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.     

Household Supplemental Nutrition Assistance Program Participation is Associated With Higher Fruit and Vegetable Consumption

ObjectiveExamine whether differences were present by Supplemental Nutrition Assistance Program (SNAP) participation in dietary patterns, achievement of dietary recommendations, and food security for children (aged 7–18 years) receiving free/reduced-price school meals.MethodsCross-sectional study. Caregiver–child dyads at a pediatric clinic completed validated surveys. Food security, dietary patterns, and achievement of dietary recommendations were compared between child SNAP participants/nonparticipants.ResultsAmong 205 caregivers, 128 (62.4%) reported SNAP participation. Percentages of child SNAP participants/nonparticipants meeting recommendations were largely nonsignificantly different and overwhelmingly low. Supplemental Nutrition Assistance Program participants reported higher mean daily servings of vegetables (P = 0.01) and fruits (P = 0.01) than nonparticipants. Caregiver-reported household food security was not significantly different between SNAP participants and nonparticipants (P = 0.44).Conclusions and ImplicationsIn this study, child-reported fruit/vegetable intakes were significantly higher among SNAP participants than nonparticipants, suggesting child SNAP participants may experience small but noteworthy benefits related to fruit/vegetable consumption. Additional supports are needed to achieve dietary recommendations.     

Double Up Food Bucks Participation is Associated with Increased Fruit and Vegetable Consumption and Food Security Among Low-Income Adults

Objective

To evaluate the effect of the Utah Double Up Food Bucks (DUFB) program on fruit and vegetable (F&V) intake and food security status among Supplemental Nutrition Assistance Program (SNAP) recipients.

Food Insecurity Is Associated With Dysfunctional Eating Behaviors Among Adults in Puerto Rico

ObjectiveTo examine the association between food insecurity and dysfunctional eating behaviors among adults in Puerto Rico.MethodsData from 865 participants were obtained from baseline interviews from the Puerto Rico Observational Study of Psychosocial, Environmental, and Chronic Disease Trends (PROSPECT) cohort. The association between food insecurity and emotional eating (EE) and uncontrolled eating (UE) (categorized as no/moderate/high) was examined using multinomial logistic models. Potential mediation by perceived stress was explored.ResultsThe prevalence of food insecurity was 20.3%. Compared with adults with food security, adults with food insecurity had higher odds of both moderate EE (odds ratio [OR], 1.91; 95% confidence interval [CI], 1.18–3.09) and high EE (OR, 2.85; 95% CI, 1.75–4.64), and both moderate UE (OR, 1.78; 95% CI, 0.91–3.50) and high UE (OR, 3.28; 95% CI, 1.70–6.33). Perceived stress slightly attenuated these associations.Conclusions and ImplicationsFood insecurity was associated with a higher likelihood of engaging in dysfunctional eating behaviors. Interventions alleviating food insecurity or stress might help adults sustain healthy eating behaviors.     

Physical Activity and Fruit and Vegetable Intake Among American Indians

The American Indian population has among the highest rates of obesity in the United States. Thus, it is critical to understand factors related to this epidemic (e.g., physical activity, nutrition) among this ethnic minority population. The current study examined factors related to engaging in at least 4 days of physical activity (PA) per week and factors related to consuming at least 5 fruits and vegetables (FV) per day among a sample of American Indians in the Midwest. We used multiple methods to recruit participants for this study, including recruitment at pow wows, focus groups, health fairs, new student orientation for American Indian students, and other venues. A total of 998 American Indians (76% participation rate) completed a survey assessing sociodemographics, physical activity level, fruit and vegetable intake, and perceptions regarding the recommendations for physical activity and fruit and vegetable intake. Factors associated with exercising ≥4 days in the past week (44.77% of the sample) include being younger (P = .002), being male (P < .001), having at least some college education (P = .048), eating ≥5 FV per day, and higher perceived number of days of PA recommended (P < .001). Factors associated with eating ≥5 servings of FV per day (37.01% of the sample) included exercising ≥4 days in the past week (P < .001) and higher perceived number of servings of FV recommended (P < .001). These findings highlight the importance of education in enhancing engagement in positive weight control behaviors and the importance of addressing both physical activity and nutrition among the American Indian population.     

