A Randomized Controlled Trial of a Community-Based Nutrition Education Program for Low-Income Parents

ObjectiveAssess effectiveness of the Expanded Food and Nutrition Education Program on nutrition behaviors post-education and longitudinally.DesignSwitching replications randomized experimental design. Participants randomly assigned to immediate education (IE) or delayed education (DE). Participants in IE received intervention the first 8 weeks, and those in DE the second 8 weeks, with no intervention during alternate periods. Data were collected in 3 repeated measures.ParticipantsParents (n = 168 randomized; n = 134 completed) of children in 2 Head Start and 6 low-income schools.InterventionEight weekly workshops, based on Eating Right is Basic-Enhanced adapted to incorporate dialogue approach with experiential learning.Main Outcome MeasuresTen-item self-reported behavior checklist on nutrition, food resource management, food safety, and food security; responses on a 5-point scale reporting frequency of behavior.AnalysisChi-square, analysis of variance, and multiple regression.ResultsGroups were demographically similar. Both groups reported improved behaviors pre- to post-education (P < .05). There was no significant difference between groups at Time 1 (T1) or DE control period (T1 vs T2). Changed IE behavior was retained T2 to T3. A multiple regression model of overall change, controlling for T1 score and educator, showed significant improvement (n = 134, β = 5.72, P < .001).Conclusions and ImplicationsPositive outcomes were supported by this experimental study in a usual program context, with reported behavior changes retained at least 2 months.     

Associations Between Intuitive Eating Behaviors and Fruit and Vegetable Intake Among College Students

ObjectiveTo assess associations between intuitive eating behaviors and fruit and vegetable intake among college students.MethodsIntuitive eating behaviors were measured with the Intuitive Eating Scale-2 (IES-2), which reports a total and 4 subscale scores. Fruit and vegetable intake was measured with the National Institutes of Health Eating at America's Table Fruit and Vegetable screener. Questionnaires were completed online.ResultsMedian age of participants was 20 years (n = 293; n = 72 male). Total IES-2 score was not correlated with fruit and vegetable intake. Body–Food Choice Congruence and Eating for Physical Rather Than Emotional Reasons subscales were positively associated with fruit and vegetable intake (r = .462, P < .001 and r = .177, P = .002, respectively). The Unconditional Permission to Eat subscale was negatively associated with fruit and vegetable intake (r = –.308, P < .001).Conclusions and ImplicationsCorrelations between fruit and vegetable intake and intuitive eating behaviors differed by IES-2 subscale scores. If IES-2 is used in nutrition research, education, or counseling with the aim of increasing fruit and vegetable intake, addressing subscale behaviors individually might be considered.     

Variables Associated With the Use of Complete Oral Calorie Supplements in Children With Feeding Problems

ObjectiveTo examine child and parent variables associated with complete oral calorie supplement use among children with feeding problems.DesignCorrelational examination of data from patient intake surveys.SettingHospital-based feeding program.ParticipantsParticipants included 281 parents of children referred to a hospital-based feeding clinic, including 114 who received supplements (70.2% boys; mean age, 60.1 months) and 167 who did not receive (79.6% boys; mean age, 67.5 months).Variables MeasuredChildren's age, gender, weight status, diagnostic category (no special needs, autism, or other special needs), supplement intake, oral motor problems, child mealtime behavior (using the Child Eating Behavior Questionnaire), parent feeding practices (using the Parent Mealtime Action Scale), and diet variety for child and parent.AnalysisChi-square analyses compared children who did and did not receive supplements for their percentage of gender, diagnostic, and weight status categories; t tests or Mann-Whitney U tests compared children who did and did not receive supplements, for age, oral motor problems, children's mealtime behavior, parent feeding practices, and diet variety.ResultsCompared with children who did not receive nutritional supplements, those who did were younger (P < .01) and more underweight (P < .001), and showed less Food Responsiveness (P < .001), less Food Enjoyment (P < .001), more Food Satiety (P < .001, and more Slow Eating (P < .001), and their parents were more likely to use Insistence on Eating (P < .001).ConclusionsWhereas supplement use was related to underweight, 78.2% of children receiving them were normal weight or overweight, which suggests that supplements are being used to address mealtime selective eating. The use of supplements should be considered carefully because they do not appear to increase diet variety and may increase the chance of overweight over time.     

