Journal of Nutrition Education and Behavior最新文献

Background

Food insecurity (FI) is a risk factor for many negative health outcomes. While 12.8% of United States (U.S.) residents experience FI, less is known about the prevalence rate and related experiences among Asian Americans (AA) and AA ethnicities.

Objective

This scoping review examines the evidence on FI and health outcomes among AA and disaggregated AA ethnicities.

Study Design, Settings, Participants

The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. The inclusion criteria were peer-reviewed, original research studies that examined FI prevalence and health outcomes for aggregated and disaggregated AA groups; published in English between 1975-November 2023; and conducted in the U.S. All age groups and research designs were included. Search terms focused on FI, health outcomes, and AA. Four databases (Pubmed, EBSCOhost, Wiley, ScienceDirect) and the first ten pages of Google Scholar were scanned.

Measurable Outcome/Analysis

Descriptive information from the research articles, FI prevalence rate, and health outcomes among AA, were extracted. When available, disaggregated AA ethnicity data were included.

Results

Of the included articles (n=12), most (n=8) utilized cross-sectional research designs. Most studies (n= 9) examined AA as an aggregated racial group and FI rates ranged between 2.3%-31.0%. Of the reported health outcomes, significant associations between FI and low whole fruit intake, high body mass index (BMI), and poor diet, sleep, and physical activity among AA adults were observed. Of the studies that examined differences between AA ethnicities (n=3), FI prevalence varied inconsistently (Southeast Asians=24.6-63.3%; South Asians=3.14-38.2%; East Asians=16.45-71.7%). Within this group, FI was significantly associated only with the diagnosis of depression.

Conclusions

FI was associated with diet outcomes and BMI, but not diet-related chronic disease prevalence within AA. Due to the large fluctuation of FI prevalence within individual AA ethnicities, more research is warranted to examine the extent to which FI and other risk factors contribute to diet-related health outcomes.

Funding

San Jose State University Circle of Friends Research Assistance Award

Background

Community food assistance programs are vital to addressing food security (FS) among unhoused individuals, yet limited research on barriers to utilizing foods obtained from these programs exists for this population.

Objective

To explore the perceived acceptance of a food distribution program (FDP) and related food utilization barriers (FUB) for unhoused individuals in Felton, California.

Study Design, Settings, Participants

A mixed-methods interview was conducted with individuals utilizing an FDP. The inclusion criteria were English-speaking adults over 18 years of age who met FDP eligibility and utilized the program. The interview guide contained five open-ended items on program acceptability and 14 validated quantitative items to assess FS and FUB. Probing questions prompted participants to elaborate upon FUB. Interviews were conducted until data saturation was met.

Measurable Outcome/Analysis

Interviews were audio recorded and transcribed verbatim. Descriptive data on demographics, FUB, and FS levels were analyzed using SPSS. FDP acceptability and probing questions about FUB were analyzed using inductive thematic analysis.

Results

Participants (N=10) mentioned high program acceptance and reported high FUB (n=7, 70%) and very low FS (n=8, 80%). Themes included: program appreciation and enhancement; FUB and enablers; external food-related factors; and community belonging. Participants appreciated the staff, yet offered suggestions for available food items. Common FUBs included the lack of refrigeration, cooking utensils, and large kitchen appliances. Participants commented on the increased cost of food and extreme weather as external barriers to their food supply; however, sharing food among community members and group cooking were mentioned as positive factors.

Conclusions

This research revealed how unhoused populations manage their food supply despite facing multiple adversities. Despite the high acceptance of the local FDP, participants experienced very low FS and high FUB levels. Further research should explore the impact of climate change and community belonging on FUB and FS levels. Policies and programs could focus on systemic changes to address the root causes of FUB and food insecurity for unhoused populations.

Funding

San Jose State University Circle of Friends Research Assistance Award

Background

In the United States (U.S.), approximately one-third of the food supply is wasted. Although few food waste policies exist to enforce food waste reduction (FWR) in food retail settings, many food retailers (FR) have corporate social responsibility (CSR) commitments to reduce food waste. To date, no evidence-based measurement tools exclusive for evaluating FWR efforts in food retail exist.

Objective

To develop and validate a questionnaire to evaluate FRs’ commitments to reduce food waste.

