A goal-systems perspective on plant-based eating: keys to successful adherence in university students.

OBJECTIVE: To explore adherence to a plant-based diet from the perspective of goals- and motivations-based systems. DESIGN: A cross-sectional, survey-based study was conducted regarding eating patterns, goals and motivations for current eating habits. SETTING: Data were collected using an online survey platform, including the Goal Systems Assessment Battery (GSAB) and other survey tools. PARTICIPANTS: University students were recruited, including thirty-three students reporting successful maintenance of a plant-based diet (Adherents) and sixty-three students trying to adhere to a plant-based diet (Non-adherents). RESULTS: Using GSAB subscale scores, discriminant function analyses significantly differentiated adherents v. non-adherents, accounting for 49·0 % of between-group variance (χ2 (13) = 42·03, P < 0·000). It correctly classified 72·7 % of adherents and 88·9 % of non-adherents. Constructs including value, self-efficacy, planning/stimulus control and positive affect were significant and included in the discriminant function. Logistic regression results suggested that participants who successfully adhered to a plant-based diet were seventeen times more likely to report 'To manage or treat a medical condition' as motivation and almost seven times more likely to report 'To align with my ethical beliefs' as motivation compared with non-adherents. However, these participants were 94 % less likely to report 'To maintain and/or improve my health' as motivation compared with non-adherents. Controlling for motivations, hierarchical logistic regression showed that only planning as part of the GSAB self-regulatory system predicted adherence to a plant-based diet. CONCLUSIONS: Values-based approaches to plant-based diets, including consideration for ethical beliefs, self-efficacy and proper planning, may be key for successful maintenance of this diet long-term.

A qualitative study of shopper experiences at an urban farmers' market using the Stanford Healthy Neighborhood Discovery Tool.

OBJECTIVE: To understand factors which enhance or detract from farmers' market shopper experiences to inform targeted interventions to increase farmers' market utilization, community-building and social marketing strategies. DESIGN: A consumer-intercept study using the Stanford Healthy Neighborhood Discovery Tool to capture real-time perceptions via photographs and audio narratives. SETTING: An urban farmers' market in a large metropolitan US city. PARTICIPANTS: Thirty-eight farmers' market shoppers, who recorded 748 unique coded elements through community-based participatory research methods. RESULTS: Shoppers were primarily women (65 %), 18-35 years of age (54 %), non-Hispanic (81 %) and white (73 %). Shoppers captured 291 photographs (7·9 (sd 6·3) per shopper), 171 audio narratives (5·3 (sd 4·7) per shopper), and ninety-one linked photograph + audio narrative pairs (3·8 (sd 2·8) per shopper). A systematic content analysis of the photographs and audio narratives was conducted by eight independent coders. In total, nine common elements emerged from the data that enhanced the farmers' market experience (61·8 %), detracted from the experience (5·7 %) or were neutral (32·4 %). The most frequently noted elements were freshness/abundance of produce (23·3 %), product presentation (12·8 %), social interactions (12·4 %) and farmers' market attractions (e.g. live entertainment, dining offerings; 10·3 %). CONCLUSIONS: While produce quality (i.e. freshness/abundance) was of primary importance, other contextual factors also appeared important to the shoppers' experiences. These results may inform social marketing strategies to increase farmers' market utilization and community-building efforts that target market venues.

Community supported agriculture programs: a novel venue for theory-based health behavior change interventions.

Local foods programs such as community supported agriculture programs (CSAs) and farmers' markets have increased greatly in popularity. However, little research has been conducted regarding the effect of involvement in local foods programs on diet-related attitudes and behaviors. A series of focus groups was conducted to identify the motives that propel individuals to join a CSA, the experiences of belonging to a CSA, and the diet-related outcomes of CSA membership. Using the Theory of Planned Behavior (TPB) as a framework to categorize findings, data suggest the potential of CSAs as a viable intervention strategy for promoting healthful diets and behaviors.

Implementation of wireless terminals at farmers' markets: impact on SNAP redemption and overall sales.

