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1.
Prev Med Rep ; 24: 101547, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34518794

RESUMO

Early COVID-19 pandemic data showed a spike in both food insecurity and poor mental health. The purpose of this study was to examine the relationship between food insecurity and mental health outcomes nine months after the start of the COVID-19 pandemic. A national survey of adults 18 years and older was administered in December 2020 (N = 8,355). Multivariable logistic models and post-estimation margins commands were used to show the predicted probability of mental health outcomes (psychological distress, anxiety, and depression) by food security status. The majority of participants (68.5%) reported high/marginal food security, 15.5% had low food security, and 16.0% had very low food security. There was a strong dose response relationship between food insecurity and higher psychological distress, anxiety and depression. Fewer than one in five adults with high/marginal food security screened positive for all three mental health outcomes, while more than two in five adults with low food security screened positive for psychological distress (39.9%), depression (41.7%) and anxiety (41.3%). Among adults with very low food security, nearly half screened positive for psychological distress (47.7%), depression (48.1%) and anxiety (49.4%). Younger adults had higher prevalence of psychological distress compared to older adults regardless of food security status. Food insecure adults, particularly young adults, have higher rates of psychological distress, anxiety, and depression than their food secure counterparts. Facilitating opportunities to connect at risk populations with food assistance and affordable mental healthcare should be prioritized as the pandemic continues and beyond.

2.
Appetite ; 168: 105659, 2021 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-34437925

RESUMO

The potential negative effects of the COVID-19 pandemic on health-compromising behaviors including overeating, processed food intake, and alcohol use have been well documented. However, it is possible the COVID-19 pandemic has had positive effects on some health-promoting behaviors like cooking and fruit and vegetable intake. The current study was a preregistered secondary data analysis using data from a U.S. national, crowdsourced study (n = 868) on eating behaviors during the early stages of the COVID-19 pandemic. The objectives of the current study were to compare levels of cooking, fruit and vegetable intake, and physical activity among U.S. adults during the early stages of the COVID-19 pandemic to pre-pandemic levels in reference groups of U.S. adults, and test whether subjective stress from the pandemic was associated with health-promoting behaviors by obesity status. During the early stages of the COVID-19 pandemic, participants cooked more often and ate 0.23 more cups of fruits and vegetables per day, but 28.8% fewer participants met federal physical activity guidelines. Greater COVID-19 stress was minimally to moderately associated with greater cooking, fruit and vegetable intake, and physical activity. The positive association between COVID-19 stress and fruit and vegetable intake was stronger for individuals with obesity. The COVID-19 pandemic might have encouraged U.S. adults, especially those at risk for complications, to engage in some health-promoting behaviors while creating barriers for other behaviors.

3.
Public Health Nutr ; : 1-13, 2021 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-34416925

RESUMO

OBJECTIVE: Chefs have the potential to influence diet quality and food systems sustainability through their work. We aimed to assess the attitudes and perceptions of culinary students about nutrition and sustainability as part of their roles, responsibilities and future work as chefs. DESIGN: We surveyed students attending the Culinary Institute of America (CIA) in the fall of 2019 (n 546). Descriptive statistics compared food priority rankings and Likert-scale distributions of nutrition and sustainability attitudes and beliefs. Adjusted generalised linear models were used to evaluate whether there were differences in attitudes and beliefs across demographic groups. SETTING: The CIA, a private, not-for-profit college and culinary school with US campuses in New York, California and Texas. PARTICIPANTS: Students >18 years old currently enrolled in any of the school's associate's or bachelor's degree programs. RESULTS: Students agreed that chefs should be knowledgeable about nutrition (96·0 %) and the environmental impact of their ingredients (90·8 %) but fewer considered healthfulness (57·8 %) and environmental impact (60·2 %) of their food to be primary considerations in their career as a chef. Taste was the primary factor influencing culinary students' food choices but food priorities differed by race/ethnicity. CONCLUSIONS: Culinary students believe nutrition and sustainability are important. Opportunities exist to empower them with knowledge and skills for promoting public health and sustainable food systems in their future work as chefs.

