Journal of the Academy of Nutrition and Dietetics最新文献_第4页

Timing of Energy Intake and Ultra-Processed Food Consumption Are Associated With Obesity in Adults in the United Kingdom: A Pooled Cross-Sectional Analysis of the National Diet and Nutrition Survey (2008-2019) 能量摄入和超加工食品消费的时间与英国成年人的肥胖有关：对全国饮食和营养调查（2008-2019）的汇总横断面分析。

IF 4 2区医学 Q2 NUTRITION & DIETETICS

Journal of the Academy of Nutrition and Dietetics

Pub Date : 2026-03-01 Epub Date: 2025-12-13 DOI: 10.1016/j.jand.2025.156261

Patrícia de Fragas Hinnig PhD , Fernanda Rauber PhD , Kiara Chang PhD , Eszter P. Vamos PhD , Renata Bertazzi Levy PhD

<div><h3>Background</h3><div>The distribution of energy intake and types of food consumed throughout the day may influence health.</div></div><div><h3>Objective</h3><div>This study investigated the association of energy intake and ultra-processed food (UPF) consumption in the morning, at midday, and in the evening with indicators of obesity.</div></div><div><h3>Design</h3><div>A pooled cross-sectional analysis of the National Diet and Nutrition Survey (2008-2019) of adults residing in England, Wales, Scotland, and Northern Ireland was conducted. Food consumption was assessed using 4-day food diaries. UPFs intake was assessed based on the Nova food classification. The 3 time periods were classified as morning (5:00 <span>am</span> to 10:59 <span>am</span>), midday (11:00 <span>am</span> to 4:59 <span>pm</span>), and evening (5:00 <span>pm</span> to 4:59 am).</div></div><div><h3>Participants/Setting</h3><div>This study included 5749 adults aged 19 to 64 years residing in private households in the United Kingdom.</div></div><div><h3>Main Outcome Measures</h3><div>The main outcome measures were overweight, obesity, and abdominal obesity. Body mass index (calculated as kg / m<sup>2</sup>) values ≥25 and ≥30 were used to classify overweight (including obesity) and obesity, respectively. Abdominal obesity was defined as a waist circumference ≥102 cm for men and ≥88 cm for women.</div></div><div><h3>Statistical Analyses Performed</h3><div>Multivariable logistic regression assessed the associations between the percentage of energy intake and the percentage of energy intake from UPFs in the morning, at midday, and in the evening, and indicators of obesity. Models were adjusted for sociodemographic variables (ie, sex, age, ethnicity, region, year of the survey, and social class occupation), behavioral variables (ie, physical activity, smoking status, frequency of alcohol consumption, sleep duration, and weight-loss diet), and variables related to food consumption.</div></div><div><h3>Results</h3><div>The highest percentage of energy intake in the morning (third tertile) was associated with a 19% reduction in the odds of being overweight (95% CI, 0.68 to 0.96), and the highest percentage in the evening was associated with a 21% higher odds of being overweight (95% CI, 1.01 to 1.44). A 10% increase in the percentage of energy intake from UPFs at midday and in the evening was associated with an 11% (95% CI, 1.02 to 1.20) and 10% (95% CI, 1.02 to 1.18) higher odds of overweight, respectively. The highest percentage of energy intake from UPFs in the morning, at midday, and in the evening (third tertile) was associated with a 26%, 25%, and 45% higher odds of obesity, respectively. A 10% increase in the percentage of energy intake from UPFs in the evening was associated with a 12% (95% CI, 1.03 to 1.22) higher odds of abdominal obesity.</div></div><div><h3>Conclusions</h3><div>The timing of energy intake was associated with overweight, and higher consumption of UP

背景：一天中能量摄入的分布和食物的种类可能会影响健康。目的：本研究调查了早晨、中午和晚上能量摄入和超加工食品（UPF）消费与肥胖指标的关系。设计：对居住在英格兰、威尔士、苏格兰和北爱尔兰的成年人的全国饮食和营养调查（2008-2019）进行了汇总横断面分析。用为期四天的食物日记来评估食物消耗。UPF摄入量根据Nova食品分类进行评估。这三个时间段被划分为上午（上午5:00至上午10:59）、中午（上午11:00至下午4:59）和晚上（下午5:00至凌晨4:59）。参与者/环境：本研究包括5749名年龄在19至64岁之间居住在英国私人家庭的成年人。主要结局指标：主要结局指标为超重、肥胖和腹部肥胖。BMI值≥25 kg/m2和≥30 kg/m2分别作为超重（包括肥胖）和肥胖的分类标准。腹部肥胖定义为男性腰围(WC)≥102 cm，女性腰围(WC)≥88 cm。进行了统计分析：多变量逻辑回归评估了能量摄入百分比和早上、中午和晚上从UPF摄入的能量百分比与肥胖指标之间的关系。根据社会人口学变量（性别、年龄、种族、地区、调查年份和社会阶层职业）、行为变量（体育活动、吸烟状况、饮酒频率、睡眠时间和减肥饮食）以及与食物消费相关的变量对模型进行了调整。结果：早晨（三分位数）能量摄入的最高百分比与超重几率降低19%相关（95% CI 0.68-0.96），而晚上能量摄入的最高百分比与超重几率增加21%相关（95% CI 1.01-1.44）。中午和晚上从UPF摄入的能量百分比增加10%，超重的几率分别增加11% （95% CI 1.02-1.20）和10% （95% CI 1.02-1.18）。早晨、中午和晚上（第三分位数）从UPF中摄入的能量比例最高，分别与肥胖几率增加26%、25%和45%相关。晚上从UPF中摄入的能量百分比增加10%，腹部肥胖的几率增加12% （95% CI 1.03-1.22）。结论：能量摄入的时间与超重有关，而一天中任何时间UPF的高消耗与肥胖有关。与早晨和中午相比，晚上的UPF消费与肥胖指标之间的相关性更强。

{"title":"Timing of Energy Intake and Ultra-Processed Food Consumption Are Associated With Obesity in Adults in the United Kingdom: A Pooled Cross-Sectional Analysis of the National Diet and Nutrition Survey (2008-2019)","authors":"Patrícia de Fragas Hinnig PhD , Fernanda Rauber PhD , Kiara Chang PhD , Eszter P. Vamos PhD , Renata Bertazzi Levy PhD","doi":"10.1016/j.jand.2025.156261","DOIUrl":"10.1016/j.jand.2025.156261","url":null,"abstract":"<div><h3>Background</h3><div>The distribution of energy intake and types of food consumed throughout the day may influence health.</div></div><div><h3>Objective</h3><div>This study investigated the association of energy intake and ultra-processed food (UPF) consumption in the morning, at midday, and in the evening with indicators of obesity.</div></div><div><h3>Design</h3><div>A pooled cross-sectional analysis of the National Diet and Nutrition Survey (2008-2019) of adults residing in England, Wales, Scotland, and Northern Ireland was conducted. Food consumption was assessed using 4-day food diaries. UPFs intake was assessed based on the Nova food classification. The 3 time periods were classified as morning (5:00 <span>am</span> to 10:59 <span>am</span>), midday (11:00 <span>am</span> to 4:59 <span>pm</span>), and evening (5:00 <span>pm</span> to 4:59 am).</div></div><div><h3>Participants/Setting</h3><div>This study included 5749 adults aged 19 to 64 years residing in private households in the United Kingdom.</div></div><div><h3>Main Outcome Measures</h3><div>The main outcome measures were overweight, obesity, and abdominal obesity. Body mass index (calculated as kg / m<sup>2</sup>) values ≥25 and ≥30 were used to classify overweight (including obesity) and obesity, respectively. Abdominal obesity was defined as a waist circumference ≥102 cm for men and ≥88 cm for women.</div></div><div><h3>Statistical Analyses Performed</h3><div>Multivariable logistic regression assessed the associations between the percentage of energy intake and the percentage of energy intake from UPFs in the morning, at midday, and in the evening, and indicators of obesity. Models were adjusted for sociodemographic variables (ie, sex, age, ethnicity, region, year of the survey, and social class occupation), behavioral variables (ie, physical activity, smoking status, frequency of alcohol consumption, sleep duration, and weight-loss diet), and variables related to food consumption.</div></div><div><h3>Results</h3><div>The highest percentage of energy intake in the morning (third tertile) was associated with a 19% reduction in the odds of being overweight (95% CI, 0.68 to 0.96), and the highest percentage in the evening was associated with a 21% higher odds of being overweight (95% CI, 1.01 to 1.44). A 10% increase in the percentage of energy intake from UPFs at midday and in the evening was associated with an 11% (95% CI, 1.02 to 1.20) and 10% (95% CI, 1.02 to 1.18) higher odds of overweight, respectively. The highest percentage of energy intake from UPFs in the morning, at midday, and in the evening (third tertile) was associated with a 26%, 25%, and 45% higher odds of obesity, respectively. A 10% increase in the percentage of energy intake from UPFs in the evening was associated with a 12% (95% CI, 1.03 to 1.22) higher odds of abdominal obesity.</div></div><div><h3>Conclusions</h3><div>The timing of energy intake was associated with overweight, and higher consumption of UP","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"126 3","pages":"Article 156261"},"PeriodicalIF":4.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145754678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Nutrition Considerations in Youth with Type 2 Diabetes using GLP-1 Receptor Agonists: A Commentary. 青少年2型糖尿病患者使用GLP-1受体激动剂的营养考虑：评论

