Food Classifications by Brazilian Amazon Mothers: Interactions With Eating Practices

ObjectiveTo assess how mothers classify foods and how their eating practices interact with these classifications, with special attention to meanings and uses given to ultra-processed foods.DesignQualitative research with in-depth interviews and pile sorts.SettingUrban Brazilian Amazon.ParticipantsA sample of 34 mothers were selected through theoretical sampling.AnalysisContent analysis for in-depth interviews and multidimensional scaling and cluster analysis for pile sorts.Phenomenon of InterestFood classification.ResultsClassifications were based on context (ie, a time or a situation in which the food is eaten) and foods’ healthiness. Five food groupings based on mothers’ classifications were defined: (1) main meal foods, (2) fruits and fruit juices, (3) convenient foods, (4) leisure foods, and (5) canned sardines. Ultra-processed foods were classified differently from non-ultra-processed foods and considered unhealthy, consumed on special occasions or when there was no time or desire to cook.Conclusions and ImplicationsResults highlight the potential of incorporating context-based categories and personal experiences to guide nutrition interventions and the potential of pile sorts to tailor messages to target populations.     

A Content Analysis of Food References in Television Programming Specifically Targeting Viewing Audiences Aged 11 to 14 Years

ObjectiveExamine food in cable television programming specifically targeting 11- to 14-year-olds (“tweens”).DesignContent analysis of food-related scenes (FRS)—in which food was shown, mentioned, and/or consumed—in 880 minutes of programming was conducted.SettingFive days of afternoon/early evening television programs on the Disney Channel.Main Outcome Measures and AnalysisFood references were compared with USDA MyPlate and classified according to modified Ratio of Recommended to Restricted Food Components.ResultsThe authors found 331 FRS, averaging 16.6 scenes/h. Preponderance of FRS was physiological needs (40.7%), followed by display (10%), party (8.5%), social event (8%), and retail store (6.6%). Snacks dominated 41% of FRS, and breakfast, lunch, and dinner were much lower in frequency. Half of FRS was visual only, followed by verbal only. Food references were not congruent with MyPlate recommendations; 42% of food items did not fit into MyPlate food groups. Only 24% of food items were fruit or vegetables, which is considerably less than recommended by MyPlate guidelines. Using modified Ratio of Recommended to Restricted Food Components, 66% of food items scored < 1.0, signifying less nutritious.Conclusions and ImplicationsTween television programming regularly includes non-nutritious food, which likely influences tweens' attitudes and behaviors. Television programming may consider past approaches to tobacco smoking and health messages on television. More attention is warranted regarding television programming by nutrition educators, researchers, health professionals, and industry specialists.     

Adolescent Independent Eating Occasions,Dietary Intake,and Parenting Practices During the COVID-19 Pandemic: A Qualitative Study of Parents and Adolescents From Households With Low Income

ObjectiveExamine how experiencing the coronavirus disease 2019 (COVID-19) pandemic influenced adolescent independent eating occasions (iEOs) and iEO-related parenting practices from the perspective of parents and adolescentsMethodsCross-sectional remote interviews were conducted for this basic qualitative research study. Participants were a purposive sample of multiracial/ethnic adolescents aged 11–14 years and their parents from households with low income (n = 12 dyads) representing 9 US states. The main outcome measures were iEOs and iEO-related parenting practices. Data were analyzed using directed content analysis.ResultsAbout half of the parents indicated that their adolescents had more iEOs during the COVID-19 pandemic and that there were changes in the types of foods consumed during iEOs. In contrast, most adolescents indicated their iEOs had not changed remarkably in frequency or foods consumed since the onset of the pandemic. Most parents reported no change in how they taught their adolescents about healthy food, the rules for foods/beverages permitted during iEOs, or how they monitored what their adolescents ate during iEOs; adolescent reports were in general agreement. Most parents indicated that family members were home together more often during the pandemic, which increased cooking frequency.Conclusions and ImplicationsThe effect of the COVID-19 pandemic on adolescents’ iEOs varied, and the parenting practices used to influence iEOs remained stable during the pandemic. Families experienced having more time together and cooking at home more often.     

Food classifications: Levels and categories

People classify foods into multiple categories to construct order in complex food environments. This investigation in the U.S. used depth interviews and secondary analysis of existing qualitative data sets to examine how the public constructs and uses food classifications. Within sets of culturally recognized food classifications, smaller sets of socially significant classifications are found, and within these socially significant classifications are sets of personally operational classifications used most often in making everyday food choices. Food classifications become salient and are used within specific contexts. Food classifications are multidimensional, and include many organizing themes such as liked/disliked, healthy/ unhealthy, seasonal/out of season, and others. These classification dimensions and categories vary in salience and use within and between individuals and settings. Understanding food classifications may help improve communication between food and health professionals and the public.     