4.
Am J Prev Med ; 2021 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-34452744

RESUMO

INTRODUCTION: Food insecurity has been associated with adverse health and academic outcomes among college students. However, little is known about the long-term impacts of experiencing food insecurity during college. This study examines the impacts of college food insecurity (measured from 1999 to 2003) on future food insecurity (measured from 2015 to 2017) and whether this association differs by economic independence during college. METHODS: Data came from 1,508 participants in the Panel Study of Income Dynamics, the longest-running and nationally representative panel survey. Household food security was assessed using the 18-item U.S. Household Food Security Survey Module during college enrollment in 1999-2003 and again during adulthood in 2015-2017. Generalized linear models were used to examine the impacts of college food insecurity on food insecurity in adulthood, adjusting for individual- and family-level sociodemographic characteristics. Data analysis was conducted in 2020-2021. RESULTS: After multivariable adjustment, college food insecurity was associated with an increased prevalence of food insecurity in adulthood (prevalence ratio=1.45, 95% CI=1.16, 1.81). This association was more pronounced among students who were economically independent from their parents during college (prevalence ratio=2.23, 95% CI=1.27, 3.90). CONCLUSIONS: Food insecurity during college is associated with a higher prevalence of food insecurity in early to middle adulthood, particularly among economically independent students. Given the seemingly cyclical nature of food insecurity over the life course, policies are needed to alleviate food insecurity during the critical college years.

5.
Nutrients ; 13(7)2021 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-34371903

RESUMO

Nutrition during pregnancy has lifelong impacts on the health of mother and child. However, this life stage presents unique challenges to healthy cooking and eating. Cooking interventions show promising results, but often lack theoretical basis and rigorous evaluation. The objective of this formative, qualitative study was to explore motivators, strategies, and barriers related to healthy cooking during pregnancy. Pregnant individuals' preferences for a cooking education program were also explored. We conducted five focus groups with pregnant individuals (n = 20) in Southeast Michigan in 2019. Focus groups were audio-recorded and transcribed verbatim, then double coded by two members of the research team. Mean gestational age was 18.3 ± 9.6 weeks. Common motivators included feeding other children, avoiding pregnancy complications, promoting fetal growth, and avoiding foodborne illness. Challenges included pregnancy symptoms, navigating nutrition recommendations, mental energy of meal planning, family preferences, and time constraints. Strategies employed were meal planning and including a variety of foods. Participants identified organizational strategies, recipes, nutrition information, and peer support as important components of a cooking intervention during pregnancy. This study characterized multiple challenges to healthy home cooking during pregnancy, providing novel insight to inform the development of cooking skills education programs during this important life stage.


Assuntos
Culinária , Dieta Saudável , Conhecimentos, Atitudes e Prática em Saúde , Fenômenos Fisiológicos da Nutrição Materna , Motivação , Valor Nutritivo , Educação de Pacientes como Assunto , Adulto , Comportamento Alimentar , Feminino , Grupos Focais , Promoção da Saúde , Humanos , Michigan , Estado Nutricional , Gravidez , Pesquisa Qualitativa , Recomendações Nutricionais
6.
Public Health Nutr ; : 1-9, 2021 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-34321134