Although farmers' markets offer healthy foods for purchase, many lack the equipment necessary to process convenient, card-based transactions. We assessed the impact of providing wireless terminals to 5 markets on overall sales and redemption of Supplemental Nutrition Assistance Program (SNAP) benefits. Sales increased significantly at 4 of the 5 markets after implementation of the terminals, and overall sales increased above and beyond SNAP redemption alone. Implementation of wireless terminals may be important for improving the financial stability and accessibility of farmers' markets.

Community supported agriculture membership in Arizona. An exploratory study of food and sustainability behaviours.

Community supported agriculture (CSA) programs have become a viable source of locally produced foods and represent a new way to increase fruit and vegetable consumption among individuals. Because CSAs represent a way for consumers to acquire healthy foods while providing financial support to local farmers, CSA involvement could reflect, and be related to, greater concern with both health and environmental impact of food choice. As such, the aim of this study was to examine whether ecological attitudes of CSA members could predict food- and sustainability-related behaviours. Using an online survey, respondents answered questions about attitudes towards the environment, as well behaviours related to food purchases, family food preparation, composting, recycling and minimising food-packaging waste. A total of 115 CSA member responses were collected. Ordinary least squares (OLS) multivariate regression analysis was used to investigate the predictive validity of environmental attitudes on measures of behaviours. A large portion of participants reported the amount and variety of fruits and vegetables their households ate increased as a result of joining a CSA program. Ecological sensitivity was a significant predictor of sustainability-related behaviours as well as money spent eating out and times eaten away from home per week. However, it was not predictive of family involvement in home food preparation.

No Significant Differences in Muscle Growth and Strength Development When Consuming Soy and Whey Protein Supplements Matched for Leucine Following a 12 Week Resistance Training Program in Men and Women: A Randomized Trial.

There are conflicting reports regarding the efficacy of plant versus animal-derived protein to support muscle and strength development with resistance training. The purpose of this study was to determine whether soy and whey protein supplements matched for leucine would comparably support strength increases and muscle growth following 12 weeks of resistance training. Sixty-one untrained young men (n = 19) and women (n = 42) (18-35 year) enrolled in this study, and 48 completed the trial (17 men, 31 women). All participants engaged in supervised resistance training 3×/week and consumed 19 grams of whey protein isolate or 26 grams of soy protein isolate, both containing 2 g (grams) of leucine. Multi-level modeling indicated that total body mass (0.68 kg; 95% CI: 0.08, 1.29 kg; p < 0.001), lean body mass (1.54 kg; 95% CI: 0.94, 2.15 kg; p < 0.001), and peak torque of leg extensors (40.27 Nm; 95% CI: 28.98, 51.57 Nm, p < 0.001) and flexors (20.44 Nm; 95% CI: 12.10, 28.79 Nm; p < 0.001) increased in both groups. Vastus lateralis muscle thickness tended to increase, but this did not reach statistical significance (0.12 cm; 95% CI: -0.01, 0.26 cm; p = 0.08). No differences between groups were observed (p > 0.05). These data indicate that increases in lean mass and strength in untrained participants are comparable when strength training and supplementing with soy or whey matched for leucine.

Examining the nutritional quality of breakfast cereals marketed to children.

There are both public health and food industry initiatives aimed at increasing breakfast consumption among children, particularly the consumption of ready-to-eat cereals. The purpose of this study was to determine whether there were identifiable differences in nutritional quality between cereals that are primarily marketed to children and cereals that are not marketed to children. Of the 161 cereals identified between January and February 2006, 46% were classified as being marketed to children (eg, packaging contained a licensed character or contained an activity directed at children). Multivariate analyses of variance were used to compare children's cereals and nonchildren's cereals with respect to their nutritional content, focusing on nutrients required to be reported on the Nutrition Facts panel (including energy). Compared to nonchildren's cereals, children's cereals were denser in energy, sugar, and sodium, but were less dense in fiber and protein. The proportion of children's and nonchildren's cereals that did and did not meet national nutritional guidelines for foods served in schools were compared using chi2analysis. The majority of children's cereals (66%) failed to meet national nutrition standards, particularly with respect to sugar content. t tests were used to compare the nutritional quality of children's cereals with nutrient-content claims and health claims to those without such claims. Although the specific claims were generally justified by the nutritional content of the product, there were few differences with respect to the overall nutrition profile. Overall, there were important differences in nutritional quality between children's cereals and nonchildren's cereals. Dietary advice for children to increase consumption of ready-to-eat breakfast cereals should identify and recommend those cereals with the best nutrient profiles.