Position of the American Dietetic Association: Functional Foods

It is the position of The American Dietetic Association that functional foods, including whole foods and fortified, enriched, or enhanced foods, have a potentially beneficial effect on health when consumed as part of a varied diet on a regular basis, at effective levels. The Association supports research to further define the health benefits and risks of individual functional foods and their physiologically active components. Dietetics professionals will continue to work with the food industry, government, the scientific community, and the media to ensure that the public has accurate information regarding this emerging area of food and nutrition science. Knowledge of the role of physiologically active food components, both from phytochemicals and zoochemicals, has changed the role of diet in health. Functional foods have evolved as food and nutrition science has advanced beyond the treatment of deficiency syndromes to reduction of disease risk. This position reviews the definition of functional foods, their regulation, and the scientific evidence supporting this emerging area of food and nutrition. Foods can no longer be evaluated only in terms of macronutrient and micronutrient intake. Analyzing the content of other physiologically active components will be necessary. The availability of health-promoting functional foods in the US diet has the potential to help ensure a healthier population. However, each functional food should be evaluated on the basis of scientific evidence to ensure appropriate integration into a varied diet. J Am Diet Assoc. 1999;99:1278-1285.     

Abstracts of Articles on Nutrition and Bone Loss

Objective: To identify if particular foods or food groups may be associated with obesity in children and adolescents and to determine if consuming food away from home (FAFH) has an effect on the nutritional quality of their diets.

Design: One-year cross-sectional study.

Setting/Subjects: The obese subjects (n = 91) were on the waiting list for a hospital-based weight control treatment program. The non-obese subjects (n = 90) were recruited from community advertisements.

Measures of Outcome: Information on food intake was obtained using the dietary history method by a Registered Dietitian. Body fat was determined by bioelectrical impedance analysis.

Results: Obese children and adolescents consumed significantly more servings of meat and alternatives, grain products, FAFH, sugar-sweetened drinks and potato chips which contributed to a higher calorie, fat and sugar intake compared to non-obese children and adolescents. Sugar-sweetened drinks were only significantly greater in boys. The consumption of meat servings, sugar-sweetened drinks and FAFH was positively correlated with percent body fat. The frequency of food consumed outside of the Canada’s Food Guide To Healthy Eating was not different between the two groups.

Conclusions: Obese children and adolescents need to limit their access to food consumed away from home and sugar-sweetened drinks as there is a relationship between these foods and body fatness.     

Use of focus groups to understand African-Americans' dietary practices: Implications for modifying a food frequency questionnaire

ObjectiveTo generate information about dietary practices, food preferences and food preparation methods from African-Americans in Macon County, Alabama, as a precursor to an intervention designed to modify an existing dietary health questionnaire (DHQ).MethodAfrican-American males (30) and females (31) ages 20 to 75 years participated in eight focus groups in Macon County Alabama between June and July, 2007.ResultsThe core topics identified were dietary practices; food preferences; food preparation methods; fast food practices; and seasonal/specialty foods. The younger focus group participants reported consuming mostly fast foods such as hamburgers for lunch. Fruits, vegetables, salads, fish, chicken and sandwiches were the most common lunch foods for the older males and females. Across the groups, rice, cornbread and potatoes were reportedly the most commonly consumed starchy foods at dinner. Frying and baking were the most common cooking methods. Fewer participants reported removing the skin when cooking chicken versus those who did not remove. Traditional foods including fried green tomatoes and cracklings were selected for addition to the modified DHQ, while those not commonly consumed, were deleted.ConclusionsParticipants described high-fat traditional food preferences, common frying and addition of salted meats to vegetables, which informed the modification of a DHQ.     

Adolescents living in boarding houses in Nsukka,Enugu State,Nigeria I: Meal patterns,nutrition knowledge and nutrient intake

The meal patterns, nutrition knowledge and nutrient intake of 287 secondary school adolescents aged 13–18 years, living in boarding houses were determined. The meal patterns and nutrition knowledge were determined by questionnaire. The dietary intake study was conducted on 50 adolescents over a 7‐day period and nurient intake calculated from the nutrient composition of foods consumed. Ninety‐two per cent (92%) of the adolescents depended on both school meals and snacks. About 87% skipped school meals at some time. Meal skipping depended on such factors as availability of money to purchase snacks, availability of food in adolescent's locker, school regulations regarding school meals, the quality of food served and the adolescents attitude towards certain foods. The most popular snacks were “Okpa”, a pudding made from bambara groundnut (Voandaeia subterranea) and soaked “garri” (fermented cassava product) with or without groundnuts. The energy and calcium intake (337–398 mg/d) for both sexes were below FAO/WHO standards. The energy intake of the male adolescents (35–37 kcal/kg) was higher than that of the female adolescents (28–30 kcal/kg). However, anthropometric indices showed that the female adolescents had better nutritional status compared to their male counterparts. Intakes of protein and iron were above FAO/WHO standards but were marginal for phosphorus. The adolescents had a fair nutrition knowledge with a percentage mean score of 56.1 ± 14.5. However, nutrition knowledge was not significantly related to nutrient intake.     

