Journal of Nutrition Education and Behavior最新文献

Objective: This cross-sectional study explored factors associated with school lunch participation with universal free meals.

Methods: Fifty-nine foodservice authorities representing 103 Minnesota secondary schools provided survey data assessing lunch participation and school factors, including location, school enrollment, school type, free/reduced eligibility, open campus policies, eating time, lunch start times, foodservice production type, and Smarter Lunchrooms techniques. Generalized estimating equation regression assessed the relation between these factors and lunch participation.

Results: Mean lunch participation rates were 53% for high schools, 63% for middle schools, and 65% for Jr/Sr high schools. Compared with conventional foodservice production systems, nonconventional systems were associated with a 16 percentage point lower participation (P < 0.01). No other factors were statistically associated with lunch participation.

Conclusions and implications: Foodservice production systems may be a key overlooked factor related to meal participation. Larger-scale research is needed to clarify the impact foodservice production systems have on meal participation.

Objective: To examine community food and nutrition assistance providers' perceptions of Latino adults with limited income and limited English proficiency (LEP), and the services provided to them.

Design: In-depth semistructured interviews.

Setting: US (2022).

Participants: Community food and nutrition assistance providers (n = 20) ANALYSIS: Verbatim transcripts were analyzed using thematic content analysis, fitted into a theory on language use, social positioning, and Latino adults' health. Member checking verified the findings.

Results: Subordinate social positions of Latino adults with LEP when procuring community food and nutrition assistance stemmed from perceived authority (community food and nutrition assistance providers' social power), loss of Latino participants' adequation (social isolation), and their diminished authentication (barriers to validate information).

Conclusions and implications: Subordinate social positioning in community food and nutrition assistance procurement among Latino adults with LEP may persist because of structures favoring those English proficient. Evaluating approaches that intentionally design community food and nutrition assistance for this population is needed to inform their influence on these structures.

Objective: To examine students' perceptions of school lunches, their association with self-reported participation, and variations based on free or reduced-price meal (FRPM) eligibility, race, and ethnicity.

Design: Cross-sectional study with data from an online survey administered in 2023.

Participants: A total of 1,230 middle and high school students from 8 US states.

Main outcome measures: Perceptions of school lunches and self-reported participation.

Analysis: Multilevel mixed-effects Poisson and logistic regression models.

Results: Around half of students liked school lunches (49%), and less than half had positive perceptions about their quantity (42%), variety (49%), healthfulness (41%), and familiarity (20%); however, positive perceptions were associated with higher self-reported participation. Black and White students reported higher participation and more favorable perceptions of school lunches than peers from other racial/ethnic backgrounds. Students eligible for FRPM and those near eligible had higher participation, but students eligible for FRPM had less favorable lunch perceptions compared with those not eligible for FRPM. Black students and those from lower-income households more often reported that school lunches are healthier than foods they bring from home, compared with students from other backgrounds and households with higher income.

Conclusions and implications: Enhancing the quality, variety, healthfulness, and familiarity of school meals may increase participation and, over time, promote students' health and development.

Objective: We developed a culturally-grounded intervention to promote healthy beverage consumption among Navajo children aged 2-5 years. This study, which took place from 2021-2023, evaluated prepost changes in beverage habits and caregiver knowledge and attitudes.

Methods: Prospective cohort study with prepost evaluation. Children attending participating early child education sites and their primary caregivers were enrolled. Survey data were collected at baseline, during the school year, and immediately after completion of the 4-month intervention.

Results: Average daily water intake increased significantly from 17.0 to 22.3 fl oz, P = 0.003. There was no significant change in consumption of other specific beverages, nor in the consumption of all sugar-sweetened beverages combined (P = 0.94). The proportion of caregivers who agreed or strongly agreed that they were knowledgeable about Diné traditions about water increased from 59.3% to 87.0% (P = 0.001). Similarly, those who agreed that Diné traditions about water influenced what drink they offered their children increased from 46.3% to 81.5% (P < 0.001).

Conclusions and implications: Our pilot study suggests that a culturally-grounded water promotion program for Navajo families may have a positive impact on strengthening cultural connections among caregivers and increasing water intake among children aged 2-5 years. Further research is needed to evaluate effectiveness.

Objective: To examine the relationship between meal plan subscription and fruit and vegetable (F&V) intake among first- and second-year college students.

Methods: A prospective cohort study (0-6 months) assessed F&V intake using a Veggie Meter and explored perceptions of F&V intake through focus group discussions (FGDs). Participants (n = 93, follow-up n = 58) were students at a public university. Paired Wilcoxon signed-rank tests and Mann-Whitney U tests were used for quantitative analysis and thematic analysis for FGD transcripts.

