred and thirty-four parents of children aged 3–6 years were included in the study.

Results:

The final questionnaire consisted of 32 questions that were selected on the basis of content validity. Questions included closed-ended and multiple-choice items which could be answered correctly by 5%–95% of the target population with a difficulty index of 0.33–0.87, discrimination index of 0.12–0.44, and validity index of 0.10–0.86. Internal reliability of each item as measured by Cronbach's α of 0.87 was also significant.

Conclusions:

The test comprises basic psychometric criteria of a valid and reliable 32-item knowledge questionnaire which further forms an instrument for measuring current scenario and interpreting changes associated with intervention work aiming improvement of dietary and nutrition knowledge-practice in the middle-to-low socioeconomic community.

Reliability and validity of Arabic version of revised general nutrition knowledge questionnaire on university students

OBJECTIVE

The current study evaluated the reliability and validity of the Arabic version of the revised general nutrition knowledge questionnaire (GNKQ-R) for adults.

DESIGN

The eighty-eight-item English GNKQ-R was adapted into an eighty-six-item Arabic version. Four validation studies were conducted for internal (n 805) and external (n 106) reliability, construct validity between participants with (n 84) and without (n 88) nutrition background, convergent validity for associations between nutrition knowledge and demographic characteristics (n 750) and responsiveness to online nutrition information (n 55).

SETTING

United Arab Emirates University in United Arab Emirates and Hashemite University in Jordan.

PARTICIPANTS

Undergraduate students aged 18 years and above, enrolled in any programme at the two universities, were recruited.

RESULTS

Overall, internal reliability (Cronbach's α = 0·91) and external reliability (P = 0·350; intra-class correlation coefficient = 0·84) were high. Significantly higher GNKQ-R scores of students with (66·0 (10·6)) v. without (38·0 (10·7), P < 0·001; d = 2·6) nutrition background indicated high construct validity. Significantly higher GNKQ-R scores among females v. males, older and senior students v. younger and junior students and students in health discipline v. non-health discipline reflected good convergent validity. Significant differences in GNKQ-R scores with nutrition information (time 1 = 37·8 (10·5) and time 2 = 47·7 (9·1), P < 0·001; d = 1·0) indicated high responsiveness to nutrition intervention.

CONCLUSIONS

The Arabic GNKQ-R showed high reliability and validity in the young adult Arab population. Besides the reliability of the overall questionnaire, each section demonstrated adequate reliability. Further studies are warranted to establish the generalisability and applicability of the Arabic GNKQ-R in older adults and in different middle-eastern Arab countries.

Protocol for Minute Calisthenics: a randomized controlled study of a daily, habit-based, bodyweight resistance training program

BACKGROUND

Resistance-training (RT) provides significant health benefits. However, roughly 3/4 of adults in the United States do not meet current Physical Activity Guidelines in this regard. There has been a call for research examining the effectiveness of interventions to increase participation in physical activity and to better understand the dose response relationship upon health outcomes. Studies are needed that assess the effectiveness of RT programs that are time-efficient and simple to perform. This fully-powered, randomized controlled study will assess a habit-based RT program consisting of one set of push-ups, angled-rows, and bodyweight-squats performed every weekday for 12-24 weeks in untrained individuals.

METHODS

Forty-60 untrained osteopathic medical students and college/university employees who work in an office setting will be recruited and randomized (1:1) to an intervention or waitlist control group. After 12-week follow-up assessment, the intervention group will continue the program and the control group will initiate the program for 12 weeks. In addition to the equipment and training needed to safely perform the exercises, all participants will receive training in the Tiny Habits® Method (THM) and digital coaching for the duration of the study. Participants will complete weekly assessments regarding the program during their initial 12-week intervention phase. The primary outcome is the change from baseline to 12 weeks in the intervention group versus the control group, in the combined number of repetitions performed in one set of each of the three exercises (composite repetitions) under a standardized protocol. Secondary outcomes include adherence to and satisfaction with the program, and change from baseline to 12- and 24-week follow-up in blood pressure, fasting lipid panel, hemoglobin A1c, body mass index, anthropometry, body composition, mid-thigh muscle thickness, and habit strength.

DISCUSSION

This study will evaluate a simple, habit-based RT intervention in untrained individuals. The approach is unique in that it utilizes brief but frequent bodyweight exercises and, via the THM, focuses on consistency and habit formation first, with effort being increased as participants are motivated and able. If effective, the program can be easily scaled for wider adoption.

TRIAL REGISTRATION

This study was prospectively registered at ClinicalTrials.gov, identifier NCT04207567 , on December 23rd, 2019.

Nutrition knowledge is associated with greater weight loss in obese patients following a multidisciplinary rehabilitation program

BACKGROUND

A major objective of the metabolic-nutritional-psychological multidisciplinary rehabilitation of obese subjects is providing a nutritional education aimed at achieving a weight loss and the improvement of obesity-related cardio-metabolic diseases. The impact of nutrition knowledge in healthy eating patterns and weight loss is still debated. The aim of this study was to identify whether the increase in nutrition knowledge is associated with weight loss.

