Psychometric Properties of Spanish Version of the Three-Factor Eating Questionnaire-R18 (Tfeq-Sp) and Its Relationship with Some Eating- and Body Image-Related Variables

The aims of this study were to analyze the psychometric properties of the Spanish version of the Three-Factor Eating Questionnaire-R18 (TFEQ-SP), as well as determine its validity by evaluating the relationship of the TFEQ-SP with different parameters related to body mass index, weight perception, perception of physical fitness, self-esteem, and food intake, as well as with weight control-related variables. A total of 281 participants (aged 18.38 ± 6.31) were studied. The factor analysis yielded three factors: cognitive restraint (CR), uncontrolled eating (UE), and emotional eating (EE). The internal consistency of the TFEQ-SP was determined by means of Cronbach’s α coefficient, with values ranging between 0.75 and 0.87. Higher scores on CR were found in women (p < 0.5), overweight/obese participants (p < 0.001), participants with lower self-esteem (p < 0.05), participants who overestimated their weight (p < 0.001), participants who weighed themselves frequently (p < 0.001) and those who were about to go on a diet (p < 0.001). Higher EE scores were found in participants with lower self-esteem scores (p < 0.05), among participants with a poorer perception of their physical fitness (p < 0.01) and when participants were about to diet (p < 0.05). Higher scores on UE were observed in case of poorer perception of physical fitness (p < 0.05). The validation study of the TFEQ-SP meets the requirements for measuring the three different facets of eating behavior: CR, UE, and EE.     

Eating Earlier and More Frequently Is Associated With Better Diet Quality in Female Brazilian Breast Cancer Survivors Using Tamoxifen

BackgroundEmerging literature demonstrates that eating time and frequency are associated with quality and quantity of food consumption and anthropometric measurements. Considering that unhealthy dietary choices and obesity are important modifiable risk factors for breast cancer incidence and recurrence, this subject is relevant and has not been studied sufficiently in breast cancer survivors.ObjectiveThis study’s aim was to examine the association of eating time and frequency with diet quality, quantity of food consumption, anthropometric measurements, and body composition parameters in female breast cancer survivors using tamoxifen.DesignThis was a cross-sectional study.Participants/settingThis study was conducted from March 2015 to March 2016 at a Brazilian university hospital (Clinic’s Hospital, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil) and included an assessment of 84 female breast cancer survivors using tamoxifen (mean [SD] age was 53.1 [8.7] years).Main outcome measuresQuantitative dietary assessment consisted of three 24-hour dietary recalls. The Brazilian Healthy Eating Index Revised was used for the qualitative diet analysis. Participants were classified by median eating time (early or late eaters of breakfast, lunch, and dinner), as well as by considering the middle time point between the first and last meal of the day (early or late midpoint eaters). Participants were also classified by median eating frequency (<5 or ≥5 eating episodes per day). Anthropometric measurements and body fat percentage by bioelectrical impedance were obtained.Statistical analysisGeneralized linear models and generalized mixed models were used to assess the associations between variables.ResultsEarly breakfast and dinner eating and early midpoint eating were associated with better scores for specific Brazilian Healthy Eating Index Revised components (P < .05). Early breakfast and dinner eating were also associated with better scores for the total index (P = .035 and P = .017, respectively). Early dinner eaters and early midpoint eaters had significantly lower daily energy consumption (P = .007 and P = .002, respectively). Eating ≥5 episodes per day was also associated with better scores of specific Brazilian Healthy Eating Index Revised components and the total index (P < .05). No significant associations between eating time and frequency with anthropometric measurements and body composition parameters were found (P > .05). However, women in the healthy body mass index category vs women in the overweight/obesity category had higher energy consumption at breakfast (P = .046).ConclusionsEarlier food intake time was associated with better diet quality and lower daily energy consumption. Higher frequency of eating was also associated with better diet quality. Future studies, such as randomized controlled trials, are needed to evaluate interventions addressing the timing and frequency of meals and their effect on diet quality and quantity in breast cancer survivors.     