Access With Education Improves Fruit and Vegetable Intake in Preschool Children

ObjectiveTo compare effects of interventions aimed at increasing fruit and vegetable (FV) intake in children.DesignPre-post comparison and intervention study with randomly grouped classrooms.SettingHead Start classrooms.ParticipantsTwo hundred nine Head Start children.InterventionsTreatment A (n = 61) and treatment B (n = 82) children received high-carotenoid FVs for 8 weeks. Treatment B children also received weekly FV education, and their caregivers received FV information and recipes. The comparison group (n = 66) received neither FVs nor education.Main Outcome MeasureCarotenoid values in Raman units.AnalysisMultilevel mixed models, ANCOVA, and post hoc analysis were used.ResultsMultilevel mixed models with the group as fixed effect and classrooms within group as a random effect; ANCOVA showed that the only significant variable affecting the score was the group main effect. The intraclass correlation coefficient was 0.037; the Raman unit scores of treatment B were significantly higher than those of treatment A (P = .02) or comparison group (P < .001). However, there was no significant difference between treatment A and comparison (P = .10; Cohen D = .71).Conclusions and ImplicationsThe results suggested that providing education where FVs are offered may help increase consumption. Measurement of carotenoids in family members who received FVs plus education, as well as replication of this model in different locations and ages of children should be investigated in future research.     

Skin Carotenoid Scores Assessed with Reflection Spectroscopy Are Associated with Self-Reported Fruit and Vegetable Intake Among Latino Early Adolescents

BackgroundLatino early adolescents have a high prevalence of overweight and obesity. Interventions to address healthy eating among Latino youth frequently focus on fruit and vegetable (FV) intake. Reflection spectroscopy assessed skin carotenoid (SC) levels has been proposed as an easy, noninvasive method to evaluate FV intake, but validation studies involving ethnically diverse youth are lacking.ObjectiveThis study aimed to assess the association between reflection spectroscopy-measured SC scores and self-reported FV intake among low-income, urban, Latino early adolescents, controlling for potential confounding factors.DesignThis study was a cross-sectional secondary analysis of baseline data from a community-based intervention program (Padres Preparados, Jóvenes Saludables) involving Latino fathers and adolescents to improve paternal parenting practices and youth energy balance-related behaviors.Participants/settingParticipants were 195 low-income, Latino early adolescents (aged 10 to 14 years). Data were collected in the Minneapolis/St Paul metropolitan area from 2017 to 2020 during fall or winter months.Main outcome measuresSC scores were measured using reflection spectroscopy, usual intakes of FV and carotenoid compounds were estimated based on the assessment using 24-hour dietary recalls.Statistical analysisMultivariable linear regression analyses were used to estimate associations of SC scores and each dietary component and potential confounding factors after assessing variables for inclusion in the analyses.ResultsThe mean SC score was 225 ± 95. The mean FV and total carotenoid intakes were 3.3 ± 0.5 servings/day and 8,360 ± 786 μg/day, respectively. Higher SC scores were observed among youth who had higher FV (β = .37 and P < 0.01) or total carotenoid intakes (β = .31 and P < 0.01). SC scores measured during fall were higher than scores measured during winter. Study participants with higher home FV availability and accessibility had higher SC scores.ConclusionsFindings supported using SC score as a potential easy-to-use indicator of FV intake among Latino youth with consideration of seasonal variation and home FV availability and accessibility.     