IF 4 2区医学 Q2 NUTRITION & DIETETICS

Journal of the Academy of Nutrition and Dietetics

Pub Date : 2026-02-20 DOI: 10.1016/j.jand.2026.156317

Maria E Diaz, Grace Kim, Mili Vakharia

引用次数: 0

Housing Insecurity and Disordered Eating Behaviors in Adolescents: A Cross-Sectional Study Using 2022 National Survey of Children's Health Data. 青少年的住房不安全感和饮食失调行为：一项使用2022年全国儿童健康调查数据的横断面研究

IF 4 2区医学 Q2 NUTRITION & DIETETICS

Journal of the Academy of Nutrition and Dietetics

Pub Date : 2026-02-18 DOI: 10.1016/j.jand.2026.156318

Namrata Sanjeevi, Kayla Hooker

Background: Engagement in disordered eating behaviors (DEBs) during adolescence could have long-term implications on health. Previous studies investigating protective and risk factors of DEBs have predominantly focused on individual- and family-level aspects.

Objective: The objective of this study is to examine association of housing insecurity with DEBs in a nationally representative sample of adolescents from low-income households.

Design: A cross-sectional study design was used.

Participants/setting: Using 2022 National Survey of Children's Health data, adolescents, aged 12 years or older, and from households with incomes ≤200% federal poverty level were included (N = 5607). Housing insecurity was defined as experiencing 1 of the following: inability to pay mortgage/rent on time, history of homelessness, multiple moves, and caregiver stress on eviction/foreclosure.

Main outcome measures: Main outcome measures were engagement in 1 or more DEB and individual DEBs.

Statistical analyses: Logistic regression models, adjusted for demographic covariates and food security status, examined associations of experiencing housing insecurity with engaging in 1 or more DEB as well as individual DEBs (ie, skipping meals or fasting, having low interest in food, extremely picky eating, or binge eating) in male and female adolescents.

Results: Housing insecurity was significantly associated with greater odds of engaging in 1 or more DEB in female adolescents (odds ratio [OR] 1.52; 95% CI, 1.07 to 2.15). Housing insecurity also was significantly associated with greater odds of low interest in food (OR 1.64; 95% CI, 1.07 to 2.51) and extremely picky eating (OR 1.89; 95% CI, 1.20 to 2.99) in female adolescents.

Conclusions: Study findings indicate that housing insecurity is associated with certain DEBs in female adolescents, independent of food security status. Additional research is needed to elucidate mechanisms linking housing insecurity and DEBs in adolescents.

背景：青春期进食障碍行为（DEBs）可能会对健康产生长期影响。先前的研究主要集中在个人和家庭层面，调查deb的保护和风险因素。目的：本研究的目的是在低收入家庭青少年的全国代表性样本中检查住房不安全感与DEBs的关系。设计：采用横断面研究设计。使用2022年全国儿童健康调查数据，包括12岁或以上的青少年，以及收入≤200%联邦贫困水平的家庭（n=5607）。住房不安全被定义为经历以下情况之一：1)无法按时支付抵押贷款/租金，2)无家可归的历史，3)多次搬家，4)被驱逐/丧失抵押品赎回权的照顾压力。主要结果测量：主要结果测量是参与1)一个或多个DEB和2)个体DEB。统计分析：逻辑回归模型，对人口统计协变量和食品安全状况进行了调整，检查了男女青少年经历住房不安全与参与一个或多个DEB以及个人DEB（即不吃饭或禁食；对食物不感兴趣；极度挑食；暴饮暴食）之间的联系。结果：住房不安全感与女性青少年参与一个或多个DEB的几率显著相关(优势比(or)=1.52；95%置信区间(CI)=(1.07, 2.15)。住房不安全感也与女性青少年对食物不感兴趣（OR=1.64; 95% CI=(1.07, 2.51)）和极度挑食（OR=1.89; 95% CI=(1.20, 2.99)）的几率显著相关。结论：研究结果表明，住房不安全感与女性青少年的某些DEBs有关，而与食物安全状况无关。需要进一步的研究来阐明住房不安全和青少年DEBs之间的联系机制。

{"title":"Housing Insecurity and Disordered Eating Behaviors in Adolescents: A Cross-Sectional Study Using 2022 National Survey of Children's Health Data.","authors":"Namrata Sanjeevi, Kayla Hooker","doi":"10.1016/j.jand.2026.156318","DOIUrl":"10.1016/j.jand.2026.156318","url":null,"abstract":"<p><strong>Background: </strong>Engagement in disordered eating behaviors (DEBs) during adolescence could have long-term implications on health. Previous studies investigating protective and risk factors of DEBs have predominantly focused on individual- and family-level aspects.</p><p><strong>Objective: </strong>The objective of this study is to examine association of housing insecurity with DEBs in a nationally representative sample of adolescents from low-income households.</p><p><strong>Design: </strong>A cross-sectional study design was used.</p><p><strong>Participants/setting: </strong>Using 2022 National Survey of Children's Health data, adolescents, aged 12 years or older, and from households with incomes ≤200% federal poverty level were included (N = 5607). Housing insecurity was defined as experiencing 1 of the following: inability to pay mortgage/rent on time, history of homelessness, multiple moves, and caregiver stress on eviction/foreclosure.</p><p><strong>Main outcome measures: </strong>Main outcome measures were engagement in 1 or more DEB and individual DEBs.</p><p><strong>Statistical analyses: </strong>Logistic regression models, adjusted for demographic covariates and food security status, examined associations of experiencing housing insecurity with engaging in 1 or more DEB as well as individual DEBs (ie, skipping meals or fasting, having low interest in food, extremely picky eating, or binge eating) in male and female adolescents.</p><p><strong>Results: </strong>Housing insecurity was significantly associated with greater odds of engaging in 1 or more DEB in female adolescents (odds ratio [OR] 1.52; 95% CI, 1.07 to 2.15). Housing insecurity also was significantly associated with greater odds of low interest in food (OR 1.64; 95% CI, 1.07 to 2.51) and extremely picky eating (OR 1.89; 95% CI, 1.20 to 2.99) in female adolescents.</p><p><strong>Conclusions: </strong>Study findings indicate that housing insecurity is associated with certain DEBs in female adolescents, independent of food security status. Additional research is needed to elucidate mechanisms linking housing insecurity and DEBs in adolescents.</p>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":" ","pages":"156318"},"PeriodicalIF":4.0,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146256870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Household Water Insecurity Is Associated With Greater Likelihood of Early Exclusive Breastfeeding Cessation and Diarrhea Among Children Aged 6 to 59 Months in Ethiopia: Data From Haramaya University Health and Demographic Surveillance System. 埃塞俄比亚6-59个月儿童早期停止纯母乳喂养和腹泻的可能性与家庭用水不安全有关：哈拉马亚大学健康和人口监测系统的数据。

IF 4 2区医学 Q2 NUTRITION & DIETETICS

Journal of the Academy of Nutrition and Dietetics

Pub Date : 2026-02-03 DOI: 10.1016/j.jand.2026.156303

Kedir Teji Roba, Akililu Abrham Roba, Jemal Yousuf Hassen, Gretchen Thompson, Alexandra Brewis, Asher Y Rosinger

Introduction: In low-resource settings, exclusive breastfeeding (EBF) and household water security are recognized contributors to child health. Yet few studies have examined how they are related.