Changes in dietary intake and food sources of saturated and cis and trans unsaturated fatty acids in Costa Rican adolescents: 1996 versus 2006

ObjectiveTo identify how dietary intake and food sources of saturated (SFA) and cis (PUFA) and trans (TFA) unsaturated fatty acids in the diet of Costa Rican adolescents changed from 1996 to 2006—a period with several public health nutrition changes.MethodsCross-sectional comparisons used data from measured food records of 133 adolescents (ages 12–17 y) surveyed in 1996 and a similar group of adolescents surveyed in 2006. Values obtained in 1996 and 2006 were compared with the current World Health Organization guidelines for chronic disease prevention.ResultsAdolescents surveyed in 2006 reported a significantly higher mean daily energy intake from linoleic acid (LA) and alpha-linolenic acid (ALA) (0.9% and 7.8%, respectively) compared with the 1996 cohort, whereas SFA and TFA were significantly lower (9.5% and 1.3%, respectively). Food sources of fat also changed. In 2006, 2% of SFA in the diet came from palm shortening (compared with 34% in 1996); 39% of TFA came from ruminant-derived foods (in 1996, soybean oil was the main contributor of TFA, 34%), and bakery products (mainly pre-packaged cookies) provided 25% of the source of TFA, compared with only 11% in 1996. Dietary fatty intake of Costa Rican adolescents in 2006 is closer to WHO guidelines compared with 1996.ConclusionsAfter public health initiatives that changed fatty acid profile of most foods, intakes of TFA, SFA, and food sources of fatty acids in adolescents’ diets improved. Public health nutrition efforts should continue to strengthen diets that are low in SFA and TFA and higher in ALA content among Costa Rican adolescents.     

Most commonly consumed foods and food perceptions in Native American women

OBJECTIVE: To identify commonly consumed foods and the relationship of health perception on food intakes. METHODS: One hundred seventy-five Native American women completed a 1-d or 4-d food records. Perceptions of health value were obtained by the food sort method. Frequency analyses identified commonly consumed foods. Relations between intakes and perception of health value were evaluated by Spearman's correlations. RESULTS: Coffee and tea, soda (diet and regular), white bread, and table fats were the most commonly consumed foods in both samples. Health value had little impact on consumption. CONCLUSIONS: Understanding the foods consumption and the role of perception on intakes allows for targeted nutrition education programming.     

Nutrition Marketing on Food Labels

ObjectiveThis research sought to determine how often nutrition marketing is used on labels of foods that are high in saturated fat, sodium, and/or sugar.Design and SettingAll items packaged with food labels (N = 56,900) in all 6 grocery stores in Grand Forks, ND were surveyed.Main Outcome Measure(s)Marketing strategy, nutrient label information, if the product was fruit/or milk based, and target age.AnalysisFrequency distributions were computed.ResultsForty-nine percent of all products contained nutrition marketing and of those, 48% had both nutrition marketing and were high in saturated fat, sodium and/or sugar (11%, 17%, and 31% respectively). Seventy-one percent of products marketed to children had nutrition marketing. Of those, 59% were high in saturated fat, sodium and/or sugar content, with more than half being high in sugar. The most commonly used nutrition marketing statements were “good source of calcium”, “reduced/low/fat free”, and “food company's health symbol”.Conclusions and ImplicationsNutrition marketing is commonly used on products high in saturated fat, sodium and/or sugar and is more often used on products marketed toward children than products marketed toward adults. Current food industry symbols may not be helping consumers select foods low in saturated fat, sodium or sugar.     

How Do African-American Caregivers Navigate a Food Desert to Feed Their Children? A Photovoice Narrative

Objectives

To determine how African-American caregivers living in a food desert navigate neighborhood resources to procure foods for their children and to identify actions to improve those resources.

Food Photography as a Tool to Assess Type,Quantity, and Quality of Foods in Parent-Packed Lunches for Preschoolers

ObjectiveExplore using food photography to assess packed lunches in a university-based Early Childhood Center and contextualize these photographs through parent interviews.MethodsAn explanatory sequential design was used. Packed lunches were photographed to assess the type and quantity of foods offered and consumed by Child and Adult Food Care Program components (fruit, vegetable, grain, and protein) and quality of foods offered using the Healthy Meal Index. Parent interviews aimed to understand motivations and behaviors related to packing lunch.ResultsData were collected on 401 lunches. Only 16.2% of lunches met all Child and Adult Food Care Program requirements. Most lunches included fruit (84%) and grains (82%), whereas fewer included vegetables (44%). Portion sizes were large, especially for grains (2.7 ± 1.5 servings). In interviews (n = 24), parents expressed tension between offering healthful items and foods they knew their child would eat, as well as concern about children going hungry.Conclusions and ImplicationsFood photography is a feasible methodology to capture parent-packed lunches for preschoolers and may have utility in nutrition education, particularly related to age-appropriate portion sizes.     

