Association of personal characteristics and cooking skills with vegetable consumption frequency among university students.

Most university students are transitioning to adulthood, and tend to adopt unhealthy eating habits characterised by a low intake of fruits and vegetables. Few studies have specifically addressed the consumption of vegetables, which have a high content of minerals, fibre, and active compounds. The aim of this investigation was to assess vegetable consumption frequency among university students in a Brazilian capital and examine associations with individual characteristics and cooking skills. This crosssectional study used a online questionnaire to collect data. Cooking skills were evaluated in eight dimensions. Vegetable consumption was recorded in five frequency groups and then categorised into daily and non-daily consumption. Data were subjected to Pearson's chi-squared or analysis of variance followed by Bonferroni post hoc test. Associations between cooking skill dimensions and daily vegetable consumption were identified by crude and adjusted logistic regression analyses.Adjustment was performed for sex, age, paternal education, and overweight/obesity.Results are expressed as odds ratios (p < 0.05). Less than half of the respondents (N = 237; 45%) reported consuming vegetables daily. Higher level of paternal education, not being overweight or obese, and higher scores on seven cooking skill dimensions were positively associated with daily vegetable consumption. Given the scarcity of research on the topic, the findings of this study make a significant contribution to knowledge and may support public health strategies for promoting vegetable consumption among university students.

Impact of a nudging intervention and factors associated with vegetable dish choice among European adolescents.

PURPOSE: To test the impact of a nudge strategy (dish of the day strategy) and the factors associated with vegetable dish choice, upon food selection by European adolescents in a real foodservice setting. METHODS: A cross-sectional quasi-experimental study was implemented in restaurants in four European countries: Denmark, France, Italy and United Kingdom. In total, 360 individuals aged 12-19 years were allocated into control or intervention groups, and asked to select from meat-based, fish-based, or vegetable-based meals. All three dishes were identically presented in appearance (balls with similar size and weight) and with the same sauce (tomato sauce) and side dishes (pasta and salad). In the intervention condition, the vegetable-based option was presented as the "dish of the day" and numbers of dishes chosen by each group were compared using the Pearson chi-square test. Multivariate logistic regression analysis was run to assess associations between choice of vegetable-based dish and its potential associated factors (adherence to Mediterranean diet, food neophobia, attitudes towards nudging for vegetables, food choice questionnaire, human values scale, social norms and self-estimated health, country, gender and belonging to control or intervention groups). All analyses were run in SPSS 22.0. RESULTS: The nudging strategy (dish of the day) did not show a difference on the choice of the vegetable-based option among adolescents tested (p = 0.80 for Denmark and France and p = 0.69 and p = 0.53 for Italy and UK, respectively). However, natural dimension of food choice questionnaire, social norms and attitudes towards vegetable nudging were all positively associated with the choice of the vegetable-based dish. Being male was negatively associated with choosing the vegetable-based dish. CONCLUSIONS: The "dish of the day" strategy did not work under the study conditions. Choice of the vegetable-based dish was predicted by natural dimension, social norms, gender and attitudes towards vegetable nudging. An understanding of factors related to choosing vegetable based dishes is necessary for the development and implementation of public policy interventions aiming to increase the consumption of vegetables among adolescents.

Increasing vegetable intakes: rationale and systematic review of published interventions.

PURPOSE: While the health benefits of a high fruit and vegetable consumption are well known and considerable work has attempted to improve intakes, increasing evidence also recognises a distinction between fruit and vegetables, both in their impacts on health and in consumption patterns. Increasing work suggests health benefits from a high consumption specifically of vegetables, yet intakes remain low, and barriers to increasing intakes are prevalent making intervention difficult. A systematic review was undertaken to identify from the published literature all studies reporting an intervention to increase intakes of vegetables as a distinct food group. METHODS: Databases-PubMed, PsychInfo and Medline-were searched over all years of records until April 2015 using pre-specified terms. RESULTS: Our searches identified 77 studies, detailing 140 interventions, of which 133 (81 %) interventions were conducted in children. Interventions aimed to use or change hedonic factors, such as taste, liking and familiarity (n = 72), use or change environmental factors (n = 39), use or change cognitive factors (n = 19), or a combination of strategies (n = 10). Increased vegetable acceptance, selection and/or consumption were reported to some degree in 116 (83 %) interventions, but the majority of effects seem small and inconsistent. CONCLUSIONS: Greater percent success is currently found from environmental, educational and multi-component interventions, but publication bias is likely, and long-term effects and cost-effectiveness are rarely considered. A focus on long-term benefits and sustained behaviour change is required. Certain population groups are also noticeably absent from the current list of tried interventions.