Late Evening Eating Patterns among US Adults Vary in Their Associations With,and Impact on,Energy Intake and Diet Quality: Evidence from What We Eat in America,National Health and Nutrition Examination Survey 2013-2016

BackgroundEvening eating has been associated with higher energy intake and lower nutrient density. However, these qualities may not characterize all late evening (LE) eating patterns.ObjectiveWe sought to characterize US adults’ LE eating patterns on a given day and identify differences, if any, in pattern-specific associations with, and impact on, daily energy intake and total diet quality.DesignLE eating patterns, energy intakes, and Healthy Eating Index (HEI) scores were identified using Day-1 dietary recall data from the cross-sectional National Health and Nutrition Examination Survey 2013-2016.Participants/settingThe sample included adults aged ≥ 20 years (n = 9,861). LE reporters were respondents who consumed foods/beverages between 20:00 and 23:59 on the intake day.Main outcome measuresEnergy intake and HEI-2015 scores by LE status/pattern and the impact of LE consumption on these measures.Statistical analysesCluster analysis assigned individuals to LE eating patterns based on the LE energy contribution of food/beverage groups. Regression models estimated energy intake and HEI-2015 scores; estimates were compared between LE reporters and nonreporters. Similarly, LE’s contribution to total energy and the difference in total HEI inclusive vs exclusive of LE consumption were estimated and compared among patterns.ResultsAmong US adults, 64.4% were LE reporters. Eleven LE patterns were identified; the six most prevalent patterns (representing 89% of LE reporters) were further analyzed. Daily energy intake in all prevalent patterns except the fruit pattern exceeded that of nonreporters by ≥ 268 kcal (unadjusted; P < 0.001), varying by pattern. Conversely, total HEI score did not differ from that of nonreporters (51.0) in any pattern except the fruit pattern, where it was higher (57.4, unadjusted; P < 0.001). Generally, LE consumption’s impact on energy was high and its impact on HEI scores was low.ConclusionsLate evening food/beverage consumption is common among US adults, and LE patterns are not monolithic in their associations with, and impact on, total energy intake and dietary quality.     

Direct Yet Opposite Effects of Stress-related and Mindful Eating on Diet Quality

ObjectiveExamine the relationships among dietary quality, mindful eating, and constructs of the Transactional Model of Stress and Coping.MethodsIn this cross-sectional study, women (n = 67) aged 25–50 years, with a body mass index of 25–40 kg/m² completed 3 days of 24-hour recalls and a survey that included the Perceived Stress Scale, Eating and Appraisal Due to Emotions and Stress Questionnaire, and the Mindful Eating Questionnaire. Structural equation modeling assessed relationships among all constructs with the dependent variable, the Healthy Eating Index–2015.ResultsMindful Eating Questionnaire (β = 0.60, P = 0.001) and Emotion and Stress-related Eating scores from Eating and Appraisal Due to Emotions and Stress Questionnaire (β = ?0.69, P < 0.001) (r² = 0.50) were directly associated with Healthy Eating Index–2015, but no indirect effects were identified.Conclusions and ImplicationsOverall dietary quality is associated with greater mindful eating but more emotion and stress-related eating scores among women who were overweight or obese. Future studies could assess model constructs using other diet quality scores and including additional coping mechanisms such as substance use, physical activity, and meditation.     

Infant Feeding Varies Across Eating Behavior and Feeding Modalities in Mothers With Low Income

ObjectiveTo examine if eating behaviors in mothers with low income relate to attitudes toward infant feeding and whether associations differed between breastfeeding and formula-feeding mothers.DesignCross-sectional study.ParticipantsForty postpartum women (aged ≥ 18 years, body mass index ≥ 25 and < 40 kg/m²) in the Louisiana Women, Infants, and Children program participated in a telehealth postpartum intervention for health and weight loss.Main Outcome Measure(s)Maternal eating behaviors and infant feeding styles, assessed 6–8 weeks after birth (baseline) using validated questionnaires.AnalysisSignificance was detected using independent t tests, chi-square tests for independence, or linear models (P < 0.05).ResultsMost mothers formula-fed (n = 27, 68%). In formula-feeding mothers, maternal disinhibition and perceived hunger were positively associated with restrictive infant feeding (β = 0.41, P <0.001 and β = 0.41, P = 0.001, respectively). These relationships were significantly higher (Δ = ?0.85, P = 0.006 and Δ = ?0.59, P = 0.003, respectively) than among breastfeeding mothers. Comparatively, pressuring/overfeeding was lower in formula-feeding mothers than among breastfeeding mothers with dietary restraint (Δ slopes: 1.06, P = 0.02).Conclusions and ImplicationsIn this cohort of mothers with low income, maternal eating behavior was associated with infant feeding styles only when feeding modality was considered. Mothers may benefit from education on how their eating behaviors can influence their infants and children.     

