Psychometric Analyses of a Food Literacy Behaviors Questionnaire for Adults With Type 2 Diabetes Mellitus.

PURPOSE: The purpose of the study was to develop and validate a food literacy instrument specific to individuals with type 2 diabetes mellitus (T2DM). METHODS: Twelve T2DM-specific, food literacy-related statements underwent content validity and face validity testing, and exploratory factor analysis (EFA) was conducted (phase 1). The 6 statements remaining after EFA testing were added to an existing food literacy questionnaire called the Eating and Food Literacy Behaviors Questionnaire (EFLBQ). Confirmatory factor analysis (CFA) examined the EFLBQ plus the T2DM-specific statements, and the instrument was called the Eating and Food Literacy Questionnaire for Diabetics (EFLBQ-D; phase 2). Both EFA and CFA were administered by third-party provider Centiment via Qualtrics to adults with T2DM residing in the 13 United States Department of Agriculture Southern region states. Reliability was assessed via point estimate reliability testing. RESULTS: The EFA items clustered into 2 factors each with 3 statements: (1) carbohydrate counting and nutrition label reading and (2) healthy food preparation methods. The CFA indicated that the EFLBQ-D had good fit and that the factors had good reliability. The EFLBQ's integrity was maintained with its items loading on the respective constructs. CONCLUSIONS: The EFLBQ-D appears to be a valid, reliable instrument for use by researchers and professionals to better understand food behaviors and food literacy skills of those with T2DM. This is an important tool to help individualize medical nutrition therapy, improving patient care in this population.

A cooking intervention increased food literacy of students who frequently used the campus food pantry: A Pilot Program.

OBJECTIVES: Students who obtain food from a campus food pantry may benefit from participating in a nutrition/cooking intervention. PARTICIPANTS AND METHODS: Twenty-seven students 18-30 years of age attending a university in the southeastern US participated in the IRB approved study. One 2-hour class was offered each week for four weeks in the on-campus cooking laboratory. Subjects indicated how often they cooked a dinner meal at home and completed the Eating and Food Literacy Behaviors Questionnaire (EFLBQ) before and after participating in the program. RESULTS: The total EFLBQ, Factor 1 (Health and Nutrition) and Factor 3 (Food Preparation) scores, and the frequency of cooking a dinner meal at home were all higher post-program (all p < 0.05). CONCLUSIONS: This pilot study suggests that an on-campus cooking program can increase the food literacy and frequency of cooking meals by university students who obtained items from the campus food pantry.

Erratum to 'P23-075-23 Development & Validating of a Food Literacy Behavior Questionnaire for Adults With Type 2 Diabetes Mellitus' [Current Developments in Nutrition 7S1 (2023) 100184].

[This corrects the article DOI: 10.1016/j.cdnut.2023.100184.].

The Eating and Food Literacy Behaviors Questionnaire Has the Capacity to Distinguish Between Food Literacy Scores of Students Enrolled in Senior-Level Nutrition Classes Compared With Those Students Registered in Other Academic Courses Attending a University in the Southeastern United States.