Workplace foodservice; perception of quality and trust.

In settings such as workplaces there is a growing acceptance that the food provided has a significant impact on health and wellbeing. This is a captive environment where the overall contribution of the meal served could be an important element of the overall diet and represents an under researched area. Despite growing demand, little information is available; time pressure when making food choice alongside the challenge of understanding information provided can act as barriers for healthy selection and can also decrease confidence in the food system. We would also argue that the fundamental human right of informing consumers what they are eating is not currently being addressed and is underscored. This study used focus groups to explore criteria that motivate peoples' food choice in a workplace foodservice setting. Thematic analysis was applied to categorise data according to frequently occurring responses. Data were collected from four focus groups in Germany and the UK with a total of 23 participants. Although there is little expectation in the quality of food served in the workplace, respondents valued any transparency of information and the opportunity to socialise with other work colleagues. Criteria of importance were identified as: Value for money, Variety, Naturalness, Nutrition, Portion Size, Taste, Visual Appearance, Origin, Animal welfare, Environmental impact, Fair Trade and Organic. Gaining insight into these criteria can enable operators to meet the needs and expectations of their customers in order to increase confidence in the food provided and in addition signpost a healthier selection.

What do patients value in the hospital meal experience?

A number of previous studies have reported on the aspects of hospital food service that patients value, but usually as a secondary finding, and not generally based upon patient-centred approaches. This study employed a questionnaire produced ab initio from interviews with patients and hospital staff, the data from which were subjected to factor and cluster analysis, in order to identify and prioritise the factors that contribute to the meal experience empirically. The most important factors, food and service were as identified by other authors. In decreasing order of importance were social, personal and situational factors. The results confirm that improving the quality of the food and the efficiency with which it reaches the patients remain the most important objectives of hospital food service.

Sensory determinants of stated liking for vegetable names and actual liking for canned vegetables: A cross-country study among European adolescents.

Sensory properties are reported as one of the main factors hindering an appropriate vegetable intake by the young. In the present work the sensory determinants of likings for vegetables were explored in adolescents of four European countries (Denmark, n = 88; France, n = 206; Italy, n = 110 and United Kingdom, n = 93). A questionnaire was designed to study cross country differences in stated liking for and familiarity with a list of vegetables popular among European markets (between-vegetable approach). A within-vegetable comparison approach with actual tasting was used to analyze differences and similarities in liking for canned pea and sweet corn samples across the countries. A close positive relationship between stated liking and familiarity was found. Irrespective of the country, one group of highly liked vegetables (carrots, tomatoes, green salad) was identified, characterized by innately liked tastes (sweet, umami), delicate flavour and bright appealing colour. A second group of highly disliked vegetables consists of cauliflowers and broccoli, characterized by disliked sensations such as bitter taste and objectionable flavour. Internal Preference Maps from actual liking scores indicate that the generally disliked tastes (bitter, sour), are clearly correlated with a negative hedonic response for both peas and sweet corn. The hedonic valence of a generally well accepted taste such as salty and texture descriptors depends on the type of vegetable. Internal preference maps from actual liking data indicate that flavour and appearance descriptors of the distinct sensory properties of each type of vegetable positively affect liking, while the intensity of unusual flavours is related to sample disliking.

Hungry in hospital, well-fed in prison? A comparative analysis of food service systems.

Meals served in prisons and hospitals are produced in similar ways and have similar characteristics, yet hospital patients are often at risk of being undernourished, while prisoners typically are not. This article examines field notes collected during nutritional studies of prison and hospital food service, which confirmed the difference in nutrient intake claimed by other authors. A comparison of food service processes and systems showed that the production of meals and the quality leaving the kitchen was similar in both types of institution. However, the delivery and service system was found to be much less coherent in hospital than in prison. Transport and service of hospital food were subject to delays and disruptions from a number of sources, including poor communication and the demands of medical professionals. These meant that meals reached hospital patients in a poorer, less appetising condition than those received by prisoners. The findings are discussed in the light of previous work and in terms of hospital food service practice.