Objectives: This study aims to (1) test the relationship between domains of household water insecurity and EBF cessation before 6 months, and (2) examine the association between water insecurity and recent child diarrheal disease and stunting.

Design: The Haramaya University Health and Demographic Surveillance System is a cross-sectional survey.

Participants/setting: Mother-child (aged 6-59 months) dyads (n = 1019) were recruited from smallholder agricultural households in rural Eastern Ethiopia in 2019.

Main outcome measures: The primary outcome was EBF cessation before 6 months. Secondary outcomes were children's diarrhea (last 2 weeks) and stunting. Exposure variables assessing water insecurity included time spent fetching water, objective water quality (Escherichia coli presence), water source reliability, and overall household water insecurity status (classified using the Household Water InSecurity Experiences Scale).

Statistical analyses: Survey logistic regression models were used to assess associations of water insecurity domains with early EBF cessation, diarrhea, and stunting.

Results: Poor water quality (adjusted odds ratio [AOR], 1.42; 95% confidence interval [CI], 1.06-1.98), unreliable water (AOR, 1.44; 95% CI, 1.04-1.98), and water fetching time >30 minutes (AOR, 1.54; 95% CI, 1.15-2.05) were associated with early EBF cessation risk. Children in households classified as moderate (AOR, 1.54; 95% CI, 1.03-2.30) or high water insecurity (AOR, 2.07; 95% CI, 1.33-3.24) had a greater risk of diarrhea. No association was observed between domains of water insecurity and stunting.

Conclusion: Multiple domains of water insecurity were associated with early EBF cessation, and overall water insecurity was associated with children's diarrheal risk. Water insecurity has been identified as a key programmatic and policy consideration for early childhood nutrition.

简介：在资源匮乏的环境中，纯母乳喂养和家庭用水安全被公认为促进儿童健康的因素。然而，很少有研究调查它们之间的关系。目的：本研究旨在1)检验家庭水不安全领域与6个月前停止EBF之间的关系，2)检验水不安全与近期儿童腹泻病和发育迟缓之间的关系。设计：原屋大学健康和人口监测系统是一项横断面调查。参与者/环境：2019年，从埃塞俄比亚东部农村的小农家庭招募了1,019对母子（6-59个月）。主要结局指标：主要结局为6个月前EBF停止。次要结局是儿童腹泻（最后两周）和发育迟缓。评估水不安全的暴露变量包括取水时间、客观水质（大肠杆菌存在）、水源可靠性和总体家庭水不安全状况（使用家庭水不安全体验量表进行分类）。统计分析：使用调查逻辑回归模型来评估水不安全域与早期EBF停止、腹泻和发育迟缓的关系。结果：水质差（AOR=1.42: 95% CI: 1.06-1.98）、水质不可靠（AOR= 1.44: 95% CI: 1.04-1.98）和取水时间bbb30分钟（调整优势比[AOR]=1.54, 95% CI: 1.15-2.05）与EBF早期停止风险相关。中度（AOR=1.54; 95% CI: 1.03-2.30）或高度水不安全（AOR=2.07; 95% CI: 1.33-3.24）家庭的儿童腹泻风险更高。未观察到水不安全领域与发育迟缓之间的关联。结论：多个领域的水不安全与早期EBF停止有关，而整体水不安全与儿童腹泻风险有关。水不安全已被确定为幼儿营养的一个关键规划和政策考虑因素。

{"title":"Household Water Insecurity Is Associated With Greater Likelihood of Early Exclusive Breastfeeding Cessation and Diarrhea Among Children Aged 6 to 59 Months in Ethiopia: Data From Haramaya University Health and Demographic Surveillance System.","authors":"Kedir Teji Roba, Akililu Abrham Roba, Jemal Yousuf Hassen, Gretchen Thompson, Alexandra Brewis, Asher Y Rosinger","doi":"10.1016/j.jand.2026.156303","DOIUrl":"10.1016/j.jand.2026.156303","url":null,"abstract":"<p><strong>Introduction: </strong>In low-resource settings, exclusive breastfeeding (EBF) and household water security are recognized contributors to child health. Yet few studies have examined how they are related.</p><p><strong>Objectives: </strong>This study aims to (1) test the relationship between domains of household water insecurity and EBF cessation before 6 months, and (2) examine the association between water insecurity and recent child diarrheal disease and stunting.</p><p><strong>Design: </strong>The Haramaya University Health and Demographic Surveillance System is a cross-sectional survey.</p><p><strong>Participants/setting: </strong>Mother-child (aged 6-59 months) dyads (n = 1019) were recruited from smallholder agricultural households in rural Eastern Ethiopia in 2019.</p><p><strong>Main outcome measures: </strong>The primary outcome was EBF cessation before 6 months. Secondary outcomes were children's diarrhea (last 2 weeks) and stunting. Exposure variables assessing water insecurity included time spent fetching water, objective water quality (Escherichia coli presence), water source reliability, and overall household water insecurity status (classified using the Household Water InSecurity Experiences Scale).</p><p><strong>Statistical analyses: </strong>Survey logistic regression models were used to assess associations of water insecurity domains with early EBF cessation, diarrhea, and stunting.</p><p><strong>Results: </strong>Poor water quality (adjusted odds ratio [AOR], 1.42; 95% confidence interval [CI], 1.06-1.98), unreliable water (AOR, 1.44; 95% CI, 1.04-1.98), and water fetching time >30 minutes (AOR, 1.54; 95% CI, 1.15-2.05) were associated with early EBF cessation risk. Children in households classified as moderate (AOR, 1.54; 95% CI, 1.03-2.30) or high water insecurity (AOR, 2.07; 95% CI, 1.33-3.24) had a greater risk of diarrhea. No association was observed between domains of water insecurity and stunting.</p><p><strong>Conclusion: </strong>Multiple domains of water insecurity were associated with early EBF cessation, and overall water insecurity was associated with children's diarrheal risk. Water insecurity has been identified as a key programmatic and policy consideration for early childhood nutrition.</p>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":" ","pages":"156303"},"PeriodicalIF":4.0,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146117298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Neonatal Malnutrition Diagnoses Align Differently With Body Composition Outcomes: A Retrospective Cohort Analysis Evaluating 3 Different Growth Standards. 新生儿营养不良诊断与身体组成结果不同：一项评估三种不同生长标准的回顾性队列分析。

IF 4 2区医学 Q2 NUTRITION & DIETETICS

Journal of the Academy of Nutrition and Dietetics

Pub Date : 2026-02-03 DOI: 10.1016/j.jand.2026.156304

Louise Perna, Kera McNelis, Jacqueline Wessel, Stephanie Merlino Barr, Chunyan Liu, Shelley Ehrlich, Jae H Kim, Ting Ting Fu

Background: Proposed neonatal malnutrition criteria exist for nutritional assessment. Recommendations differ regarding which growth chart to use after premature birth.

Objective: This study compared malnutrition classification across Fenton, Olsen, and International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH) growth charts; examined their associations with body composition; and evaluated discrepancies in identifying fat-free mass (FFM) deficit and fat mass (FM) excess in preterm infants.

Design: This was a retrospective cohort study of preterm infants who underwent air displacement plethysmography.

Participants and setting: Two hundred eighty-five preterm infants (<37 weeks) from 4 Ohio neonatal intensive care units (2012-2023) were included. After excluding 22 infants for early air displacement plethysmography assessments (at or before 14 days) and 5 for gestational age <23 weeks + 4 days, 258 remained.

Main outcome measures: Main outcomes were malnutrition diagnosis using weight z score decline from birth to air displacement plethysmography assessment for each growth chart and FFM and FM z scores.

