Relationships among Food Label Use,Motivation, and Dietary Quality

Nutrition information on packaged foods supplies information that aids consumers in meeting the recommendations put forth in the US Dietary Guidelines for Americans such as reducing intake of solid fats and added sugars. It is important to understand how food label use is related to dietary intake. However, prior work is based only on self-reported use of food labels, making it unclear if subjective assessments are biased toward motivational influences. We assessed food label use using both self-reported and objective measures, the stage of change, and dietary quality in a sample of 392 stratified by income. Self-reported food label use was assessed using a questionnaire. Objective use was assessed using a mock shopping task in which participants viewed food labels and decided which foods to purchase. Eye movements were monitored to assess attention to nutrition information on the food labels. Individuals paid attention to nutrition information when selecting foods to buy. Self-reported and objective measures of label use showed some overlap with each other (r = 0.29, p < 0.001), and both predicted dietary quality (p < 0.001 for both). The stage of change diminished the predictive power of subjective (p < 0.09), but not objective (p < 0.01), food label use. These data show both self-reported and objective measures of food label use are positively associated with dietary quality. However, self-reported measures appear to capture a greater motivational component of food label use than do more objective measures.     

Food Label Use and Food Label Skills among Immigrants from the Former Soviet Union

ObjectiveTo assess food label use and skills and to identify their correlates among immigrants from the former Soviet Union (FSU).Design/Setting/ParticipantsCross-sectional survey of a convenience sample of 200 FSU immigrants residing in New York City.Variables MeasuredFood label use and skills; acculturation; and socioeconomic and psychosocial factors.AnalysisChi-square tests and multivariate logistic regression analysis assessed relationships among the outcomes and socioeconomic and other characteristics.ResultsFifty-five percent reported using food labels always/often; only 32% had good label skills. FSU immigrants particularly had difficulty understanding servings per package and percent daily value. Food label use was significantly associated with factors such as positive attitude toward food labels, and importance of recommendations such as avoiding too much salt and saturated fat. However, these factors were not related to food label skills, which was positively associated with longer residency in the United States (> 7 y).Conclusions and ImplicationsThere is a need for nutrition education among FSU immigrants to increase their food label use and skills to promote healthful food selection. Developers of new food labels should consider ways to present percent daily value and servings per package in a more consumer-friendly manner. Simplifying the presentation of this information could improve food label skills in FSU immigrants, among others.     

Dietary Patterns and Hepatocellular Carcinoma Risk among US Adults

The objective of this study was to assess the association between dietary patterns and risk of hepatocellular carcinoma (HCC) among US adults in a hospital-based case-control study. We analyzed data from 641 cases and 1002 controls recruited at The University of Texas MD Anderson Cancer Center during 2001–2018. Cases were patients with a pathologically or radiologically confirmed new diagnosis of HCC; controls were cancer-free spouses of patients with cancers other than gastrointestinal, lung, liver, or head and neck cancer. Cases and controls were frequency-matched by age and sex. Dietary patterns were identified by principal component analysis. Odds ratios (ORs) and corresponding confidence intervals (CIs) were computed using unconditional logistic regression with adjustment for major HCC risk factors, including hepatitis B virus and hepatitis C virus infection. A vegetable-based dietary pattern was inversely associated with HCC risk (highest compared with lowest tertile: OR 0.66, 95% CI 0.46–0.94). A Western diet pattern was directly associated with HCC risk (highest compared with lowest tertile: OR 1.79, 95% CI 1.19–2.69). These findings emphasize the potential role of dietary intake in HCC prevention and clinical management.     

Dietary Sources of Nutrients among US Adults, 1989 to 1991

Objective To identify major food sources of 27 nutrients and dietary constituents for US adults.Design Single 24-hour dietary recalls were used to assess intakes. From 3,970 individual foods reported, 112 groups were created on the basis of similarities in nutrient content or use. Food mixtures were disaggregated using the US Department of Agriculture (USDA) food grouping system.Subjects/setting A nationally representative sample of adults aged 19 years or older (n=10,638) from USDA's 1989-91 Continuing Survey of Food Intakes by Individuals.Analyses performed For each of 27 dietary components, the contribution of each food group to intake was obtained by summing the amount provided by the food group for all respondents and dividing by total intake from all food groups for all respondents.Results This article updates previous work and is, to the authors’ knowledge, the first to provide such data for carotenes, vitamin B-12, magnesium, and copper. Beef, yeast bread, poultry, cheese, and milk were among the top 10 sources of energy, fat, and protein. The following other major sources also contributed more than 2% to energy intakes: carbohydrate: yeast bread, soft drinks/soda, cakes/cookies/quick breads/doughnuts, sugars/syrups/jams, potatoes (white), ready-to-eat cereal, and pasta; protein: pasta; and fat: margarine, salad dressings/mayonnaise, and cakes/cookies/quick breads/doughnuts. Ready-to-eat cereals, primarily because of fortification, were among the top 10 food sources for 18 of 27 nutrients.Applications/conclusions These analyses are the most current regarding food sources of nutrients and, because of disaggregation of mixtures, provide a truer picture of contributions of each food group. J Am Diet Assoc. 1998; 98:537-547.     