METHODS

Two hundred fifty-six obese patients (80% women, mean age 57.5±12.4 years) were consecutively recruited among those referred for a three-month metabolic-nutritional-psychologic rehabilitation program. Education level and time of the onset of obesity were collected. Before and at the end of the intervention, anthropometric measures and body composition were assessed and the Moynihan Questionnaire (MQ) and the International Physical Activity Questionnaire administered. The weight loss maintenance was evaluated in patients who attended the 6-month follow-up visit.

RESULTS

Nutrition knowledge was poor/sufficient in 97 out of 256 obese patients. The MQ Score was associated with the education level but not with age, gender and Body Mass Index. After rehabilitation, there was an increase in nutrition knowledge (mean score change -12±10.5%, P<0.0001) in the whole group of patients as well as in those with poor knowledge, 77% of whom reached a good/high level of knowledge on healthy diet. The improvement in knowledge was greater in patients with a weight loss ≥5% (P<0.05 vs. patients with a lower weight loss). Weight maintenance at follow-up, was associated with a better improvement in the nutritional knowledge during the previous rehabilitation.

CONCLUSIONS

Weight-management programs should include a strong component of nutrition education to alleviate knowledge inequalities and promote more effective weight loss and control. The MQ may be a useful tool to verify the nutritional education carried out during the rehabilitation of obese subjects.

Prevalence and predictors of overweight and obesity among women in the Gaza strip-Palestine: a cross-sectional study

BACKGROUND

The prevalence of overweight and obesity among women of childbearing age is considered a public health concern. Few studies have been conducted in the Gaza Strip to determine the magnitude of overweight and obesity. This study aimed to determine the prevalence of overweight and obesity along with their associated factors among women in the Gaza Strip.

METHODS

A cross-sectional study was conducted to recruit a total of 357 mothers aged 18-50 years. Interviews were carried out among mothers to collect sociodemographic information, nutritional information, and physical activity. Anthropometric measurements [height, weight and waist circumference (WC)] were conducted with the mothers. Body Mass Index (BMI) was computed to determine the prevalence of overweight and obesity. Multinomial logistic regression was used to examine the associated factors of overweight and obesity.

RESULTS

The combined prevalence of overweight and obesity among mothers was (64.1%). The results of multinomial logistic regression showed the risk of overweight and obesity increased with age, the highest risk being in mothers aged > 33.0 years (OR = 2.7, 95% CI: (1.06,6.86)), and (OR = 5.72, 95% CI: (2.07,15.78)), respectively, compared to mothers aged < 33.0 years. Moreover, mothers with medium and high educational levels had a slightly higher risk of obesity (OR = 0.31, 95% CI: (0.15,0.64)), and (OR = 0.32, 95% CI: (0.12,0.82)) respectively than mothers with low educational level. Household income was positively associated with overweight and obesity. Mothers exposed to higher monthly income were more likely to be overweight or obese (OR = 2.64, 95% CI: (1.20, 5.83)), and (OR = 3.06, 95% CI: (1.28,7.29)), respectively. Nutrition knowledge was significantly associated with a high prevalence of obesity (OR = 1.20, 95% CI: (1.03,1.38)).

CONCLUSIONS

This study showed a higher prevalence of overweight and obesity among Palestinian women than previous studies. Age, educational level, monthly income, and nutrition knowledge were associated with the prevalence of overweight and obesity, compared to other variables that were not associated with overweight and obesity such as location, work status, physical activity, and sitting hours. Urgent action is needed to tackle overweight and obesity among women. Effective intervention is required to increase nutrition knowledge among women to improve their eating behaviors.

Empirically derived dietary-lifestyle patterns and cardiometabolic health in young men: a review

Sex and gender are important factors that impact cardiometabolic traits. Men have lower life expectancy and higher prevalence of fatal chronic conditions at younger age. Lifestyle risk profiles in young men have been rarely studied in the context of cardiometabolic health. This review aimed to summarise the evidence regarding the patterns of dietary-lifestyle behaviours in a population of young men (age <40years) and their associations with cardiometabolic health. Overall, unfavourable clusters of health behaviours are more prominent in men, when compared to women and more prevalent in younger adults, when compared to older age groups. Early signs of cardiometabolic health abnormalities have been reported among men with higher adherence to patterns which consistently shared poor dietary habits as a common denominator, combined with stimulant use, inadequate sleep or insufficient physical activity. In the majority of studies, dietary assessment was limited to the investigation of one or two behaviours, most frequently fruit and vegetable intake. Since young men may engage in a mixture of explicit behaviours, the examination of a singular dietary habit may not represent the overall diet quality. To conclude, the data regarding the synergistic effects of a broad spectrum of dietary and lifestyle behaviours in the context of cardiometabolic health remain scarce in this population. The inclusion of a broader range of dietary and lifestyle variables into the multicomponent pattern analysis might have a greater potential in explaining the association with cardiometabolic health. Defining behavioural clusters can help to develop interventions, tailored to the specific needs of the targeted group.