Weight loss practices and body weight perceptions among US college students.

OBJECTIVE: The authors assessed associations between body weight perception and weight loss strategies. PARTICIPANTS: They randomly selected male and female college students (N = 38,204). METHODS: The authors conducted a secondary data analysis of the rates of weight loss strategies and body weight perception among students who completed the National College Health Assessment survey. RESULTS: Half of respondents (50%) were trying to lose weight, although only 28% of students were overweight or obese. Also, 12% of respondents had inaccurate body weight perception. Women and men with inaccurate body weight perception were significantly more likely to engage in inappropriate weight loss strategies than were those with accurate body weight perception. Of all students attempting to lose weight, 38% used both diet and exercise. CONCLUSIONS: These data show that college students are interested in weight loss and that body weight perception plays an important role in the desire to lose weight.

The association between mental health and acute infectious illness among a national sample of 18- to 24-year-old college students.

UNLABELLED: Poor mental health is associated with physical illness, but this association is poorly characterized among college students. OBJECTIVE AND PARTICIPANTS: Using American College Health Association-National College Health Assessment data, the authors characterized poor mental health (depression, anxiety, negative affect) and examined the relationship between poor mental health and acute infectious illnesses (bronchitis, ear infection, sinusitis, strep throat) among 47,202 US college students. METHODS: The authors used frequency and cross-tabulation analyses to characterize mental health and determine univariate associations among variables. They used binary logistic regression to determine the association between poor mental health and acute infectious illness, controlling for research-derived covariates. RESULTS: The prevalence of acute infectious illness ranged from 8% to 29%. The prevalence of anxiety and depression ranged from 12% to 20%, respectively. Depression, anxiety, and exhaustion were associated with acute infectious illness across all dependent measures, with odds ratios ranging from .56 to .91. CONCLUSIONS: Poor mental health is associated with acute infectious illness among college students.

Changing nutrition standards in schools: the emerging impact on school revenue.

BACKGROUND: Although great focus has been placed on nutritional and other consequences of changes in food-related policies within schools, few reports exist describing the impact of such changes on school revenue. This review provides an overview of the few revenue-related studies published recently, as well as information from a sampling of state reports on the subject. METHODS: A systematic review of the literature was conducted. Four peer-reviewed papers and 3 state-based reports were identified that assessed the impact on revenues of either targeted policy changes or overarching, district-wide changes in food-related policies. RESULTS: Thus far, few data exist to substantiate the concern that changes in nutrition standards in schools lead to a loss in total revenue. An interesting phenomenon of increased participation in the National School Lunch Program was noted in a number of reports and might play a role in buffering financial losses. CONCLUSIONS: A renewed focus on school policies related to health provides the opportunity for researchers to investigate how nutrition-related policy change can affect, if at all, food service and overall school revenues.

Short-Form Audit Instrument for Assessing Corner Store Healthfulness.