BACKGROUND: The Eating and Food Literacy Behaviors Questionnaire (EFLBQ) is an instrument that has not been tested for its capacity to distinguish among individuals assumed to have higher and lower food literacy. OBJECTIVE: The aim of this study was to examine and compare EFLBQ scores among university students with and without formal nutrition-related training. DESIGN: This study had a cross-sectional design. PARTICIPANTS AND SETTINGS: Two hundred twenty-seven young adult university students enrolled in non-nutrition-related classes (n = 76), introductory nutrition classes (n = 98), and senior-level nutrition classes (n = 53) were recruited from a large university in the southeastern United States during the spring and fall semesters of 2022. The students ranged in age from 18 to 30 years. MAIN OUTCOME MEASURES: Mean EFLBQ total scores and factor scores of health and nutrition, taste, food preparation, planning and decision making, and convenience were compared among the three groups. STATISTICAL ANALYSES: Linear regression backward method examined whether level of training, age, sex, race and ethnicity, and BMI were independent variables associated with total EFLBQ mean scores. Analysis of variance (ANOVA) compared normally distributed data and Kruskal-Wallis and Mann-Whitney U tests compared non-normally distributed data. RESULTS: Linear regression testing found that the level of nutrition training was significantly associated with total EFLBQ scores. Students in senior-level nutrition classes had higher total EFLBQ mean scores (M = 3.1 ± 0.2) than students in non-nutrition-related classes (M = 2.9 ± 0.3) (P = 0.002; 95% CI = 0.055, 0.280) and introductory nutrition classes (M = 2.9 ± 0.3) (P = 0.001; 95% CI = 0.275, 0.061). Total EFLBQ mean scores were not different among the students in non-nutritional-related classes and introductory nutrition classes (P = 1.000; 95% CI = -0.096, 0.096). Scores differed by training level for items measuring EFLBQ Factor 1: Health and Nutrition. Factor 1 mean scores were higher in students in senior-level classes (M = 3.1 ± 0.4) than for those in non-nutrition classes (M = 2.7 ± 0.5) (P < 0.001; 95% CI = 0.294, 0.670) and introductory nutrition classes (M = 2.8 ± 0.5) (P < 0.001; 95% CI = 0.228, 0.553). The other EFLBQ factor mean scores were not different among the three groups (all P-values > 0.12). CONCLUSION: The EFLBQ demonstrated the capacity to distinguish food literacy scores between students expected to have higher as compared with lower food literacy.

Effect of Disclosed Information on Product Liking, Emotional Profile, and Purchase Intent: A Case of Chocolate Brownies Containing Edible-Cricket Protein.

Edible insects, a sustainable and nutritious alternative to conventionally derived proteins, are unfamiliar to Westerners and often associated with negative sentiments. Edible-cricket protein (ECP) added to chocolate brownies (CB) [0% ECP = CBWO (without) vs. 6% w/w ECP = CBW (with)], and disclosed information [no ECP added = (-) vs. ECP with benefits = (+), ECP- and ECP+, respectively] yielded four CB treatments (CBWO-, CBWO+, CBW-, and CBW+). Subjects (n = 112 female and n = 98 male) rated liking, selected emotions before- and after-tasting, and determined consumption (CI) and purchase intent (PI) after tasting. Likings were analyzed with mixed-effects ANOVA and post hoc Tukey's HSD test. Emotions were evaluated with Cochran's-Q test and correspondence analysis. Emotions driving or inhibiting overall liking (OL) were assessed with penalty-lift analyses using two-sample t-tests. A random forest algorithm was used to predict PI and estimate variables' importance. Female's and male's expected OL were higher for CBWO- than for CBWO+. Females' actual OL was higher for CBWO than for CBW regardless of the disclosed information but males' actual OL was the same across treatments. Females exhibited negative-liking disconfirmation for CBW-. In both tasting conditions, the disclosed information affected treatments' emotional profiles more than formulation. After-tasting emotions "happy" and "satisfied" were critical predictors of PI.

Effect of Informed Conditions on Sensory Expectations and Actual Perceptions: A Case of Chocolate Brownies Containing Edible-Cricket Protein.