Better Dietary Knowledge and Socioeconomic Status (SES), Better Body Mass Index? Evidence from China-An Unconditional Quantile Regression Approach

Obesity is a rapidly growing public health threat in China. Improvement of dietary knowledge may potentially reduce the risk of obesity and being overweight. However, existing studies focus on measuring the mean effects of nutrition knowledge on body mass index (BMI). There is a lack of literature on the effect of dietary knowledge on BMI, and the potential heterogeneity of the effect across the whole BMI distribution and across socioeconomic status (SES) groups. This study aims to investigate the heterogeneous nature of the relationship between dietary knowledge, SES, and BMI, using data from the China Health and Nutrition Survey (CHNS) in 2015. We employed unconditional quantile regression (UQR) to assess how the relationship between dietary knowledge, SES, and BMI varies across the whole BMI distribution, and conducted subgroup analyses using different socio-economic subsamples. Results indicate that dietary knowledge had no statistically significant impact on BMI across the BMI distribution. There was a large degree of heterogeneity in the SES effect across the BMI distribution as well as a major gender difference in the SES effect on BMI. Education had a significant and inverse association with BMI across the BMI distribution, greater at higher BMI quantiles. Income growth had a larger effect on the 50th quantile of BMI for males in the middle-income group, but was not significant for females. As income increased, males without college educations had higher BMI while females with college or higher education generally had lower BMI. The findings of this study reveal the heterogeneous nature of the relationship between SES, gender, and obesity across the entire BMI distribution, suggesting that quantile regressions might offer a valuable framework for exploring the complex relationship of dietary knowledge, demographic, and socio-economic factors on obesity.

Is Nutrition Knowledge Related to Diet Quality and Obesity?

The aim of this study is to assess the relationship between nutrition knowledge and diet quality. It was conducted with 382 individuals aged 18-64 living in Famagusta, Cyprus. Data was obtained through face-to-face interviews. Individuals with a high-quality diet had high nutrition knowledge (p < .05). Nutrition knowledge level increases as education level increases (p < .001). An increase in the level of nutrition knowledge is related to a reduction in body mass index (r = -0.12, p = .02), waist circumference (r = -0.16, p < .001), and body fat mass (r = -0.10, p = .04). Gender, education level, obesity, and diet quality were all found to be correlated with nutrition knowledge. There is a need for advanced analysis of nutrition knowledge level, diet quality, and obesity with larger samples.

Impact of a playful booklet about diabetes and obesity on high school students in Campinas, Brazil

Obesity and diabetes are two of the biggest public health problems in the modern world. One possible way to combat the rising prevalence of these diseases is through the spread of awareness about its consequences and how to prevent them. Therefore, educational interventions focused on teaching the physiological basis of these conditions might be valuable tools. However, most scholar curriculums lack high-quality material devoted to this topic. Thus we developed an educational booklet, composed of playful elements, targeted toward high school students and destined for application in classrooms. The efficacy of the developed material was validated through a pretest-posttest design, in which the students had to answer a 10-question test. After booklet completion, students had better outcomes, with an increase in the percentage of correct answers in 7 out of 10 questions contained in the test (P < 0.05). Thus we developed an effective material for usage in the high school classroom to spread the awareness of the risks of metabolic diseases and how to prevent them.

School education and childhood obesity: A systemic review

Childhood obesity prevalence is shooting up at a phenomenal rate worldwide, leading to long-term devastating consequences. A great number of studies have investigated factors contributing to the increase in BMI of children and adolescents. School-based, home-based and clinic-based solutions have been suggested as possible viable strategies, among which school-based interventions is believed to produce a noticeable effect on a massive scale. However, the question of whether school interventions, especially school education exert significant impact on childhood obesity or not, is left with mixing results. This article aims to holistically review the relationship between school education and childhood obesity. Various factors are covered, including health education, nutrition education, school nutrition, physical education, teachers' awareness, teaching practice and school stress, In all, school education is not the answer to childhood obesity but just part of it. More attempts from other stakeholders (parents, community, policy makers, researchers, etc.) should be made in order to solve this complicated puzzle.

Measuring nutritional knowledge using Item Response Theory and its validity in European adolescents

OBJECTIVE

To analyse the Nutritional Knowledge Test (NKT) using Item Response Theory (ITR) analysis and to assess the construct validity of the Nutritional Knowledge Scale (NKTS) and its associations with adolescent food group consumption and nutritional biomarkers.

DESIGN

Cross-sectional study.

SETTING

Multicentre investigation conducted in ten European cities.ParticipantsAdolescents aged 12·5-17·5 years (n 3215) who completed over 75 % of the NKT.

RESULTS

Factor analysis indicated that the NKT can be analysed with a one-dimensional model. Eleven out of twenty-three items from the NKT presented adequate parameters and were selected to be included in the NKTS. Nutrition knowledge was positively associated with consumption of fruits, cereals, dairy products, pulses, meat and eggs, and fish, as well as with blood concentrations of vitamin C, β-carotene, n-3 fatty acids, holo-transcobalamin, cobalamin and folate; nutrition knowledge was negatively associated with intake of olives and avocado, alcohol and savoury snacks.

CONCLUSIONS

The NKTS assessed nutritional knowledge adequately and it is proposed as a new tool to investigate this subject in future studies.

Knowledge of nutrition and physical activity in apparently healthy Indian adults

Objective

To assess knowledge of nutrition and physical activity; examine associations of knowledge with sociodemographic and anthropometric parameters; and evaluate the relationship between knowledge and practice in adults.