Feeding Style Differences in Food Parenting Practices Associated With Fruit and Vegetable Intake in Children From Low-income Families

ObjectiveTo examine the moderating effects of feeding styles on the relationship between food parenting practices and fruit and vegetable (F & V) intake in low-income families with preschool-aged children.DesignFocus group meetings with Head Start parents were conducted by using the nominal group technique. Parents completed information on food parenting practices and feeding styles. Three dietary recalls were collected on each child.SettingParents completed measures in Head Start centers and/or over the telephone.Participants667 parents of preschool-aged children participated.OutcomesFood parenting practices and F & V intake.AnalysisMean differences in the food parenting practices across the 4 feeding styles were established through multivariate general linear modeling using MANOVA. Moderated multiple regression analysis was conducted to examine the moderating role of feeding style on food parenting practices and child F & V intake.ResultsThe indulgent feeding style moderated the relationship between food parenting practices and child F & V intake.Conclusions and ImplicationsThis study indicates that parents' feeding styles have a moderating effect on the relationship between the food parenting practices and children's F & V intake. This finding can facilitate the development of interventions aimed at reducing childhood overweight.     

Fruit and Vegetable Consumption,Fat Intake,and Physical Activity Participation in Relation to Socio-demographic Factors Among Medically Underserved Adults

Fruit and vegetable intake as well as physical activity participation in Mississippi is consistently lower than recommendations. We conducted a cross-sectional study to examine fruit and vegetables consumption, fat intake, and moderate-intensity physical activity participation and how these variables relate to socio-demographic factors among medically underserved adults in south Mississippi. Fruit and vegetable consumption and fat intake along with physical activity participation and socio-demographic characteristics was collected from a sample of 161 (48 male and 113 female) adults in south Mississippi. A majority (81.9%) of participants reported consuming less than five servings of fruits and vegetables per day and 54% reported exercising less than three times a week. Only 14% of participants reported eating a low fat diet. Bivariate correlations revealed no significant relationships between fruit and vegetable consumption and fat intake as well as no significant relationships between fruit and vegetable consumption and gender, ethnicity, income, marital status, or education. However, there were significant correlations between physical activity and fat intake (r = -0.21, p = 0.01), and physical activity with fruit and vegetable consumption (r = 0.16, p = 0.05). Higher physical activity rates were associated with decreased fat intake and increased fruit and vegetable consumption. Physical activity was also higher among men (r = -0.16, p = 0.05) and positively correlated with income level (r = 0.21 p = 0.01). In order to effectively identify or develop strategies to improve health by promoting increased fruit and vegetable intake and physical activity, further research is needed to understand the factors that affect behavior choices regarding nutrition and physical activity in this medically underserved adult population.     

Higher Fruit and Vegetable Intake Is Associated with Participation in the Double Up Food Bucks (DUFB) Program

Incentivizing fruit and vegetable (F&V) purchases may help address barriers to healthy eating among populations with low income. In a repeated measures natural experiment study, we examined whether participation in the Double Up Food Bucks (DUFB) program increased F&V consumption among Supplemental Nutrition Assistance Program (SNAP) recipients. Two hundred and twelve participants recruited at baseline through telephone calls were informed about the availability of DUFB at their local farmers’ market (FM). F&V consumption frequency and DUFB use were obtained at baseline, mid FM, and end of FM season approximately 5 months later. Participants (N = 212) were primarily white (76.4%) women (77.3%) with an average age of 43.5 years. Only 34 participants opted to use the DUFB program. A linear mixed model showed a significant main effect of DUFB use (p = 0.001) and of time (p = 0.002), with a decrease in F&V intake over time. Compared to non-users, DUFB users had a significantly higher F&V consumption at baseline and midpoint (p = 0.02 and p = 0.02, respectively). F&V consumption was associated with participation in the DUFB program and higher F&V consumption frequency was observed prior to program use among program participants. Future interventions that specifically target SNAP recipients with low F&V intake to use the DUFB program are needed.     