Who's Using MyPlate?

ObjectiveTo understand key characteristics of mothers who were early adopters of MyPlate (the iconic representation of the 2010 Dietary Guidelines for Americans) in order to speed adoption among others.MethodsThrough a national online survey, 497 mothers answered questions about MyPlate, demographics, attitudes, and behaviors. Spearman's rho correlation analysis was conducted between MyPlate familiarity and usage and these attitudinal and behavioral predictor variables.ResultsMyPlate familiarity was highest among those who found it easy to understand (P = .001) and who were also familiar with MyPyramid (P < .001). Vegetable lovers most strongly believed that MyPlate would help them eat better (P = .009). This was not true with fruit lovers (P = .36).Conclusions and ImplicationsEarly MyPlate adopters found it clear and easy to use, perhaps owing to nutrition knowledge and cooking experience. Efforts to expand MyPlate to new user groups should explain its purpose and applications, build on familiarity with MyPyramid, and offer practical guidance for preparing vegetables.     

Factors influencing food choices, dietary intake, and nutrition-related attitudes among African Americans: application of a culturally sensitive model

Objectives. The goals of the project were: (1) to explore how culture and community impact on the nutrition attitudes, food choices, and dietary intake of a select group of African Americans in north central Florida; and (2) to identify segments of the population and community that should be targeted for education programs, desirable components of nutrition education programs, topics of interest, and health promotion channels to reach the target group. Design. Six focus groups were conducted with African American males and females. The data were analyzed using the PEN-3 model, a theoretical model that centralizes culture as the primary reason for health behavior and the primary consideration for health promotion and disease prevention programs. Results. There was a general perception that 'eating healthfully' meant giving up part of their cultural heritage and trying to conform to the dominant culture. Friends and relatives usually are not supportive of dietary changes. Barriers to eating a healthful diet also included no sense of urgency, the social and cultural symbolism of certain foods, the poor taste of 'healthy' foods, the expense of 'healthy' foods, and lack of information. Segments of the population that potentially could be motivated to make dietary changes included women, men with health problems, young adults, the elderly, and those diagnosed with a severe, life-threatening disease. Conclusion. The findings suggest that the PEN-3 model is an appropriate framework for assessing how community and culture impact dietary habits of African Americans. African Americans still need information on basic nutrition topics such as serving sizes and reading food labels. The findings also suggest that programs and materials should be specifically developed for churches, neighborhood grocery stores, and local restaurants.     

Development and Validation of a Beverage and Snack Questionnaire for Use in Evaluation of School Nutrition Policies

School nutrition policies limiting access to sweetened beverages, candy, and salty snacks have the potential to improve the health of children. To effectively evaluate policy success, appropriate and validated dietary assessment instruments are needed. The objective of this study was to develop and validate a beverage and snack questionnaire suitable for use among young adolescents. A new 19-item Beverage and Snack Questionnaire (BSQ) was administered to middle school students on two occasions, 2 weeks apart, to measure test-retest reliability. The questionnaire inquired about frequency of consumption, both at school and away from school, of soft drinks, salty snacks, sweets, milk, and fruits and vegetables. Students also completed 4-day food records. To assess validity, food-record data were compared with BSQ data. Forty-six students of diverse backgrounds from metropolitan Seattle, WA, participated in this study. Participants answered the BSQ during class time and completed the food record at home. Pearson correlation coefficients assessed test-retest reliability and validity. Using frequency per week data, the test-retest reliability coefficients were r=0.85 for fruits and vegetables consumed at school and r=0.74 and r=0.72 for beverages and sweets/snacks, respectively, consumed at school. Correlations ranged from r=0.73 to 0.77 for foods consumed outside of school. Compared with the criterion food record, validity coefficients were very good: r=0.69 to 0.71 for foods consumed at school and r=0.63 to 0.70 for foods consumed away from school. The validity coefficients for the 19 individual food items ranged from r=0.56 to 0.87. This easy-to-administer 19-item questionnaire captures data on sugar-sweetened beverages, salty snacks, sweets, milk, and fruit and vegetables as well as a more lengthy and expensive food record does. The BSQ can be used by nutrition researchers and practitioners to accurately evaluate student consumption of foods that are the focus of school nutrition policies.