Design

In a cross-sectional design, 720 adults were selected using random sampling. Data on anthropometry, body fat, diet, physical activity, and nutrition and physical activity knowledge were collected using standardized questionnaires. Tertiles were used to categorize nutrition knowledge (NK) and physical activity knowledge (PK).

Settings

Subjects selected through routine health checks from hospitals, housing societies and residential areas.

Subjects

A total of 720 adults (361 men) aged 35–50 years participated.

Results

Mean age was 42·7 (sd 9·4) years and mean BMI was 25·8 (sd 5·0) kg/m2. Mean energy intake was 64 %, protein was 68 % and fat was 144 % of the RDA. Mean NK and PK scores were 10·2 (sd 2·9) and 6·5 (sd 1·7), respectively, and were similar across genders (P>0·05). Individuals with higher education exhibited significantly higher NK and PK. Individuals with high fat had significantly higher NK and PK (P<0·05) than participants with normal fat percentage. Overweight and obese individuals had significantly higher PK (P<0·05). Multivariate regression modelling indicated that NK was positively associated with dietary intakes of leafy vegetables, salads and sprouts but negatively associated with fruit intake. BMI, television and reading time were positively associated with PK, even after adjusting for sociodemographic status.

Conclusions

There is a need for increased efforts towards developing health education programmes focusing on transforming nutrition and physical activity knowledge into practice and adherence to guidelines.

Nutritional knowledge and body mass index: A cross-sectional study

OBJECTIVE

To verify the knowledge about food and nutrition and its association with the nutritional status of obese patients with noncommunicable diseases (NCDs), and to identify the relationship between information sources and level of knowledge.

METHOD

Cross-sectional study that included 263 outpatients of a cardiology referral hospital in Porto Alegre, Rio Grande do Sul, Brazil. The participants filled out a questionnaire on socioeconomic data and knowledge about food and nutrition and had their nutritional status evaluated by body mass index (BMI), waist circumference (WC) and waist-hip ratio (WHR).

RESULTS

BMI showed a significant inverse association with the percentage of correct answers (p=0.002), as well as WC (p=0.000) and WHR (p<0.001). This was also true for education (p<0.001) and female gender (p=0.005) compared to males. More than 60% of patients reported using television and 23% reported using newspaper as sources of nutritional information.

CONCLUSION

Our study revealed a significant association between BMI and the level of knowledge about foods, showing that there is need for more information on obesity-related NCDs for greater understanding by patients.

Effect of dietary counseling on preventing excessive weight gain during pregnancy

OBJECTIVES

Excessive gestational weight gain (EGWG) is associated with short- and long-term health problems among mothers and their offspring. The aim of this study was to assess the effect of dietary counseling on EGWG.

STUDY DESIGN

Randomized controlled intervention trial.

METHODS

The study was conducted at the antenatal care (ANC) clinic, Center for Social and Preventive Medicine, Pediatrics Hospital, Cairo University, during the period from July 2015 to April 2016. A total of 200 primigravidae aged between 20 and 30 years were included and randomized into intervention and control groups. Based on data analysis from phase 1, nutritional practices of the studied participants were identified and tailored nutrition counseling sessions designed. Follow-up of the studied participants throughout ANC visits was done to enforce the healthy dietary intake and encourage weight gain according to the recommendations to avoid EGWG.

RESULTS

The intervention resulted in a significantly higher proportion of women in the intervention group who gained gestational weight within the Institute of Medicine recommendations compared to women in the control group (42.7% vs 13.9%, respectively) (P-value <0.001); this was detected between the 25th and 35th weeks of gestation. Dietary counseling had significantly improved the frequency of consumption of different food items and knowledge, attitude, and practice mean scores of the intervention group in comparison with the control group (P-value <0.001).

CONCLUSIONS

The results of the present study demonstrated that dietary counseling given to pregnant women reduced the proportion of EGWG and improved dietary practices. There is a strong need for effective intervention strategies targeting EGWG to prevent adverse pregnancy outcomes.

Residents of Central Queensland, Australia Are Aware of Healthy Eating Practices but Consume Unhealthy Diets

We aimed to determine nutritional knowledge and behaviors of normal weight, overweight, and obese residents of Central Queensland, Australia. Data were collected as part of the 2010 Central Queensland Social Survey (N = 1289). Residents were asked questions assessing nutritional knowledge and behaviors. Statistical analyses were performed to examine differences in nutritional knowledge and behaviors by body mass index (BMI) classification: normal weight, overweight, and obese. Independent of BMI, residents ate fewer than the recommended daily servings of vegetables (p < 0.05) and fruits (p < 0.05) with no differences found between BMI classifications. Overweight (OR: 1.52; 95% CI: 1.13⁻2.04) and obese (OR: 1.43; 95% CI: 1.04⁻1.98) residents were more likely to have eaten fast food the week of the survey than normal weight residents. Residents correctly identified the amount of kilocalories required to maintain current body weight with no differences between BMI classifications. Each BMI classification underestimated the amount of kilojoules required to maintain current body weight (p < 0.05). Nutritional knowledge may not be the limiting factor preventing residents from making proper nutritional choices.