Currently, many consumers are reluctant to consume edible-cricket protein (ECP). Chocolate brownie (CB) formulations without (WO) and with (W) 6%w/w ECP (CBWO and CBW, respectively) were presented under two informed conditions: formulated without ECP (ECP-) and formulated with ECP+benefits (ECP+). CBWO- (CBWO presented with the "ECP-" claim), CBWO+ (CBWO presented with the "ECP+" claim), CBW- (CBW presented with the "ECP-" claim), and CBW+ (CBW presented with the "ECP+" claim) were evaluated by 210 consumers for expected and actual attribute liking, and after-tasting consumption and purchase intent. Multi-way ANOVA, principal component analysis, and agglomerative clustering examined liking. Cochran-Q tests compared actual-liking profiles, purchase and consumption intent. Before tasting, CBW- obtained the lowest appearance liking, flavor liking was higher for ECP- than for ECP+ for either formulation, and ECP+ decreased aroma and overall liking only for CBWO. After tasting, CBWO had higher liking than CBW (except for aroma) for either informed condition. Regardless of the formulation, ECP- and ECP+ had similar actual liking. Nevertheless, ECP+ prevented negative disconfirmation for both formulations while ECP- decreased texture liking (for CBWO) and all liking (for CBW) upon tasting. Females' consumption intent was higher for CBWO regardless of the informed condition, but CBW+ achieved a similar purchase intent to CBWO- for both genders.

The Eating with Ease Program Improved Veterinary Medical Students' Perceived Ability to Buy, Cook, and Eat Healthy Foods.

College students are challenged to consume healthy diets, and veterinary medical students may also have difficulty achieving optimal dietary intake, yet improved well-being is associated with following healthy dietary patterns. Individuals with food literacy-the inter-related knowledge, skills, and behaviors to plan and manage, select, prepare, and eat healthy foods-are better able to meet dietary recommendations. The Eating with Ease program developed and tested a nutrition education/culinary skill-building program to build first- and second-year veterinary medicine students' food literacy and healthy behaviors toward food. The curriculum emphasized health and nutrition, taste, food preparation skills, planning/decision making, and convenience. Students engaged in four 30-minute sessions and communicated through a mobile group messaging application. Pre- and post-program scores on the Eating and Food Literacy Behaviors Questionnaire (EFLBQ) were compared between those who finished the intervention and a control group of graduate students who completed a money management program. The intervention group (n = 23) had a mean age of 24.2 years (SD = 2.6), and the control group (n = 14) had a mean age of 27.1 years (SD = 2.3). Most participants were female (87%, n = 20 and 79%, n = 11 in the intervention and control groups, respectively). After completing the program, the veterinary medical students' mean EFLBQ factor change score for health and nutrition was significantly higher (p = .03) when compared to the control group. These findings suggest that a short, evidence-based nutrition education/culinary skill-building program may improve veterinary medical students' behaviors to choose, prepare and consume healthy foods.

Psychometric Analyses of the Eating and Food Literacy Behaviors Questionnaire with University Students.

OBJECTIVES: This study developed and validated a questionnaire to measure young adults' perceived food literacy and behaviors toward food and created an explanatory model. DESIGN: Cross-sectional. SETTING: Large southeastern US university. PARTICIPANTS: A total of 1,896 students, aged 18-30 years, were recruited. Data from 1,813 were analyzed. VARIABLES MEASURED: Health and nutrition, taste, food preparation, planning and decision-making, and convenience. ANALYSIS: Exploratory factor analysis, test-retest reliability, confirmatory factor analysis, and structural equation modeling were performed. RESULTS: Exploratory factor analysis returned 5 factors with acceptable internal structure. Test-retest reliability coefficients ranged from 0.63 to 0.92. Confirmatory factor analysis suggested that a 5-factor model was an appropriate fit for the data (χ2 = 588.05; degrees of freedom = 142; root mean square error of approximation = 0.06; comparative fit index = 0.98; Tucker-Lewis Index = 0.97; standardized root mean square residual = 0.05). Structural equation modeling revealed relationships from health and nutrition to food preparation (0.25, P < 0.001), planning and/or decision-making (0.57, P < 0.001), taste (-0.14, P < 0.001), and convenience (-0.31, P < 0.001). The structural equation model demonstrated adequate fit (adjusted goodness of fit = 0.91; comparative fit index = 0.93; non-normed fit index = 0.91; root mean square error of approximation = 0.06; and standardized root mean square residual = 0.07) and a significant chi-square test (χ2 = 628.92; degrees of freedom = 171, P < 0.001). CONCLUSIONS AND IMPLICATIONS: Young adults consider food literacy-related factors and behavioral concerns when making food choices.

