Journal of Nutrition Education and Behavior最新文献

Objective: To assess the mean differences in outcomes of 3 delivery modalities of a nutrition education program targeting older adults.

Methods: A natural experiment was conducted from March 2020 to September 2021, with presurveys and postsurveys used to assess dietary and physical activity behaviors. Results were analyzed using descriptive statistics, t tests, and ANOVA, with a Bonferroni-corrected significance threshold at P < 0.001.

Results: There were 3 groups: in-person (n = 212), Zoom (n = 61), and phone (n = 104). Respondents aged > 70 years and in rural areas were more likely to be enrolled in person (P < 0.001). Across all modalities, there were significant improvements from before to after for most outcomes. The phone group reported significantly larger mean differences than the in-person group for fruit, vegetable, and whole grain consumption (P < 0.001).

Conclusions and implications: Healthy Eating, Staying Active as We Age can be delivered across all modalities. Future practitioners can use the findings to consider alternative modalities that may better meet the needs of their audience.

Introduction: This systematic review examines dietary interventions in the military nutrition environment (MNE) to support the health and performance of service members (SM).

Methods: Articles that implemented a dietary intervention for active duty SMs on military installations were included in this analysis (from 2010 to 2013). Of the 723 articles yielded in screening through Covidence, 6 studies qualified to be included in this review.

Results: Study interventions were grouped into color coding, food choice architecture, and menu modifications. All studies indicated increased nutrient intake. One study reported enhanced diet quality using the Healthy Eating Index. Two studies received positive customer feedback, and all selected studies demonstrated positive behavior modification among SM.

Discussion: All studies demonstrated improvement in diet-related outcomes, and behavior modification. Many barriers exist within MNE that need to be addressed to make meaningful changes. The heterogeneity in study designs and interventions poses challenges in reaching definitive conclusions.

Implications for research and practice: These results highlight the need for a more extensive examination of the military food environment across all venue types. Replication of standardized nutrition practices throughout the diverse military landscape can further impact the health, readiness, and performance of SM.

Objective: Assess if a virtual culinary medicine program improves healthy eating, glycosylated hemoglobin (HbA1c), and associated variables among adults with type 2 diabetes.

Design: Mixed-methods, intervention-only pilot study.

Setting: Classes via video conferencing from the teaching kitchen, with participants cooking from their homes.

Participants: One hundred and four patients from a Texas primary care system.

Interventions: Five-session program (Spanish and English) led by a dietitian.

Main outcome measures: HbA1c. Secondary outcomes included MyPlate knowledge, self-efficacy, healthy eating and cooking behaviors, diabetes self-management, perceived health, and blood pressure.

Analysis: Multilevel mixed-effects regression to analyze changes at pretreatment, posttreatment, and 6-month follow-up. Framework analysis to analyze postintervention interviews.

Results: Participants with complete posttest data (n = 61) demonstrated statistically significant (P <0.05) improvements in MyPlate knowledge, cooking self-efficacy, servings of fruits and vegetables, frequency of healthy food intake, shopping, cooking and eating behaviors, diabetes self-management, and perceived health, compared with pretest. HbA1c levels showed statistically significant reductions from pretest to posttest (P = 0.02) and at 6-month follow-up (P <0.001). Participants reported high satisfaction and sustained new habits.

Conclusions and implications: We saw improvements in healthy eating and cooking behaviors and HbA1c. While further rigorous testing is needed, this program could be incorporated into clinical practices as a brief intervention for patients with type 2 diabetes.

Objective: Describe experiences of, and responses to, 2022 infant formula shortages among households with infants aged up to 18 months by race/ethnicity using Household Pulse Survey data.

Methods: Outcomes included whether households were affected by shortages and, if so, 3 nonmutually exclusive response categories (increased breastmilk, obtained formula atypically, and disruptive coping [disruptions to breastmilk and/or formula]) and 1 mutually exclusive response category (solely disruptive coping). Unadjusted shares reporting each were compared using t tests. Regressions adjusting for household characteristics and fixed effects were used to examine associations between race/ethnicity and the outcomes.

Results: Shares affected by shortages declined over time as the formula supply improved. We found no association between race and ethnicity and reports of being affected by a shortage. Among affected households, non-Hispanic Black households were more likely to report disruptive coping than non-Hispanic White households (P = 0.03).