RESUMO

OBJECTIVE: To examine the effect of food insecurity during college on graduation and degree attainment. DESIGN: Secondary analysis of longitudinal panel data. We measured food insecurity concurrent with college enrolment using the 18-question United States Department of Agriculture Household Food Security Survey Module. Educational attainment was measured in 2015-2017 via two questions about college completion and highest degree attained. Logistic and multinomial logit models adjusted for socio-demographic characteristics were estimated. SETTING: USA. PARTICIPANTS: A nationally representative, balanced panel of 1574 college students in the USA in 1999-2003 with follow-up through 2015-2017 from the Panel Study of Income Dynamics. RESULTS: In 1999-2003, 14·5 % of college students were food-insecure and were more likely to be older, non-White and first-generation students. In adjusted models, food insecurity was associated with lower odds of college graduation (OR 0·57, 95 % CI: 0·37, 0·88, P = 0·01) and lower likelihood of obtaining a bachelor's degree (relative risk ratio (RRR) 0·57 95 % CI: 0·35, 0·92, P = 0·02) or graduate/professional degree (RRR 0·39, 95 % CI: 0·17, 0·86, P = 0·022). These associations were more pronounced among first-generation students. And 47·2 % of first-generation students who experienced food insecurity graduated from college; food-insecure first-generation students were less likely to graduate compared to first-generation students who were food-secure (47·2 % v. 59·3 %, P = 0·020) and non-first-generation students who were food-insecure (47·2 % v. 65·2 %, P = 0·037). CONCLUSIONS: Food insecurity during college is a barrier to graduation and higher-degree attainment, particularly for first-generation students. Existing policies and programmes that help mitigate food insecurity should be expanded and more accessible to the college student population.

7.
J Acad Nutr Diet ; 121(11): 2267-2274, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33972204

RESUMO

BACKGROUND: Food insecurity, a state of not being able to consistently access nutritious food due to financial constraints, has been associated with poor dietary intake among college students. The extent to which campus food resources contribute to this association is unknown. OBJECTIVES: This study examined the association between food insecurity and dietary intake in a sample of undergraduate students with unlimited meal plans and dining hall access at a large, public Midwestern university. DESIGN: The study design is cross-sectional. The data used are baseline data from a broader sugar-sweetened beverage intervention study that were collected using a Qualtrics survey prior to the intervention. PARTICIPANTS/SETTING: The sample consisted of 1033 undergraduate students recruited from 3 dining halls. The data were collected in November 2018. MAIN OUTCOME MEASURES: Food security was assessed using the 6-item Short Form Food Security Survey Module. Dietary intake was assessed using the National Cancer Institute 26-item Dietary Screener Questionnaire and the Beverage Intake Questionnaire-15. STATISTICAL ANALYSES PERFORMED: Generalized linear regression models were used to examine differences in dietary intake by students' food security status, adjusting for students' sociodemographic characteristics. RESULTS: In the sample, 14% of students were food-insecure. After adjusting for sociodemographic variables, food-insecure students reported 9% lower intake of fruits (P = 0.02), 9% lower intake of vegetables (P < 0.001), 10% higher intake of dairy (P = 0.002), 6% higher intake of total added sugars (P = 0.01), 10% higher intake of added sugars from sugar-sweetened beverages (P = 0.01), 4% higher intake of calcium (P = 0.01), and 4% lower intake of fiber (P = 0.01) compared with food-secure students. With respect to beverage intake, food-insecure students had 56% higher intake of total sugar-sweetened beverages (P = 0.002), which was driven by 185% higher intake of energy and sports drinks (P = 0.001), and 121% higher intake of sweetened teas (P = 0.001). CONCLUSIONS: Despite having identical food resources within campus dining halls, there were significant differences in the diets of college students by food security status.