Design and Implementation of a Nutrition and Breastfeeding Education Program for Black Expecting Mothers and Fathers

ObjectiveTo describe the intervention and research methods of Project Dads in Nutrition Education, an intervention that adds nutrition and breastfeeding education to the existing Healthy Start program in Georgia for Black expecting mothers and fathers to improve nutrition literacy, health outcomes, and breastfeeding rates.DesignThis 2-year community-based participatory research study employs a cluster randomization factorial design.SettingSix Healthy Start program sites (3 intervention and 3 control sites) in Georgia counties with high infant and maternal mortality rates.ParticipantsApproximately 480 Black, expecting, Healthy Start program participants (20 couples [mother and father] and 40 single mothers from each site) will be enrolled over the study period.Intervention(s)Project Dads in Nutrition Education will strengthen the capacity of the Georgia Healthy Start program to integrate an evidence-based nutrition education program, breastfeeding education, and father engagement into its routine services.Main Outcome Measure(s)Changes in prepost survey assessment of participants’ nutrition literacy and eating behaviors; changes in prepost survey assessment of participants’ breastfeeding knowledge, attitudes, intent, initiation, and duration; and health and food diary collected 3 times (ie, at baseline, 3 months, and 6 months after enrollment).AnalysisProcess evaluation throughout the study to document implementation. Generalized linear mixed modeling will be used to determine the impact of the intervention.     

Valid and Reliable Measure of Adherence to Satter Division of Responsibility in Feeding

ObjectiveTo examine the validity and psychometrics of sDOR.2-6y, a 12-item measure of adherence to the Satter Division of Responsibility in Feeding (sDOR).DesignCross-sectional survey.SettingOnline respondents in central Pennsylvania.Participants117 parents (94% female, 77% White, 62% in ≥1 income-based assistance program) of preschoolers aged 2–6 years (28% moderate/high nutrition risk).Main Outcome MeasuresThe sDOR.2-6y and Nutrition Screening Tool for Every Preschooler (NutriSTEP), a measure of child nutrition risk and other validated measures of eating behavior and parent feeding practices.AnalysisRelationships were evaluated with Pearson r, t tests, ANOVA, or chi-square. Factor structure was investigated using principal components analysis with varimax rotation. Binary logistic regression and general linear model controlling for low-income status compared with sDOR.2-6y and NutriSTEP scores. Linear regression predicted NutriSTEP and Satter Eating Competence Inventory 2.0 scores from sDOR.2-6y.ResultsThe sDOR.2-6y ranged from 16–32 (mean, 25.9 ± 3.3; n = 114). Parents of youth at nutrition risk had lower sDOR.2–6y scores (P = 0.004). Each 1 point sDOR.2-6y increase decreased nutrition risk odds by 21% (95% confidence interval, 0.675–0.918; P = 0.002). The sDOR.2-6y scores were higher with less restriction and pressure to eat (both P < 0.001) and were associated with feeding style. Specificity was 87% with sDOR.2-6y cutoff ≥24; sensitivity was 66% with cutoff ≥26.Conclusions and ImplicationsThe sDOR.2-6y accurately and reliably indicated adherence of low-income mothers to sDOR. Larger, diverse samples for future studies are recommended.     

Eating Competence of College Students in an Introductory Nutrition Course

ObjectiveDescribe eating competence, a positive and flexible way of conceptualizing eating attitudes and behaviors, in students enrolled in an introductory nutrition course.MethodsOnline completion of the Satter Eating Competence Inventory (ecSI) and self-assessment of eating disorder status by 557 students (343 ages 18-20 years and 180 ages 21-26 years; 377 females) at the beginning of 1 semester. Analysis of variance and post hoc Tukey adjusted tests were used.ResultsThe mean ecSI score was 30.7 ± 0.29; 47.4% were classified as eating competent, or ecSI ≥ 32. Mean ecSI was higher for males than females (29.4 ± 0.95 vs 27.4 ± 0.77; P < .001). Mean ecSI was higher for students who never had an eating disorder, compared with those reporting current (32.0 ± 0.43 vs 22.9 ± 1.91; P < .001) or past (28.8 ± 0.93; P < .01) eating disorders.Conclusions and ImplicationsStudents had limited eating competence, but a majority of males were eating competent. Students who had never had an eating disorder had higher eating competence than students with current or past disorders. Examining nutrition courses as currently taught may reveal ways courses could contribute to eating competence.     