Twelve-Month Efficacy of an Obesity Prevention Program Targeting Hispanic Families With Preschoolers From Low-Income Backgrounds

ObjectiveAssess effects of an obesity prevention program promoting eating self-regulation and healthy preferences in Hispanic preschool children.DesignRandomized controlled trial with pretest, posttest, 6- and 12-month assessments. Fourteen waves, each lasting 7 weeks.SettingFamilies recruited from Head Start across 2 sites.ParticipantsTwo hundred fifty-five families randomized into prevention (n = 136) or control (n = 119).InterventionPrevention received curriculum; control received no curriculum.Main Outcome Measure(s)Feeding knowledge/practices/styles (parent); body mass index percentile, eating self-regulation, trying new foods, and fruit/vegetable consumption (child).AnalysisMultilevel analyses for nested data (time points within families; families within waves) and multinomial regression.ResultsProgram increased mothers’ repeated presentation of new foods (P < 0.05), measured portion sizes (P < 0.05), child involvement in food preparation (P < 0.001), feeding responsiveness (P < 0.001), knowledge of best feeding practices (P < 0.001), and feeding efficacy (P < 0.05); reduced feeding misconceptions (P < 0.01) and uninvolved feeding (P < 0.01). Effects on child eating behavior were minimal. At 12 months, children in the prevention group were less likely to have overweight (P < 0.05) or obesity (P < 0.05).Conclusions and ImplicationsProgram effects emphasize the importance of feeding approaches in reducing childhood obesity.     

Consequences of Picky Eating in College Students

ObjectiveTo examine the relation between young adult picky eating (PE) and psychosocial outcomes (eg, social phobia, quality of life) and dietary intake.DesignCross-sectional study including demographic, quantitative, and qualitative measures.ParticipantsMidwestern undergraduate convenience sample (n = 488) recruited early 2020.Main outcome measuresPicky eating identity and bias internalization, social phobia, quality of life, and dietary intake.AnalysesPearson correlations were conducted among study variables. Independent t tests compared picky eaters and nonpicky eaters on key variables. Qualitative data were coded using content analysis.ResultsPicky eaters reported eating less fiber (t[445] = −3.51; P < 0.001; d = 0.34) and vegetables (t[464] = −3.57; P < 0.001; d = 0.33), and reported more social phobia (t[336.84] = 4.04; P < 0.001; d = 0.39) than nonpicky eaters. Picky eating behaviors were positively correlated with PE identity (r[190] = 0.48; P < 0.001; R² = 0.23) and bias internalization (r[190] = 0.44; P < 0.001; R² = 0.19).Conclusions and ImplicationsFuture research might explore additional factors that theoretically overlap with PE behavior (eg, other eating styles, disordered eating patterns) or play a role in PE (eg, anxiety, obsessive-compulsive difficulties). A greater understanding of these factors may lead to intervention to reduce PE in adults. In addition, validation of the PE identity and PE distress measures is essential for future use and to replicate this study's findings.     

Beyond alcohol and drug addiction. Does the negative trait of low distress tolerance have an association with overeating?

Low distress tolerance is an inability to withstand negative emotions. The connection between low distress tolerance and addiction to cigarettes, alcohol, and illegal drugs has been established. The purpose of the current study was to extend this work to overeating, which is an important symptom of food addiction. We investigated whether low distress tolerance was related to overeating as measured by the emotional and external eating scales of the Dutch Eating Behavior Questionnaire and the disinhibition scale of the Three-Factor Eating Questionnaire. Participants were 225 college students with a median age of 19; 32% were overweight or obese. Linear regression models adjusting for sex and BMI demonstrated significant inverse associations among distress tolerance and emotional eating (P = 0.001), external eating (P = 0.002), and disinhibition (P < 0.001). These initial results suggest the importance of additional research in the area of low distress tolerance, overeating, and food addiction.     

