Growing Kalo (Taro) in the Continental United States.

As an increasing number of Native Hawaiian and Pacific Islander adults move to the continental United States, the development and implementation of resources that promote access to cultural foods and support food sovereignty on the continent is crucial to perpetuate cultural practice and connection to the 'aina (land that feeds). Kalo (taro) is an important cultural food central to Native Hawaiian identity. Native Hawaiians connect their genealogy as far back to the cultivation of kalo and the creation of kalo itself. In this practice note, we describe the creation of a mala kalo (cultivated field for taro) in Oregon by the Ka'aha Lahui O 'Olekona Hawaiian Civic Club. An ongoing project over the past 3 years, the creation of a mala kalo exceeded expectations. Not only did the mala allow the cultivation of kalo outside of Hawaii, the mala became a place for the community to unite toward common goals of connecting with the land, promoting mental health, and creating a sense of place in their diaspora. This project indicates that not only is the creation of mala kalo in Oregon feasible, it may also be an important opportunity for the growing number of Native Hawaiians and Pacific Islanders adults living on the continent to improve health outcomes through connections with cultural foods and practices.

"I enjoy the good foods, all of which are not good for me." The categorization and moralization of food.

Intuitive eating emphasizes eating in response to physiological cues of hunger and satiety and is associated with multiple positive health outcomes. Unconditional permission to eat (UPE), a domain of intuitive eating, encourages removing food classifications and permission to eat all foods. However, the categorization of food is described as a method to simplify decision making and moralization of foods can help prioritize food items in consumption. Thus, we were interested in understanding how foods are labeled and applied, the moralization of foods, and how individuals with low UPE labeled and moralize foods. Using Prolific Academic, we recruited 49 adults 18 years and older living in the United States to complete an online survey and interview. The survey assessed intuitive eating (IES-2) and the interview explored what and how participants eat and their thoughts and feelings about their body. Participants frequently used multiple labels when talking about foods. Healthy and unhealthy were common and offered a rationale for consumption, emotions were used to label foods, and taste and cost were important to food choice. Participants frequently moralized foods, although three participants explicitly stated they choose not to moralize foods. Individuals reporting low UPE described the importance of restriction and were following strict dietary recommendations. While labeling foods has been proposed to simplify decision-making, the use of labels is highly nuanced and thus understanding the connections between how foods are labeled and behaviors may be highly complex. We suggest future research explore how the categorization and moralization of food are associated with health behaviors and outcomes, how differing definitions of "healthy/unhealthy" foods are associated with behaviors, and the impacts of food insecurity and chronic disease management on food categorization and moralization.

Methodological Challenges in Web-Based Qualitative Research With Medically Underserved Populations.

Internet- or web-based research is rapidly increasing, offering multiple benefits for researchers. However, various challenges in web-based data collection have been illustrated in prior research, particularly since the onset of the COVID-19 pandemic. To add to the literature on best practices for web-based qualitative data collection, we present 4 case studies in which each research team experienced challenges unique to web-based qualitative research and had to modify their research approaches to preserve data quality or integrity. The first 2 case examples describe issues with using social media to recruit hard-to-reach populations, the third example demonstrates the challenge in engaging adolescents in sensitive conversations on the web, and the final example discusses both the issues in recruitment and the use of different modalities in collecting data to accommodate the medical needs of study participants. Based on these experiences, we provide guidance and future directions for journals and researchers in collecting qualitative data on the web.

Body image and eating behaviors: A latent profile analysis.

Body image is multidimensional and less is known about how the combination of positive and negative body image relates to eating behaviors. We used a person-centered approach to identify profiles of body image and explore the relationship between profile membership, sex, age, race, and current marital status, and eating behaviors in a community sample of adults. We recruited 288 adults 18 and older living in the United States using Prolific Academic. Participants completed an online survey assessing body appreciation, functionality appreciation, body dissatisfaction, weight bias internalization, and adaptive and maladaptive eating behaviors. We used latent profile analysis to identify four distinct body image profiles: appreciation & mild dissatisfaction, functional appreciation & moderate dissatisfaction, strong dissatisfaction, and strong appreciation. Profile membership differed by sex with more women and younger adults in profiles higher in negative body image. The relationships between profiles and eating behaviors differed; the three profiles including negative body image had the lowest adaptive and highest maladaptive eating behaviors. The identification of clinically relevant profiles: (1) confirm positive and negative body image coexist, (2) identify high- and low-risk profiles of body image and eating behavior, and (3) offer preliminary suggestions for screening and tailoring preventive interventions.