Effects of Intrinsic and Extrinsic Visual Cues on Consumer Emotion and Purchase Intent: A Case of Ready-to-Eat Salad.

With increasing demand for ready-to-eat (RTE) fresh vegetables, it is important to understand how visual information cues, both intrinsic and extrinsic, affect consumer perception of these products. This study developed an emotional and wellness lexicon related to RTE salads. Subsequent questionnaires with images of salads were used to quantify consumer (N = 150) emotional and hedonic perceptions related to green color shade, shape/size of pieces, multicolor scheme, product name, and packaging. The different visual cues significantly impacted emotions and their intensities. Qualitatively, feelings of health and wellness predominated across salad samples. Negative emotions were more influenced by size of piece and green-color (intrinsic), while positive emotions were influenced by viewing salads of multiple colors (intrinsic) and packaging (extrinsic). Pale green salads were generally less liked than darker green ones. Values, in one case, ranged from 4.39 to 7.28 (on a 9-point hedonic scale), but naming the product ("iceberg lettuce") did raise the lowest score to 5.75. The addition of vegetables with orange and purple colors to the salad mix had a positive impact on the perception of pale green salads. This study demonstrated that intrinsic and extrinsic visual cues significantly influenced consumer emotions, hedonic perception and purchase intent of RTE salads, but the effects of extrinsic cues were generally less prominent.

Possible Sugar and Calorie Reduction by Visual Cues: A Case of Syrup Added to Brewed Coffee.

Visual cues have been reported to influence taste and flavor perceptions. The objectives of this study were to evaluate the impact of visual cues (color and viscosity) of syrups on expected sweetness and bitterness perception (Study I), and on sweetness perception and sweetness liking of brewed coffee after syrup had been added, and the amount of syrups to be added to brewed coffee (Study II). For Study I, the visual stimuli were developed by varying viscosity (80, 800, and 8000 cP) and yellow index (YI) (0.04, 0.08, 0.16, and 0.32), resulting in 12 syrups with 20 degrees Brix. Visual observations indicated greater expected sweetness perceptions of syrups when YI and viscosity were increased. However, YI, but not viscosity, affected expected bitterness perceptions. Increasing YI raised the frequency (%) of "too sweet" perceptions of syrups on a JAR scale. For Study II, only four syrups (LC1, LC2, HC1, HC2; L = viscosity, 80 cP, H = 8,000 cP; C1 = YI 0.04, C2 = YI 0.32) were studied. The visual perception affected consumers' behaviors concerning the amount of syrup added to brewed coffee. Consumers added the greatest volume of syrups with the lowest viscosity and YI (LC1), while the lowest volume of syrups with the highest viscosity and YI (HC2). There were no significant differences in sweetness liking of brewed coffees added with LC1, LC2, and/or HC1 syrups. This study indicated that visual cues could potentially intensify the perceived sweetness of syrups, and reduced the volume of syrup added to brewed coffee and consequently calories consumed. PRACTICAL APPLICATION: Sensory visual cues associated with a syrup can be used to reduce the volume consumed and thereby promote reduced consumption of calories while maintaining sensory acceptability. Increasing a syrup's viscosity and yellow/brown color intensity enhanced the expectation of sweetness and resulted in less volume of syrup added to brewed coffee. This research demonstrated that the impact of visual cues not only influenced expectation and sensory acceptability but also impacted the cognitive process of eating. This strategy could provide a way to promote a sustainable reduction in sugar and, hence, calorie consumption without compromising sensory liking.

Psychometric Analyses of the Motivation to Prepare Healthy Foods Questionnaire Used With Adult College Students.