Effects of pistachio nuts on body composition,metabolic, inflammatory and oxidative stress parameters in Asian Indians with metabolic syndrome: A 24-wk,randomized control trial

ObjectiveThe aim of this study was to evaluate the effects of pistachio nuts as an adjunct to diet and exercise on body composition, metabolic, inflammatory, and oxidative stress parameters in Asian Indians with metabolic syndrome.MethodsIn this 24-wk randomized control trial, 60 individuals with the metabolic syndrome were randomized to either pistachio (intervention group) or control group (diet as per weight and physical activity profile, modulated according to dietary guidelines for Asian Indians) after 3 wk of a diet and exercise run in. In the first group, unsalted pistachios (20% energy) were given daily. A standard diet and exercise protocol was followed for both groups. Body weight, waist circumference (WC), magnetic resonance imaging estimation of intraabdominal adipose tissue and subcutaneous abdominal adipose tissue, fasting blood glucose (FBG), fasting serum insulin, glycosylated hemoglobin, lipid profile, high-sensitivity C-reactive protein (hs-CRP), adiponectin, free fatty acids (FFAs), tumor necrosis factor (TNF)-α, leptin, and thiobarbituric acid reactive substances (TBARS) were assessed before and after the intervention.ResultsStatistically significant improvement in mean values for various parameters in the intervention group compared with control group were as follows: WC (P < 0.02), FBG (P < 0.04), total cholesterol (P < 0.02), low-density lipoprotein cholesterol (P < 0.006), hs-CRP (P < 0.05), TNF-α (P < 0.03), FFAs (P < 0.001), TBARS (P < 0.01), and adiponectin levels (P < 0.001).ConclusionA single food intervention with pistachios leads to beneficial effects on the cardiometabolic profile of Asian Indians with metabolic syndrome.     

Association between stress and dietary habits,emotional eating behavior and insomnia of middle-aged men and women in Seoul and Gyeonggi

BACKGROUND/OBJECTIVESThe study was performed to investigate the degree of perceived stress by sex in middle-aged people, and to provide basic data for appropriate nutrition education and interventional measures for middle-aged subjects through comparative analysis of association between stress and dietary habits, emotional eating behavior, and insomnia.SUBJECTS/METHODSA survey was conducted in 670 middle-aged subjects (320 men and 350 women) aged 40–64 years, resided in Seoul and Gyeonggi area. Collected data were analyzed using SPSS WIN 25.0 program.RESULTSPerceived stress in middle-aged subjects was not different by sex. Stress was higher in men with low dietary habits level compared to other groups (P < 0.001), and was higher in women with low and moderate dietary habits level compared to women with high dietary habits level (P < 0.05). Stress in men was higher in the group with emotional eaters (P < 0.05), and the same result was shown in women (P < 0.001). Stress was higher in both men and women with poor sleep quality (P < 0.001). Stress score was positively correlated with emotional dietary behavior and insomnia (P < 0.001) and negatively correlated with dietary habits (P < 0.001).CONCLUSIONSIt is considered that proper nutrition education and interventional measures according to sex are needed for stress control and proper dietary behavior and lifestyle in middle-aged people population, along with projects and policies at the national level.     

Socioecological Path Analytic Model of Diet Quality among Residents in Two Urban Food Deserts