Parents’ Perceptions of 5210 Nutrition Messaging and Child Weight Status

ObjectiveTo explore parent perceptions of child weight status and 5210 nutrition messaging recommendations, including daily consumption of 5 fruits and vegetables, limiting child screen time to ≤2 hours, incorporating 1 hour of daily physical activity, and no consumption of sugary, sweetened beverages.MethodsUsing the Convergence Model of Communication as a framework, qualitative focus groups (n = 5) were conducted at 4 Head Start sites across 1 Ohio County. Twenty-eight parents aged 20–60 years comprised the groups. A deductive analysis technique with respondent validation was used.ResultsParents have limited understanding of 5210 messages delivered by the program. Parent food preferences, family finances, and children's picky eating were identified as barriers to integrating healthy eating habits at home. Parents prefer practical strategies regarding how to integrate healthy eating habits into the home environment. Participants expressed concern about children's psychological health and happiness vs weight status.Conclusions and ImplicationsUnderstanding parental perceptions of 5210 messaging and program-reported weight status may assist Head Start programs in addressing childhood obesity through focused parent education and support.     

Parent Food and Eating Behavior Assessments Predict Targeted Healthy Eating Index Components

ObjectiveTo examine the ability of parent response to assessments of in-home availability of 20 fruits and vegetables (FV), self-efficacy/outcome expectancy to prepare FV that their child would eat, modeling of FV eating behavior, and eating competence to predict parents’ targeted Healthy Eating Index–2010 (HEI) scores at baseline.DesignCross-sectional survey.SettingSixty-one classrooms in 8 northern Colorado elementary schools over 4 years participating in Fuel for Fun (FFF), a school-based culinary and physical activity intervention.ParticipantsParents and guardians (n = 71) of fourth-grade youths from participating classrooms.Main Outcome Measure(s)Healthy Eating Index–2010 scores as derived from 24-hour recalls administered with the Automated Self-Administered 24-hour dietary assessment tool.AnalysisGeneralized linear regression models tested the predictive validity of survey assessments for targeted HEI components. Results were considered statistically significant at P ≤ .05.ResultsIn-home FV availability predicted total fruit (P = .01), whole fruit (P = .001), and total vegetable (P = .01) HEI, and parent modeling of FV eating behavior predicted total fruit (P = .01) and whole fruit (P = .02) HEI. However, these survey measures were not associated with other HEI components, including total HEI. Parent self-efficacy/outcome expectancy to prepare FV that their child would eat or like was not associated with total HEI or HEI components. Eating competence did not predict total HEI but was associated with seafood and plant proteins in the anticipated direction (P = .04).Conclusions and ImplicationsThe results demonstrated construct validation of some parent Fuel for Fun survey assessments with targeted HEI components. Additional assessment in larger and more diverse samples is warranted so that nutrition education and behavior researchers may use these valid and reliable, brief, low-cost, and easy-to-use survey instruments as a proxy for dietary intake.     

Food Resource Management Mediates the Relationship Between Participation in a SNAP-Ed Nutrition Education Program and Diet Quality

ObjectiveTo examine the mediating effects of food resource management skills (FRM) on the relationship between participation in a Supplemental Nutrition Assistance Program Education (SNAP-Ed) nutrition education program and diet quality.DesignSecondary analysis of data from a propensity score-matched sample of participants (n = 396) and nonparticipants (n = 111) in a SNAP-Ed nutrition education program.AnalysisIndependent-samples t tests were used to compare entry, exit, and gain scores in FRM and diet quality between participants and nonparticipants. Structural equation modeling was used to examine direct and mediated relationships among participation, FRM, and diet quality.Main Outcome MeasuresFood resource management was measured as a summated rating scale, and diet quality measured as Healthy Eating Index and program participation.ResultsMediated effect of FRM on the relationship between participation in a SNAP-Ed program and diet quality was statistically significant (P < 0.01). The effect size for the mediation effect indicated that about 70% of program participation on diet quality was transferred by FRM skills. The hypothesized model had acceptable fit indices as model χ² was nonsignificant (P = 0.31), all fit indices were above 0.9, and the root mean square of error approximation was low at 0.02.Conclusions and ImplicationsParticipation in a SNAP-Ed program enhanced participants’ FRM, which in turn enhanced their diet quality.     