8.
J Acad Nutr Diet ; 121(7): 1306-1311.e8, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33775621

RESUMO

BACKGROUND: Consumer demand for vegetarian options is growing. Fast-food restaurants have responded by adding high-profile vegetarian offerings, but little is known about the overall availability or nutrient profile of vegetarian options at these establishments, or how these items compare with nonvegetarian items. OBJECTIVE: The purpose of this study was to quantify trends in the availability and nutrient profile of vegetarian items in US fast-food restaurants from 2012 to 2018. DESIGN: This study was a longitudinal analysis of secondary data. We used nutrient data from the MenuStat database for menu offerings at 36 large US fast-food chain restaurants (2012 to 2018). Vegetarian items were identified through automated key word searches and item description hand-coding. OUTCOME MEASURES: Annual counts and proportions of vegetarian and nonvegetarian items by category, and annual trends and differences in predicted mean calories; saturated, unsaturated, and trans fats; sugar; nonsugar carbohydrates; protein; sodium between and within vegetarian and nonvegetarian items. STATISTICAL ANALYSIS PERFORMED: We report counts and proportions of vegetarian items by menu category, then use Tobit regression models to examine annual trends and differences in predicted mean nutrients between and within vegetarian and nonvegetarian items. Sensitivity analyses were calorie-adjusted. RESULTS: The annual proportion of vegetarian items remained consistent (approximately 20%), and counts increased (2012, n = 601; 2018, n = 713). Vegetarian items had significantly fewer calories (2018: -95 kcal) and, even after adjustment for calories, lower saturated fat (-1.6 g), unsaturated fat (-1.8 g), protein (-3.8 g), and sodium (-62 mg) annually (P < .05) compared with nonvegetarian items. Vegetarian items were significantly higher in sugar (2018: +2.0 g; P < .01) and nonsugar carbohydrates (2018: +9.7 g; P < .01), after calorie adjustment, compared with nonvegetarian items. CONCLUSIONS: Vegetarian items were generally lower in several overconsumed nutrients of public health concern (eg, sodium and saturated fat) than nonvegetarian items, but nutrient changes suggest surveillance remains important as vegetarian options increase in popularity.


Assuntos
Dieta Vegetariana/estatística & dados numéricos , Fast Foods/provisão & distribuição , Nutrientes/análise , Restaurantes/estatística & dados numéricos , Humanos , Valor Nutritivo , Análise de Regressão , Estados Unidos
9.
Nutrients ; 13(3)2021 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-33652765

RESUMO

The Supplemental Nutrition Assistance Program (SNAP) is critical to alleviating food insecurity, but low diet quality among program participants is a concern. Nutrition-related interventions have focused on SNAP-authorized food retailers, but the perspectives of small food store owners and managers have not been represented in national policy discussions. This study aimed to explore the opinions of store owners/managers of SNAP-authorized small food stores about their overall perceptions of the program and the stricter stocking standards previously proposed in 2016. We conducted in-depth, semi-structured interviews with 33 small food store owners and managers in San Francisco and Oakland, California in 2016. Interviews were analyzed for thematic content using the general inductive approach. Four themes emerged from owners/managers' discussion of their overall perceptions of SNAP: the beneficial impact of SNAP on their business, how SNAP enables them to connect with the broader community, the importance of SNAP in preventing hunger, and the nutrition-related struggles that SNAP participants face. Store owners/managers had a generally favorable response towards the proposed stricter stocking standards. Additional themes discussed pertained to the concern about whether stocking changes would lead SNAP participants to purchase more healthful food and some logistical challenges related to sourcing and storing perishable foods.


Assuntos
Assistência Alimentar , Abastecimento de Alimentos/normas , Empresa de Pequeno Porte/organização & administração , Adulto , Atitude , California , Comportamento do Consumidor , Humanos , Pessoa de Meia-Idade , Percepção , Pesquisa Qualitativa
10.
Health Equity ; 5(1): 64-71, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33681691

RESUMO

Purpose: To understand associations between food insecurity and depression, anxiety, and stress during the COVID-19 pandemic among low-income adults in the United States. Methods: During March 19-24, 2020, we fielded a national, web-based survey (53% response rate) among low-income adults (<250% of the federal poverty line) in the United States (N=1,476). Food security status was measured using the 18-question USDA Household Food Security Module. Multivariable-adjusted logistic regression models examined the association between food insecurity and psychological distress outcomes and COVID-19-specific worries. Qualitative data from an open-response question were also analyzed. Results: More than one-third of low-income adults screened positive for depression (33%), anxiety (39%), and high stress (39%). Greater food insecurity was associated with a dose-response relationship with all psychological distress outcomes (all outcomes p-trend <0.001) and COVID-19-specific worries (all outcomes p-trend <0.001). Compared to food-secure adults, adults with very low food security were more likely to screen positive for depression (odds ratio [OR] 7.72; 95% confidence interval [CI]: 5.52-10.80), anxiety (OR 6.19; 95% CI: 4.51-8.51), and high perceived stress (OR 10.91; 95% CI: 7.78-15.30). Very low food security was also associated with increased worries about the effect of COVID-19 on one's health (OR 2.56; 95% CI: 1.90-3.45), income (OR 5.18; 95% CI: 3.78-7.06), and ability to feed one's family (OR 9.24; 95% CI: 6.61-12.92). Conclusions: The COVID-19 pandemic is negatively associated with the mental health of low-income adults in the United States, with disproportionate associations among adults experiencing food insecurity. These disparities have the potential to increase mental health disparities over the long term.

