Journal of Nutrition Education and Behavior最新文献

Objective: Describe young children's beverage intake in early care and education (ECE) settings between 2008 and 2020 across multiple states in the US.

Methods: Multivariable-adjusted, age-stratified estimates of beverage consumption among children aged 12-60 months (n = 4,457) in ECE centers and homes (n = 846).

Results: During any given day in ECE, younger children had a 79.7% per-meal probability of consuming milk, 8.9% water, 19.8% 100% juice, and 3.2% sugar-sweetened beverages (SSBs), and a per-meal mean intake of 1.5 oz milk, 1.7 oz water, 2.2 oz 100% juice, and 2.9 oz SSBs. Older children had an 87.2% probability of consuming milk, 0.6% water, 2.9% 100% juice, and 4.2% SSBs, and a mean intake of 4.2 oz milk, 2.3 oz water, 3.6 oz 100% juice, and 5.9 oz SSBs.

Conclusions and implications: There is room to improve beverage intake in ECE, with a focus on increasing water and decreasing juice and SSB consumption. These results may justify policies to limit or prohibit juice consumption in ECE.

Objective: To explore postsecondary students' perspectives of the impacts of a mobile health (mHealth) food literacy intervention on dietary behaviors and why the intervention was or was not effective at influencing their dietary behavior.

Design: Qualitative study using semistructured focus groups.

Setting: Ontario, Canada.

Participants: Ten focus groups were conducted with postsecondary students (n = 30) aged 17-25 years from 2 universities.

Phenomenon of interest: The impacts of a mHealth food literacy intervention on participants' dietary behaviors and why the intervention was or was not effective.

Analysis: Focus group data were transcribed verbatim and analyzed using inductive thematic analysis.

Results: Themes regarding dietary impacts included increased dietary consciousness, decrease in perceived unhealthy foods, increase in perceived healthy foods, making healthier dietary choices, and the Hawthorne effect. Intervention effectiveness themes encompassed barriers and facilitators to engagement and participants' ability to implement the intervention into their dietary behaviors. Facilitators included intervention suitability and application functionality; barriers included technology concerns, lacking time, food accessibility, food affordability, and intervention suitability.

Conclusion and implications: This study provides insights into the impact, facilitators, and barriers of a mHealth food literacy intervention on postsecondary students' dietary behaviors. Consideration of these facilitators and barriers may improve the effectiveness of future interventions.

This report proposes the multisystem interconnected lifestyle (MIL) framework to describe how lifestyle behaviors (i.e., sleep, stress, activity, diet) work together to create profiles of young children's obesogenic risk. This report argues that considering lifestyle behaviors collectively within and across days more accurately captures the complexity of obesity risk. The MIL framework builds on social ecological models to situate lifestyle behavior profiles within the social connections and ecological contexts of children's lives. The MIL framework potentiates the next generation of obesity research, reflecting a holistic understanding of lifestyle behavior engagement that could inform more effective and targeted education and intervention approaches.

Objective: To explore the knowledge-action gap regarding health behaviors and their influencing factors among patients with metabolic dysfunction-associated fatty liver disease (MAFLD), using the Health Belief Model as a theoretical framework.

Design: A qualitative approach was adopted, involving semistructured interviews with individuals with MAFLD.

Setting: Participants were recruited from a community hospital and a tertiary hospital in Nanjing, China, between July and October 2022.

Participants: A purposive sample of 21 adults with MAFLD, who were primarily overweight or obese (86%), males (52%), and aged ≥ 60 years (52%).

Phenomenon of interest: This study focused on the knowledge-action gap in health behaviors among MAFLD patients.

Analysis: Data were analyzed using content analysis, with the Health Belief Model guiding the identification of themes and categorization of specific domains.

Results: This study found that perceptions of disease susceptibility and severity, perceived barriers to healthy lifestyles, and various modifying factors impeded the adoption of healthy behaviors. In contrast, perceived benefits, cues to action, and self-efficacy facilitated the implementation of these behaviors.

Conclusions and implications: This research highlights the factors contributing to the knowledge-action gap in health behaviors among MAFLD patients. The findings suggest potential targets for interventions aimed at enhancing the alignment between patients' knowledge and their actions, ultimately promoting better health outcomes.

Objective: Evaluate the usability and acceptability of a digital infant feeding module for use in a home visiting program.

Methods: Home visitors (n = 11) and mothers (n = 10) completed a qualitative interview while viewing a digital nutrition education module on infant feeding. Quantitative data were collected using the mHealth App Usability Questionnaire. Qualitative data were analyzed using inductive thematic analysis.

Results: Most participants (90%) reported that they would very likely use the module as part of home visits. mHealth App Usability Questionnaire subscale scores supported usability on a scale of 0-7 with ease of use (6.9 ± 0.40), interface and satisfaction (6.9 ± 0.30), and usefulness (6.8 ± 0.50). Barriers to usability included technology access and phone compatibility.

Conclusions and implications: The digital infant feeding module was deemed usable and acceptable by home visiting stakeholders. Future research is needed to determine the impact of brief digital educational modules on parental feeding behaviors and child health outcomes.

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.