Identifying the mechanisms through which behavioral weight-loss treatment improves food decision-making in obesity

OBJECTIVES

Behavioral weight loss (BWL) programs are the recommended treatment for obesity, yet it is unknown whether these programs change one's ability to use self-control in food choices and what specific mechanisms support such change. Using experimental economics methods, we investigated whether changes in dietary behavior in individuals with obesity following BWL are driven by one or more of the following potential mechanisms: changes in the perception of the 1) health or 2) taste of food items, and/or 3) shifting decision weights for health versus taste attributes. Therefore, we compared these mechanisms between obese participants and lifetime normal weight controls (NW) both before and after BWL.

METHODS

Females with obesity (N = 37, mean BMI = 33.2) completed a food choice task involving health ratings, taste ratings, and decision-making pre- and post-standard BWL intervention. NW controls (N = 30, BMI = 22.4) completed the same task.

RESULTS

Individuals with obesity exhibited increased self-control (selecting healthier, less tasty food choices) post-treatment. However, their rates of self-control remained significantly lower than NW. We found no differences in initial health perceptions across groups, and no changes with treatment. In contrast, taste ratings and the relative value of taste versus health decreased following treatment. Although, post-treatment participants continued to perceive unhealthy foods as tastier and used less self-control than NW controls, they showed significant improvements in these domains following a BWL intervention.

CONCLUSIONS

To help individuals improve dietary decisions, additional research is needed to determine how to make greater changes in taste preferences and/or the assignment of value to taste versus health attributes in food choices.

The impact of changes in dietary knowledge on adult overweight and obesity in China

Overweight and obesity are rapidly growing threats in China. Improvement in dietary knowledge can potentially prevent overweight and obesity, conditions which are receiving substantial attention from international organizations and governments. The purpose of this study was to investigate the impact of changes in dietary knowledge on adult overweight and obesity, using a balanced panel data consisting of 10,401 samples from the 2006, 2009, and 2011 iterations of the China Health and Nutrition Survey. Results indicate that overweight and obesity are becoming increasingly problematic in China, and the level of dietary knowledge among Chinese adults needs improvement. Moreover, the empirical results indicate that changes in dietary knowledge among adults has no significant influence on adult overweight and obesity, a likely result of lacking systematic dietary knowledge and having inadequate guidance on overweight/obesity-related behaviors.

Importance of consumer perceptions in fiber-enriched food products. A case study with sponge cakes

Sponge cakes enriched with fiber from different sources (maltodextrin, wheat, apple, blackcurrant and a mixture of potato and Plantago ovata) were studied.

A systematic review of factors affecting energy intake of adolescent girls

BACKGROUND

Adolescence is considered a critical period marked by an increase in energy intake to meet the body's physiological needs especially during puberty. This study reviews existing literature and critically analyses factors associated with eating habits and energy intake of adolescent girls.

METHODS

A comprehensive search was conducted to identify at least 200 peer reviewed articles which dealt with the factors affecting energy intake (EI) and eating habits of adolescent girls. Studies were identified using a reference period between 1994 and 2016, based primarily on the PubMed/ CINL/ Science Direct/Google Scholar databases using keywords adolescent/ teenagers, factors/determinants and energy intake.

RESULTS

No studies investigated all factors affecting energy intake among adolescents. Some studies found mixed association among the determinants of EI in adolescent girls. However, a number of reviews confirm that many factors namely physical activity level, socio-economic status, diet, individual and social factors do contribute to either a higher or a lower EI of adolescents.

CONCLUSION

There is a dire need to consider factors associated with EI when designing nutritional intervention programs to prevent health problems in adulthood. The goal is not to change behavior of all but to increase the percentage of people adopting healthier lifestyle.

Is a Nutrition Education Intervention Associated with a Higher Intake of Fruit and Vegetables and Improved Nutritional Knowledge among Housewives in Mauritius?

The purpose of the study was to assess the determinants of nutrition behaviors and body mass index and determine the impact of a nutrition education intervention (NEI) among Mauritian housewives. A pretest-posttest design was used assessing Nutrition Knowledge (NK), Nutrition Attitudes, Fruit and Vegetable Intake (FVI), body mass index (BMI). Two hundred Mauritian housewives were recruited. The NEI was in the form of a lecture and lasted for twenty minutes. Statistical tests performed revealed that the mean NK score at baseline was 65.8 ± 6.92 and a significant increase of +17.1 at post-test and +16.1 at follow-up was observed. Determinants of NK were age, presence of elderly people, and BMI. Mean nutrition attitude score at baseline was 2.37 ± 0.22 with significant increase of +0.2 (post-test) and +0.17 at follow-up. Age, level of education, presence of elders, and NK were linked to a positive attitude. FVI was predicted by age, income, presence of elders, NK, and nutrition attitudes. Baseline FVI was 4.77 ± 1.11 which increased significantly (p < 0.001) to 4.98 ± 1.13 at post-test and 5.03 ± 1.20 at follow up. NEI had a positive impact suggesting the benefits of such intervention in the promotion of healthy nutrition behaviors.

Reliability and validity of a revised version of the General Nutrition Knowledge Questionnaire

BACKGROUND/OBJECTIVES

The General Nutrition Knowledge Questionnaire (GNKQ) was developed in the 1990s and has been widely used. Since then advances in understanding of associations between diet and disease have led to changes in dietary recommendations. This study reports the validity and reliability of an updated version of the GNKQ, bringing it into line with current nutritional advice.