The relationship between emotions and food consumption (macronutrient) in a foodservice college setting - a preliminary study.

Many aspects of eating out have been studied, yet emotions remain an under-researched area, despite having been shown to play a significant role in food consumption. The aim of this research is to critically evaluate the relationship between emotions and food consumption (macronutrient) in a realistic eating environment, a college cafeteria. Subjects (n = 408), diners using a cafeteria, completed an emotions questionnaire before and after freely choosing, paying for and consuming a hot main meal. The results demonstrated a greater feeling of contentment with a high fat, high energy meal, whereas with a low carbohydrate meal, participants felt unfulfilled. In addition, a high protein meal also leads to a feeling of contentment. These results are rather counter-intuitive to public health nutrition policy but indicate the importance of inclusion of a protein or high carbohydrate item in any dish design in a foodservice setting.

A taste of the unfamiliar. Understanding the meanings attached to food by international postgraduate students in England.

Using findings from semi-structured interviews with international postgraduate students in England, this paper explores the meanings attached to the food they eat in a new culture. Our study, using interviews, aimed to uncover student responses to both the food they eat whilst abroad and to the food they have left behind. Many students criticised local English food as bland, fattening, and unhealthy; nevertheless, most showed an openness to new foods, trying not only local food but also dishes prepared by their international friends, but this sat alongside a strong attachment to their home country dishes. Eating together was a popular leisure activity, and food of the origin country or region was the most popular cuisine. Eating home country food offered emotional and physical sustenance; students felt comforted by familiar taste, and that their physical health was stabilised by the consumption of healthier food than was available locally. Despite acknowledgement of the importance of food to cultural identity and overall quality of life in the anthropology and nutrition literatures, there is a dearth of research into this aspect of the international student experience; this study, therefore, marks an important beginning.

Improving the provision of meals in hospital. The patients' viewpoint.

This study examines the provision of hospital meals from the patients' viewpoint, with the aim of improving hospital food service. Patients were approached in early 2008 in a National Health Service hospital in the South of England and invited to comment on the good and bad aspects of eating in hospital. Comments were collected in an abbreviated "key word" format which incurred the minimum of bias and allowed emergent themes to be analysed both quantitatively and qualitatively. Seven main themes emerged, of which "food" and "choice" were mentioned most frequently, but had a low ratio (1.8 and 1.7, respectively) of approving over disapproving comments. The next most mentioned theme, "service staff", showed the highest approving/disapproving ratio (4.8) overall. Less frequent themes were: "meals and lifestyle", "timing and routine", "service quality" and "food quantity". These data, together with qualitative analysis of the responses showed patients' views of hospital food to be positive, on the whole meeting or surpassing their expectations. However, these expectations were low, the experience of eating in hospital contrasted unfavourably with home, and the meals were at best a distraction from the rigours of hospital treatment. Service staff were positively regarded because they offered an important opportunity for "normal" discourse with a non-medical person. On the basis of the findings, changes are recommended in the management of service staff, menus, food presentation, nutritional intake and patients' lifestyle. Of these, the first is likely to have most impact on the experience and viewpoint of hospital patients.

The Promotion of Eating Behaviour Change through Digital Interventions.

Diet-related chronic disease is a global health epidemic giving rise to a high incidence of morbidity and mortality. With the rise of the digital revolution, there has been increased interest in using digital technology for eating behavioural change as a mean of diet-related chronic disease prevention. However, evidence on digital dietary behaviour change is relatively scarce. To address this problem, this review considers the digital interventions currently being used in dietary behaviour change studies. A literature search was conducted in databases like PubMed, Cochrane Library, CINAHL, Medline, and PsycInfo. Among 119 articles screened, 15 were selected for the study as they met all the inclusion criteria according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) search strategy. Four primary digital intervention methods were noted: use of personal digital assistants, use of the internet as an educational tool, use of video games and use of mobile phone applications. The efficiency of all the interventions increased when coupled with tailored feedback and counselling. It was established that the scalable and sustainable properties of digital interventions have the potential to bring about adequate changes in the eating behaviour of individuals. Further research should concentrate on the appropriate personalisation of the interventions, according to the requirements of the individuals, and proper integration of behaviour change techniques to motivate long-term adherence.