Study Design, Settings, Participants

This study had two phases; 1) to review existing literature to guide questionnaire development and 2) to conduct cognitive interviews to assess face validity of the developed questionnaire. Literature on existing FWR and sustainability frameworks guided the development of questionnaire items. Feedback for the questionnaire was gathered through structured cognitive interviews. Participants were recruited via purposive sampling. Inclusion criteria were that they were older than 18 years, worked in the U.S., and worked as a food systems researcher/professional.

Measurable Outcome/Analysis

Participants were asked about the overall questionnaire, areas that needed clarification, and the scoring system. Interviews continued until data saturation was met. The interviews were audio recorded, transcribed using Otter.AI, de-identified, and analyzed for recurring themes using inductive thematic analysis.

Results

The initial questionnaire contained six domains informed by existing FWR literature. These included current FWR commitments, food waste prevention practices, food rescue practices, food recycling practices, other sustainability-informed practices, and future commitments. Participants of the cognitive interview (n=4) mentioned that the tool was comprehensive and aligned with the Environmental Protection Agency Wasted Food Scale. Suggestions for improvement included adding a domain to address retailers employee education for FWR, improving readability of the questionnaire, and including examples of public FWR policies.

Conclusions

This evidence-based questionnaire comprehensively addresses areas for FWR among US FR. Future researchers can use this questionnaire to assess current CSR commitments toward FWR. Additionally, FR and policymakers can use this tool to guide the development of FWR initiatives.

Funding

Circle of Friends

Background

Despite the various pandemic-related food system challenges, national food security (FS) rates were largely unchanged during COVID-19. The charitable food system (CFS) played a vital role to address FS during the pandemic by adapting and innovating methods to feed communities.

Objective

This study explored the role of registered dietitian nutritionists (RDNs) in the CFS pandemic response.

Study Design, Settings, Participants

Semi-structured phone and Zoom interviews were conducted with staff, volunteers, partners, and neighbors (n=56) from 6 CFS programs/organizations across the USA between May and August 2022 as part of a cross-case analysis exploring innovative COVID-19 response.

Measurable Outcome/Analysis

Two coders used a data-driven analysis process to independently apply codes to transcripts within NVivo 12. Thematic analysis was used to explore codes related to roles and nutrition expertise in the CFS response among a subsample (n=11) of interviewees who identified as RDNs and/or nutrition experts.

Results

Over 90% of participants were RDNs (n=10), while the other nutrition expert (n=1) held a doctorate in nutrition. The integration of three key RDN scope of practice areas including foodservice systems management (eg, logistics, food safety), community nutrition (eg, needs/strengths assessment, community/client-centered approaches), and clinical dietetics (eg, tailoring for health/wellness/cultural preferences) emerged from interviews as vital strengths in the CFS pandemic response.

Conclusions

RDNs indicated that their broad training uniquely situated them to strengthen the CFS efforts during COVID-19. With the recent emphasis on Food is Medicine initiatives, examining the roles and responsibilities of RDNs working in the CFS can inform nutrition security initiatives beyond the pandemic.

Funding

Academy of Nutrition and Dietetics Foundation Accelerating Food Security: Supply Chain Innovation Fellowship

Objective

Compare the diet quality of a meal consumed at a community café (café meals), a pay-what-you-can restaurant, to a meal consumed for an equivalent eating occasion on the day before (comparison meal) by guests with food insecurity.

Methods

Dietary recalls were collected from café guests with food insecurity to determine the Healthy Eating Index-2020 (HEI-2020) total and component scores. Healthy Eating Index-2020 scores were compared between meals using paired-sample t tests and Wilcoxon signed-rank tests.

Results

Most participants (n = 40; 80% male; 42.5% Black) had very low food security (70.0%). Café meal had a higher HEI-2020 total score (46.7 ± 10.5 vs 34.4 ± 11.6; P < 0.001) and total vegetables (2.6 ± 2.0 vs 1.2 ± 1.7; P = 0.004), total fruits (2.1 ± 2.2 vs 0.6 ± 1.5; P < 0.001), whole fruits (1.6 ± 2.0 vs 0.3 ± 0.9; P < 0.001), and refined grains (7.8 ± 3.5 vs 3.9 ± 3.9; P < 0.001) scores than comparison meals.

Conclusions and Implications

The café meal had better diet quality than the comparison meal, suggesting its potential for improving diet quality among guests with food insecurity.