Results: Veggie Meter scores showed no significant changes within or between groups from baseline to 6 months. FGDs revealed similar influencing factors among students with and without meal plans, including sensory appeal, F&V knowledge, cost, and limited appealing F&V options.

Conclusions and implications: Meal plan subscription was not associated with higher Veggie Meter scores. Enhancing meal plan structures to improve the access, appeal, and affordability of F&V may support healthier dietary behaviors among college students.

Objective: To explore adolescents' perceptions of disordered eating behaviors, influencing factors, and perceived effects on health and well-being.

Design: Focus group discussions.

Setting: Porto, Portugal.

Participants: 80 adolescents aged 15-19 years.

Phenomenon of interest: Disordered eating behaviors.

Analysis: Thematic content analysis.

Results: Factors influencing disordered eating behaviors include individual (including response to emotional status, body image, and self-perception), interpersonal (encompassing interactions with school peers and family, and health professionals), and social factors (namely social norms regarding beauty and their influences, such as social media). In terms of the impact of disordered eating, health implications such as malnutrition, obesity, and some cardiometabolic disorders were mentioned. Disordered eating behaviors, according to the adolescents' perspective, can also lead to guilt and depression and serve as a pathway to eating disorders. In addition, concerns about weight and body image were identified as contributing to social isolation.

Conclusions and implications: Findings highlight the complex interplay of factors shaping disordered eating behaviors in adolescents. Comparison with others, body image concerns, beauty standards, and social media emerged as key influencing factors, along with appearance-related comments. Future research could assess longitudinal social media effects, media literacy interventions, and explore gender-specific experiences across clinical and nonclinical settings.

The digital transformation of the retail food environment is reshaping public health, producing both positive and negative impacts on how US consumers access food. This Research Report synthesizes these changes and explains why public health nutrition must modernize definitions and measures of food access, highlighting priority directions for new measurement approaches. Finally, we discuss future research and practice needs and directions, and describe how innovative nutrition education and behavior strategies, appropriate measurement, and policy, systems, and environmental (PSE) approaches can align public health and health equity efforts with the ongoing digital transformation of the food environment.

Objective: To evaluate the validity of 2 brief screeners designed to assess overall diet quality: the Med-South Dietary Risk Assessment for medium-contact dietary counseling and the Med-South Starting the Conversation tool for brief dietary counseling by primary care clinicians.

Design: Cross-sectional study comparing scores from brief dietary screeners to diet quality indexes derived from the Harvard Food Frequency Questionnaire.

Setting: Participants were enrolled from 7 practices located in North Carolina.

Participants: Patients (n = 346) referred to a weight loss study by primary care clinicians.

Main outcome measures: Correlations between screener scores and the Alternate Healthy Eating Index-2010, Dietary Approaches to Stop Hypertension, and alternate Mediterranean Diet scores.

Analysis: Pearson correlation coefficients for crude correlations and partial correlation coefficients for adjusted correlations.

Results: The mean ± SD age was 54.6 ± 12.1 years, and the median (interquartile range) body mass index was 35.1 (32.4-40.0) kg/m². Crude and adjusted correlations between the brief screeners and the diet quality indexes ranged from 0.53-0.61.

Conclusions and implications: Observed validation correlations were similar to those for other previously validated brief screeners. Because referent measures were diet quality scores associated with favorable health outcomes, these screeners are preferred over previously validated screeners, which focus on limited components (e.g,. fat intake) of dietary intake.

Objective: To explore attitudes and preferences related to remote nutrition education programming for Latino families in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and primary care.

Design: Community-engaged, qualitative, thematic analysis of interviews and focus groups.

Setting: Prenatal and pediatric primary care and WIC sites in Manhattan, Queens, and Nassau Counties, New York.

Participants: Four stakeholder groups: (1) past participants of a primary care-based obesity prevention program (Starting Early Program Prenatal) for Latino families that transitioned to remote delivery because of coronavirus disease 2019 (n = 40), (2) Latina WIC participants, including pregnant women and mothers of young children (n = 40), (3) Starting Early Program Prenatal staff (n = 6), and (4) WIC staff (n = 16).

Phenomenon of interest: Attitudes and preferences related to in-person vs remote nutrition education programming.

Analysis: Focus groups and interviews were audio-recorded, transcribed, and analyzed for emergent themes using reflexive thematic analysis.

Results: Four themes emerged: (1) valuing in-person social connection while recognizing barriers to in-person gathering, (2) navigating distraction-related barriers to remote engagement, (3) consistent content delivery but uncertain quality of remote programs, and (4) coronavirus disease 2019 pandemic-related contextual factors.

Conclusions and implications: Future remote programs in WIC may benefit from incorporating opportunities for social interaction, explicit discussion of anticipated barriers, and strategies to overcome them.