A Mobile Phone App for the Provision of Personalized Food-Based Information in an Eating-Out Situation: Development and Initial Evaluation.

BACKGROUND: Increasing pressure from governments, public health bodies, and consumers is driving a need for increased food-based information provision in eating-out situations. Meals eaten outside the home are known to be less healthy than meals eaten at home, and consumers can complain of poor information on the health impact and allergen content of meals eaten out. OBJECTIVE: This paper aimed to describe the development and early assessment of a mobile phone app that allows the provision of accurate personalized food-based information while considering individual characteristics (allergies, diet type, and preferences) to enable informed consumer choice when eating out. METHODS: An app was designed and developed to address these requirements using an agile approach. The developed app was then evaluated at 8 public engagement events using the System Usability Scale (SUS) questionnaire and qualitative feedback. RESULTS: Consideration of the literature and consultation with consumers revealed a need for information provision for consumers in the eating-out situation, including the ability to limit the information provided to that which was personally relevant or interesting. The app was designed to provide information to consumers on the dishes available in a workplace canteen and to allow consumers the freedom to personalize the app and choose the information that they received. Evaluation using the SUS questionnaire revealed positive responses to the app from a range of potential users, and qualitative comments demonstrated broad interest in its use. CONCLUSIONS: This paper details the successful development and early assessment of a novel mobile phone app designed to provide food-based information in an eating-out situation in a personalized manner.

Vegetable Consumption and Factors Associated with Increased Intake among College Students: A Scoping Review of the Last 10 Years.

Vegetable consumption is a predictor for improved health outcomes, such as reduced obesity and likelihood of food-related noncommunicable diseases. Young adults are a key population, being in a transitional stage-of-life: Habits gained here are taken through the lifespan. This review establishes insight into the consumption of vegetables among young adults during their college/university years, and factors associated with increased consumption. Seventy-one papers were extracted, published between January 2009 and October 2018. Search terms related to consumption; vegetables; and college/university setting and sample. A diverse range of definitions, guidelines, and study approaches were observed. Findings identify that the majority of students do not consume World Health Organization recommendations. Being female was the most frequent predictor of higher intake of vegetables, and no consumption patterns were identified by countries. Living at family home; body mass index; happiness and stress level; perceived importance of healthy eating; socioeconomic level; breakfast consumption; stage of study; openness to new experiences; sleep pattern; nutrition knowledge; activity level; alcohol usage; and energy intake were identified as influential factors. Public policies and new strategies to encourage vegetable consumption among college students are indispensable, especially targeting subgroups with even lower intakes, such as males and those living outside family home.

Repeated exposure and conditioning strategies for increasing vegetable liking and intake: systematic review and meta-analyses of the published literature.

Background: Vegetable intakes are typically lower than recommended for health. Although repeated exposure has been advocated to increase vegetable liking and consumption, no combination of the evidence yet provides a measure of benefit from repeated exposure or alternative conditioning strategies. Objective: This work aimed to identify and synthesize the current evidence for the use of repeated exposure and conditioning strategies for increasing vegetable liking and consumption. Design: Three academic databases were searched over all years of records using prespecified search terms. Published data from all suitable articles were tabulated in relation to 3 research questions and combined via meta-analyses. Results: Forty-three articles detailing 117 comparisons investigating the use of repeated exposure and conditioning strategies for increasing liking and intakes of vegetables were found. Our analyses demonstrate: 1) increased liking and intakes of the exposed vegetable after repeated exposure compared with no exposure; 2) increased liking for the exposed vegetable after conditioning compared with repeated exposure, increased intakes after the use of rewards, and some suggestion of decreased intakes after flavor-nutrient conditioning; and 3) increased liking and intakes of a novel vegetable after repeated exposure to a variety of other vegetables compared with no exposure or repeated exposure to one other vegetable. Effect sizes, however, are small, and limited evidence suggests long-term benefits. Our analyses, furthermore, are limited by limitations in study design, compliance, and/or reporting. Conclusions: Based on our findings, we recommend the use of repeated exposure to one and a variety of vegetables, and the use of rewards, for increasing vegetable liking and consumption. Confirmation from further large, well-conducted studies that use realistic scenarios, however, is also required. This study was registered at PROSPERO as CRD42017056919.