OBJECTIVE: To develop and validate a questionnaire to measure adult college students' motivation to prepare healthy foods based on the psychosocial needs identified by Self-determination Theory. DESIGN: This study used a cross-sectional design. SETTING: A major southeastern public university. SUBJECTS: A total of 1,027 free-living adults, aged 18-30 years, were recruited. Data from 997 were analyzed. VARIABLES MEASURED: The 5 constructs of Self-determination Theory were validated. ANALYSIS: Descriptive statistics, exploratory factor analysis, internal consistency, test-retest reliability, confirmatory factor analysis, and respecification analysis were performed. RESULTS: The exploratory factor analysis returned 5 factors with acceptable internal structure. Cronbach α values were .94 for perceived competence, .85 for autonomy support, .87 for intrinsic motivation, .78 for relatedness, and .77 for autonomy. Test-retest reliability coefficients were 0.66-0.79. Confirmatory factor and respecification analyses revealed that the 5-factor structure was an appropriate fit for the data. CONCLUSIONS AND IMPLICATIONS: More research is needed to test the questionnaire's use in a culinary classroom setting to reaffirm these findings. Future research includes testing the instrument's convergent and discriminant validity, performing differential analyses to generalize its use in a wider adult population, and using it to assess change in motivation as a result of participating in a classroom-based culinary skills-building intervention. Additional confirmatory studies are needed to determine whether using nutrition and kinesiology students in the current study affected construct validity.

Emerging Relationships Between Vitamin D Status, Physical Activity Habits, and Immune Indices in College-Aged Females.

It has been determined that individuals who are regularly physically active have more favorable inflammatory profiles; less is known about how vitamin D levels can impact inflammation. This study explored the relationship between inflammatory indices in physically active (PA) and not physically active (NPA) individuals with 25-hydroxyvitamin D (25OHD) concentrations either above or below optimal concentrations. All female subjects (n = 63, age 19 - 35 years) were evaluated for body composition, maximal aerobic capacity (VO2peak), and anaerobic power (Wingate). Blood samples were analyzed for 25OHD and C-reactive protein (CRP), stimulated with lipopolysaccharide (LPS) and assessed for interleukin-6 (IL-6) production, and used for flow cytometric analysis. PA (n = 30) had higher 25OHD levels (45.2 ± 2.7 vs. 17.05 ± 1.4 ng / mL; p = 0.015), higher VO2peak (p < 0.0001), lower body weight (p = 0.039) and lower estimated percent body fat (p = 0.011) compared to NPA (n = 33). PA also had lower LPS-stimulated IL-6 production compared to NPA (p = 0.0163), although there were no differences between resting CRP concentrations. NPA with optimal 25OHD had fewer total monocytes, CD14+CD16-cells, CD14+CD16+ cells, and decreased TLR4 expression on CD14+CD16+ cells compared to NPA with suboptimal 25OHD (< 32 ng / mL). In summary, regular physical activity was associated with higher serum 25OHD, healthier measures of body composition, and reduced stimulated IL-6 production. However, optimal vitamin D status was not associated with anti-inflammatory benefits beyond those which are provided by regular physical activity.

Exploratory and confirmatory factor analysis of the Adolescent Motivation to Cook Questionnaire: A Self-Determination Theory instrument.

Increasing adolescents' motivation and competence to cook may improve diet quality and reduce the risk for obesity and chronic diseases. The objective of this study was to develop an instrument to measure adolescents' intrinsic motivation to prepare healthy foods and the four psychological needs that facilitate motivation identified by the Self Determination Theory (SDT). Five hundred ninety-three high school students (62.7% female) were recruited to complete the survey. Participants indicated to what extent they agreed or disagreed with 25 statements pertaining to intrinsic motivation and perceived competence to cook, and their perceived autonomy support, autonomy, and relatedness to teachers and classmates. Data were analyzed using exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and internal consistency reliability. EFA returned a five-factor structure explaining 65.3% of the variance; and CFA revealed that the best model fit was a five-factor structure (χ2 = 524.97 (265); Comparative Fit Index = 0.93; RMSEA = 0.056; and SRMR = 0.04). The sub-scales showed good internal consistency (Intrinsic Motivation: α = 0.94; Perceived Competence: α = 0.92; Autonomy Support: α = 0.94; Relatedness: α = 0.90; and Autonomy: α = 0.85). These results support the application of the Adolescent Motivation to Cook Questionnaire to measure adolescents' motivation and perceived competence to cook, autonomy support by their instructor, autonomy in the classroom, and relatedness to peers. Further studies are needed to investigate whether this instrument can measure change in cooking intervention programs.