11.
Appetite ; 162: 105163, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-33587985

RESUMO

The coronavirus SARS-CoV-2 (COVID-19) pandemic has created widespread stress. Since many people cope with stress by eating, the current study investigated whether eating behaviors shifted among U.S. adults after the emergence of the pandemic. Data from national, crowdsourced surveys conducted on March 31st, 2020 and February 13th, 2019 were compared. Average levels of eating to cope and food addiction symptoms did not appear to shift during the early stages of the pandemic; however, U.S. adults ate about 14% more added sugars. Moreover, greater stress in response to the pandemic was associated with greater eating to cope, added sugars intake, food addiction symptoms, drinking to cope, and drinking frequency. These associations differed by the presence of state-level stay-at-home orders, perceived vulnerability to disease, age, U.S. political party affiliation, and gender. Although eating behaviors did not appear to majorly shift during the early stages of the pandemic, stress from the pandemic may intensify some maladaptive coping tendencies among U.S. adults.


Assuntos
Adaptação Psicológica , COVID-19/psicologia , Comportamento Alimentar/psicologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Estados Unidos/epidemiologia
12.
J Am Geriatr Soc ; 69(4): 964-971, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33403662

RESUMO

BACKGROUND/OBJECTIVES: Food insecurity has emerged as a critical health issue for older adults. Food insecurity has been shown to disrupt healthy eating patterns, but these associations have not been widely studied among older adults. The objectives of the present study were to: (1) examine national trends in food insecurity across a 10-year period, and (2) evaluate the associations between food insecurity and multiple diet quality indices in a recent and nationally representative sample of adults aged 60 or older. DESIGN: Cross-sectional analysis of the 2007-2016 National Health and Nutrition Examination Surveys. SETTING: Nationally representative sample of the United States. PARTICIPANTS: The analytic sample was comprised of 5,097 adults aged 60 or older, with household incomes at or below 300% of the federal poverty level. MEASUREMENTS: Household food security was measured using the 18-item US Household Food Security Survey Module. Diet was assessed using two 24-hour dietary recalls. Multivariate linear and logistic regression models examined the associations between household food security and three evidence-based diet quality indices, adjusting for sociodemographic and health characteristics. RESULTS: Across the 10-year period, food insecurity increased significantly from 5.5% to 12.4% among older adults; this increase was more pronounced among lower-income older adults. From the linear regression models, food insecurity was associated with lower scores on the Healthy Eating Index (ß = -1.90, 95% confidence interval (CI) = -3.70, -0.09), the Alternate Healthy Eating Index-2010 (ß = -1.47, 95% CI = -2.51, -0.44), and the Mediterranean Diet Score (ß = -0.54, 95% CI = -1.06, -0.01) after multivariate adjustment. Further adjustment for the presence of chronic medical conditions did not attenuate these results. CONCLUSION: Food insecurity is associated with lower overall diet quality among older adults, supporting the need for clinical efforts to identify those at risk of food insecurity and public health efforts to alleviate food insecurity and promote healthy eating behaviors among older adults.