A Systematic Review of Behavioural Interventions Promoting Healthy Eating among Older People.

Because eating habits are inseparably linked with people's physical health, effective behaviour interventions are highly demanded to promote healthy eating among older people. The aim of this systematic review was to identify effective diet interventions for older people and provide useful evidence and direction for further research. Three electronic bibliographic databases-PubMed, Scopus and Web of Science Core Collection were used to conduct a systematic literature search based on fixed inclusion and exclusion criteria. English language peer-reviewed journal articles published between 2011 and 2016 were selected for data extraction and quality assessment. Finally, a total of 16 studies were identified. The studies' duration ranged from three weeks to seven years. The majority of studies were carried out in European countries. Seven studies had a moderate quality while the remaining studies were at a less than moderate level. Three dietary educational interventions and all meal service related interventions reported improvements in older people's dietary variety, nutrition status, or other health-related eating behaviours. Multicomponent dietary interventions mainly contributed to the reduction of risk of chronic disease. The results supported that older people could achieve a better dietary quality if they make diet-related changes by receiving either dietary education or healthier meal service. Further high-quality studies are required to promote healthy eating among older people by taking regional diet patterns, advanced information technology, and nudging strategies into account.

Plate versus bulk trolley food service in a hospital: comparison of patients' satisfaction.

OBJECTIVE: The aim of this research was to compare plate with bulk trolley food service in hospitals in terms of patient satisfaction. Key factors distinguishing satisfaction with each system would also be identified. METHODS: A consumer opinion card (n = 180), concentrating on the quality indicators of core foods, was used to measure patient satisfaction and compare two systems of delivery, plate and trolley. Binary logistic regression analysis was used to build a model that would predict food service style on the basis of the food attributes measured. Further investigation used multinomial logistic regression to predict opinion for the assessment of each food attribute within food service style. RESULTS: Results showed that the bulk trolley method of food distribution enables all foods to have a more acceptable texture, and for some foods (potato, P = 0.007; poached fish, P = 0.001; and minced beef, P < or = 0.0005) temperature, and for other foods (broccoli, P < or = 0.0005; carrots, P < or = 0.0005; and poached fish, P = 0.001) flavor, than the plate system of delivery, where flavor is associated with bad opinion or dissatisfaction. A model was built indicating patient satisfaction with the two service systems. CONCLUSION: This research confirms that patient satisfaction is enhanced by choice at the point of consumption (trolley system); however, portion size was not the controlling dimension. Temperature and texture were the most important attributes that measure patient satisfaction with food, thus defining the focus for hospital food service managers. To date, a model predicting patient satisfaction with the quality of food as served has not been proposed, and as such this work adds to the body of knowledge in this field. This report brings new information about the service style of dishes for improving the quality of food and thus enhancing patient satisfaction.

Comparison of three nudge interventions (priming, default option, and perceived variety) to promote vegetable consumption in a self-service buffet setting.

BACKGROUND: Dietary choices in out-of-home eating are key for individual as well as for public health. These dietary choices are caused by a wide array of determinants, one of which is automatic decision-making. Nudging is attracting considerable interest due to its understanding and application of heuristic biases among consumers. The aim of this study is to test and compare three nudges in promoting vegetable consumption among test persons in a food lab-based experiment. METHODS: The initial sample consisted of 88 participants recruited in Copenhagen, Denmark. Each study participant was randomly assigned to one of the three experiments: priming, default and perceived variety. The priming arm of the experiment consisted of creating a leafy environment with green plants and an odour of herbs. In the default arm of the experiment, the salad was pre-portioned into a bowl containing 200g of vegetables. The third experiment divided the pre-mixed salad into each of its components, to increase the visual variety of vegetables, yet not providing an actual increase in items. Each individual was partaking twice thus serving as her/his own control, randomly assigned to start with control or experimental setting. RESULTS: The default experiment successfully increased the energy intake from vegetables among the study participants (124 kcal vs. 90 kcal in control, p<0.01). Both the priming condition and perceived variety reduced the total energy intake among the study participants (169 kcal, p<0.01 and 124 kcal, p<0.01, respectively), mainly through a decrease in the meat-based meal component. CONCLUSIONS: Considerable progress has been made with regard to understanding the use of nudging in promoting a healthier meal composition, including increasing vegetable intake. This study suggests that the nature of a nudge-based intervention can have different effects, whether it is increasing intake of healthy components, or limiting intake of unhealthy meal components. This work has demonstrated that consumer behaviour can be influenced without restricting or providing incentives for behaviour change. The present findings have promising application to the foodservice sector.

