Dietary Intake and Quality among Stroke Survivors: NHANES 1999-2018.

BACKGROUND: Nutrition is an important modifiable risk factor for prevention and treatment of stroke. However, examination of nutrient intake and diet quality in stroke survivors is limited. OBJECTIVES: The aim of the study was to estimate usual nutrient intake and diet quality in US adults with and without a history of self-reported stroke. METHODS: Using US National Health and Nutrition Examination Survey (NHANES) 1999-2018, we analyzed demographics, health history, and dietary intake data in 1626 individuals with a history of stroke matched for age, gender, and survey cycle to respective controls (n=1621) with no history of stroke. A minimum of one 24-h dietary recall was used to assess dietary intake. Diet quality was determined using Healthy Eating Index 2015 (HEI-2015) scores. Adult food security was assessed based on responses to the US Department of Agriculture Household Food Security Survey Module. Physical and mental limitations were assessed from responses to the NHANES Physical Functioning Questionnaire. Estimates were reported as mean (standard error). RESULTS: In comparison to controls, stroke survivors were more likely to be food insecure, experience poverty, and report physical and mental limitations (P < .001, all comparisons). Stroke survivors were more likely to report excessive (% > acceptable macronutrient distribution range) intake for total fat (50.9 [2.7]% vs. 40.4 [2.2]%, P < .001) and inadequate intake (% < estimated average requirement) for calcium (54.6 [1.8]% vs. 43.5 [2.4]%, P = .001) and magnesium (66 [1.8] vs. 53.6 [1.8]%, P < .001). In addition, stroke survivors reported lower HEI-2015 total scores than controls (49.8 vs. 51.9, P < .001). Finally, HEI-2015 total scores were lower in stroke survivors who were food insecure and those with a lower income-to-poverty ratio (< 185%) (P = .001). CONCLUSIONS: Dietary intake in stroke survivors was nutritionally poor, with suboptimal nutrient intake and lower overall diet quality compared with age- and gender-matched controls. Furthermore, poverty and food insecurity were more prevalent in stroke survivors and associated with worse diet quality.

College Campus Food Pantry Program Evaluation: What Barriers Do Students Face to Access On-Campus Food Pantries?

The purpose of this study was to explore barriers Texas Woman's University (TWU) students face in accessing on-campus food pantries. This cross-sectional, survey-based study was conducted in Fall 2021. Students' use of the food pantries and barriers to utilization, including qualitative questions, were evaluated using descriptive statistics and thematic analyses. Students (n = 529) completed the survey. Despite a high prevalence of food insecurity (49.2%), most students reported never using the pantries (89.8%). Almost half of the students were unaware that these pantries existed on campus (47.8%). More than one in four students believed there were barriers to accessing the pantries, with time tissues, lack of transportation, limited food pantry hours of operation, and social stigma most commonly cited as major barriers to access. Food insecurity remains an urgent problem at TWU since the prevalence has remained high since 2019 despite the institutions' efforts to reduce it. One of those resources has not been utilized as expected, which might impede improvements in food security among students. TWU on-campus food pantries can use these findings to address major barriers by offering after-hours access through the libraries or campus police, partnering with public transportation, and normalizing accessing food assistance.

Implementation of a food scholarship program improves nutrient intake and dietary quality of college students.

Objective: To determine the impact of a new food scholarship program on nutrient intake and dietary quality. Participants: College students (n = 49), female (78%), single (76%), average age 28 years, and white (49%). Methods: Fruits, vegetables, dairy, meat products and nonperishable foods were distributed twice a month. A one-group pretest post-test intervention compared baseline and 10 weeks data. Food security was measured and three-day food records assessed nutrient intake, Health Eating Index (HEI)-2015 (total and component) scores, and food group servings. Paired t-test at baseline and 10 weeks were performed (SPSS v25) (p < 0.05). Results: Prevalence of food insecurity did not change (baseline 53%, 10 weeks 47%). Protein, (p = 0.001), niacin (p = 0.002), magnesium (p = 0.034), phosphorous (p = 0.039), potassium (p = 0.019), and vegetable servings (p = 0.034) intake increased. Total HEI-2015 scores remained unchanged but HEI-2015 vegetable scores increased (p = 0.023). Conclusion: Increased intake of some nutrients and vegetable servings were achieved with the food scholarship program.

Influence of COVID-19 Pandemic Restrictions on College Students' Dietary Quality and Experience of the Food Environment.

The COVID-19 pandemic restrictions sent college students online and off campus, potentially reducing access to healthy food. The objective of this cross-sectional, internet-based study was to use qualitative and quantitative survey methods to evaluate whether COVID-19 pandemic restrictions in Texas, USA affected college students' ability to buy food, how/what they shopped for, how they prepared food, what they ate, how they felt about eating, and overall dietary quality (assessed using Healthy Eating Index [HEI] scores). Survey responses from 502 students (87.5% female; 59.6% nonwhite, mean age 27.5 ± 0.4 years, >50% graduate students) were analyzed. The qualitative analysis of open-ended questions revealed 110 codes, 17 subthemes, and six themes. Almost all students experienced changes in at least one area, the most common being changes in shopping habits. Participants with low or very low food security had lower HEI scores compared to food secure students (p = 0.047). Black students were more likely to report changes in their ability to buy food (p = 0.035). The COVID-19 restrictions varied in their impact on students' ability to access sufficient healthy food, with some students severely affected. Thus, universities should establish procedures for responding to emergencies, including identifying at-risk students and mobilizing emergency funds and/or food assistance.