Supporting optimal dietary behaviors in women with perinatal depression: A qualitative exploration of experiences, practices, and challenges.

BACKGROUND: Women with perinatal depression (PD) are at high risk for unhealthy dietary behaviors and suboptimal child feeding practices. Despite evidence supporting the importance of healthful nutrition-related behaviors during and after pregnancy, few behavioral nutrition interventions for women with PD have been developed. The objectives of this study were to identify nutrition-related challenges and needs among women with PD and to elucidate the role that feeding plays in mother-infant interaction, to inform the development of nutrition interventions. METHODS: Using a qualitative study design, in-depth interviews were conducted with 18 mothers with a history of PD and 10 interdisciplinary healthcare providers with expertise in PD. Data were thematically analyzed using a hybrid inductive and deductive coding approach. RESULTS: Mean age of mothers was 31 ± 6 years, 56% identified as non-Hispanic White, and 33% identified as Black/African American. Eighty percent of healthcare providers practiced for more than five years. Six themes were identified: (a) Time scarcity mindset; (b) Importance of social support; (c) Unrealistic expectations of motherhood; (d) Mom as the last priority; (e) Postpartum body changes and shape ideals; and (f) Contentment associated with infant and young child feeding. CONCLUSION: Women with PD have several needs pertaining to their nutrition and that of their children. The findings from this study illustrate key considerations and recommendations for addressing these needs.

The Connections among Interacting with Nature, Nature Relatedness and Dietary Choices: A Pilot Mixed Methods Study.

Interacting with nature and a connection to nature (Nature Relatedness [NR]) have been associated with better mental and physical health as well as higher levels of physical activity. However, limited research has explored how interacting with nature and NR may promote healthful dietary behaviors. The purpose of this pilot convergent mixed methods study was to explore the connections between interacting with nature, NR, and dietary choices. For descriptive purposes, we measured participants' (n = 25) interactions with nature, NR (total, experience, perspective, and self) scores, physical activity, and Healthy Eating Index-2020 scores. In-depth interviews (n = 13) explored the factors that influence interacting with nature and food choices. Quantitative and qualitative data were analyzed separately, and later integrated to yield a more complete understanding of the research inquiry than either form of data would have provided alone. The results from this pilot mixed methods study indicate that there are connections between the variables of interest and that NR may play a pivotal role in how interacting with nature may promote sustainable dietary behaviors. These findings could promote the potential for utilizing nature-based experiences to improve dietary intake.

Culinary Home Empowerment for Food Waste Prevention and Minimization: Feasibility and Efficacy Protocol.

The purpose of this research is to evaluate the feasibility, acceptability, and preliminary efficacy of a household food-waste prevention and minimization intervention, titled the Culinary Home Empowerment for Food Waste Prevention and Minimization (CHEF-WPM), which consists of a culinary education video series for home cooks. The specific aims are to (1) assess the effects of the intervention at a population level across process (feasibility, usage, acceptability, satisfaction) and preliminary efficacy (motivation, opportunity, ability) metrics and (2) assess the effects of the intervention at a community level across process (feasibility, usage, acceptability, satisfaction) and preliminary efficacy (motivation, opportunity, ability, household food waste, sustainable dietary practices) metrics. The intervention includes eight modules, each containing three to five brief videos, as well as downloadable recipes and worksheets. The evaluation will explore the effects of the program through two distinct investigations, namely (1) voluntary access to the intervention content in a population-based setting and (2) intensive delivery of the intervention content as part of a remote class in a community setting. Evaluation of the intervention in the population-based setting will use a single-arm, quasi-experimental post-test only study design. All home cooks who access the videos will be invited to answer a five-question post-video survey about acceptability, satisfaction, and potential implementation of the learning. A separate sample of individuals will be recruited to participate in a more in-depth evaluation (pre- and multiple post-test survey). Evaluation of the community-based intervention will use a mixed methods study design. Findings from the two distinct evaluation studies will be jointly discussed and triangulated to support larger conclusions about the intervention's desirability, impact on motivation, opportunity, ability, and food waste, and the potential directions for further improvement.

Interactions with Nature, Good for the Mind and Body: A Narrative Review.

Interacting with nature may promote mental and physical health. There are multiple ways to interact with nature: indirectly, incidentally, and intentionally. How these types of interactions with nature may be associated with mental and physical health status and health behaviors is unclear. The purpose of this narrative review is to (1) describe the relationship between interactions with nature (indirect, incidental, and intentional) and mental and physical health outcomes and behaviors, (2) identify gaps in the literature, and (3) provide recommendations for future research. Considerable evidence suggests that interacting with nature, indirectly and intentionally, is associated with improvements in mental health and physical exhibitions of mental status. Furthermore, intentionally interacting with nature is associated with engagement in physical activity and gardening is associated with fruit and vegetable consumption. Research suggests that incidentally interacting with nature may be associated with positive mental health status. More research is needed to understand the relationships between incidental interactions with nature and physical health status and behaviors; as well as among all types of interactions with nature and physical health disorders, sleep, and dietary behaviors.

Examining the Role of Nutrition in Cancer Survivorship and Female Fertility: A Narrative Review.