Consumption of a High Quantity and a Wide Variety of Vegetables Are Predicted by Different Food Choice Motives in Older Adults from France, Italy and the UK.

BACKGROUND: Consumption of a high quantity and wide variety of vegetables is currently recommended for health. Dietary variety can be low, however, particularly for older adults. This study investigated the affective factors associated with the quantity and variety of vegetables consumed by older adults in France, Italy and the UK. METHODS: Adults aged 65 years plus completed questionnaires on self-reported vegetable intake (quantity and variety), liking for vegetables, attitudes towards intake, and demographic variables. RESULTS: In 497 older adults (France, n = 187, Italy, n = 152, UK, n = 158), higher quantities of vegetables consumed were associated with a higher age, affluence score and liking for vegetables, and a lower importance in consumption of familiarity (smallest ß = 0.11, p = 0.03). Greater variety was associated with a higher liking and importance of health benefits, and a lower importance of familiarity (smallest ß = -0.11, p < 0.01). Higher quantity and variety combined (quantity × variety) was associated with a higher age, liking and importance of health benefits, and a lower importance of familiarity (smallest ß = 0.14, p = 0.02). Country-specific effects were also found (smallest ß = 0.20, p < 0.01). CONCLUSIONS: These findings demonstrate a role for liking and a lower concern for eating familiar foods in vegetable consumption, and a particular role for concern for health benefits in the consumption of a greater variety of vegetables.

Catering for health: a review.

Food, nutrition and health are currently under scrutiny. British eating patterns have radically changed over the past few decades, with the emergence of a 'grazing', 'snacking' culture. Simultaneously, more food is eaten outside the home and therefore the nutritional composition of foods/meals provided by catering establishments is of increasing relevance to the diet overall. Consumers are aware of the need for a healthy lifestyle and are encouraged to follow improved eating habits to avoid 'diseases of affluence' such as coronary heart disease, obesity, diet-related cancer and type 2 diabetes. For both economic and health reasons caterers should be encouraged to provide healthy options; however, often misconceptions exist and gaps are evident in the nutritional knowledge of this profession. Training curricula require revision. With the right information, training and support caterers can play a vital role in improving the health of the population.

Food safety awareness of older people at home: a pilot study.

The UK has an increasingly ageing population with the majority of older people preferring to remain independent and live in their own homes. However, during their lifetime, there have been many changes in areas such as food technology and shopping practices which have had a profound influence on the health and well-being of this vulnerable group. The aim of this pilot study, therefore, was to investigate issues surrounding food safety of older people living at home. A focus group (n = 9) was initially conducted to elucidate areas of potential concern. This was followed up by semi-structured interviews and observations (n = 16) within the home. Results show that most participants had not measured their refrigerator temperature and did not know what it should be. The majority had not adjusted the temperature control/dial and gauged the 'correct' temperature by the feel of goods inside. 'Use by' dates were generally well understood, but not always adhered to due to difficulty in reading the labels. Items were purchased near to the end of this date as they are sometimes cheaper, and although older people appreciated these dates related to food safety, items were often kept for up to a month before consumption. This has major implications, particularly if the refrigerator is not working at the correct temperature. There is a lack of readily available educational material on this topic and most people would like to be better informed. If the Government are to encourage more independent lifestyles of older people, then awareness of food safety should be higher on the agenda. Further research to ascertain food safety needs, and awareness of this group are also required. This should also include an assessment of the impact of situations where food consumed at home is prepared elsewhere, e.g. meals-on-wheels.