Statistical analyses performed: Linear regression models compared relationships between weight z score change amongst the 3 growth charts and with FFM and FM z scores. κ Coefficient and Bowker or McNemar test assessed malnutrition agreement between charts. Kruskal-Wallis test compared median body composition z scores across malnutrition categories.

Results: The 3 charts demonstrated strong associations between weight z score changes (R² = 0.8 to 0.9) but statistically significant discrepancies in malnutrition classifications (Fenton vs INTERGROWTH κ = 0.46, 95% CI 0.36 to 0.57; INTERGROWTH vs Olsen κ = 0.49, 95% CI 0.36 to 0.61; Fenton vs Olsen κ = 0.69, 95% CI 0.61 to 0.77; P < .05). INTERGROWTH identified fewer cases of malnutrition (P < .0001). Weight z score change and size-for-gestational-age exhibited significant associations with body composition z scores (P < .0001). Fenton classified more malnutrition in infants with low FFM (46.1% vs 16.4%; P < .0001), whereas INTERGROWTH classified more infants with no malnutrition in those with high FM (94.8% vs 69%; P < .0001).

Conclusions: Fenton growth chart is more likely than Olsen or INTERGROWTH to categorize infants with low FFM as having malnutrition.

背景：建议的新生儿营养不良标准存在于营养评估中。对于早产后使用哪种生长图表，建议存在分歧。目的：本研究比较了Fenton、Olsen和INTERGROWTH生长图的营养不良分类；研究了它们与身体成分的关系；并评估了早产儿在识别无脂量（FFM）不足和脂肪量（FM）过剩方面的差异。设计：这是一项回顾性队列研究，研究对象是接受空气置换体积脉搏描记术（ADP）的早产儿。参与者/环境：285名早产儿(主要结果测量：主要结果是使用体重z分数从出生到每个生长图表的ADP评估以及FFM和FM z分数进行营养不良诊断。进行了统计分析：线性回归模型比较了三个生长图中权重z分数变化与FFM和FM z分数之间的关系。Kappa系数和Bowker或McNemar测试评估图表间营养不良的一致性。Kruskal-Wallis测试比较了营养不良类别的身体成分z分数中位数。结果：三个图表显示体重z分数变化之间有很强的相关性（R2 0.8-0.9），但营养不良分类存在统计学上的显著差异(Fenton vs. INTERGROWTH κ=0.46, 95% CI:[0.36至0.57];INTERGROWTH vs. Olsen κ=0.49, 95% CI:[0.36至0.61];Fenton vs. Olsen κ=0.69, 95% CI:[0.61至0.77]；结论：Fenton生长图比Olsen或INTERGROWTH更有可能将低FFM婴儿分类为营养不良。

{"title":"Neonatal Malnutrition Diagnoses Align Differently With Body Composition Outcomes: A Retrospective Cohort Analysis Evaluating 3 Different Growth Standards.","authors":"Louise Perna, Kera McNelis, Jacqueline Wessel, Stephanie Merlino Barr, Chunyan Liu, Shelley Ehrlich, Jae H Kim, Ting Ting Fu","doi":"10.1016/j.jand.2026.156304","DOIUrl":"10.1016/j.jand.2026.156304","url":null,"abstract":"<p><strong>Background: </strong>Proposed neonatal malnutrition criteria exist for nutritional assessment. Recommendations differ regarding which growth chart to use after premature birth.</p><p><strong>Objective: </strong>This study compared malnutrition classification across Fenton, Olsen, and International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH) growth charts; examined their associations with body composition; and evaluated discrepancies in identifying fat-free mass (FFM) deficit and fat mass (FM) excess in preterm infants.</p><p><strong>Design: </strong>This was a retrospective cohort study of preterm infants who underwent air displacement plethysmography.</p><p><strong>Participants and setting: </strong>Two hundred eighty-five preterm infants (<37 weeks) from 4 Ohio neonatal intensive care units (2012-2023) were included. After excluding 22 infants for early air displacement plethysmography assessments (at or before 14 days) and 5 for gestational age <23 weeks + 4 days, 258 remained.</p><p><strong>Main outcome measures: </strong>Main outcomes were malnutrition diagnosis using weight z score decline from birth to air displacement plethysmography assessment for each growth chart and FFM and FM z scores.</p><p><strong>Statistical analyses performed: </strong>Linear regression models compared relationships between weight z score change amongst the 3 growth charts and with FFM and FM z scores. κ Coefficient and Bowker or McNemar test assessed malnutrition agreement between charts. Kruskal-Wallis test compared median body composition z scores across malnutrition categories.</p><p><strong>Results: </strong>The 3 charts demonstrated strong associations between weight z score changes (R<sup>2</sup> = 0.8 to 0.9) but statistically significant discrepancies in malnutrition classifications (Fenton vs INTERGROWTH κ = 0.46, 95% CI 0.36 to 0.57; INTERGROWTH vs Olsen κ = 0.49, 95% CI 0.36 to 0.61; Fenton vs Olsen κ = 0.69, 95% CI 0.61 to 0.77; P < .05). INTERGROWTH identified fewer cases of malnutrition (P < .0001). Weight z score change and size-for-gestational-age exhibited significant associations with body composition z scores (P < .0001). Fenton classified more malnutrition in infants with low FFM (46.1% vs 16.4%; P < .0001), whereas INTERGROWTH classified more infants with no malnutrition in those with high FM (94.8% vs 69%; P < .0001).</p><p><strong>Conclusions: </strong>Fenton growth chart is more likely than Olsen or INTERGROWTH to categorize infants with low FFM as having malnutrition.</p>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":" ","pages":"156304"},"PeriodicalIF":4.0,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146117279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Scoping Review of Dietary Management for Nondiabetic Gastroparesis: Evidence Limitations and Research Gaps. 非糖尿病性胃轻瘫饮食管理的范围综述：证据限制和研究空白。

IF 4 2区医学 Q2 NUTRITION & DIETETICS

Journal of the Academy of Nutrition and Dietetics

Pub Date : 2026-02-02 DOI: 10.1016/j.jand.2026.156302

Gemma P Fagan, Reema Rabheru, Danielle E Bear, Miranda C E Lomer

Background: Dietary management is essential in gastroparesis, but existing guidelines primarily focus on diabetic gastroparesis, highlighting a lack of evidence-based guidelines for patients with nondiabetic gastroparesis, who experience higher malnutrition and mortality rates. Management is complicated by a suggested bidirectional relationship with eating disorders.

Objective: To investigate evidence on dietary interventions, patterns, and intake in nondiabetic gastroparesis, including effects on symptoms, nutritional outcomes, quality of life (QoL), and their potential role in disordered eating behaviors.

Methods: A scoping review was conducted using the Joanna Briggs Institute methodology. A comprehensive search was conducted across 8 databases: Embase, MEDLINE, Web of Science Core Collection, Global Health, CINAHL, Scopus, CENTRAL and PsycInfo, alongside gray literature and citation searching. English-language studies from 2008 investigating dietary interventions, patterns, and intake in adults with objectively confirmed nondiabetic gastroparesis (idiopathic, autoimmune-related, postviral, or eating disorder-associated causes) were included. Two reviewers independently screened, extracted data, and synthesized findings using a narrative approach.

Results: Of 6212 articles screened by title/abstract, 88 underwent full-text review, and 13 met inclusion criteria. Of these, 7 studies examined dietary interventions, 5 assessed dietary patterns, and 2 reported dietary intake. Two were randomized controlled trials (RCTs) including 16 participants with nondiabetic gastroparesis; the remaining 11 observational studies included 679 participants with confirmed nondiabetic gastroparesis and 752 for whom cause was unspecified or delayed gastric emptying could not be confirmed. All included studies assessed symptom burden; 5 reported nutritional outcomes, and 2 evaluated dietary impact on QoL. No studies explored the role of diet in disordered eating. Considerable variation was observed in dietary management strategies across studies.

Conclusion: Research on dietary management in nondiabetic gastroparesis is limited, with significant variability in interventions, dietary definitions, and study designs, reflecting lack of standardization across intervention protocols and research methodology. Well-designed trials are needed to clarify the impact of diet on symptoms, nutritional status, and QoL, considering psychosocial effects and potential disordered eating risks.

