Journal of The American Dietetic Association最新文献

Preliminary evidence in support of fruit intake for the prevention of cardiovascular disease in patients with type 2 diabetes mellitus (T2DM) is still limited. The objective of this study was to evaluate the association between fruit consumption and cardiovascular risk factors such as carotid intima-media thickness (CIMT) and high-sensitive C-reactive protein (hsCRP) in patients with T2DM. In this cross-sectional study, 407 patients with T2DM were recruited from August 2007 to December 2009. Dietary assessment based on 3-day 24-hour recall interviews, hsCRP levels, and CIMT were examined. Participants were categorized into three tertiles based on fruit intake. Comparisons of the participants' clinical characteristics among the three categories were performed using either one-way analysis of variance or analysis of covariance. In patients with type 2 diabetes with CIMT ≥1 mm, the intake of fruit was lower (P=0.001), whereas the serum hsCRP level was higher (P<0.001) compared with patients showing CIMT <1 mm. Results of the multivariable logistic regression analysis showed that the odds ratios of CIMT and hsCRP were 8% and 31% lower, respectively, in participants in the top tertile compared with those in the lowest tertile (P=0.018 and P<0.001, respectively) after adjustment for potential confounders. Hence, a reduction in hsCRP concentration and CIMT were found to be associated with an increase in fruit intake. Sufficient daily intake of fruits should, therefore, be considered as an important component of a medical nutritional therapy strategy for the prevention of cardiovascular diseases in patients with T2DM.

Consumption of whole grains, such as brown rice, compared to white rice can decrease the risk of type 2 diabetes mellitus. This qualitative study conducted in 2009 sought to identify factors that can act as barriers to or promote acceptance of brown rice as a staple food among South Indian adults (n=65). Using purposeful sampling, eight focus groups were conducted among adults with normal body mass index and adults who were overweight, aged 24 to 47 years, living in slum and non-slum sites in Chennai, a city in Southern India. These focus groups, conducted in Tamil, the local language of Chennai, were homogenous by sex. The focus groups were audiotaped after obtaining consent. Results were transcribed and coded according to four major themes that emerged during the focus group discussions, including culture and dietary practices, factors influencing rice preferences, awareness and perceptions of brown rice, and barriers to and factors influencing acceptance of brown rice. Overall, the majority of participants favored eating rice and rice-based foods. Tradition largely dictated the specific form of rice that people consumed. Awareness about the nutritive properties of brown rice was poor and was cited as a major barrier to its acceptance. In addition, participants tended to consider cooked rice that was neither white nor long-grained to be inferior. However, they believed that although convincing people to switch to brown rice would be a slow process, promoting its healthful benefits could serve to popularize it.

Predictions about enjoyment of future experiences are influenced by recalling similar past experiences. However, little is known about the relationship between hedonic memories of past eating episodes and future eating behavior. We investigated recall of previous experiences of eating vegetables and the effect of recall on future predicted liking for and consumption of vegetables. British University undergraduate students were asked to retrieve memories of previous occasions when they ate vegetables and were asked to rate how enjoyable those experiences were (Study 1, n=54). The effect of different types of memory recall (including vegetable eating recall) and visualization of someone else eating vegetables (to control for priming effects) on predicted likelihood of choosing vegetables and predicted enjoyment of eating vegetables was examined (Study 2, n=95). Finally, the effect of recalling vegetable eating memories on actual food choice from a buffet was assessed (Study 3, n=63). It is reported that people recall positive memories of past vegetable consumption (P<0.05) and that reminding people of these experiences results in higher predicted future liking for vegetables (P<0.05) and choice of a larger portion size of vegetables (P<0.05) compared with recall of a personal nonfood memory, a nonvegetable food memory, or visualization of someone else enjoying eating vegetables (increase of approximately 70% in vegetable portion size compared to controls). The results suggest that recall of previous eating experiences could be a potential strategy for altering food choices.

High cost and limited access to food have been associated with lower intake of fruits and vegetables in limited-income individuals. The Veggie Mobile is a van that carries fresh produce and travels in low-income neighborhoods, selling fruits and vegetables at a fraction of regular supermarket prices. The purpose of this study was to determine whether participation in the Veggie Mobile increases fruit and vegetable intake in a group of seniors. The intervention, buying fruits and vegetables from the Veggie Mobile, was implemented between April and October 2008 in two senior housing sites that had not previously received Veggie Mobile services. Participants were asked about fruit and vegetable intake using a modified six-item questionnaire based on the Behavioral Risk Factor Surveillance System at preintervention and again at 3 to 5 months. The post-survey also included questions about perceived benefits and barriers to using the Veggie Mobile. The two cross-sections of seniors were matched using date of birth. Wilcoxon signed rank test and paired samples t tests examined change in pre- and post-intervention variables. Seventy-nine older adults completed the baseline survey and 63 completed the post-survey. Of these, 43 participants completed both surveys (70% white [n=30], mean age 69 ± 9 years). Mean intake of fruits and vegetables after using the Veggie Mobile increased by 0.37 servings/day. Vegetable intake alone increased from 1.98 ± 1.71 servings/day to 2.58 ± 1.4 servings/day (P=0.027), half of which was potatoes. Change in fruit intake was not significant (P=0.358). At post-intervention, seniors visited the supermarket less often (P=0.001) and spent an average of $14.92 less during their last visit. The majority of participants who completed the post-survey (62 of 63) indicated being satisfied with the program. The Veggie Mobile provides an example of a simple community intervention that has potential to lead to positive behavior change among low-income seniors.

Lower fruit and vegetable (F/V) intake among socioeconomically disadvantaged groups has been well documented, and may be a consequence of a higher consumption of take-out foods. This study examined whether, and to what extent, take-out food consumption mediated (explained) the association between socioeconomic position and F/V intake. A cross-sectional postal survey was conducted among 1,500 randomly selected adults aged 25 to 64 years in Brisbane, Australia, during 2009 (response rate 63.7%, N=903). A food frequency questionnaire assessed usual daily servings of F/V (0 to 6), overall take-out consumption (times per week), and the consumption of 22 specific take-out items (never to once per day or more). These specific take-out items were grouped into “less healthy” and “healthy” choices and indexes were created for each type of choice (0 to 100). Socioeconomic position was ascertained by education. The analyses were performed using linear regression, and a bootstrap resampling approach estimated the statistical significance of the mediated effects. Mean daily servings of F/V were 1.89±1.05 and 2.47±1.12, respectively. The least educated group members were more likely to consume fewer servings of fruit (β= −.39, P<0.001) and vegetables (β= −.43, P<0.001) compared with members of the highest educated group. The consumption of “less healthy” take-out food partly explained (mediated) education differences in F/V intake; however, no mediating effects were observed for overall and “healthy” take-out consumption. Regular consumption of “less healthy” take-out items may contribute to socioeconomic differences in F/V intake, possibly by displacing these foods.