METHODS/SUBJECTS

Following a review of current recommendations, the revised version of the GNKQ (GNKQ-R) was created, consisting of 88 items and four sections. Reliability and validity of the GNKQ-R were determined in four validation studies: (1) reliability was examined using an online sample (n=266), (2) construct validity was assessed with 96 Dietetics students and 89 english students using the 'known-groups' method, (3) associations between nutrition knowledge and socio-demographic characteristics were examined using the previously described samples and (4) sensitivity to change was tested by measuring GNKQ-R scores pre- and post-exposure to online nutrition information in written (n=65) and video (n=41) formats.

RESULTS

The reliability was >0.7 in all sections. Dietetics students scored significantly higher than english students. As predicted, GNKQ-R scores were significantly higher among females vs males, people with a degree vs without, and people with very good vs poor or good health status. They were lower in those older than 50 years vs younger adults. GNKQ-R scores were significantly greater after the nutrition interventions in both written and video formats.

CONCLUSIONS

The GNKQ-R is a valid measure of nutrition knowledge that is consistent, reliable and sensitive to change.

Is an ecological school-based nutrition intervention effective to improve adolescents' nutrition-related knowledge, attitudes and behaviour in rural areas of China?

PURPOSE

The purpose of this article is to examine the effect of a school-based nutrition intervention using an ecological approach to improve adolescents' nutrition-related knowledge, attitudes and behaviour in rural China.

METHODS

A cluster-randomised intervention trial design was employed. Two middle schools were randomly selected and assigned to the school that was conducting a holistic school-based intervention using health-promoting school (HPS) framework, 'HPS School', or to the 'Control School' in Mi Yun County, Beijing. From each school we randomly selected 65 seventh-grade students to participate in the study. Their nutrition-related knowledge, attitudes and behaviour were measured by pre- and post-intervention surveys with the same instrument. The nutrition intervention lasted for six months.

RESULTS

Adolescents in the intervention school were more likely to know the nutrition knowledge items, with an odds ratio (OR) ranging from 1.86 (95% confidence interval (CI): 1.11-3.09) to 6.34 (95% CI: 3.83-10.47); more likely to think nutrition is very important to health, developing healthy dietary habits is very important, and that expired foods should be thrown away, with ORs of 3.03 (95% CI: 1.60-5.76), 2.76 (95% CI: 1.66-4.59) and 2.35 (95% CI: 1.33-4.17) respectively, and more likely to consume no soft drinks, desserts or fried food, and to eat vegetables every day of the last week, with ORs of 1.99 (95% CI: 1.31-3.04), 3.96 (95% CI: 2.43-6.46), 3.63 (95% CI: 2.26-5.85), and 2.51 (95% CI: 1.41-4.48) respectively, as compared with those in the control school after interventions.

CONCLUSIONS

Our intervention using the HPS framework, an ecological approach, was an appropriate model to promote nutrition among adolescents in rural China and its use should be advocated in future school-based nutrition promotion programmes for adolescents.

School-based intervention for nutrition promotion in Mi Yun County, Beijing, China

Purpose

– The purpose of this paper is to assess whether the school-based nutrition programme using the health-promoting school (HPS) framework was effective to improve parents’ knowledge, attitudes and behaviour (KAB) in relation to nutrition in rural Mi Yun County, Beijing.

Design/methodology/approach

– A cluster-randomised intervention trial design was employed. Two middle schools were randomly selected and assigned to either the intervention school using the HPS framework (HPS School), or to the Control School, in Mi Yun County, Beijing. From each school 65 parents of seventh-grade students were randomly selected to participate in the study. Nutrition-related KAB were measured at pre- and post-intervention surveys with the same instrument. The nutrition intervention last for six months.

Findings

– The school-based nutrition intervention using the HPS framework was effective in increasing parents’ nutrition knowledge; however, it had no statistical significant impact on improving parents’ attitudes towards nutrition and their eating behaviours.

Research limitations/implications

– The intervention appeared to be inadequate from the point of view of its impact on parents in terms of content, form and frequency.

Practical implications

– Future school-based nutrition promotion programmes using the HPS framework should focus more on parents, providing them with a more informative, participative and interactive, and frequent intervention.

Originality/value

– There is very limited published research focusing on the effect of the school-based nutrition promotion programmes using an HPS framework on parents’ nutrition-related KAB. Although, the improved KAB in relation to nutrition among parents is essential to promote young people’s nutrition and healthy eating behaviours.

Knowledge of Recommended Calorie Intake and Influence of Calories on Food Selection Among Canadians

OBJECTIVE

To examine knowledge of recommended daily calorie intake, use of calorie information, and sociodemographic correlates between knowledge and use.

DESIGN

Population-based, random digit-dialed phone surveys.

PARTICIPANTS

Canadian adults (n = 1,543) surveyed between October and December, 2012.

MAIN OUTCOME MEASURES

Knowledge of recommended calorie intake and use of calorie information when purchasing food.

ANALYSIS

Regression models, adjusting for sociodemographics and diet-related measures.