背景：饮食管理对胃轻瘫至关重要，但现有指南主要关注糖尿病性胃轻瘫，强调缺乏针对非糖尿病性胃轻瘫患者的循证指南，非糖尿病性胃轻瘫患者营养不良和死亡率较高。与饮食失调的双向关系使管理变得复杂。目的：探讨非糖尿病性胃轻瘫患者饮食干预、模式和摄入的证据，包括对症状、营养结局、生活质量（QoL）的影响及其在饮食失调行为中的潜在作用。方法：采用乔安娜布里格斯研究所的方法进行范围审查。在Embase、MEDLINE、Web of Science Core Collection、Global Health、CINAHL、Scopus、CENTRAL和PsycInfo等8个数据库中进行了全面的检索，同时进行了灰色文献和引文检索。2008年的英语研究调查了客观确诊的非糖尿病性胃轻瘫（特发性、自身免疫相关、病毒后或饮食失调相关病因）的成人饮食干预、模式和摄入量。两位审稿人独立筛选、提取数据并使用叙述方法综合研究结果。结果：通过标题/摘要筛选的6212篇文章中，88篇进行了全文审查，13篇符合纳入标准。其中，7项研究检查了饮食干预，5项研究评估了饮食模式，2项研究报告了饮食摄入量。其中两项是随机对照试验（rct），包括16名非糖尿病性胃轻瘫患者；其余11项观察性研究包括679名确诊为非糖尿病性胃轻瘫的参与者和752名病因不明或胃排空延迟无法确认的参与者。所有纳入的研究都评估了症状负担；5个报告了营养结果，2个评估了饮食对生活质量的影响。没有研究探讨饮食在饮食失调中的作用。各研究在饮食管理策略上观察到相当大的差异。结论：非糖尿病性胃轻瘫患者的饮食管理研究有限，干预措施、饮食定义和研究设计存在显著差异，反映出干预方案和研究方法缺乏标准化。需要精心设计的试验来阐明饮食对症状、营养状况和生活质量的影响，同时考虑到心理社会影响和潜在的饮食失调风险。

{"title":"A Scoping Review of Dietary Management for Nondiabetic Gastroparesis: Evidence Limitations and Research Gaps.","authors":"Gemma P Fagan, Reema Rabheru, Danielle E Bear, Miranda C E Lomer","doi":"10.1016/j.jand.2026.156302","DOIUrl":"10.1016/j.jand.2026.156302","url":null,"abstract":"<p><strong>Background: </strong>Dietary management is essential in gastroparesis, but existing guidelines primarily focus on diabetic gastroparesis, highlighting a lack of evidence-based guidelines for patients with nondiabetic gastroparesis, who experience higher malnutrition and mortality rates. Management is complicated by a suggested bidirectional relationship with eating disorders.</p><p><strong>Objective: </strong>To investigate evidence on dietary interventions, patterns, and intake in nondiabetic gastroparesis, including effects on symptoms, nutritional outcomes, quality of life (QoL), and their potential role in disordered eating behaviors.</p><p><strong>Methods: </strong>A scoping review was conducted using the Joanna Briggs Institute methodology. A comprehensive search was conducted across 8 databases: Embase, MEDLINE, Web of Science Core Collection, Global Health, CINAHL, Scopus, CENTRAL and PsycInfo, alongside gray literature and citation searching. English-language studies from 2008 investigating dietary interventions, patterns, and intake in adults with objectively confirmed nondiabetic gastroparesis (idiopathic, autoimmune-related, postviral, or eating disorder-associated causes) were included. Two reviewers independently screened, extracted data, and synthesized findings using a narrative approach.</p><p><strong>Results: </strong>Of 6212 articles screened by title/abstract, 88 underwent full-text review, and 13 met inclusion criteria. Of these, 7 studies examined dietary interventions, 5 assessed dietary patterns, and 2 reported dietary intake. Two were randomized controlled trials (RCTs) including 16 participants with nondiabetic gastroparesis; the remaining 11 observational studies included 679 participants with confirmed nondiabetic gastroparesis and 752 for whom cause was unspecified or delayed gastric emptying could not be confirmed. All included studies assessed symptom burden; 5 reported nutritional outcomes, and 2 evaluated dietary impact on QoL. No studies explored the role of diet in disordered eating. Considerable variation was observed in dietary management strategies across studies.</p><p><strong>Conclusion: </strong>Research on dietary management in nondiabetic gastroparesis is limited, with significant variability in interventions, dietary definitions, and study designs, reflecting lack of standardization across intervention protocols and research methodology. Well-designed trials are needed to clarify the impact of diet on symptoms, nutritional status, and QoL, considering psychosocial effects and potential disordered eating risks.</p>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":" ","pages":"156302"},"PeriodicalIF":4.0,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146117248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Effectiveness of Medical Nutrition Therapy in Prevention and Treatment of Chronic Disease: A Position Paper of the Academy of Nutrition and Dietetics 医学营养治疗在慢性疾病预防和治疗中的有效性：营养与饮食学会立场文件。

IF 4 2区医学 Q2 NUTRITION & DIETETICS

Journal of the Academy of Nutrition and Dietetics

Pub Date : 2026-02-01 Epub Date: 2025-10-11 DOI: 10.1016/j.jand.2025.10.010

Lisa Moloney PhD, RDN , Mary Rozga PhD, RDN , Alison Steiber PhD, RDN , Deepa Handu PhD, RDN

It is the position of the Academy of Nutrition and Dietetics that all individuals with nutrition-related health conditions or risk factors should have access to medical nutrition therapy (MNT) provided by a registered dietitian nutritionist (RDN). MNT provided by RDNs is effective in improving health outcomes for many chronic conditions that are leading drivers of morbidity, mortality, and health care costs in the United States. Widespread access to MNT using an individualized, client-centered, and evidence-based approach has the potential to improve population health, reduce health disparities, and reduce health care costs associated with nutrition-related health conditions. This Academy of Nutrition and Dietetics position paper summarizes recent evidence from systematic reviews on the effectiveness of MNT provided by an RDN for the prevention and treatment of nutrition-related health conditions. A total of 25 systematic reviews published between 2017 and 2024 were summarized and assessed for certainty of evidence. Systematic reviews with high or moderate certainty of evidence demonstrate that MNT is likely effective in improving a range of health outcomes in adults with pre-diabetes, type 1 diabetes, type 2 diabetes, obesity, pre-hypertension, hypertension, dyslipidemia, chronic kidney disease, head and neck cancer, and chronic obstructive pulmonary disease compared with no MNT or standard care. Barriers exist to accessing MNT, including inadequate staffing of RDNs in some areas, a lack of provider referrals to an RDN for MNT, and a lack of payer coverage and reimbursement. This position was approved in September 2025 and will remain in effect until December 31, 2032.

营养和饮食学会的立场是，所有患有与营养有关的健康状况或风险因素的个人都应获得由注册营养师（RDN）提供的医疗营养治疗（MNT）。rdn提供的MNT在改善许多慢性疾病的健康结果方面是有效的，这些慢性疾病是美国发病率、死亡率和医疗保健费用的主要驱动因素。采用个性化、以客户为中心和以证据为基础的方法广泛获得妇幼保健服务，有可能改善人口健康，缩小健康差距，并降低与营养相关的健康状况相关的卫生保健费用。这份营养与饮食学会的立场文件总结了最近系统评价的证据，这些证据是由RDN提供的MNT在预防和治疗与营养有关的健康状况方面的有效性。总结并评估了2017年至2024年间发表的25篇系统综述的证据确定性。具有高或中等证据确定性的系统评价表明，与没有MNT或标准治疗相比，MNT可能有效改善患有糖尿病前期、1型糖尿病、2型糖尿病、肥胖、高血压前期、高血压、血脂异常、慢性肾病、头颈癌和慢性阻塞性肺疾病的成人的一系列健康结局。获得妇幼保健存在障碍，包括一些地区妇幼保健注册护士人员配备不足，缺乏提供人员向妇幼保健注册护士转诊，以及缺乏付款人覆盖和报销。该职位于2025年9月获得批准，有效期至2032年12月31日。