Associations between body image, eating behavior, and diet quality.

Background: Weight-neutral interventions that promote adaptive eating behaviors are becoming a growing area of practice. Understanding whether adaptive eating behaviors are associated with improved diet quality is essential. Body image may be an important factor in this relationship given its close connection to eating behaviors. Aim: The purpose of this study was to develop an understanding of the relationships between positive and negative body image, adaptive and maladaptive eating behaviors, and diet quality. Methods: We recruited 288 adults 18 years and older who were living in the US using Prolific Academic. Participants completed an online survey including measures of positive and negative body image, adaptive and maladaptive eating behaviors, and a dietary screener questionnaire (DSQ). We ran a hierarchical linear regression and tested whether body image and diet quality were mediated by eating behavior. Results: Body image and maladaptive eating behaviors were not associated with diet quality. Body-food choice congruence (B-FCC), an adaptive eating behavior, was associated with diet quality. B-FCC mediated the relationship of positive and negative body image to diet quality. Conclusions: Our findings provide additional support for weight-neutral or adaptive eating interventions as a mechanism to promote diet quality. Additional research may benefit from exploring indirect effects of body image on diet intake, the relationship between eating behavior and diet quality using qualitative data, and the comparison of weight-neutral or non-diet interventions with traditional behavior change interventions.

A lifespan perspective of structural and perceived social relationships, food insecurity, and dietary behaviors during the COVID-19 pandemic.

Physical distancing and economic impacts of the COVID-19 pandemic may influence dietary behaviors. Using a parallel mixed method design, we examined the relationships between structural and perceived social relationships on dietary behaviors across the adult lifespan and by food security status. A representative sample of 360 adults (18-78 years old) living in the United States were recruited through Prolific Academic to complete an online cross-sectional survey. Participants provided data about demographics, food insecurity, structural and perceived social relationships, diet quality, and unhealthy snacking at the onset of the pandemic. Participants responded to open-ended questions about perceived changes in social connections and dietary behavior since COVID-19. Quantitative findings indicated food insecure emerging and older adults were at highest risk for low diet quality and frequent unhealthy snacking. Friend support was associated with higher diet quality. Qualitative findings suggested overall decreases in social connection and changes in dietary behavior, with food insecure adults describing decreases in diet quality. Participants who reported increases in emotional eating also reported decreases in social connection. Findings suggest the pandemic may exacerbate inequalities, particularly among food insecure emerging and older adults. Scaling up preventive interventions to increase social connection and reduce food insecurity during unprecedented challenges may promote healthier dietary behaviors now and in the long-term.

Child-Centered Nutrition Phrases Plus Repeated Exposure Increase Preschoolers' Consumption of Healthful Foods, but Not Liking or Willingness to Try.

OBJECTIVE: To determine whether the use of child-centered nutrition phrases (CCNP) with repeated exposure (RE) improved willingness to try, liking, and consumption of healthful foods compared with RE alone. DESIGN: The researchers used a 2 × 2 × 4 fractionated within-subjects experimental design in the study: phrase condition (RE vs CCNP + RE) by time of measurement (preintervention, postintervention, and 1-month follow-up), by type of food (tomatoes, bell peppers, lentils, and quinoa). SETTING: Children were recruited from 2 early education centers; 89% participated. PARTICIPANTS: Children aged 3-6 years old (n = 87) who were predominantly white (67%) and from middle-income homes and had parents with some higher education. INTERVENTION: Adult delivery of CCNP + RE weekly for 6 weeks. MAIN OUTCOME MEASURE(S): Willingness to try, change in liking, and change in consumption. ANALYSIS: Two-level random-effects models were used to account for repeated measurements of willingness to try, liking, and consumption nested within participants. RESULTS: Children exhibited greater consumption of CCNP foods at follow-up assessment compared with RE foods (b = -16.28, SE = 5.41, t(528) = 3.01; P = .003). CONCLUSIONS AND IMPLICATIONS: Use of CCNP combined with RE may encourage healthy eating, especially for novel foods that children may typically refuse.