Assuntos
Dieta Saudável , Comportamento Alimentar , Insegurança Alimentar , Abastecimento de Alimentos , Pobreza , Fatores Socioeconômicos , Idoso , Dieta/estatística & dados numéricos , Dieta Saudável/métodos , Dieta Saudável/estatística & dados numéricos , Feminino , Abastecimento de Alimentos/normas , Abastecimento de Alimentos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde , Inquéritos Nutricionais , Pobreza/prevenção & controle , Pobreza/estatística & dados numéricos , Medição de Risco , Estados Unidos/epidemiologia
13.
Appetite ; 161: 105117, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-33460693

RESUMO

The frequency of cooking at home has not been assessed globally. Data from the Gallup World Poll in 2018/2019 wave (N = 145,417) were collected in 142 countries using telephone and face to face interviews. We describe differences in frequency of 'scratch' cooking lunch and dinner across the globe by gender. Poisson regression was used to assess predictors of cooking frequency. Associations between disparities in cooking frequency (at the country level) between men and women with perceptions of subjective well-being were assessed using linear regression. Across the globe, cooking frequency varied considerably; dinner was cooked more frequently than lunch; and, women (median frequency 5 meals/week) cooked both meals more frequently than men (median frequency 0 meals/week). At the country level, greater gender disparities in cooking frequency are associated with lower Positive Experience Index scores (-0.021, p = 0.009). Prior to the COVID-19 pandemic, the frequency with which men and women cook meals varied considerably between nations; and, women cooked more frequently than men worldwide. The pandemic, and related 'stay at home' directives have dramatically reshaped the world, and it will be important to monitor changes in the ways and frequency with which people around the world cook and eat; and, how those changes relate to dietary patterns and health outcomes on a national, regional and global level.


Assuntos
Culinária/estatística & dados numéricos , Fatores Sexuais , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19 , Feminino , Humanos , Masculino , Refeições , Pessoa de Meia-Idade , Pandemias , Adulto Jovem
15.
Appetite ; 161: 105125, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-33482302

RESUMO

Cooking interventions have been criticised for their weak designs and 'kitchen sink' approach to content development. Currently, there is no scientific guidance for the inclusion of specific skills in children's cooking interventions. Therefore, a four step method was used to develop age-appropriate cooking skill recommendations based on relevant developmental motor skills. The steps include: 1) a critical review of academic and publicly available sources of children's cooking skills recommendations; 2) cooking skill selection, deconstruction and mapping to relevant motor skills; 3) grouping the cooking skills by underlying motor skills for age appropriateness to generate evidence based recommendations; 4) establish face validity using a two-stage expert review, critique and refinement with a multidisciplinary international team. Seventeen available sources of cooking skills recommendations were identified, critiqued and deconstructed and cooking skills mapped to developmental motor skills. These new recommendations consist of 32 skills, across five age categories: 2-3 years, 3-5 years, 5-7 years, 7-9 years, and 9+ years. The proposed recommendations will strengthen programme design by providing guidance for content development targeted at the correct age groups and can act as a guide to parents when including their children in cooking activities at home.


Assuntos
Culinária , Pais , Criança , Pré-Escolar , Humanos , Destreza Motora , Relações Pais-Filho , Reprodutibilidade dos Testes
16.
Am J Health Promot ; 35(2): 275-278, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32783461

RESUMO

PURPOSE: Food insecurity is a concern on college campuses and is correlated with other basic needs insecurities. We examined the cumulative burden of food, financial, and housing insecurities on college students' health and academic performance. DESIGN: Cross-sectional survey. SETTING: Large, public Midwestern university. SAMPLE: A total of 793 college students completed an online survey in 2018 (43% response rate). MEASURES: Food, financial, and housing insecurity were measured using validated instruments. Primary outcomes were general health status, anxiety and depression, and grade point average (GPA). ANALYSIS: Weighted linear and logistic regression analyses were used to examine associations between cumulative basic needs insecurities and primary outcomes. RESULTS: Approximately 11% of students experienced all 3 insecurities. Compared to fully secure students, students with all 3 insecurities were more likely to have anxiety and depression (odds ratio [OR] = 4.65, 95% CI: 4.31-5.01), fair/poor health (OR = 4.06, 95% CI: 3.73-4.42), and lower GPA (ß = -0.19, 95% CI: -0.30 to -0.09), adjusting for sociodemographic characteristics. CONCLUSION: Interventions that address multiple basic needs insecurities are needed to promote college students' well-being and foster academic success.