{"title":"The Effectiveness of Medical Nutrition Therapy in Prevention and Treatment of Chronic Disease: A Position Paper of the Academy of Nutrition and Dietetics","authors":"Lisa Moloney PhD, RDN , Mary Rozga PhD, RDN , Alison Steiber PhD, RDN , Deepa Handu PhD, RDN","doi":"10.1016/j.jand.2025.10.010","DOIUrl":"10.1016/j.jand.2025.10.010","url":null,"abstract":"<div><div>It is the position of the Academy of Nutrition and Dietetics that all individuals with nutrition-related health conditions or risk factors should have access to medical nutrition therapy (MNT) provided by a registered dietitian nutritionist (RDN). MNT provided by RDNs is effective in improving health outcomes for many chronic conditions that are leading drivers of morbidity, mortality, and health care costs in the United States. Widespread access to MNT using an individualized, client-centered, and evidence-based approach has the potential to improve population health, reduce health disparities, and reduce health care costs associated with nutrition-related health conditions. This Academy of Nutrition and Dietetics position paper summarizes recent evidence from systematic reviews on the effectiveness of MNT provided by an RDN for the prevention and treatment of nutrition-related health conditions. A total of 25 systematic reviews published between 2017 and 2024 were summarized and assessed for certainty of evidence. Systematic reviews with high or moderate certainty of evidence demonstrate that MNT is likely effective in improving a range of health outcomes in adults with pre-diabetes, type 1 diabetes, type 2 diabetes, obesity, pre-hypertension, hypertension, dyslipidemia, chronic kidney disease, head and neck cancer, and chronic obstructive pulmonary disease compared with no MNT or standard care. Barriers exist to accessing MNT, including inadequate staffing of RDNs in some areas, a lack of provider referrals to an RDN for MNT, and a lack of payer coverage and reimbursement. This position was approved in September 2025 and will remain in effect until December 31, 2032.</div></div>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"126 2","pages":"Article 156219"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Greenhouse Gas Emission Menu Icons Decrease Service of All Menu Items in Residential Dining Halls at a Large, Midwestern Public US University 温室气体排放菜单图标减少了美国中西部一所大型公立大学宿舍食堂所有菜单项目的服务。

IF 4 2区医学 Q2 NUTRITION & DIETETICS

Journal of the Academy of Nutrition and Dietetics

Pub Date : 2026-02-01 Epub Date: 2025-09-15 DOI: 10.1016/j.jand.2025.09.008

Andrew D. Jones PhD , Lesli Hoey PhD , Cindy W. Leung ScD , Melissa J. Slotnick PhD , Wei Hao PhD , Kitty Oppliger MPH , Alex Bryan , Steve Giardini MBA , Ha Young Kim , Steve Mangan , Hailey McQuaid MS , Melanie Reid , Keith Soster

Background

Reducing food-related greenhouse gas (GHG) emissions is essential for meeting global climate goals. Consumer information food labels are often associated with healthier diet choices, although less is known about the influence of environment-focused food labels.

Objective

Determine the effect of GHG emission menu icons on the service and intake of high-emission menu items in residential dining halls of a large, midwestern public US university.

Design

A cluster-randomized mixed-methods study design was employed. Three matched pairs of dining halls were randomized to intervention or control status. Data were collected on the amount of menu items served at dining halls; recent diet intake among a survey of frequent diners; and changes in food choices in response to menu icons among focus group participants.

Participants and Setting

The study was conducted in 6 residential dining halls. Foodservice data were based on 1 017 447 entries into dining halls; data were analyzed from 799 frequent diners who submitted survey responses at baseline (January 2022) and follow-up (March to April 2022). Five focus groups were conducted with 23 frequent diners in total across all groups.

Intervention

Traffic light-style GHG emission menu icons, representing the life cycle emissions of recipes, were displayed on all menu items in intervention dining halls for 10 weeks following a 4-week baseline period, alongside informational materials explaining the icons.

Main Outcome Measures

The difference between treatment groups in the change in per-person service (in grams) of high-emission menu items from baseline to follow-up.

Statistical Analyses

Generalized estimating equations using a gamma distribution and log link function were used to model treatment effects.

Results

Analyses of all menu items served indicated that per-person service (in grams) of high-, moderate-, and low-GHG emission menu items was lower at follow-up compared with baseline in intervention dining halls. This observed decline in service was statistically significantly greater than the change in service in control dining halls, wherein service declined more modestly or increased. Examining menu items that were exactly matched within dining hall pairs, only the service of low-emission menu items within intervention halls declined to a greater extent compared with control halls. Data from self-reports of recent diet by frequent diners showed no statistically significant treatment effects for the frequency of intake of any food category or overall diet quality.

Conclusions

GHG emission menu icons may not be sufficient to shift consumer food choices at scale in university dining settings.

背景：减少与粮食有关的温室气体（GHG）排放对于实现全球气候目标至关重要。消费者信息食品标签通常与健康饮食选择联系在一起，尽管人们对注重环境的食品标签的影响知之甚少。目的：确定温室气体排放菜单图标对美国中西部一所大型公立大学宿舍食堂高排放菜单项目的服务和摄入的影响。设计：采用集群-随机混合方法研究设计。三对匹配的食堂被随机分为干预组和对照组。收集了食堂菜单上菜品数量的数据；对经常用餐者的近期饮食摄入量的调查；此外，焦点小组参与者对菜单图标做出的食物选择变化。参与者/环境：该研究在六个住宿食堂进行。餐饮服务数据基于1,017,447次进入食堂的记录；研究人员分析了799名经常用餐者的数据，他们在基线（2022年1月）和随访（2022年3月至4月）期间提交了调查回复。五个焦点小组进行了研究，所有小组共有23名经常用餐的人。干预：在为期四周的基准期之后，在干预大厅的所有菜单项上显示代表食谱生命周期排放的温室气体排放菜单图标，为期10周，并提供解释图标的信息材料。主要结果测量：治疗组之间高排放菜单项目的人均服务(g)变化从基线到随访的差异。统计分析：使用伽玛分布和对数链接函数的广义估计方程来模拟治疗效果。结果：对所有菜单项目的分析表明，与基线相比，干预食堂的高、中、低温室气体排放菜单项目的人均服务(g)在随访时较低。这种观察到的服务下降在统计上明显大于控制食堂服务的变化，在控制食堂服务下降更温和或增加。在对餐厅内完全匹配的菜单项进行检查时，只有干预厅内低排放菜单项的服务比对照厅下降得更大。经常用餐者自我报告的近期饮食数据显示，在统计上，摄入任何种类食物的频率或整体饮食质量都没有显著的治疗效果。结论：温室气体排放菜单图标可能不足以在大学餐饮环境中大规模改变消费者的食物选择。