Conclusions and implications: Shortages may have widened racial/ethnic differences in infant feeding practices. Efforts to inform about infant feeding behaviors, improve access to formula, and/or increase participation in assistance programs could be targeted to those most likely to be affected by unexpected shortages or most likely to resort to disruptive coping behaviors. Further research could examine geographic variation in shortages and their long-term effects on infant feeding behaviors and infant and maternal health.

Objective: To explore dietary salt-related knowledge, attitudes, and behaviors of New Zealand (NZ) adults aged 18-65 years and assess differences by demographic subgroups.

Design: Cross-sectional online survey conducted between June 1, 2018 and August 31, 2018.

Setting: Participants were recruited in shopping malls, via social media, and a market research panel.

Participants: English-speaking adults residing in NZ.

Variables measured: An amended version of The Pan American and World Health Organization Knowledge, Attitudes, and Behaviors standardized survey tool was used. Demographic data (age, sex, ethnicity, and educational attainment) were also collected.

Analysis: Descriptive statistics reported. Chi-square test for independence to assess differences by demographics.

Results: The survey was completed by 1,131 adults (mean age 36 ± 15 years; n = 876 [78%] female; n = 661 [78%] NZ European/other; n = 210 [19%] Asian; n =164 [15%] Māori). In addition, 865 participants (83%) knew the primary dietary source of salt; 406 (40%) knew the recommended salt intake; 946 (95%) believed food manufacturers are responsible for sodium reduction; 563 (55%) supported government regulations; and 259 (26%) used food labels. Females and NZ European/other participants reported more favorable salt-reducing behaviors, such as avoiding fast-food and packaged, ready-to-eat foods (P < 0.001).

Conclusions and implications: Improving salt-related knowledge, attitudes, and behaviors in NZ is particularly important for men, underserved populations, and adults aged 45-65 years. A multicomponent, national NZ salt reduction program based on research addressing engagement and effectiveness for at-risk groups is warranted.

Objective: To assess the ability of trained university students to implement Cooking Matters for Kids, a hands-on nutrition and cooking education curriculum for third through fifth-grade children.

Methods: Process evaluation data were collected from 6 Cooking Matters for Kids courses led by university students in the fall of 2019 and spring of 2020 at 6 afterschool programs in Orange County, North Carolina. Trained research assistants observed lessons and reported whether key intervention components were implemented as planned, the level of participant engagement, what worked well, and what could be improved on.

Results: University students implemented the curriculum with high fidelity and kept most participants engaged during lessons. Dividing children into smaller groups and assigning instructor roles worked well. Limited completion of take-home challenge activities was an area to improve on.

Conclusions and implications: University students may be effective instructors for Cooking Matters for Kids and other related programs.

Objective: To explore the context, behaviors, strategies, and motivators of pregnant women who consume 5 servings of vegetables daily.

Methods: Positive deviance study involving Australian pregnant women (9 of 529) identified through a validated food frequency questionnaire. Semistructured interviews explored their strategies, behaviors, and motivators.

Results: Women valued vegetables for health benefits and disease management. Prioritizing vegetables in main meals and snacks was key, supported by planning, purchasing, and preparation. Social support and a positive environment facilitated regular vegetable consumption easier. Cooking skills and, in some cases, gardening were important enablers. Results provide practical strategies to address commonly reported challenges to vegetable consumption.

Conclusions and implications: Pregnant women's experiences of meeting vegetable intake recommendations offer valuable insights into practices that enhance dietary quality. Further research and testing in practice is warranted with pregnant women and their significant others to promote increased vegetable intake and better outcomes for families.

This article examines the recent implementation of Universal School Meals (USM) programs in several US states in the context of the increasing influence of neoliberalism in the public schooling system. By subverting a neoliberal paradigm, USM programs disrupt prevailing narratives of poverty and work to reclaim education's central place in the public sphere. A systems-thinking analysis of this issue reveals USM programs to be a powerful leverage point for change. Examining Vermont as a case study, this analysis explores how USM programs present an opportunity to reimagine the purpose of public schooling beyond the boundaries of a neoliberal paradigm.