This paper describes the 30-year evolution of Supplemental Nutrition Assistance Program-Education (SNAP-Ed) to provide evidence to support our perspective that SNAP-Ed has earned its position as a pillar of the public health infrastructure in the US. Legislatively designated as a nutrition education and obesity prevention program, its focus is the nearly 90 million Americans with limited income. This audience experiences ongoing health disparities and is disproportionately affected by public health crises. The SNAP-Ed program works to reduce nutrition-related health disparities at all levels of the Social-Ecological Model, follows a robust evaluation framework, and leverages strong partnerships between state-based practitioners, state agencies, and the US Department of Agriculture. The expansion of SNAP-Ed would enable the program to reach more Americans so that our nation can end hunger and reduce diet-related health disparities.

Background

Evidence has shown inconclusive relationships between parent and child diets, including diet quality, despite an expected link.

Objective

The objective of this pilot study was to determine whether parent diet quality predicts child diet quality among low-income families in Indiana, United States.

Study Design, Settings, Participants

Baseline data collected from April 2023 to January 2024 from 49 paired parents 26-75 years and their children 5-17 years (one parent and one child) from low-income households throughout Indiana was utilized for this secondary analysis.

Measurable Outcome/Analysis

The parent completed the U.S. Household Food Security Survey Module and parent and child each completed one to four 24-hour dietary recalls. The Healthy Eating Index (HEI-2015) for both parent and child were derived using the simple method for individuals. Their associations were assessed via Pearson correlation (unadjusted) as well as multiple linear regression models with child HEI as the dependent variable, adjusted for food security status; child's sex, ethnicity, and age; and parent's age and smoking status.

Results

The HEI-2015 total scores indicated poor dietary quality for parents and children (50.9±11.6 and 51.5±12.1, respectively). The parent-child correlations for HEI-2015 that were statistically significant (p < 0.05) were weak to moderate (r=0.4 for total HEI, total fruits, greens and beans, and saturated fats; r=0.3 for whole fruits, total vegetables, and fatty acids; and r=0.5 for whole grains). When controlling for covariates, parent diet quality was not significantly related to child diet quality for the total HEI-2015 score but was significantly related for components such that an increase in one HEI point in the parent score, on average, was related to a small increase of 0.4 points for greens and beans (p=0.01), whole grains (p=0.004), and saturated fats (p=0.01); and 0.3 points for fatty acids (p=0.02) in the child scores.

Conclusions

A weak-moderate relationship existed between parent-child diets for several dietary quality components. Factors other than parental dietary quality may potentially play a role in child dietary quality among low-income households.

Funding

NIFA

Background

Literature regarding the relationship between stress and undergraduates’ dietary choices has been extensively documented, yet limited evidence recognizes the implications of emotional eating and one's ability to apply nutrition knowledge to diet quality (DQ).

Objective

To examine the relationship between undergraduates’ emotional response to food (ERF), interactive nutrition literacy (INL), and DQ.

Study Design, Settings, Participants

A cross-sectional study was conducted using an online survey among first-year nursing students enrolled in a four-year public university one week before the fall semester and at the beginning of an experiential learning program.

Measurable Outcome/Analysis

The Mindful Eating Questionnaire assessed ERF, with higher scores indicating decreased influence of one's emotions on dietary choices. INL was measured using the Young Adult Nutrition Literacy Scale, with higher scores indicating higher INL. DQ was indicated by the Short Healthy Eating Index, with higher scores indicating better DQ. Complete data were used in the analysis. Hierarchical multiple linear regression was used to identify if ERF and INL predicted DQ, while controlling for gender. Significance levels were p<0.05.

Results

Participants (N=56) were mostly white (93.5%), female (90.3%), and on average 19.1 ± 1.0 years old. Average DQ was 50.9 ± 9.6, out of 100. Average EFR was 3.11 ± 0.5 out of 5, and the average INL was 3.5 ± 0.7 out of 5. The first model was significant in predicting DQ. Significance remained when controlling for gender (F(2,55)=11.79, p<0.001). Participants’ ERF (β=.24, t(55)=3.47,p=0.001) accounted for 30% variance in DQ, and INL approached significance in the model (β=.41, t(55)=1.99, p=0.052).

Conclusions

Findings provide evidence for interventions emphasizing mindfulness and applying nutrition knowledge through experiential learning to facilitate positive eating behaviors and improve DQ among undergraduates.

Funding

NIH