Identification of a Framework for Best Practices in Nutrition Education for Low-Income Audiences

To promote effective low-income nutrition education programs, an expert panel of nutrition education and public health researchers built consensus around 28 best practices grouped into 5 domains (Program Design, Program Delivery, Educator Characteristics, Educator Training, and Evaluation) targeting direct delivery of nutrition education. These best practices can be used to assess program strengths, promote fidelity in delivery and evaluation, and design research to strengthen programs’ evidence base. A survey of Supplemental Nutrition Assistance Program–Education nutrition education leaders helped identify staff development needs and interest relative to specific best practices. Best practices can be used to identify staff development needs among frontline educators, supervisors, and program leaders in Supplemental Nutrition Assistance Program–Education, Expanded Food and Nutrition Education Program, and other programs targeting low-income audiences.     

Contributions of Early Care and Education Programs to Diet Quality in Children Aged 3 to 4 Years in Central North Carolina

BackgroundParents and early care and education (ECE) are the key influencers of young children’s diets, but there is limited information about how each contribute to children’s overall diet quality.ObjectiveThis study aimed to determine what proportion of children’s dietary intake occurs within the ECE setting and whether diet quality is higher at ECE centers and, consequently, on weekdays than weekends.DesignThis cross-sectional analysis of a larger cluster randomized controlled trial used multiple 24-hour dietary intakes measured through a combination of the Dietary Observation in Child Care protocol and parent-reported food diaries.Participants/settingParticipants (N=840) included children aged 3 to 4 years enrolled in ECE centers in central North Carolina for whom 24-hour dietary intake was captured via observation of meals and snacks consumed at ECE and parent-report of all remaining meals and snacks. Data were collected from 2015 to 2016.Main outcome measuresDiet quality at ECE and elsewhere was evaluated using the Healthy Eating Index 2015.Statistical analyses performedMixed-effects models were used to determine differences in mean Healthy Eating Index 2015 component and total scores. Models were adjusted for children’s age and sex and accounted for clustering within ECE centers and families.ResultsChildren consumed approximately 40% of daily energy, nutrients, and food groups at ECE centers. The mean total Healthy Eating Index 2015 score was higher for foods and beverages consumed at ECE centers (58.3±0.6) than elsewhere (52.5±0.6) (P<0.0001). The mean total Healthy Eating Index 2015 score was also higher on weekdays (58.5±0.5) than on weekends (51.3±0.5) (P<0.0001).ConclusionsChildren consume a majority of dietary intake away from ECE centers. Overall, diet quality is low, but the quality of foods consumed by children at ECE centers is higher than that consumed elsewhere. ECE centers remain an important source of nutrition and further investigation is warranted to identify ways to support both ECE centers and families to provide healthier eating environments.     

Effect of a Nutrient Rich Foods consumer education program: results from the nutrition advice study