BackgroundDiet is critical to chronic disease prevention, yet there are persistent disparities in diet quality among Americans. The socioecological model suggests multiple factors, operating at multiple levels, influence diet quality.ObjectiveThe goal was to model direct and indirect relationships among healthy eating identity, perceived control of healthy eating, social support for healthy eating, food retail choice block scores, perceptions of healthy food availability, and food shopping behaviors and diet quality measured using Healthy Eating Index-2010 scores (HEI-2010) for residents living in two urban communities defined as food deserts.DesignA cross-sectional design was used including data collected via self-reported surveys, 24-dietary recalls, and through objective observations of food retail environments.Participants/settingData collection occurred in 2015-2016 in two low-income communities in Cleveland (n=243) and Columbus (n=244), OH.Main outcome measureHEI-2010 scores were calculated based on the average of three 24-hour dietary recalls using the Nutrition Data System for Research.AnalysisSeparate path models, controlled for income, were run for each community. Analysis was guided by a conceptual model with 15 hypothesized direct and indirect effects on HEI-2010 scores. Associations were considered statistically significant at P<0.05 and P<0.10 because of modest sample sizes in each community.ResultsAcross both models, significant direct effects on HEI-2010 scores included healthy eating identity (β=.295, Cleveland; β=.297, Columbus, P<0.05) and distance traveled to primary food store (β=.111, Cleveland, P<0.10; β=.175, Columbus, P<0.05). Perceptions of healthy food availability had a significant, inverse effect in the Columbus model (β=−.125, P<0.05). The models explained greater variance in HEI-2010 scores for the Columbus community compared with Cleveland (R²=.282 and R²=.152, respectively).ConclusionsFindings highlight the need for tailored dietary intervention approaches even within demographically comparable communities. Interventions aimed at improving diet quality among residents living in food deserts may need to focus on enhancing healthy eating identity using culturally relevant approaches while at the same time addressing the need for transportation supports to access healthy food retailers located farther away.     

Association of Snacking Frequency,Size, and Energy Density with Weight Status among Preschool-Aged Children in the United States

BackgroundSnacking (ie, eating between meals) is common among US preschool-aged children, but associations with weight status are unclear.ObjectiveThis research evaluated associations of snack frequency, size, and energy density as well as the percent of daily energy from snacking with weight status and sociodemographic characteristics among US children aged 2 to 5 years.DesignCross-sectional analysis of 2007-2018 National Health and Nutrition Examination Survey data using two, caregiver proxy, 24-hour dietary recalls.Participants/settingUS children aged 2 to 5 years (n = 3,313) with at least one snack occasion over 2 days of intake.Main outcome measuresSnacking parameters included frequency (number of occasions per day), size (kilocalories per occasion), and energy density (kilocalories per gram per occasion) as well as percent of daily energy from snacking.Statistical analysesGeneralized linear regression models evaluated associations of snacking with child weight status (ie, normal weight and overweight/obesity), adjusting for survey weights, energy misreporting, mean meal size, and sociodemographic covariates.ResultsChildren with overweight/obesity consumed more frequent snacks (2.8 [0.06] vs 2.5 [0.03] snacks/day, respectively; P < 0.001), larger snacks (188 [4] vs 162 [23] kcal/occasion, respectively; P < 0.001), and a greater percent of daily energy from snacking (29.80% [1.00%] vs 26.09% [0.40%], respectively; P < 0.001) than children with normal weight. Mean snack frequency and size as well as percentage of daily energy from snacking varied with child age, gender, and head of household education. Associations of snacking with child race and ethnicity were less consistent.ConclusionsThese nationally representative findings provide evidence that the consumption of larger, more frequent snacks is associated with overweight/obesity among US children aged 2 to 5 years and snacking varies by sociodemographic characteristics.     

Disordered Eating Behaviors Are Associated with Poorer Diet Quality in Adolescents with Type 1 Diabetes

Disordered eating behaviors may pose a risk for poor long-term health outcomes in patients with type 1 diabetes. This cross-sectional study examined associations of disordered eating behaviors with diet quality, diet-related attitudes, and diabetes management in adolescents with type 1 diabetes (N=151, 48% female). Participants, recruited July 2008 through February 2009, completed 3-day diet records and survey measures, including the Diabetes Eating Problem Survey (DEPS) and measures of eating-related attitudes. Biomedical data were obtained from medical records. Participants scoring more than 1 standard deviation above the mean DEPS were classified as at risk for disordered eating. The Healthy Eating Index-2005 was calculated to assess diet quality. Analysis of covariance was used to test for differences between risk groups in diet quality, eating attitudes, and diabetes management, controlling for age, sex, and body mass index (BMI) percentile. Youth at risk for disordered eating were more likely to be overweight/obese than those at low risk (59.1% vs 31.8%, P=0.01). The at-risk group had poorer diet quality (P=0.003) as well as higher intake of total fat (P=0.01) and saturated fat (P=0.007) compared with the low-risk group. The at-risk group reported lower self-efficacy (P=0.005), greater barriers (P<0.001), and more negative outcome expectations (P<0.001) for healthful eating, as well as worse dietary satisfaction (P=0.004). The at-risk group had lower diabetes adherence (P<0.01), less-frequent blood glucose monitoring (P<0.002), and higher hemoglobin A1c (P<0.001). The constellation of excess weight, poorer dietary intake, and poorer diabetes management associated with youth at risk for disordered eating suggests potential risk of future poor health outcomes. Attention should be given to healthful weight management, especially among overweight youth with type 1 diabetes.     