Female cancer survivors have a higher chance of experiencing infertility than females without a history of cancer diagnosis. This risk remains high despite advances in fertility treatments. There is a need to augment fertility treatments with cost-effective methods such as nutritional guidance to improve fertility chances. The aim of this review article is to connect the current literature on cancer survivorship nutrition and fertility nutrition, focusing on the importance of integrating nutritional guidance into fertility counseling, assessment, and treatment for female cancer survivors. Consuming a healthful diet comprising whole grains, soy, fruits, vegetables, seafood, and unsaturated fats has improved both female fertility and cancer survivorship. Similarly, maintaining a healthy body weight also improves female fertility and cancer survivorship. Therefore, dietary interventions to support female cancer survivors with fertility challenges are of immense importance. The period of follow-up fertility counseling and assessment after cancer treatment may provide a unique opportunity for implementing nutritional guidance for female cancer survivors. Dietary interventions are a promising strategy to improve pregnancy chances and overall quality of life among female cancer survivors; thus, researchers should investigate perceptions regarding fertility, barriers, and challenges to changing nutrition-related behaviors, and preferences for nutritional guidance to support fertility treatments in this population.

Optimizing Fertility Treatment With Nutrition Guidance: Exploring Barriers and Facilitators to Healthful Nutrition Among Female Cancer Survivors With Fertility Challenges.

INTRODUCTION: Young women diagnosed with cancer are at an increased risk for infertility compared to women without a cancer diagnosis. Consuming a healthful diet comprised of whole grains, fruits, vegetables, and unsaturated fats has been found to improve both fertility and cancer survivorship. Given this reason, dietary interventions tailored to support female cancer survivors with fertility challenges are of immense importance. Therefore, the aim of this study was to explore barriers and facilitators to healthful nutrition among female cancer survivors with fertility challenges, to inform the development of dietary interventions for this population. METHODS: Using a formative research design, interview, survey, and dietary intake data were collected from 20 female cancer survivors of reproductive age. Participant-check focus group discussions were conducted to validate findings. All interviews were recorded and transcribed verbatim. Transcripts were coded and analyzed using a thematic analysis approach. Quantitative data were analyzed using means, standard deviations, ranges, frequencies, and percentages. RESULTS: The average age of respondents was 31.47 ± 3.5 years and the average BMI was 24.78 ± 4.1 kg/m2. All participants were college educated, 45% identified as White, 50% as Black, and 10% as Hispanic or Latinx. Cancer diagnoses included breast, thyroid, ovarian, leukemia, and gastrointestinal cancers. The following themes were identified: (1) Lack of nutrition-related resources and detailed guidance, (2) Work-life balance, (3) Perceived rigidity of dietary guidance, (4) Treatment-related fatigue, (5) Having trust in healthcare providers, (6) Higher motivation to change nutrition behavior, and (7) Recognizing the additional benefits of nutrition. CONCLUSION: These findings indicate a sought-after yet unmet need for post-cancer treatment fertility nutrition recommendations. Interventions should be tailored to women's needs and focus on improving their self-efficacy to make healthful dietary choices.

Nutrition-Related Experiences of Women With Perinatal Depression During the COVID-19 Pandemic: A Qualitative Study.

Women with perinatal depression are at a high risk for unhealthy dietary behaviors but whether the coronavirus disease 2019 (COVID-19) pandemic has exacerbated this risk is unknown. Here we report the findings of a qualitative study exploring the impact of the COVID-19 pandemic on nutrition-related experiences of women with perinatal depression. Using a qualitative descriptive approach, in-depth interviews were conducted with 18 women with a history of perinatal depression and 10 healthcare providers. A semistructured format elicited how food and nutrition-related behaviors of women with perinatal depression were affected by the COVID-19 pandemic. Thematic analysis identified 4 themes related to the COVID-19 pandemic: (1) Adaptations in shopping and cooking behaviors; (2) increases in stress and declines in respite; (3) declines in support and increases in isolation; and (4) low levels of breastfeeding guidance. Our findings confirm the importance of resilience among women with perinatal depression and future research is needed to elucidate the mechanisms connecting resilience and dietary behaviors.

Nature Relatedness Is Positively Associated With Dietary Diversity and Fruit and Vegetable Intake in an Urban Population.

PURPOSE: Feeling connected to nature, or nature relatedness (NR), can positively impact physical and psychological well-being. However, the relationship between NR and dietary behaviors has not been studied. This research examined the relationship between NR and dietary behaviors, including dietary diversity and fruit and vegetable intake. DESIGN: Cross-sectional online survey study. SETTING: Philadelphia, Pennsylvania. SUBJECTS: Adults (n = 317) over 18 years who resided in Philadelphia, PA. MEASURES: The NR Scale was used to measure participants' connection to nature. It includes 21 items across three subscales: self, experience, and perspective (total and subscales range from 1 to 5). Dietary Diversity was assessed using the FAO's standardized tool (scores range from 0 to 9). To calculate dietary diversity, food groups reported were aggregated into nine food categories: starchy staples; dark green leafy vegetables; vitamin A rich fruits/vegetables; other fruits/vegetables; organ meat; meat/fish; eggs; legumes, nuts/seeds; and milk products. The NCI's 2-item CUP Fruit and Vegetable Screener was used to estimate daily fruit and vegetable intake (cups/day), and socio-demographic questions were asked. ANALYSIS: Simple and multivariable regression models were used to examine associations between NR Total and subscale scores with dietary diversity scores and fruit and vegetable intake with NR Total scores and subscale scores. The multivariable models were adjusted for age, race, gender, and income. RESULTS: People with higher NR Total (P < .001), NR Self (P < .001), NR Perspective (P = .002), and NR Experience (P = .002) were more likely to report greater dietary diversity. Those with higher NR Total (P < .001), NR Self (P < .001), and NR Experience (P < .001) reported greater fruit and vegetable intake. Associations remained significant after adjusting for covariates. CONCLUSION: NR was associated with better dietary intake after accounting for socio-demographic indicators. These findings highlight the need for health promotion interventions that enhance NR, such as nature prescription initiatives, urban gardening and greening, and immersion in urban green spaces.