17.
Public Health Nutr ; 24(3): 549-560, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32993845

RESUMO

OBJECTIVE: To develop and implement a community-tailored, food agency-based cooking programme at a community health centre (CHC) and evaluate the effect of the intervention on cooking confidence and food waste. DESIGN: This study used an exploratory, sequential mixed methods design. Focus groups (n 38) were conducted to inform the development of a cooking intervention, then six cooking classes (n 45) were planned and piloted in the health centre's teaching kitchen. Changes in cooking confidence and related outcomes were assessed using pre- and post-class surveys. Follow-up interviews (n 12) were conducted 2-4 months post-intervention to assess satisfaction and short-term outcomes. SETTING: A CHC in Detroit, MI. PARTICIPANTS: Spanish- and English-speaking adults aged ≥18 years recruited at the CHC. RESULTS: In the formative focus groups, patients identified multiple barriers to cooking healthy meals, including trade-offs between quality, cost and convenience of food, chronic disease management and lack of time and interest. Each cooking class introduced a variety of cooking techniques and food preservation strategies. Participants demonstrated increased confidence in cooking (P 0·004), experimenting with new ingredients (P 0·006) and knowing how to make use of food before it goes bad (P 0·017). In post-class interviews, participants reported that they valued the social interaction and participatory format and that they had used the recipes and cooking techniques at home. CONCLUSIONS: A community-tailored, hands-on cooking class was an effective way to engage patients at a CHC and resulted in increased cooking confidence.

18.
J Nutr ; 151(1): 179-185, 2021 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-33245125

RESUMO

BACKGROUND: Health-related warning labels may reduce the intake of sugar-sweetened beverages (SSBs), but the effectiveness of such labels in real-world settings is not well established. OBJECTIVES: We investigated the influence of warning labels on SSB intake among college students at a large public Midwestern university. METHODS: We conducted a quasi-experimental intervention study among 840 undergraduate students recruited from 3 dining halls on 1 university campus. One dining hall was selected as the intervention (I) site, whereas the other dining halls served as control (C) sites. In January 2019, warning labels were posted on SSB dispensers at the I site. All students reported their beverage intake using a modified beverage frequency questionnaire 2 mo before and 2 mo after the warning label implementation. Generalized linear models examined the influence of the warning labels on SSB consumption at the I site compared with the C sites, adjusting for students' sociodemographic characteristics. RESULTS: In the sample, 68% were aged 17-18 y old at baseline, and 51% identified as female. From baseline to follow-up, there was a 19% decrease in SSB intake at the I site, compared with a 5% decrease at the C sites (P = 0.049 comparing I with C). This difference was driven by significant decreases in the intakes of fruit-flavored drinks, sweetened teas, and flavored milk at the I site compared with the C sites. Although not an SSB, 100% fruit juce consumption decreased 21% at the I site, compared with a 1% increase at the C sites (P = 0.01 comparing I with C). No significant differences were observed in the intakes of soda, energy drinks, sweetened coffees, and nonsugary drinks at the I site compared with the C sites. CONCLUSIONS: Warning labels were effective in reducing SSB intake among college students, particularly for fruit-flavored drinks, sweetened teas, and flavored milk.This trial was registered at clinicaltrials.gov as NCT04435145.