BackgroundThe Nutrient Rich Foods (NRF) approach to eating uses the NRF Index, a nutrient profiling metric to help consumers choose foods that contain more vitamins, minerals, and other nutrients per kilocalorie. Research is needed to test the efficacy of dietary guidance using nutrient profiling systems to rank foods.ObjectiveTo examine whether nutrition education and supporting materials would increase understanding of the NRF approach and improve food shopping, meal planning, consumption of nutrient-rich foods, and diet quality.DesignUnbalanced randomized controlled trial conducted in February to May 2009 with participants assigned to NRF education group (n=128) or control group receiving standard nutrition education (n=61).Participants/settingAdult primary food shoppers and preparers with at least one child in the household aged 3 to 17 years.InterventionGroup education session and support tools (pocket guide, shopping list, refrigerator magnet, weekly e-mail messages, and biweekly mailings).Main outcome measuresSurveys of knowledge, attitudes, and behaviors and two 24-hour telephone dietary recalls at baseline and after an 8-week intervention period.Statistical analysesExamined time-by-treatment interactions in outcome measures.ResultsCompared to controls, NRF participants increased meal planning (+24.2% vs ?4.9%; P<0.01), ability to identify nutrient-rich foods (+60.2% vs +24.6%; P<0.001), and use of shopping lists (+14.1% vs +3.3%; nonsignificant trend), and consumed more vegetables and fruits (P<0.05). NRF participants improved overall diet quality as shown by their scores on the Healthy Eating Index (P=0.04) and NRF scale scores (nonsignificant trend). Significant improvements were observed in Healthy Eating Index component scores for total fruit; whole fruit; whole grains; saturated fat; and energy from solid fats, alcohol, and added sugars.ConclusionsFindings of this study showed that a consumer education program increased participants' use of the NRF approach and improved diet quality. Larger and longer-term studies are needed to confirm the findings and better understand processes of change.     

Eating Behaviors and Diet Quality: A National Survey of Australian Young Adults

ObjectiveTo investigate associations between eating behavior constructs (social eating, perceived competence, habit automaticity, self-determined motivation) and diet quality among young adults.DesignCross-sectional analysis.ParticipantsYoung adults (n = 1,005; mean age, 21.7 ± 2.0 years; 85% female) enrolled in the Advice, Ideas, and Motivation for My Eating (Aim4Me) study.Main outcome measuresFour eating behavior measures collected via online surveys: Social Eating Scale, Perceived Competence in Healthy Eating Scale, Self-Report Behavioral Automaticity Index, and Regulation of Eating Behaviors scales. Diet quality was assessed using the Australian Recommended Food Score (ARFS) and percentage energy from energy-dense, nutrient-poor (EDNP) foods.AnalysisMultivariate linear regression investigating associations between eating behavior measures (independent variables) and ARFS and EDNP foods (dependent variables), adjusting for sociodemographic and lifestyle confounders.ResultsGreater perceived competence in healthy eating and behavioral automaticity for consuming healthy foods, limiting EDNP food intake, and higher intrinsic motivation, integrated regulation, and identified regulation of eating behaviors were associated with higher ARFS and lower percentage energy EDNP foods (P < 0.001). Greater self-reported social influence on eating behaviors was associated with higher ARFS (P = 0.01). Higher amotivation was associated with greater % energy from EDNP foods (P < 0.001).Conclusions and ImplicationsPerceived competence, habit automaticity, and self-determined motivation are determinants of diet quality in young adults. These findings support the development of interventions that promote healthy eating habits by focusing on eating behavior constructs and evaluating their use in improving diet quality.     

Diet Quality and Fruit,Vegetable, and Sugar-Sweetened Beverage Consumption by Household Food Insecurity among 8- to 12-Year-Old Children during Summer Months

BackgroundSchool-delivered nutrition assistance programs have improved dietary intake for children from food-insecure households during the school year. However, little is known about their diet quality and eating patterns during summer months.ObjectiveSchool-aged children’s summer month weekday and weekend day diet quality and eating patterns were assessed by household food insecurity.DesignSecondary analysis of cross-sectional data was employed.Participants/settingDuring the summers of 2011 through 2017, baseline data were collected from parent–child dyads participating in one of two community-based obesity prevention trials in metropolitan Minnesota (N=218). The mean age of children was 10 years; 50% were girls, 49% were nonwhite, and 25% were from food-insecure households.Main outcome measuresChildren from food-secure and food-insecure households were identified by using the short form of the US Household Food Security Survey. Healthy Eating Index 2015 and eating patterns—including energy intake and consumption of whole fruits, vegetables, 100% fruit/vegetable juice, and sugar-sweetened beverages—were estimated by means of 24-hour dietary recall interviews conducted on weekdays and weekend days.Statistical analysis performedGeneral linear modeling was used to examine diet quality and eating patterns by food insecurity, controlling for child age, child body mass index z score, and parent education.ResultsChildren from food-insecure and food-secure households had Healthy Eating Index 2015 scores less than 50. Children from food-insecure households reported less energy intake, fewer cups of whole fruit, and more sugar-sweetened beverage consumption for every 1,000 kcal consumed on a weekend day when compared with their counterparts from food-secure households (P<0.05). Similar results were not seen for weekday eating patterns.ConclusionsWhole fruit and sugar-sweetened beverage consumption varied by food insecurity on weekend days during summer months. Because children tend to gain weight during summer months, efforts to increase weekend access to whole fruits and promote water consumption may contribute to weight gain prevention and healthy development, especially for children from food-insecure households.     