Factors Influencing Dietary Intake Frequencies and Nutritional Risk among Community-Residing Older Adults

Abstract

Older adult (OA) dietary practices may be placing them at nutritional risk. This cross-sectional study examined the dietary intake frequencies (DIF) and nutritional risk (NR) using the Dietary Screening Tool (DST) of OA attending community-based nutrition education and physical activity programs. Most were white females aged 60–80 years. The majority (80.1%) were classified as “at NR” or “at possible NR.” Participants had “low” lean protein, dairy, and processed meat DIF and “moderate” whole fruit and juice, total and whole grains, vegetables and added fats, sugars, and sweets DIF. State influenced whole fruit and juice (p?≤?.001) and vegetable (p?=?.021) DIF, age influenced processed meat DIF (p?=?.001), and gender influenced NR (p?=?.006), vegetable (p?=?.022), and processed meat (p?=?.033) DIF. Results indicate that OA participating in lifestyle interventions are at NR. When developing future nutrition education programs, educators should consider sociodemographic factors to promote dairy and protein-rich foods to OA at NR.     

Association between Ultra-processed Food Consumption and Dietary Intake and Diet Quality in Korean Adults

BackgroundFood environments have changed rapidly, and the global interest in ultra-processed foods has increased. Ultra-processed foods are typically energy dense, high in sugars and fat, and low in fiber, protein, minerals, and vitamins.ObjectiveThis study aimed to estimate the energy contribution of ultra-processed foods in the diet of Korean adults and to examine the association between ultra-processed food consumption and dietary intake and diet quality.DesignThis study is a secondary analysis of cross-sectional data from the Korea National Health and Nutrition Examination Survey (2016–2018).Participants/settingsA total of 16,657 adults aged ≥19 years who completed a 1-day 24-hour recall.Main outcome measuresAbsolute and relative intake of energy and nutrients were measured and dietary quality was assessed using the Korean Healthy Eating Index (KHEI).Statistical analysisMultiple regression models adjusted for sociodemographic variables were used to examine the association between quintiles of ultra-processed foods dietary energy contribution and dietary intake and quality.ResultsMean reported daily energy intake was 2,031 kcal, with 25.1% of calories coming from ultra-processed foods. Mean energy contribution from ultra-processed foods ranged from 3.6% kcal (Q1) to 52.4% kcal (Q5). Energy contribution of ultra-processed foods was positively associated with reported intake of daily energy, total sugars, and total and saturated fat and inversely associated with reported intake of carbohydrates, fiber, minerals, and vitamins. Both sodium and potassium were negatively associated with percentage of energy from ultra-processed foods. However, the sodium-to-potassium ratio was high regardless of quintile of energy contribution from ultra-processed foods, and the ratio was positively associated with percentage of total energy from ultra-processed foods. Although the KHEI score was inversely associated with percentage of daily energy from ultra-processed foods, all levels of ultra-processed food consumption were associated with poor diet quality.ConclusionsThe ultra-processed foods consumption of Korean adults accounted for one fourth of daily energy intake, and a higher dietary energy contribution from ultra-processed foods was associated with poorer dietary intakes and a lower dietary quality. Further studies are needed to understand factors influencing selection and consumption of ultra-processed foods and to identify effective strategies to promote healthy food choices.     