Eight weeks of intermittent fasting versus calorie restriction does not alter eating behaviors,mood, sleep quality,quality of life and cognitive performance in women with overweight

Human trials that compare intermittent fasting (IF) to calorie restriction (CR) with psychological, behavioral and cognition outcomes are limited. We hypothesized that there would be no difference between CR and IF on perceived eating behaviors, mood, sleep quality, quality of life (QOL) and cognition in women with overweight and obesity. In this prespecified secondary analysis of an open-label, single center, parallel assignment, randomized controlled trial, healthy women with overweight or obesity (N = 46, mean [SD] age 50 [9] years, BMI 32.9 [4.4] kg/m²), without a diagnosed eating disorder and who were randomized into 2 weight loss groups (prescribed 70% of calculated energy requirements as IF or CR) were included. Measurements were assessed in both IF and CR groups following a 12-hour overnight fast during baseline and week 8 and additionally following a 24-hour fast in the IF group only at week 8. We observed that IF produced greater weight and body fat loss than CR (P < .001). We did not detect any statistical difference between groups for the change in dietary restraint, disinhibition, hunger, mood, sleep quality, and QOL. An increase in cognitive performance was found in both IF (P = .036) and CR (P = .006) groups in one of the cognitive tasks, but there was no statistical difference between groups. Perceived eating behaviors, mood, sleep quality and cognitive performance were not changed by an acute 24-hour fast within the IF group (all P > .05). IF may be a viable alternative to CR for weight loss, in the short-term, without adversely impacting eating behaviors, mood, sleep quality, QOL or cognition in healthy women with overweight or obesity. However, larger and long term trials are required.     

Eating Timing: Associations with Dietary Intake and Metabolic Health

BackgroundEmerging research indicates that eating timing may influence dietary intake and metabolic health. However, studies to date have not examined the association of multiple measures of eating timing with both dietary intake and metabolic health in adults with overweight and obesity.ObjectiveTo examine the association of multiple measures of eating timing with dietary intake (ie, dietary composition, diet quality, and eating frequency) and metabolic health (ie, body composition and cardiometabolic risk).DesignThis is a cross-sectional analysis of baseline data from a weight loss and maintenance intervention collected from May 2015 to January 2018.Participants/settingParticipants were women with overweight or obesity who were dependents of active duty and retired military personnel (N = 229; mean ± standard error, BMI = 34.7 ± 0.4 kg/m², age = 40.9 ± 0.7 years). The study was conducted at military installations in Massachusetts, Connecticut, New York, Colorado, and Kentucky.Main outcome measuresEating timing variables examined included daily eating interval (time between first and last eating occasion), time-restricted eating (≤11 hours daily eating interval), early energy eaters (eating ≥60% of energy during the first half of time awake), and bedtime eaters (eating within 2 hours of bedtime).Statistical analysisThe main analysis was limited to those reporting plausible energy intake (64% of total sample [n = 146]). Linear, quantile, or logistic regression models were used to determine the association of eating timing with measures of dietary intake and metabolic health.ResultsIn individuals reporting plausible energy intake, each additional 1 hour in daily eating interval was associated with 53 kcal higher energy intake, higher glycemic load, eating frequency, and waist circumference (P < 0.05 for all). Significant associations were observed for: time-restricted eating and a lower energy intake, glycemic load, and eating frequency; early energy eating and higher carbohydrate intake; bedtime eating and a higher energy intake, glycemic load, and eating frequency.ConclusionsThese findings lend support for the mechanistic targeting of eating timing in behavioral interventions aimed at improving dietary intake and body composition.     