{"title":"Greenhouse Gas Emission Menu Icons Decrease Service of All Menu Items in Residential Dining Halls at a Large, Midwestern Public US University","authors":"Andrew D. Jones PhD , Lesli Hoey PhD , Cindy W. Leung ScD , Melissa J. Slotnick PhD , Wei Hao PhD , Kitty Oppliger MPH , Alex Bryan , Steve Giardini MBA , Ha Young Kim , Steve Mangan , Hailey McQuaid MS , Melanie Reid , Keith Soster","doi":"10.1016/j.jand.2025.09.008","DOIUrl":"10.1016/j.jand.2025.09.008","url":null,"abstract":"<div><h3>Background</h3><div>Reducing food-related greenhouse gas (GHG) emissions is essential for meeting global climate goals. Consumer information food labels are often associated with healthier diet choices, although less is known about the influence of environment-focused food labels.</div></div><div><h3>Objective</h3><div>Determine the effect of GHG emission menu icons on the service and intake of high-emission menu items in residential dining halls of a large, midwestern public US university.</div></div><div><h3>Design</h3><div>A cluster-randomized mixed-methods study design was employed. Three matched pairs of dining halls were randomized to intervention or control status. Data were collected on the amount of menu items served at dining halls; recent diet intake among a survey of frequent diners; and changes in food choices in response to menu icons among focus group participants.</div></div><div><h3>Participants and Setting</h3><div>The study was conducted in 6 residential dining halls. Foodservice data were based on 1 017 447 entries into dining halls; data were analyzed from 799 frequent diners who submitted survey responses at baseline (January 2022) and follow-up (March to April 2022). Five focus groups were conducted with 23 frequent diners in total across all groups.</div></div><div><h3>Intervention</h3><div>Traffic light-style GHG emission menu icons, representing the life cycle emissions of recipes, were displayed on all menu items in intervention dining halls for 10 weeks following a 4-week baseline period, alongside informational materials explaining the icons.</div></div><div><h3>Main Outcome Measures</h3><div>The difference between treatment groups in the change in per-person service (in grams) of high-emission menu items from baseline to follow-up.</div></div><div><h3>Statistical Analyses</h3><div>Generalized estimating equations using a gamma distribution and log link function were used to model treatment effects.</div></div><div><h3>Results</h3><div>Analyses of all menu items served indicated that per-person service (in grams) of high-, moderate-, and low-GHG emission menu items was lower at follow-up compared with baseline in intervention dining halls. This observed decline in service was statistically significantly greater than the change in service in control dining halls, wherein service declined more modestly or increased. Examining menu items that were exactly matched within dining hall pairs, only the service of low-emission menu items within intervention halls declined to a greater extent compared with control halls. Data from self-reports of recent diet by frequent diners showed no statistically significant treatment effects for the frequency of intake of any food category or overall diet quality.</div></div><div><h3>Conclusions</h3><div>GHG emission menu icons may not be sufficient to shift consumer food choices at scale in university dining settings.</div></div>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"126 2","pages":"Article 156206"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Self-Efficacy: The Key to Nutrition Facts Label Use: Theory-Based Findings from the 2019 Food and Drug Administration Food Safety and Nutrition Survey 自我效能：营养成分标签使用的关键——2019年FDA食品安全和营养调查（FSANS）基于理论的发现。

IF 4 2区医学 Q2 NUTRITION & DIETETICS

Journal of the Academy of Nutrition and Dietetics

Pub Date : 2026-02-01 Epub Date: 2025-09-13 DOI: 10.1016/j.jand.2025.09.007

Fanfan Wu PhD, Martine Ferguson MS, Amy Lando MPP, Linda Verrill PhD

Background

The Nutrition Facts label is a useful tool for consumers to achieve a healthy diet.

Objective

This study aimed to develop and test a theoretical framework examining factors that may influence consumers’ use of the Nutrition Facts label, using a nationally representative sample.

Design

Analyses of cross-sectional, nationally representative 2019 Food and Drug Administration Food Safety and Nutrition Survey data included developing a theoretical framework adopting key constructs from 2 health behavior theories—the Integrated Behavior Model and the Theory of Planned Behavior—to test research hypotheses.

Participants and Setting

Participants were 2041 US adults who participated in the 2019 Food and Drug Administration Food Safety and Nutrition Survey, Nutrition Version.

Main Outcome Measures

Consumers’ use of the Nutrition Facts label, health habits, self-efficacy, attitude, knowledge and skills, economic conditions, health status, potential exposure to the Nutrition Facts label, age, sex, education, race/ethnicity, and urbanicity were measured.

Statistical Analyses Performed

A structural equation model was used.

Results

Eighty-seven percent of respondents reported having used the Nutrition Facts labels on food packages. Among all factors tested, self-efficacy has the strongest positive relationship with consumers’ use of the label (standardized regression estimate = .67; P < .001). Findings also suggest that people living in urban areas are more likely to report using the Nutrition Facts label (standardized regression estimate = .11; P = .02). Results suggest that although knowledge and skills and attitude are not directly associated with consumers’ label use, the relationship between these 3 constructs is strongly mediated by self-efficacy (standardized regression estimates = .38; P < .001 and .10; P = .01, respectively). Furthermore, individuals with better health status and more exposure to the Nutrition Facts label are more likely to have higher levels of self-efficacy (standardized regression estimates = .34; P < .001 and .28; P < .001, respectively).

Conclusions

This study highlights the vital role self-efficacy plays in the theoretical model determining consumers’ use of the Nutrition Facts label. The results also shed light on the factors that are important to consider when developing strategies to increase self-efficacy for Nutrition Facts label use and target populations for education and intervention.

背景：营养成分标签是消费者实现健康饮食的有用工具。目的：本研究旨在开发和测试一个理论框架，考察可能影响消费者使用营养成分标签的因素，使用具有全国代表性的样本。设计：对具有全国代表性的2019年FDA食品安全和营养调查（FSANS）数据进行横断面分析，包括开发一个理论框架，该框架采用两种健康行为理论——综合行为模型（IBM）和计划行为理论（TPB）——的关键结构来检验研究假设。参与者是2041名美国成年人，他们参加了2019年FSANS营养版。主要结果测量：测量了消费者对营养成分标签的使用、健康习惯、自我效能、态度、知识和技能、经济条件、健康状况、潜在接触营养成分标签、年龄、性别、教育程度、种族/民族和城市化程度。进行统计分析：采用结构方程模型（SEM）。结果：87%的受访者报告使用过食品包装上的营养成分标签。在所有测试的因素中，自我效能感与消费者使用标签的正相关最强（标准化回归估计为0.67,p）。结论：本研究突出了自我效能感在决定消费者使用营养成分标签的理论模型中所起的重要作用。研究结果还揭示了在制定策略以提高营养成分标签使用的自我效能时需要考虑的重要因素，以及教育和干预的目标人群。

{"title":"Self-Efficacy: The Key to Nutrition Facts Label Use: Theory-Based Findings from the 2019 Food and Drug Administration Food Safety and Nutrition Survey","authors":"Fanfan Wu PhD, Martine Ferguson MS, Amy Lando MPP, Linda Verrill PhD","doi":"10.1016/j.jand.2025.09.007","DOIUrl":"10.1016/j.jand.2025.09.007","url":null,"abstract":"<div><h3>Background</h3><div>The Nutrition Facts label is a useful tool for consumers to achieve a healthy diet.</div></div><div><h3>Objective</h3><div>This study aimed to develop and test a theoretical framework examining factors that may influence consumers’ use of the Nutrition Facts label, using a nationally representative sample.</div></div><div><h3>Design</h3><div>Analyses of cross-sectional, nationally representative 2019 Food and Drug Administration Food Safety and Nutrition Survey data included developing a theoretical framework adopting key constructs from 2 health behavior theories—the Integrated Behavior Model and the Theory of Planned Behavior—to test research hypotheses.</div></div><div><h3>Participants and Setting</h3><div>Participants were 2041 US adults who participated in the 2019 Food and Drug Administration Food Safety and Nutrition Survey, Nutrition Version.</div></div><div><h3>Main Outcome Measures</h3><div>Consumers’ use of the Nutrition Facts label, health habits, self-efficacy, attitude, knowledge and skills, economic conditions, health status, potential exposure to the Nutrition Facts label, age, sex, education, race/ethnicity, and urbanicity were measured.</div></div><div><h3>Statistical Analyses Performed</h3><div>A structural equation model was used.</div></div><div><h3>Results</h3><div>Eighty-seven percent of respondents reported having used the Nutrition Facts labels on food packages. Among all factors tested, self-efficacy has the strongest positive relationship with consumers’ use of the label (standardized regression estimate = .67; <em>P</em> < .001). Findings also suggest that people living in urban areas are more likely to report using the Nutrition Facts label (standardized regression estimate = .11; <em>P</em> = .02). Results suggest that although knowledge and skills and attitude are not directly associated with consumers’ label use, the relationship between these 3 constructs is strongly mediated by self-efficacy (standardized regression estimates = .38; <em>P</em> < .001 and .10; <em>P</em> = .01, respectively). Furthermore, individuals with better health status and more exposure to the Nutrition Facts label are more likely to have higher levels of self-efficacy (standardized regression estimates = .34; <em>P</em> < .001 and .28; <em>P</em> < .001, respectively).</div></div><div><h3>Conclusions</h3><div>This study highlights the vital role self-efficacy plays in the theoretical model determining consumers’ use of the Nutrition Facts label. The results also shed light on the factors that are important to consider when developing strategies to increase self-efficacy for Nutrition Facts label use and target populations for education and intervention.</div></div>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"126 2","pages":"Article 156205"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A 2-Group Path Analysis of a Food Environment Conceptual Model by Food Security Status: Home Food Environment Variables Were Associated With Healthy Eating Index 2015 Component Scores for Total Vegetables Among Those With Food Security 基于食品安全状况的食品环境概念模型的2组路径分析：家庭食品环境变量与食品安全人群健康饮食指数2015年总蔬菜分量得分相关