Effects of sensory education based on classroom activities for lower grade school children

This study is to verify the effects of sensory education based on classroom activities for 2^nd and 3^rd grade children. The hypothesis is that children who participated in sensory education would demonstrate positive changes in eating behaviors through sensory experiences. The sensory education program consists of 12 lessons. Twenty-six children were being recruited from one school in Changwon, Korea. Two control groups, one of which was the same age as the educated group and the other group of sixth graders, were selected by random sampling from the same school. Children answered a self-administered questionnaire. The parents (n = 20) of the children who participated in the program, took part in evaluating the program through self-administered questionnaires after the program ended. The questionnaire contained variables of general characteristics, education satisfaction, nutrition knowledge, eating attitude and behavior concerning unfamiliar foods. The score of nutrition knowledge was improved in educated children (P < 0.05). Food neophobia score towards unfamiliar foods (P < 0.05) was increased in educated children, but there are no changes in eating behaviors in all groups towards unfamiliar foods. In conclusion, sensory education is useful for having a positive eating attitude among children. Its consistent implementation could lead to healthier and well-balanced eating behaviors for children.     

Randomized Controlled Clinical Trial of Yoga in the Treatment of Eating Disorders

PurposeThis was a pilot project designed to assess the effect of individualized yoga treatment on eating disorder outcomes among adolescents receiving outpatient care for diagnosed eating disorders (anorexia nervosa, bulimia nervosa, eating disorder not otherwise specified).MethodsA total of 50 girls and 4 boys aged 11–21 years were randomized to an 8-week trial of standard care vs. individualized yoga plus standard care. Of these, 27 were randomized to standard care and 26 to yoga plus standard care (attrition: n = 4). Standard care (every other week physician and/or dietician appointments) was required to meet ethical guidelines. The No Yoga group was offered yoga after study completion as an incentive to maintain participation. Outcomes evaluated at baseline, end of trial, and 1-month follow-up included Eating Disorder Examination (EDE), Body Mass Index (BMI), Beck Depression Inventory, State-Trait Anxiety Inventory, and Food Preoccupation questionnaire.ResultsThe Yoga group demonstrated greater decreases in eating disorder symptoms. Specifically, the EDE scores decreased over time in the Yoga group, whereas the No Yoga group showed some initial decline but then returned to baseline EDE levels at week 12. Food preoccupation was measured before and after each yoga session, and decreased significantly after all sessions. Both groups maintained current BMI levels and decreased in anxiety and depression over time.ConclusionsIndividualized yoga treatment decreased EDE scores at 12 weeks, and significantly reduced food preoccupation immediately after yoga sessions. Yoga treatment did not have a negative effect on BMI. Results suggest that individualized yoga therapy holds promise as adjunctive therapy to standard care.     

Psychosocial factors and eating behaviors according to the stages of change in nutrition management among elementary and middle school athletes