Diet Quality of Frequent Fast-Food Consumers on a Non-Fast Food Intake Day Is Similar to a Day with Fast Food,What We Eat in America,NHANES 2013-2016

BackgroundFrequent fast food (FF) consumers may make more healthful food choices at eating occasions without FF. However, it is not clear if poor diet quality of frequent FF consumers is a function of FF consumption or less healthful food choices overall.ObjectiveThe objective of this study was to compare diet quality, energy, and nutrient intakes of infrequent FF consumers (INFREQ) with that of frequent FF consumers on an intake day with FF (FREQ-FF) or without FF (FREQ_NO FF).DesignThis study is a cross-sectional analysis of 1 day dietary intake data from What We Eat in America, National Health and Nutrition Examination Survey 2013-2016, the dietary intake component of National Health and Nutrition Examination Survey.Participants/settingParticipants included adults aged 20 years and older (N = 4,012), who, during the previous 7 days, reported no consumption of FF or pizza (n = 2,142 INFREQ) or reported FF or pizza three or more times and either had FF/pizza (n = 1,455 FREQ_FF) or did not have FF/pizza (n = 415 FREQ_NO FF) on the intake day.Main outcome measuresMain outcomes were energy, nutrient density (nutrient intake per 1,000 kcal), and diet quality evaluated using Healthy Eating Index (HEI) 2015.Statistical analyses performedGroup comparisons were made using t tests. Differences were considered significant at P < 0.001.ResultsCompared with INFREQ consumers, FREQ_FF consumers had higher intakes of energy and fat per 1,000 kcal, lower scores for total HEI and most components, and lower nutrient densities of most micronutrients (P < 0.001). HEI component scores of INFREQ consumers for vegetables, fruit, whole grains, and added sugars were higher than FREQ_FF consumers (P < 0.001). Energy intake, most nutrient densities, and total HEI and component scores of FREQ_NO FF consumers were not significantly different from FREQ_FF consumers with the exception of fruit but were different from INFREQ consumers for some nutrients and HEI components.ConclusionsResults suggest diet quality and nutrient intake of frequent FF consumers on a non-FF intake day is not markedly different from a day with FF.     

Family Eating Behavior and Child Eating Patterns Differences Between Children With and Without Siblings

ObjectiveTo examine the differences in family eating behaviors and child eating patterns in children with siblings (nonsingletons) and without siblings (singletons).MethodsCross-sectional analysis of mother–child dyads of 5–7-year-old children, (nonsingletons with a 2-to-4-year-old sibling) was conducted. Anthropometrics were measured. Mothers completed questionnaires and a child dietary log. Healthy Eating Index 2010 (HEI) score was calculated. Linear regression models adjusting for child age, child sex, maternal body mass index, and hours-away-from-home were conducted, with a revised P < .021.ResultsSixty-eight mother–child dyads (27 singletons, 41 nonsingletons) participated. Singletons exhibited less healthy family eating behaviors (β = ?4.98, SE = 1.88, P = .003), and lower total HEI scores than did nonsingletons (average: β = ?8.91, SE =2.40, P = .001). On average, singletons had lower scores in 3 HEI components compared with nonsingletons (P < .021 for all).ConclusionIn this sample, singleton children exhibited less healthy eating behaviors. Additional investigation into parent-level differences is warranted.     

Are adolescents' perceptions of dietary practices associated with their dietary behaviors?

Despite interventions designed to change behavior, many adolescents continue to consume unhealthy foods. Dietary patterns are important for disease prevention, making it necessary to understand the reasons for these poor choices. This cross-sectional study explored the relationship between perception of dietary practices and dietary behaviors among adolescents. Participants (n=15,283; mean age=15 years; 50.7% female) completed the 2004-2005 Texas School Physical Activity and Nutrition survey. Perception of dietary practices included fat content of foods usually eaten and healthiness of usual eating habits. Dietary behavior was measured by self-report of foods eaten the day before survey administration. Composite scores of unhealthy and healthy eating were created. Regression analyses examined whether perception of dietary practices was consistent with actual dietary behavior, controlling for sex, grade, and race/ethnicity, and accounting for the complex sampling design. Higher perceived fat content was associated with increased consumption of unhealthy foods, while higher perceived healthiness of eating was associated with increased consumption of healthy foods. For perceived fat content, the difference in the Healthy Eating Index between extreme categories was 26% (P<0.001), while the difference in the Unhealthy Eating Index between extreme categories was 81% (P<0.001). For perceived healthiness, the difference in the Healthy Eating Index between extreme categories was 23% (P<0.001), while the difference for the Unhealthy Eating Index was 44% (P<0.001). Self-perceptions of dietary practices were significantly associated with dietary behaviors, indicating awareness about the relative nutrient content of foods consumed. Interventions that move beyond dietary knowledge and create changes in the social and physical environment are needed.     