Dietary Polyphenol Intake in US Adults and 10-Year Trends: 2007-2016

BackgroundPolyphenols are a class of phytochemicals that have antioxidant, anti-inflammatory, anticancer, and antiviral properties. Previous research suggests that dietary polyphenol intake is protective against major chronic diseases. To our knowledge, no data on polyphenol intake for the US adult population are available.ObjectiveThis study explored usual dietary polyphenol intake among US adults in 2013-2016 and examined trends in intake during 2007-2016 by demographic characteristics, and identified major dietary sources of polyphenols.DesignThe National Health and Nutrition Examination Survey is a series of cross-sectional surveys representative of the civilian noninstitutionalized US population.Participants/settingThis study included 9,773 adults aged 20 years and older.Main outcome measuresDietary and supplement data were obtained from two 24-hour dietary recalls. Polyphenol intake was estimated using the Phenol Explorer Database and adjusted for total energy intake.Statistical analysis performedUsual intake was estimated both overall and by demographic characteristics using the National Cancer Institute method. Trends in intake on a given day over 10 years were evaluated using regression analysis. The complex survey design was incorporated in all analyses.ResultsIn 2013-2016, the usual intake of dietary polyphenols was a mean (standard error) of 884.1 (20.4) mg per 1,000 kcal/d. Polyphenol intake was higher in adults 40 years and older, women, non-Hispanic White adults, and college graduates. During 2007-2016, the mean daily polyphenol intake did not change significantly over time for overall and demographic groups. Main polyphenol classes consumed were phenolic acids (mean [standard error] of 1,005.6 [34.3] mg/d) and flavonoids (mean [standard error] of 379.1 [10.7] mg/d). Foods and beverages contributed 99.8% of polyphenol intake, with coffee (39.6%), beans (9.8%), and tea (7.6%) as major dietary contributors.ConclusionFindings from this study suggest that polyphenol intake is consistent with the low intake of fruits, vegetables, and whole grains in the US population, and provide more evidence of the need for increased consumption of these food groups.     

Major Dietary Patterns in Relation to General and Central Obesity among Chinese Adults

Limited evidence exists for the association between diet pattern and obesity phenotypes among Chinese adults. In the present study, we analyzed the cross-sectional data from 474,192 adults aged 30–79 years from the China Kadoorie Biobank baseline survey. Food consumption was collected by an interviewer-administered questionnaire. Three dietary patterns were extracted by factor analysis combined with cluster analysis. After being adjusted for potential confounders, individuals following a traditional southern dietary pattern had the lowest body mass index (BMI) and waist circumference (WC); the Western/new affluence dietary pattern had the highest BMI; and the traditional northern dietary pattern had the highest WC. Compared to the traditional southern dietary pattern in multivariable adjusted logistic models, individuals following a Western/new affluence dietary pattern had a significantly increased risk of general obesity (prevalence ratio (PR): 1.06, 95% confidence interval (CI): 1.03–1.08) and central obesity (PR: 1.07, 95% CI: 1.06–1.08). The corresponding risks for the traditional northern dietary pattern were 1.05 (1.02–1.09) and 1.17 (1.25–1.18), respectively. In addition, the associations were modified by lifestyle behaviors, and the combined effects with alcohol drinking, tobacco smoking, and physical activity were analyzed. Further prospective studies are needed to elucidate the diet-obesity relationships.     

Food Insecurity: Its Relationship to Dietary Intake and Body Weight among Somali Refugee Women in the United States

ObjectiveTo examine the association between food insecurity, dietary intake, and body mass index among Somali refugee women living in the United States.MethodsCross-sectional study utilizing the snowball sampling method.ResultsMost (67%) participants experienced some level of food insecurity, which was common among recent arrivals and those who spoke only Somali at home (P < .05). Intake of meat and eggs was higher, whereas intake of fruits and vegetables was lower, among food insecure than secure participants. Food insecurity was positively related to overweight and obesity (odds ratio: 2.66; confidence interval: 1.25-5.69; P < .01).Conclusions and ImplicationsSomali refugees experienced high levels of food insecurity upon resettlement. Poor dietary habits and the high overweight/obesity rate among insecure families call for future research in understanding what role family structure, cultural norms, and food preference play in predicting food security and dietary habits among Somali and overall African refugees in the United States.     

The Relationship between Health-Related Knowledge and Sugar-Sweetened Beverage Intake among US Adults

Because there is limited information on associations between health-related knowledge and sugar-sweetened beverage (SSB) intake, our cross-sectional study examined this question using the 2010 HealthStyles Survey data for 3,926 adults (aged ≥18 years). Multivariable logistic regression analysis was used to estimate the adjusted odds ratios and 95% CIs for drinking SSBs ≥2 times per day. About 31% of adults consumed SSBs ≥1 time per day, with 20% doing so ≥2 times per day. About eight of 10 adults agreed that drinking SSBs can contribute to weight gain, yet, eight of 10 adults in this study did not know the actual kilocalorie content of a 24-oz fountain soda. After controlling for age, sex, race/ethnicity, education level, annual household income, and geographic region, the odds for drinking SSBs ≥2 times per day were significantly higher among adults who neither agreed nor disagreed (ie, were neutral) that drinking SSBs can contribute to weight gain (odds ratio 1.61, 95% CI 1.15 to 2.25 vs agree); however, knowledge about the energy content of regular soda was not associated with SSB intake. Our finding that knowledge about the adverse effects of SSB intake is significantly associated with SSB intake among adults suggests that health education regarding the potential contribution of excess energy intake from SSBs to weight gain could contribute to lowered consumption and lower rates of obesity. Although knowledge about the kilocalorie content of regular soda was unrelated to SSB intake, health education on the kilocalorie content of SSBs may still be beneficial because most adults did not know the actual kilocalorie content of SSBs. Longitudinal studies are needed to explore associations between knowledge about energy provided by SSBs and SSB intake.     