RESULTS

Overall, 24% of participants correctly stated their recommended daily calorie intake; the majority (63%) underestimated it, whereas few (4%) overestimated it. Females, younger participants, those with a higher income and more education, and those who consumed fruits and vegetables at least 5 times daily were significantly more likely to state recommended intake correctly. Most respondents (82%) reported considering calories when selecting foods. Respondents considered calories more often if they were female, had a higher income and more education, perceived themselves to be overweight, were actively trying to control their weight, reported a healthier diet, or consumed fruits and vegetables at least 5 times daily.

CONCLUSIONS AND IMPLICATIONS

Although most Canadians reported using calorie information to guide their food choices, few knew their daily recommended calorie intake. To promote healthy weights, policy initiatives, including education regarding daily calorie intake and changes to the Nutrition Facts table, may help consumers make better choices about food.

The Presence of Real Food Usurps Hypothetical Health Value Judgment in Overweight People

To develop more ecologically valid models of the neurobiology of obesity, it is critical to determine how the neural processes involved in food-related decision-making translate into real-world eating behaviors. We examined the relationship between goal-directed valuations of food images in the MRI scanner and food consumption at a subsequent ad libitum buffet meal. We observed that 23 lean and 40 overweight human participants showed similar patterns of value-based neural responses to health and taste attributes of foods. In both groups, these value-based responses in the ventromedial PFC were predictive of subsequent consumption at the buffet. However, overweight participants consumed a greater proportion of unhealthy foods. This was not predicted by in-scanner choices or neural response. Moreover, in overweight participants alone, impulsivity scores predicted greater consumption of unhealthy foods. Overall, our findings suggest that, while the hypothetical valuation of the health of foods is predictive of eating behavior in both lean and overweight people, it is only the real-world food choices that clearly distinguish them.

Level of nutrition knowledge and its association with weight loss behaviors among low-income reproductive-age women

To examine influence of nutrition knowledge on weight loss behaviors among low-income reproductive-age women. We conducted a self-administered cross-sectional survey of health behaviors including socio-demographic characteristics, nutrition knowledge, and weight loss behaviors of 16-40 year old women (n = 1,057) attending reproductive health clinics located in Southeast Texas between July 2010 and February 2011. Multiple linear regression and multivariable logistic regression analyses were performed to identify correlates of nutrition knowledge and examine its association with various weight loss behaviors after adjusting for confounders. The mean nutrition knowledge score was low (5.7 ± 2.8) (possible score 0-15). It was significantly lower among African American women than whites (P < .001). Obese women (P = .002), women with high school enrollment/diploma (P = .030), and some college hours/degree (P < .001) had higher nutrition knowledge scores than their counterparts. The higher score of nutrition knowledge was significantly associated with higher odds of engaging in healthy weight loss behaviors: eating less food [odds ratio (OR) 1.12, 95% confidence interval (CI) 1.06-1.18], switching to foods with fewer calories (OR 1.10, 95% CI 1.04-1.16), exercising (OR 1.10, 95% CI 1.04-1.16), eating more fruits/vegetables/salads (OR 1.11, 95% CI 1.06-1.17) and less sugar/candy/sweets (OR 1.09, 95% CI 1.04-1.15). However, it was not associated with unhealthy weight loss behaviors, such as using laxatives/diuretics or inducing vomiting. Nutrition knowledge is low among reproductive-age women. An increase in nutrition knowledge may promote healthy weight loss behaviors.

CONHECIMENTO NUTRICIONAL E ESTADO ANTROPOMÉTRICO DE ATLETAS UNIVERSITÁRIOS

Introdução O estudo do consumo alimentar fornece informações específicas sobre a ingestão de energia e nutrientes, podendo estar associado com o conhecimento sobre nutrição e alimentação. Nesse contexto, a entrada dos estudantes na universidade envolve uma tendência de transição nutricional e mudanças negativas no nível de atividade física, resultando em alterações importantes na sua composição corporal. Objetivo Analisar a relação entre perfil antropométrico e o conhecimento nutricional de atletas universitários de futebol. Métodos Participaram da pesquisa 37 universitários, jogadores de futebol, do sexo masculino, entre 18 e 28 anos, estudantes das áreas de Saúde e Biológica (SB), Tecnológica e Exatas (TE) e Humanas e Sociais (HS). Foram aferidas a massa corporal, estatura e dobras cutâneas (tricipital, subescapular, supra-ilíaca, abdominal e coxa medial). A fim de mensurar o conhecimento nutricional dos atletas, foi aplicado um questionário de conhecimento nutricional (QCN), traduzido, adaptado e validado para o Brasil. Para análise estatística foi utilizada correlação de Pearson e ANOVA one-way com post-hoc de Games-Howell. Resultados Foi observada diferença na massa corporal, estatura e massa livre de gordura (MLG) entre os atletas. Na comparação entre as áreas, verificou-se que não houve diferença significativa entre os estudantes da área SB em relação aos demais. Também foi observado que não houve diferenças significativas para a parte I, parte II ou total de acertos. Ainda houve correlação positiva, forte e significativa da área HS com a MLG. Observando-se as demais variáveis na área TE, foi encontrada correlação negativa e moderada. No restante das variáveis, as correlações entre a pontuação obtida no QCN e as variáveis de composição corporal foram fracas. Conclusão A amostra avaliada apresentou conhecimento nutricional moderado, verificando-se baixa associação deste com o perfil antropométrico. Os resultados também sugerem que o conhecimento nutricional, isoladamente, não é capaz de influenciar o comportamento alimentar.