PURPOSE: To develop a valid and feasible short-form corner store audit tool (SCAT) that could be used in-store or over the phone to capture the healthfulness of corner stores. DESIGN: Nonexperimental. SETTING: Four New Jersey cities. SUBJECTS: Random selection of 229 and 96 corner stores in rounds 1 and 2, respectively. MEASURES: An adapted version of the Nutrition Environment Measures Survey for Corner Stores (NEMS-CS) was used to conduct in-store audits. The 7-item SCAT was developed and used for round 2 phone audits. ANALYSIS: Exploratory factor analysis and item response theory were used to develop the SCAT. RESULTS: The SCAT was highly correlated with the adapted NEMS-CS ( r = .79). Short-form corner store audit tool scores placed stores in the same healthfulness categories as did the adapted NEMS-CS in 88% of the cases. Phone response matches indicated that store owners did not distinguish between 2% and low-fat milk and tended to round up the fruit and vegetable count to 5 if they had fewer varieties. CONCLUSION: The SCAT discriminates between higher versus lower healthfulness scores of corner stores and is feasible for use as a phone audit tool.

Cardiorespiratory Fitness and Peak Torque Differences between Vegetarian and Omnivore Endurance Athletes: A Cross-Sectional Study.

In spite of well-documented health benefits of vegetarian diets, less is known regarding the effects of these diets on athletic performance. In this cross-sectional study, we compared elite vegetarian and omnivore adult endurance athletes for maximal oxygen uptake (VO2 max) and strength. Twenty-seven vegetarian (VEG) and 43 omnivore (OMN) athletes were evaluated using VO2 max testing on the treadmill, and strength assessment using a dynamometer to determine peak torque for leg extensions. Dietary data were assessed using detailed seven-day food logs. Although total protein intake was lower among vegetarians in comparison to omnivores, protein intake as a function of body mass did not differ by group (1.2 ± 0.3 and 1.4 ± 0.5 g/kg body mass for VEG and OMN respectively, p = 0.220). VO2 max differed for females by diet group (53.0 ± 6.9 and 47.1 ± 8.6 mL/kg/min for VEG and OMN respectively, p < 0.05) but not for males (62.6 ± 15.4 and 55.7 ± 8.4 mL/kg/min respectively). Peak torque did not differ significantly between diet groups. Results from this study indicate that vegetarian endurance athletes' cardiorespiratory fitness was greater than that for their omnivorous counterparts, but that peak torque did not differ between diet groups. These data suggest that vegetarian diets do not compromise performance outcomes and may facilitate aerobic capacity in athletes.

Healthy store programs and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), but not the Supplemental Nutrition Assistance Program (SNAP), are associated with corner store healthfulness.

In response to lack of access to healthy foods, many low-income communities are instituting local healthy corner store programs. Some stores also participate in the United States Department of Agriculture's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and the Supplemental Nutrition Assistance Program (SNAP). This study used two assessment tools to compare the healthfulness of offerings at stores participating in local healthy store programs (upgraded stores), WIC, and/or SNAP to that of similar non-participating stores. Based on store audits conducted in 315 New Jersey corner stores in 2014, we calculated healthy food availability scores using subsections of the Nutrition Environment Measures Survey for Corner Stores (NEMS-CS-Availability) and a short-form corner store audit tool (SCAT). We used multivariable regression to examine associations between program participation and scores on both instruments. Adjusting for store and block group characteristics, stores participating in a local healthy store program had significantly higher SCAT scores than did non-participating stores (upgraded: M = 3.18, 95% CI 2.65-3.71; non-upgraded: M = 2.52, 95% CI 2.32-2.73); scores on the NEMS-CS-Availability did not differ (upgraded: M = 12.8, 95% CI 11.6-14.1; non-upgraded: M = 12.5, 95% CI 12.0-13.0). WIC-participating stores had significantly higher scores compared to non-participating stores on both tools. Stores participating in SNAP only (and not in WIC) scored significantly lower on both instruments compared to non-SNAP stores. WIC-participating and non-SNAP corner stores had higher healthfulness scores on both assessment tools. Upgraded stores had higher healthfulness scores compared to non-upgraded stores on the SCAT.

Beverage consumption and risk of obesity among Native Americans in Arizona.