Lower Dietary Calcium Intake is Associated with a Higher Risk of Mortality in Korean Adults

BackgroundCalcium, one of the most abundant minerals in the human body, has a pivotal role in human physiology. However, only a few studies have examined the association of dietary calcium intake with mortality in a population with low calcium intake.ObjectiveThe aim of this study was to examine the association of dietary calcium intake with risk of all-cause and cause-specific mortality among Korean adults with low calcium intake.DesignThis study was a prospective cohort study.Participants/settingThe analysis was conducted using data from 44,327 eligible Korean adults aged 19 years and older who participated in the Korea National Health and Nutrition Examination Survey 2007-2015. Dietary calcium intake was assessed using 1-day 24-hour recall data.Main outcome measuresThe main outcomes of this study were mortality from all causes, cancer, cardiovascular disease, respiratory disease, and all other causes combined. The outcome was ascertained through linkage to the death registry compiled by Statistics Korea with the use of the resident registration number.Statistical analyses performedWeighted Cox proportional hazard models were used to estimate the hazard ratios and 95% CIs of the all-cause and cause-specific mortality according to dietary calcium intake.ResultsDuring a mean follow-up of 7.28 person-years, 1,889 deaths were ascertained. After multivariable adjustment, the hazard ratios for all-cause mortality for the second quintile to the highest quintile of dietary calcium intake, respectively, compared with the first quintile were 0.86 (95% CI 0.73 to 1.00), 0.82 (95% CI 0.69 to 0.98), 0.85 (95% CI 0.69 to 1.03), and 0.78 (95% CI 0.64 to 0.96) (P for trend from the lowest to the highest quintile = .04). There were no statistically significant associations between dietary calcium intake and risk of mortality from cancer, cardiovascular, or respiratory disease.ConclusionsIn this large prospective cohort study of Korean adults, lower dietary calcium intake was associated with a higher risk of all-cause mortality.     

Assessing Healthful Eating Among Community Dwelling Rural Older Adults Using Self-Reported Fruit and Vegetable Consumption via a Community-Wide Mail-Out Health Status Assessment

Abstract

This project assessed fruit and vegetable intakes among rural older adults on a regional mail-out community health assessment. Over 95% of respondents answered questions regarding fruit and vegetable consumption. Rural older adults in this sample were willing to respond to questions regarding their fruit and vegetable intake; yet they were not likely to be meeting minimum recommended intakes of these foods. Including questions about dietary healthfulness on such an assessment may provide key stakeholders and policymakers a clearer understanding of their community's overall health status.     

Healthy Eating Index-2015 Scores Among Adults Based on Observed vs Recalled Dietary Intake

BackgroundThe construct and predictive validity of the Healthy Eating Index (HEI) have been demonstrated, but how error in reported dietary intake may affect scores is unclear.ObjectiveThese analyses examined concordance between HEI-2015 scores based on observed vs reported intake among adults.DesignData were from two feeding studies (Food and Eating Assessment STudy, or FEAST, I and II) in which true intake was observed for three meals on 1 day. The following day, participants completed an unannounced 24-hour dietary recall.Participants/settingFEAST I (2012) included 81 men and women, aged 20 to 70 years, living in the Washington, DC, area. FEAST II (2016) included 302 women, aged 18 years or older, with low household incomes and living in the Washington, DC, area. In FEAST I, recalls were completed independently using the Automated Self-Administered 24-hour Dietary Assessment Tool (ASA24-2011) or interviewer-administered using the Automated Multiple-Pass Method. In FEAST II, recalls were completed using ASA24-2016, independently or in a small group setting with assistance.Main outcome measuresHEI-2015 scores were calculated using the population ratio method.Statistical analyses performedT-tests determined whether differences between scores based on observed and reported intake were different from zero. FEAST I data were stratified by sex, and in FEAST II, analyses were repeated by education and body mass index (BMI).ResultsDifferences in total HEI-2015 scores between observed and reported intake ranged from −1.3 to 5.8 points among those completing ASA24 independently in both studies, compared with −2.5 points in the small group setting. For interviewer-administered recalls, the differences were −1.1 for men and 2.3 for women. In FEAST II, total HEI-2015 scores derived from observed intake were lower than scores derived from reported intake among those who had completed high school or less (−3.2, SE 1.1, P<0.01) and those with BMI ≥ 30 (−2.8, SE 1.1, P = 0.01).ConclusionsHEI-2015 scores based on 24-hour dietary recall data are generally well estimated.     