Assuntos
Inquéritos sobre Dietas , Rotulagem de Alimentos , Bebidas Adoçadas com Açúcar , Universidades , Adolescente , Bebidas Gaseificadas , Feminino , Humanos , Masculino , Adulto Jovem
19.
Nutr Rev ; 2020 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-33249446

RESUMO

CONTEXT: Frequent consumption of home-prepared meals is associated with higher diet quality in children and adults. Therefore, increasing the culinary skills of women and couples during their childbearing years may be an effective strategy for the prevention of overweight and obesity. OBJECTIVE: To determine the impact of culinary nutrition-education interventions for women with or without their partners during preconception, pregnancy, or postpartum (PPP) on parental cooking skills, nutrition knowledge, parent/child diet quality, or health outcomes. DATA SOURCES: Eligibility criteria were defined using a PICOS framework. A systematic search strategy was developed to identify eligible studies and was implemented in 11 electronic databases. Reference lists of selected systematic reviews were manually searched for additional studies. DATA EXTRACTION: Study characteristics and outcomes were extracted from eligible studies by 1 reviewer and checked by a second reviewer. DATA ANALYSIS: A narrative synthesis of the findings of eligible studies was prepared including descriptive statistics. Reporting was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and Synthesis Without Meta-Analysis in systematic reviews reporting guideline. RESULTS: A total of 6951 articles were identified from the search strategy and 31 studies during pregnancy or postpartum were included. By category, the number of studies with a favorable outcome per total number of studies measuring outcome were as follows: parental food/cooking skills (n = 5 of 5), nutrition knowledge (n = 6 of 11), parent/child diet quality (n = 10 of 19), infant feeding (n = 6 of 11), eating behavior (n = 2 of 5), maternal (n = 2 of 5) and child anthropometry (n = 6 of 10), mental health and development n = (2 of 3), and clinical indictors (n = 1 of 1). CONCLUSIONS: Culinary nutrition-education interventions during pregnancy and the postpartum period show promise in improving cooking skills, diet quality, and a variety of health-related outcomes. The precise effect of these interventions during PPP is limited by the quality and heterogeneity of study designs to date. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration number: CRD42020154966.

20.
JAMA Netw Open ; 3(10): e2019519, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33026451

RESUMO

Importance: Restaurants spend billions of dollars on marketing. However, little is known about the association between restaurant marketing and obesity risk in adults. Objective: To examine associations between changes in per capita county-level restaurant advertising spending over time and changes in objectively measured body mass index (BMI) for adult patients. Design, Setting, and Participants: This cohort study used regression models with county fixed effects to examine associations between changes in per capita county-level (370 counties across 44 states) restaurant advertising spending over time with changes in objectively measured body mass index (BMI) for US adult patients from 2013 to 2016. Different media types and restaurant types were analyzed together and separately. The cohort was derived from deidentified patient data obtained from athenahealth. The final analytic sample included 5 987 213 patients, and the analysis was conducted from March 2018 to November 2019. Exposure: Per capita county-level chain restaurant advertising spending. Main Outcomes and Measures: Individual-level mean BMI during the quarter. Results: The included individuals were generally older (37.1% older than 60 years), female (56.8%), and commercially insured (53.5%). For the full population of 29 285 920 person-quarters, there was no association between changes in all restaurant advertising per capita (all media types, all restaurants) and changes in BMI. However, restaurant advertising spending was positively associated with weight gain for patients in low-income counties but not in high-income counties. A $1 increase in quarterly advertising per capita across all media and restaurant types was associated with a 0.053-unit increase in BMI (95% CI, 0.001-0.102) for patients in low-income counties, corresponding to a 0.12% decrease in BMI at the 10th percentile of changes in county advertising spending vs a 0.12% increase in BMI at the 90th percentile. Conclusions and Relevance: The results of this study suggest that restaurant advertising is associated with modest weight gain among adult patients in low-income counties. To date, there has been no public policy action or private sector action to limit adult exposure to unhealthy restaurant advertising. Efforts to decrease restaurant advertising in low-income communities should be intensified and rigorously evaluated to understand their potential for increasing health equity.


Assuntos
Publicidade/estatística & dados numéricos , Fast Foods/estatística & dados numéricos , Obesidade/epidemiologia , Características de Residência/estatística & dados numéricos , Restaurantes/organização & administração , Adulto , Índice de Massa Corporal , Estudos de Coortes , Feminino , Humanos , Masculino , Planejamento de Cardápio/métodos , Pessoa de Meia-Idade , Fatores Socioeconômicos , Estados Unidos
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