An Entropy-Based Approach to Measuring Diet Adherence.

The aim of this study is to put forward an approach designed to calculate and sum up discrepancies between the actual food acquisition or intake and any standard or norm. Based on secondary analysis of cross-sectional data from the Mexican National Survey of Household Income and Expenditure, our proposed method to produce classes of entropy-based Diet Adherence Indices generates a Food Basket Adherence Index (FBAI) for Mexico City (2129 households). Findings suggest that it is possible to measure and decompose diet adherence using a cross entropy measure. Using food expenditure data and a normative food basket for Mexico City results, we show households' deviations from the suggested norm for different food groups. The average FBAI was 0.44, far above the minimum score of 0 which would indicate full adherence to the normative food basket. Our measure has a distribution wide enough to detect meaningful changes and distinguish between groups with known differences, providing important new insights on the linkages between home food environments and income distribution, and food insecurity and household distribution.

Cost-Minimized Nutritionally Adequate Food Baskets as Basis for Culturally Adapted Dietary Guidelines for Ethiopians.

The high prevalence of undernutrition, especially stunting, in Ethiopia hampers the country's economic productivity and national development. One of the obstacles to overcome undernutrition is the relatively high cost of food for low economic groups. In this study, linear programming was used to (i) identify urban and rural nutritionally adequate food baskets (FBs) with the highest affordability for an Ethiopian family of five and (ii) create urban and rural FBs, optimized for cultural acceptability, which are affordable for a family with the lowest income. Nutritionally adequate rural and urban FBs with highest affordability cost as little as Ethiopian Birr (ETB) 31 and 38 (~USD 1.07 and 1.31), respectively, but have poor dietary diversity (16 and 19 foods). FBs that cost ETB 71.2 (~USD 2.45) contained 64 and 48 foods, respectively, and were much more similar to the food supply pattern reported by FAO (15% and 19% average relative deviation per food category). The composed FBs, which are affordable for the greater part of the Ethiopian population, may serve as a basis for the development of culturally acceptable food-based dietary guidelines. These guidelines would recommend a diet composed of approximately up to 60% cereals, up to 20% roots and tubers, 10% legumes, and 10% fruits and vegetables by weight, plus only a small share from animal foods.

Nutritionally Optimized, Culturally Acceptable, Cost-Minimized Diets for Low Income Ghanaian Families Using Linear Programming.

The Ghanaian population suffers from a double burden of malnutrition. Cost of food is considered a barrier to achieving a health-promoting diet. Food prices were collected in major cities and in rural areas in southern Ghana. Linear programming (LP) was used to calculate nutritionally optimized diets (food baskets (FBs)) for a low-income Ghanaian family of four that fulfilled energy and nutrient recommendations in both rural and urban settings. Calculations included implementing cultural acceptability for families living in extreme and moderate poverty (food budget under USD 1.9 and 3.1 per day respectively). Energy-appropriate FBs minimized for cost, following Food Balance Sheets (FBS), lacked key micronutrients such as iodine, vitamin B12 and iron for the mothers. Nutritionally adequate FBs were achieved in all settings when optimizing for a diet cheaper than USD 3.1. However, when delimiting cost to USD 1.9 in rural areas, wild foods had to be included in order to meet nutritional adequacy. Optimization suggested to reduce roots, tubers and fruits and to increase cereals, vegetables and oil-bearing crops compared with FBS. LP is a useful tool to design culturally acceptable diets at minimum cost for low-income Ghanaian families to help advise national authorities how to overcome the double burden of malnutrition.

A Brief Community-Based Nutrition Education Intervention Combined With Food Baskets Can Increase Fruit and Vegetable Consumption Among Low-Income Latinos.

OBJECTIVE: To evaluate the impact of an 8-week community-based nutrition education program combined with food baskets on fruit and vegetable consumption (FVC) among Latinos. DESIGN: Pre-post intervention study assessing perceived barriers, knowledge, food efficacy, food outcomes, and FVC, using mixed methods (quantitative and qualitative). SETTING: Participants' recruitment and data collection took place in the Seattle Metropolitan area from September 2012 to July 2013. PARTICIPANTS: Participants' (n = 40) mean age was 37.8 (±10.5) years. Participants were mostly women, from Mexico, uninsured, low income, and overweight or obese. INTERVENTION: Nuestras Comidas was developed through the use of the Social Cognitive Theory and focused on increasing behavioral capability, food efficacy, food outcomes, and FVC. MAIN OUTCOME MEASURE: Dependent variables were knowledge, perceived barriers, food efficacy, food outcomes, and FVC. Independent variable was the intervention (pre-post). STATISTICAL ANALYSES: A McNemar exact test was computed for categorical variables and Wilcoxon signed-rank test and paired t test for continuous variables. Focus group data were analyzed by identifying common themes. RESULTS: Participation in the intervention was significantly associated with increased knowledge, food efficacy, and vegetable consumption. CONCLUSIONS AND IMPLICATIONS: A brief nutrition education intervention combined with food baskets can improve healthy eating among Latinos.