Effect of interventions to improve adolescents’ nutrition knowledge in China

Purpose

– The purpose of this paper is to improve adolescents’ nutrition knowledge and to examine the effect of interventions component to improve adolescents’ nutrition knowledge.

Design/methodology/approach

– The study design was multi-factorial with repeated measures, at two points in time, of dependent samples from three schools, which were randomly selected from 15 middle schools in Miyun County, Beijing, and then randomly assigned to control school or intervention school. The instrument for baseline survey was a 14-item and for follow-up survey was a 26-item, self-administered, structured questionnaire, designed in Chinese.

Findings

– Students’ nutrition knowledge improved significantly in intervention schools after intervention compared with controls. The extent to which students felt that peer support activities were helpful and that what they learned in class about nutrition was helpful, was related to their resultant level of nutrition knowledge.

Originality/value

– To the authors’ knowledge there have been no previous studies which explore the effect of specific intervention components on levels of nutrition knowledge among adolescents.

Knowledge of appropriate foods and beverages needed for weight loss and diet of patients in an Obesity Clinic

BACKGROUND/OBJECTIVE

Knowledge does not automatically translate into behaviour change. This study examined the relationship between knowledge of appropriate foods and beverages needed for weight loss and the diet of patients seeking weight management.

SUBJECTS/METHODS

A cross-sectional study of 104 consecutive first-time patients (55 women and 49 men) seeking weight management, with a mean age of 37.3 ± 11.8 years and a BMI of 44.9 ± 9.4 kg/m(2), was carried out; 67.3% of these patients had a BMI of 40 kg/m(2) or greater. Patients were told to design a detailed weight-loss diet that they would recommend to a person with the same characteristics (recommended diet or RD) as themselves and asked whether the RD was similar to their own. Consumed diet (CD) was assessed by a different dietitian through a 24-h diet recall. Estimated energy requirement (EER), energy content of RD and CD and number of fruit, vegetable, cereal and sweetened-beverage portions were calculated. Statistical differences were assessed through the Pearson's correlation and the Wilcoxon's rank-sum tests.

RESULTS

RD and CD were 1104 ± 243 and 1976 ± 708 kcal for women and 1254 ± 287 and 2743 ± 1244 kcal for men, with statistical differences for both genders (P<0.001). Energy content of the RD was lower than the EER in men and women (P<0.001); CD was lower than the EER in women (P=0.033). Number of fruit/vegetable portions was lower in CD than in the RD in women (P<0.001), whereas cereal and sweetened-beverage portions were higher in CD than in the RD in both genders (P<0.001). RD was not followed by 46.1% of the patients.

CONCLUSIONS

Patients with obesity seeking care have knowledge of the appropriate dietary strategies needed for weight loss, but do not translate it into practice. Treatment approaches should include tools that help patients to implement their nutrition knowledge.

Nutrition knowledge: application and perception of food labels among women

Knowing the level of consumers' nutritional knowledge is useful for promoting dietary habits. The aim of this study was to assess women's nutritional knowledge and their food label perception and their correlates. Three hundred and eighty Women referring to four large supermarkets in Shiraz were selected for this study. Data were collected through face-to-face interview. The NKQ questionnaire was used for designing the study questionnaire. The first part contained demographic characteristics and the second section encompassed questions related to nutritional knowledge of consumers about food components. The third part consisted of questions about labeling. Data were analyzed using SPSS 16. ANOVA and t-test were used for analyzing multi-variant variables. Chi-square test was used for evaluating the relationship between variables. 49.7% of the participants were healthy and others had chronic diseases. The mean score of the women's nutrition knowledge was 20.13 (from 24) and the average knowledge of women about food components were near 50%. Consumers' information about food labels application was less than 50% for all situations. The lowest use of labels was about low-salt labels and the highest for calorie content of foods. There was a significant relationship between educational status and food label use and also a significant relationship between information about added sugar and using low-sugar labels and between knowledge about low-salt foods and using low-salt labels. A significant relationship was also seen between knowledge about fat and cholesterol use for low fat foods. So, label application was correlated with educational level and nutritional knowledge of women.

Nutrition knowledge of low-income parents of obese children

Minority and low-income children are overrepresented among obese US children. Lack of basic nutrition knowledge among parents may contribute to this disparity. The purpose of this study is to measure nutrition knowledge of parents of Medicaid-insured obese children using a simple low-literacy tool. Parents, recruited from pediatric clinics, demonstrated their nutrition knowledge by placing food stickers into cells on a printed grid with food groups displayed in columns and three nutrition categories displayed in rows. In general, parents (n = 135; 74.8 % black; 79.2 % income of ≤$25,000/year) correctly identified food groups (median = 90.5 % correct). Nutritional categories were more commonly misidentified (median = 67 % correct), with parents mostly believing foods were healthier than they were. Multivariable linear regression revealed black race (p = 0.02), no college education (p = 0.02) and income of <$15,000 (p = 0.03) independently predicted misidentification of nutritional categories. Parents' understanding of food's nutritional value is variable. Black race, less education, and very low income are associated with poorer nutrition knowledge.