Intuitive Eating and Biomarkers Related to Cardiovascular Disease in Older Adults

ObjectiveExamine whether exercise and diet motivation are associated with 4 biomarkers related to cardiovascular disease.DesignCross-sectional analysis. Data collection involved questionnaires, blood draws, body composition assessments, and accelerometry.SettingSmall, midwestern college town.ParticipantsCommunity older adults (≥ 58 years of age; n = 79) recruited through convenience sampling; the sample was representative of the population of interest for some demographic characteristics (eg, age and sex) but not representative of other characteristics (eg, level of activity).Variables MeasuredIndependent variables comprised self-reported intrinsic exercise motivation (Behavioral Regulation for Exercise Questionnaire-3) and intuitive eating (Intuitive Eating Scale-2). Dependent variables included inflammatory proteins (C-reactive protein and interleukin-6) and lipid levels (low-density lipoprotein/high-density lipoprotein and triglycerides) quantified from blood samples. Covariates included age, body mass index, sex, and objective physical activity measured by accelerometers worn for 7 days.AnalysisMultiple linear regression was used to assess the association between diet and exercise motivation and biomarker outcomes; we analyzed 4 regression models (1 for each biomarker). Significance level P < 0.05.ResultsGreater intuitive eating was associated with a lower low-density lipoprotein/high-density lipoprotein ratio (β = ?0.45, P = 0.001) and lower triglycerides (β = ?0.37, P = 0.003). Intrinsic exercise motivation was not associated with the biomarkers.Conclusions and ImplicationsIntuitive eating may be a key determinant of certain biomarkers and could be a viable target for interventions to help decrease the risk of cardiovascular disease among older adults.     

Prenatal and Postnatal Fruit and Vegetable Intake Among US Women: Associations with WIC Participation

Objective Evaluate variation in fruit and vegetable intake by Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation and poverty status among pregnant, and postpartum women participating in the Infant Feeding Practice Study II (IFPSII). Methods IFPSII (2005–2007) followed US women from third trimester through 1 year postpartum through mailed questionnaires measuring income, WIC participation, breastfeeding; and dietary history questionnaires (DHQ) assessing prenatal/postnatal fruit and vegetable consumption. Poverty measurements used U.S. Census Bureau Federal Poverty thresholds to calculate percent of poverty index ratio (PIR) corresponding to WIC’s financial eligibility (≤185 % PIR). Comparison groups: WIC recipients; WIC eligible (≤185 % PIR), but non-recipients; and women not financially WIC eligible (>185 % PIR). IFPSII participants who completed at least one DHQ were included. Intake variation among WIC/poverty groups was assessed by Kruskal–Wallis tests and between groups by Mann–Whitney Wilcoxon tests and logistic regression. Mann–Whitney Wilcoxon tests examined postnatal intake by breastfeeding. Results Prenatal vegetable intake significantly varied by WIC/poverty groups (p = 0.04) with WIC recipients reporting significantly higher intake than women not financially WIC eligible (p = 0.02); association remained significant adjusting for confounders [odds ratio 0.66 (95 % confidence interval: 0.49–0.90)]. Prenatal fruit and postnatal consumption did not significantly differ by WIC/poverty groups. Postnatal intake was significantly higher among breastfeeding than non-breastfeeding women (fruit: p < 0.0001; vegetable: p = 0.006). Conclusions for Practice Most intakes did not significantly differ by WIC/poverty groups and thus prompts research on WIC recipient’s dietary behaviors, reasons for non-participation in WIC, and the influence of the recent changes to the WIC food package.