Native Americans face some of the highest rates of obesity and diabetes in the world. Despite numerous education programs to reduce obesity among Native Americans, little attention has been paid to reducing fructose, particularly in the form of high-fructose corn syrup in beverages. Considerable data indicate that energy from beverages does not displace energy from other foods throughout the day, often leading to energy imbalance, and numerous studies have documented that beverages are a leading contributor to energy intakes among Native Americans. Prevention programs that target pregnant women and parents of infants and very young children are necessary to halt the epidemic of obesity among Native Americans; one approach may be by promoting sugar-free beverages.

Dietary self-monitoring, but not dietary quality, improves with use of smartphone app technology in an 8-week weight loss trial.

OBJECTIVE: Dietary self-monitoring is linked to improved weight loss success. Mobile technologies, such as smartphone applications (apps), might allow for improved dietary tracking adherence. The authors assessed the use of a popular smartphone app for dietary self-monitoring and weight loss by comparing it with traditional diet counseling and entry methods. METHODS: Diet tracking and weight loss were compared across participants during an 8-week weight loss trial. Participants tracked intake using 1 of 3 methods: the mobile app "Lose It!", the memo feature on a smartphone, or a traditional paper-and-pencil method. RESULTS: App users (n = 19) recorded dietary data more consistently compared with the paper-and-pencil group (n = 15; P = .042) but not the memo group (n = 13). All groups lost weight over the course of the study (P = .001), and no difference in weight loss was noted between groups. CONCLUSIONS AND IMPLICATIONS: Smartphone apps could represent a novel and feasible dietary self-monitoring method for individuals.

Women, infants, and children cash value voucher (CVV) use in Arizona: a qualitative exploration of barriers and strategies related to fruit and vegetable purchases.

OBJECTIVE: Women, Infants, and Children (WIC) cash value vouchers (CVV) have been inconsistently redeemed in Arizona. The objective of this study was to explore perceived barriers to use of CVV as well as strategies participants use to overcome them. DESIGN: Eight focus groups were conducted to explore attitudes and behaviors related to CVV use. SETTING: Focus groups were conducted at 2 WIC clinics in metro-Phoenix, AZ. PARTICIPANTS: Participants in WIC who were at least 18 years of age and primarily responsible for buying and preparing food for their households. PHENOMENON OF INTEREST: Perceived barriers to CVV use and strategies used to maximize their purchasing value. ANALYSIS: Transcripts were analyzed using a general inductive approach to identify emergent themes. RESULTS: Among 41 participants, multiple perceived barriers emerged, such as negative interactions in stores or confusion over WIC rules. Among experienced shoppers, WIC strategies also emerged to deal with barriers and maximize CVV value, including strategic choice of times and locations at which to shop and use of price-matching, rewards points, and other ways to increase purchasing power. CONCLUSIONS AND IMPLICATIONS: Arizona WIC participants perceived barriers that limit easy redemption of CVV. Useful strategies were also identified that could be important to explore further to improve WIC CVV purchasing experiences.

Strength and comprehensiveness of district school wellness policies predict policy implementation at the school level.

BACKGROUND: In 2006, all local education agencies in the United States participating in federal school meal programs were required to establish school wellness policies. This study documented the strength and comprehensiveness of 1 state's written district policies using a coding tool, and tested whether these traits predicted school-level implementation and practices. METHODS: School wellness policies from 151 Connecticut districts were evaluated. School principal surveys were collected before and after the writing and expected implementation of wellness policies. Sociodemographic variables were assessed for each district, including enrollment, population density, political climate, racial composition, and socioeconomic status. Changes in school-level policy implementation before and after the federal wellness policy mandate were compared across districts by wellness policy strength; policies were compared based on district-level demographics. RESULTS: Statewide, more complete implementation of nutrition and physical activity policies at the school level was reported after adoption of written policies. Districts with stronger, more comprehensive policies were more successful in implementing them at the school level. Some sociodemographic characteristics predicted the strength of wellness policies. CONCLUSIONS: Written school wellness policies have the potential to promote significant improvements in the school environment. Future regulation of school wellness policies should focus on the importance of writing strong and comprehensive policies.