Exploratory and confirmatory factory analysis of the Willingness to Eat Whole Grains Questionnaire: A measure of young adults' attitudes toward consuming whole grain foods.

Whole grains are recommended by dietary guidelines because of their health-promoting properties, yet attitudes toward consuming these foods have not been examined. This study developed and validated a questionnaire to estimate willingness to consume whole grain foods. Focus group interviews with high school students and input from nutrition educators produced a list of 10 whole grain items that were included in the "Willingness to Eat Whole Grains Questionnaire". Young adult university students 18-29 years of age indicated their willingness to consume each of the whole grain foods using a 4-point, Likert-type scale with responses ranging from "always unwilling" to "always willing" and a fifth option of "never eaten". Participants' age, race/ethnicity, and gender were collected. Data were examined using exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and test-retest reliability. The EFA test (n = 266; 65% female; 69% white) using principal axis factoring returned a single factor that included all survey items and explained 58.3% of the variance. The CFA (n = 252; 62% female, 74% white) supported a single-factor solution: χ(2) = 80.57 (35); RMSEA = 0.07; Comparative Fit Index = 0.92; Tucker-Lewis Index = 0.90; and SRMR = 0.05. The questionnaire, administered on two occasions separated by two weeks to 36 university students, demonstrated good testretest reliability (r = 0.87, p < 0.0001). The "Willingness to Eat Whole Grains Questionnaire" had good face validity when used with a young adult population and will be a useful tool to help nutrition educators examine attitudes toward consuming nutrient-rich whole grain foods.

Endurance and resistance training lowers C-reactive protein in young, healthy females.

The purpose of this study was to determine whether endurance (E) or endurance + resistance (ER) training affects C-reactive protein (CRP) and if these changes are related to alterations in fitness and (or) body composition in young females. Thirty-eight females (aged 18-24 years) were assigned to 1 of 3 groups: (1) E, (2) ER or (3) active control (AC). The E and ER groups completed 15 weeks of marathon training. The ER group performed additional resistance training and the AC group maintained their usual exercise routine. Primary outcomes were measured pre- and post-training and included anthropometric indices, dual-energy x-ray absorptiometry, plasma CRP, time to complete 1.5 miles (in minutes), and upper and lower body strength tests (i.e., 8 repetition max on bench and leg press (ER group only)). There were no differences in any variable among the groups at baseline. After training, the E group decreased time to complete 1.5 miles (p < 0.05). The AC group decreased percent and absolute body fat while the E group decreased percent body fat, absolute body fat, and android and gynoid body fat (p < 0.05). The ER group significantly improved strength (p < 0.001) and reduced plasma CRP from 2.0 ± 1.1 to 0.8 ± 0.3 mg·L(-1) (p = 0.03). No significant associations were observed between CRP and measures of body composition or aerobic capacity. Combined endurance and resistance training may be an effective modality for reducing plasma CRP in young adult females independent of changes in aerobic capacity or body composition.

Quantitative ultrasound normative reference data for community-dwelling white and black females in the United States.

Quantitative ultrasound (QUS) race-specific normative reference data are not available for accurate calculation of Z-scores. The primary aims of this study were (1) to develop a race-specific QUS reference database for white and black females and to compare estimated fracture risk between these 2 racial groups and (2) to compare stiffness index (SI) values of white females in this study to manufacturer-obtained values. Subjects included 1111 females (31% black), aged 20-85 yr (52 ± 19 yr), with a mean SI score of 93.7 ± 20.1. White females, aged 20-39 yr (n=213), were used to calculate T-scores, whereas Z-scores were age and race specific. Black females had significantly higher SI scores than white females (p<0.001). White females aged 50+ yr in this study had significantly higher SI scores compared with manufacturer-derived values. Results highlight the need for population- and race-specific normative data when using QUS as a screening tool for identifying high fracture risk.