IF 4 2区医学 Q2 NUTRITION & DIETETICS

Journal of the Academy of Nutrition and Dietetics

Pub Date : 2026-02-01 Epub Date: 2025-10-25 DOI: 10.1016/j.jand.2025.156222

Cerra C. Antonacci PhD, MBE, MHS , Regine Haardörfer PhD, MEd, MS , Megan R. Winkler PhD, RN , Terry J. Hartman PhD, MPH, RD , Alexandra B. Morshed PhD, MS , Candace Muncy , Michelle C. Kegler DrPH, MPH

Background

The Model of Community Nutrition Environments is a well-known conceptual model in public health nutrition, although few studies have tested the model as a valid representation of food environment-diet pathways. Further, no study has explored whether the model differs by food security status, despite documented disparities in food environments and diet for those experiencing food insecurity.

Objective

To test the Model of Community Nutrition Environments by food security status using multigroup path analysis.

Design

This secondary analysis of baseline data from a hybrid-effectiveness implementation trial, Healthy Homes/Healthy Families, which included a home environment survey and 2 unscheduled 24-hour dietary recalls, was merged with the US Department of Agriculture 2019 Food Access Research Atlas.

Participants/setting

Participants recruited through 4 United Way 2-1-1 agencies in Georgia were eligible if they were aged 18 to 70 years, spoke English, and self-reported a body mass index ≥20. Baseline data collection occurred from October 2020 to December 2022 (N = 510 participants).

Main outcome measures

Main outcomes included Healthy Eating Index 2015 component scores for total fruits and total vegetables.

Analyses

Multigroup path analysis compared the unstandardized effects of pathways in the Model of Community Nutrition Environments for those who were food secure and food insecure.

Results

The 2-group model had good global model fit (root mean square error of approximation = 0.000, comparative fit index = 1.000, Tucker-Lewis index = 1.000, standardized root mean square residual = 0.047). Home availability (b = .08 ± .04; P = .029) and accessibility (b = .68 ± .27; P = .012) of fruits and vegetables were positively associated with Healthy Eating Index 2015 scores for total vegetables among those with food security. No significant associations were found with either outcome among those with food insecurity. The food secure model explained more variance in the outcomes than the food insecure model (food secure: R²_total _fruits = 0.20, R²_{total vegetables} = 0.36; food insecure: R²_{total fruits} = 0.10, R²_total _vegetables = 0.06).

Conclusions

Additional mechanisms need to be added to the Model of Community Nutrition Environments to better explain food environment-diet pathways for those experiencing food insecurity.

社区营养环境模型是一个众所周知的公共卫生营养概念模型，尽管很少有研究测试该模型作为食物环境-饮食途径的有效代表。此外，没有研究探讨该模型是否因粮食安全状况而异，尽管有文献记载粮食不安全人群的粮食环境和饮食存在差异。目的应用多群通径分析方法对粮食安全状况对社区营养环境的影响模型进行检验。对混合效果实施试验“健康家庭/健康家庭”的基线数据进行的二次分析，包括家庭环境调查和两次计划外的24小时饮食召回，并与美国农业部2019年食品获取研究地图集合并。参与者/设置通过佐治亚州4家联合劝募协会2-1-1机构招募的参与者，年龄在18至70岁之间，会说英语，自我报告的体重指数≥20，符合条件。基线数据收集时间为2020年10月至2022年12月（N = 510名参与者）。主要结果包括2015年健康饮食指数的总水果和总蔬菜成分得分。多组路径分析比较了社区营养环境模型中路径对粮食安全和粮食不安全人群的非标准化影响。结果2组模型整体拟合良好（近似均方根误差= 0.000，比较拟合指数= 1.000，Tucker-Lewis指数= 1.000，标准化均方根残差= 0.047）。家庭可得性（b = 0.08±0.04;P = 0.029）和可得性（b = 0.68±0.27;P = 0.012）与食品安全人群2015年健康饮食指数总蔬菜得分呈正相关。在粮食不安全人群中，这两种结果均未发现显著关联。与粮食不安全模型相比，粮食安全模型解释的结果差异更大（粮食安全：r2水果总量= 0.20，r2蔬菜总量= 0.36；粮食不安全：r2水果总量= 0.10，r2蔬菜总量= 0.06）。结论需要在社区营养环境模型中添加其他机制，以更好地解释粮食不安全人群的食物环境-饮食途径。

{"title":"A 2-Group Path Analysis of a Food Environment Conceptual Model by Food Security Status: Home Food Environment Variables Were Associated With Healthy Eating Index 2015 Component Scores for Total Vegetables Among Those With Food Security","authors":"Cerra C. Antonacci PhD, MBE, MHS , Regine Haardörfer PhD, MEd, MS , Megan R. Winkler PhD, RN , Terry J. Hartman PhD, MPH, RD , Alexandra B. Morshed PhD, MS , Candace Muncy , Michelle C. Kegler DrPH, MPH","doi":"10.1016/j.jand.2025.156222","DOIUrl":"10.1016/j.jand.2025.156222","url":null,"abstract":"<div><h3>Background</h3><div>The Model of Community Nutrition Environments is a well-known conceptual model in public health nutrition, although few studies have tested the model as a valid representation of food environment-diet pathways. Further, no study has explored whether the model differs by food security status, despite documented disparities in food environments and diet for those experiencing food insecurity.</div></div><div><h3>Objective</h3><div>To test the Model of Community Nutrition Environments by food security status using multigroup path analysis.</div></div><div><h3>Design</h3><div>This secondary analysis of baseline data from a hybrid-effectiveness implementation trial, Healthy Homes/Healthy Families, which included a home environment survey and 2 unscheduled 24-hour dietary recalls, was merged with the US Department of Agriculture 2019 Food Access Research Atlas.</div></div><div><h3>Participants/setting</h3><div>Participants recruited through 4 United Way 2-1-1 agencies in Georgia were eligible if they were aged 18 to 70 years, spoke English, and self-reported a body mass index ≥20. Baseline data collection occurred from October 2020 to December 2022 (N = 510 participants).</div></div><div><h3>Main outcome measures</h3><div>Main outcomes included Healthy Eating Index 2015 component scores for total fruits and total vegetables.</div></div><div><h3>Analyses</h3><div>Multigroup path analysis compared the unstandardized effects of pathways in the Model of Community Nutrition Environments for those who were food secure and food insecure.</div></div><div><h3>Results</h3><div>The 2-group model had good global model fit (root mean square error of approximation = 0.000, comparative fit index = 1.000, Tucker-Lewis index = 1.000, standardized root mean square residual = 0.047). Home availability (<em>b</em> = .08 ± .04; <em>P</em> = .029) and accessibility (<em>b</em> = .68 ± .27; <em>P</em> = .012) of fruits and vegetables were positively associated with Healthy Eating Index 2015 scores for total vegetables among those with food security. No significant associations were found with either outcome among those with food insecurity. The food secure model explained more variance in the outcomes than the food insecure model (food secure: <em>R</em><sup>2</sup><sub>total</sub> <sub>fruits</sub> = 0.20, <em>R</em><sup>2</sup><sub>total vegetables</sub> = 0.36; food insecure: <em>R</em><sup>2</sup><sub>total fruits</sub> = 0.10, <em>R</em><sup>2</sup><sub>total</sub> <sub>vegetables</sub> = 0.06).</div></div><div><h3>Conclusions</h3><div>Additional mechanisms need to be added to the Model of Community Nutrition Environments to better explain food environment-diet pathways for those experiencing food insecurity.</div></div>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"126 2","pages":"Article 156222"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0