Consuming Vegetable-Based Salad Is Associated with Higher Nutrient Intakes and Diet Quality among US Adults,What We Eat in America,National Health and Nutrition Examination Survey 2011-2014

BackgroundConsuming salad is one strategy with the potential to harmonize diets more closely with national dietary guidance. However, it is not known whether nutrient intake and diet quality differ between people who consume vegetable-based salad and those who do not.ObjectiveThe objective of this study was to compare nutrient intake and diet quality between salad reporters and nonreporters.DesignThis study is a cross-sectional analysis of 1 day of dietary intake data collected via 24-hour recall.Participants/settingAdults 20 years and older (n=9,678) in What We Eat in America, National Health and Nutrition Examination Survey 2011-2014 were included. Respondents who ate salad on the intake day were considered salad reporters.Main outcome measuresThis study estimated nutrient intake from all foods and beverages (excluding supplements) and evaluated diet quality using the Healthy Eating Index (HEI) 2015.Statistical analysesNutrient intake and HEI scores were compared between salad reporters and nonreporters using paired t tests with regression adjustment for confounding variables. Results were considered significant at P<0.001.ResultsOn the intake day, 23% of adults consumed salad. Energy, protein, and carbohydrate intakes did not differ between salad reporters and nonreporters. Salad reporters had higher intakes than nonreporters of dietary fiber, total fat, unsaturated fatty acids, vitamins A, B-6, C, E, K, folate, choline, magnesium, potassium, and sodium (P<0.001). Total HEI 2015 scores were significantly higher for reporters (56 of a possible 100 points) than nonreporters (50 points) P<0.001. Reporters also had significantly higher scores for eight of 13 HEI components: total vegetables, greens and beans, whole fruits, total protein foods, seafood and plant proteins, fatty acids, refined grains, and added sugars (P<0.001).ConclusionsIncorporating vegetable-based salad into one’s diet may be one effective way to increase nutrient intake and improve overall diet quality. Regardless of salad reporting status, HEI scores show that diets of US adults need improvement.     

Nutrition-Focused Wellness Coaching Promotes a Reduction in Body Weight in Overweight US Veterans

Diet plays a critical role in the pathogenesis of major chronic diseases common in populations of US veterans. The role of nutrition-focused wellness coaching in improving dietary behavior and/or reducing weight in overweight and obese US veterans is not known. At the San Francisco Veterans Affairs Medical Center, US veterans aged 25 to 80 years were randomized to receive nutrition coaching on eating behaviors at baseline only (control group, n=22) or an additional eight times over the course of 6 months (intervention group, n=28) in 2010-2011. Multiple coaching contacts decreased intake of energy, fat, and carbohydrate by 31% (P≤0.001) as evaluated by the 2005 Block food frequency questionnaire, which is composed of 111 food items. A weight loss of 5% from baseline (92.8 to 88.2 kg; P<0.01) was observed in the intervention group with mean body mass index decreasing from 30.4 to 28.9 (P<0.05). The control group showed a decrease in fat intake by 20% (P=0.01), but no statistically significant changes in intake of other nutrients or body weight (88.7 to 87.4 kg). Those in the intervention group reported diets at follow-up that were lower in cholesterol, saturated fat, sodium, sugar (P≤0.01), calcium (P< 0.05), and vitamin D (P<0.01), although when adjusted for energy (ie, nutrient density) calcium intake increased and vitamin D remained unchanged. Veterans' readiness to change eating behavior for weight loss improved with nutrition coaching. This study demonstrates that intermittent nutrition coaching can be an effective strategy to promote reductions in energy intake, body weight, and body mass index in overweight US veterans. Further research is needed to determine whether nutrition coaching improves other clinical outcomes and sustains weight loss.