A cafeteria-based tasting program increased liking of fruits and vegetables by lower, middle and upper elementary school-age children.

This study aimed to increase 1st, 3rd, and 5th grade children's liking for fruits and vegetables by offering repeated opportunities to taste selected items. Tastes of four fruits or four vegetables were offered to children (51% boys; 32% 1st graders and 34% 3rd graders) on alternate weeks for 8 weeks. Two-week follow-up tastings occurred 4 months and 10 months post-intervention. Children who began the program disliking the targeted fruits and vegetables improved liking for all items after 8 weeks and maintained higher scores at both follow-up assessments. Grade and gender differences in liking were observed but were not consistent at each time point.

Repeated taste exposure increases liking for vegetables by low-income elementary school children.

Children's food preferences play a major role in their food choices and consumption. The objective of the present study was to examine if repeated tastings of selected vegetables in a school setting increased children's liking of these items. A total of 360 fourth- and fifth-grade students attending four low-income, public elementary schools in southeastern Louisiana volunteered to participate. During the spring of 2008, children were offered a taste of carrots, peas, tomatoes, and bell peppers once a week for 10 weeks. At each tasting session children recorded whether they swallowed each of the vegetables, spit it into the napkin, or did not put it in their mouth and indicated their liking for each vegetable using a Likert-type response scale. Approximately one-half of the children tasted eight of ten times during the program (46.5% for those who began disliking and 68.5% for those who began liking the vegetables). Proc Glimmix analyses indicated that for children who began the program disliking the vegetables, repeated tasting improved liking scores for carrots, peas, and tomatoes; liking for bell peppers did not change. The number of children who reported liking or liking a lot for previously disliked vegetables was greater after eight or nine taste exposures. Repeated tasting of less-liked vegetables by children in a cafeteria-based setting is a strategy to promote liking of these items and is effective in approximately half of the participants.

Gestational nutrition improves outcomes of vaginal deliveries in Jordan: an epidemiologic screening.

Adequate and balanced nutrition during gestation is essential for achieving healthy pregnancy outcomes. This retrospective survey tested the hypothesis that maternal nutrition (macronutrients intake, micronutrients intake, and weight gain) during gestation will impact gestational outcomes (gestational age, birth weight, and labor spontaneity). The objectives of this study were to test the impact of macronutrients and micronutrients consumed during gestation, pregestational weight and weight gain during gestation on gestational age, birth weight, and labor spontaneity among Jordanian women. Study participants (n = 700) were recruited from a women's hospital in northern Jordan. Data were collected using structured interviews. Dietary determinants examined in the study included daily intake of macronutrients (energy, carbohydrate, protein, fat, and n-3 and n-6 fatty acids) and micronutrients (zinc, calcium, folate, vitamin C, vitamin A, and vitamin B6), pregestational body mass index, total weight gain, and weight gain pattern during pregnancy. Dietary data were obtained from a semiquantitative food frequency questionnaire. Mean (SEM) daily intakes of energy, carbohydrate, and protein were 10894 (138) Kj, 320 (3.8) g, and 90 (0.95) g, respectively; with fat contributing 36% of total energy. Average daily energy and carbohydrate intake during pregnancy were related negatively to gestational age (P < .05). Pregestational body mass index was associated positively with gestational age and birth weight (P < .05). Intakes of vitamin A and calcium had significant relationships with birth weight. Daily intakes of zinc, calcium, vitamin B6, and n-3 and n-6 fatty acids were associated with labor spontaneity. Dietary factors consumed during pregnancy are associated with pregnancy outcomes.