BACKGROUND/OBJECTIVESThis study examined the differences in psychosocial factors and eating behaviors by the stages of change (SOC) in nutrition management among elementary and middle school athletes.SUBJECTS/METHODSSubjects were young athletes recruited from the athletic clubs of 10 organizations. Subjects responded to a survey questionnaire, and data on 167 athletes were analyzed. Subjects were grouped into the pre-action or action stage in nutrition management. The χ² test, t-test, analysis of covariance, and correlation analysis were used in data analysis.RESULTSAthletes in the action stage (62.3%) compared to the pre-action stage, showed a higher self-efficacy (P < 0.01), and felt more confidence in performing specific eating behaviors (P < 0.05 to P < 0.01). Those in the action stage had more favorable beliefs regarding nutrition (P < 0.001) and agreed less strongly on the specific misconceptions/disadvantages of nutrition (P < 0.01) than those in the pre-action stage. Eating behaviors (P < 0.001) and subscales of the eating behaviors (P < 0.05 to P < 0.01) also differed significantly by the SOC group. Place of eating dinner (P < 0.05) and the person who prepares dinner (P < 0.05) showed significant differences by the SOC group. The relationship of self-efficacy, beliefs regarding nutrition, and eating behaviors to the SOC differed by sports type. Beliefs for football athletes, self-efficacy, and beliefs for baseball athletes were correlated significantly with the SOC, whereas all 3 variables were related to the SOC for handball and other athletes.CONCLUSIONSThis study showed differences in psychosocial factors and eating behaviors between the pre-action and action stages. Nutrition education should include strategies to help young athletes modify their beliefs, mainly misconceptions/disadvantages of nutrition, increase self-efficacy, and adopt specific and desirable eating behaviors. Nutrition education might employ different strategies considering the sports type that student-athletes participate.     

Food Insecurity is Related to Disordered Eating Behaviors Among College Students

ObjectiveTo determine the association between food insecurity and disordered eating behaviors (DEBs) in undergraduate college students.MethodsCross-sectional data of college students (n = 533) were collected from February to April 2020. Food security was measured with the US Department of Agriculture's Adult Food Security Survey Module. Disordered eating behaviors were measured with the Eating Disorder Examination Questionnaire. Associations were examined statistically with Pearson chi-square tests of independence and general linear regression models.ResultsAcross all food security ranges, linear trends detailed significant associations between food insecurity and global DEBs (β = 0.17; P < 0.001), eating concern (β = 0.27; P < 0.001), shape concern (β = 0.17; P = 0.001), and weight concern (β = 0.21; P < 0.001), but not restraint (β = 0.10; P = 0.08).Conclusions and ImplicationsFood insecurity was consistently related to DEBs. Future research may consider longitudinally examining this relationship, as food insecurity and DEBs may be associated with worse health outcomes among vulnerable college students.     

Results of an Online Survey about Food Insecurity and Eating Disorder Behaviors Administered to a Volunteer Sample of Self-Described LGBTQ+ Young Adults Aged 18 to 35 Years

BackgroundThere are few published studies addressing food insecurity and eating disorders in lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ+) individuals.ObjectiveThe primary objective of this study was to describe the proportion of food insecurity and eating disorder behaviors in a volunteer sample of LGBTQ+ individuals aged 18 to 35 years.DesignThis study was a cross-sectional analysis of questionnaire data collected from 253 participants between March 2018 and March 2019.Participants and settingTo be included in the study, participants had to be aged 18 to 35 years and identify as being LGBTQ+.Main outcome measuresFood security score, Eating Attitudes Test score, Eating Disorder Examination Self-Report Questionnaire score, anxiety score (Beck), and depressive symptoms score.Statistical analyses performedThe χ² test was used to analyze the categorical outcomes. One-way analysis of variance was used to compare continuous variables across gender identity groups. All P values < 0.05 were taken as statistically significant.ResultsThe proportion of participants identifying as a woman, trans male, gender nonconforming, and a man were 39%, 24%, 24%, and 13%, respectively. Food insecurity was reported by 54.4% of respondents with trans males reporting the highest proportions (64.8%). High levels of depressive symptoms were reported by 68.2% of men, 89.8% of women, 91.4% of trans males, and 95.5% of gender-nonconforming respondents (P = 0.009). High anxiety was reported by 20.5%. Eating Disorder Examination Self-Report Questionnaire scores were significantly higher (P < 0.001) compared with a community-based sample. The eating disorder behavior most frequently reported by respondents was binge eating. Only 4.3% reported having sought treatment for an eating disorder.ConclusionsMembers of the LGBTQ+ community are at greater risk for food insecurity, eating disorders, and depression, particularly those who identify as trans males. These findings denote the need to focus future research efforts on effective prevention and treatment strategies that are specific to sexual and gender identity groups within the LGBTQ+ community.