Taxonomic Composition and Diversity of the Gut Microbiota in Relation to Habitual Dietary Intake in Korean Adults

We investigated associations of habitual dietary intake with the taxonomic composition and diversity of the human gut microbiota in 222 Koreans aged 18–58 years in a cross-sectional study. Gut microbiota data were obtained by 16S rRNA gene sequencing on DNA extracted from fecal samples. The habitual diet for the previous year was assessed by a food frequency questionnaire. After multivariable adjustment, intake of several food groups including vegetables, fermented legumes, legumes, dairy products, processed meat, and non-alcoholic beverages were associated with major phyla of the gut microbiota. A dietary pattern related to higher α-diversity (HiαDP) derived by reduced rank regression was characterized by higher intakes of fermented legumes, vegetables, seaweeds, and nuts/seeds and lower intakes of non-alcoholic beverages. The HiαDP was positively associated with several genera of Firmicutes such as Lactobacillus, Ruminococcus, and Eubacterium (all p < 0.05). Among enterotypes identified by principal coordinate analysis based on the β-diversity, the Ruminococcus enterotype had higher HiαDP scores and was strongly positively associated with intakes of vegetables, seaweeds, and nuts/seeds, compared to the two other enterotypes. We conclude that a plant- and fermented food-based diet was positively associated with some genera of Firmicutes (e.g., Lactobacillus, Ruminococcus, and Eubacterium) reflecting better gut microbial health.     

Reported Action to Decrease Sodium Intake Is Associated with Dining Out Frequency and Use of Menu Nutrition Information among US Adults

Background

Restaurant foods have been shown to be high in sodium and limited sodium content information provided through menu nutrition information (MNI) is available at the point of purchase. Dining out and use of MNI are behaviors that can be altered by consumers who are trying to decrease their sodium intake.

Quantitative Use of the Food Guide Pyramid to Evaluate Dietary Intake of College Students

Objectives To evaluate the usefulness of the Food Guide Pyramid as a quantitative tool for assessing nutritional adequacy and quality.Design One-day food records (n=2,489) were assigned food group scores (1 through 5) by two systems. System 1 recorded the number of food groups on a given record that included the minimum number of servings suggested by the Food Guide Pyramid. System 2 recorded the number of food groups in the Food Guide Pyramid for which at least one serving was included. The food records were further evaluated by mean adequacy ratio (MAR) for iron, calcium, magnesium, vitamin A, and vitamin B-6 (MAR-5 score) and percentage of energy contributed by fat and sugar. Sensitivity and specificity of the food group scores to predict nutritional inadequacy were determined.Subjects College students (n = 2,489) attending introductory nutrition, foods, and health-related courses at a mid-western university.Statistical analyses Student's t test, χ² test, Dunnett's multiple mean comparison test.Results A food group score of 5 was given to 11% and 35% of the diet records by systems 1 and 2, respectively; MAR-5 scores of 75 or greater were given to 70% of the records. Only 4% of the diets contained both 30% or less and 10% or less of energy from fat and sugar, respectively. Both scoring systems can be used as a quantitative tool for screening nutritional inadequacy with high sensitivity (correctly classifying nutritionally inadequate diets) but with a moderate to low specificity (correctly classifying nutritionally adequate diets). J Am Diet Assoc. 1996; 96:453-457.     

US Acculturation, Food Intake, and Obesity among Asian-Pacific Hotel Workers

Background

Both obesity and immigration continue to increase in the United States. Studies suggest that a transition in lifestyle patterns, such as food intake, may mediate the relationship between immigration and obesity.

Objective

We examine obesity among hotel workers in relation to age, sex, race/ethnicity, and indicators of food intake, immigration, and acculturation.

Subjects/setting

Four thousand five hundred thirty hotel workers in 30 hotels were studied from the first year of the Work, Weight and Wellness program, before intervention (during 2005-2006).

Main outcome measures

Weight and height were measured, whereas race/ethnicity, language, education, immigration, acculturation, and food intake variables were assessed by questionnaire.

Results

The study included 43% male and 57% female hotel workers (mean age 44.4±11.3 years; 42% Filipino, 32% other Asian, 13% Pacific Islander, 9% white, 1% black/African American, and 3% other race/ethnicity). On average (mean value), 55% of participants were born outside the United States; 57% were overweight or obese (body mass index [BMI] >25). The BMI of those born in the United States was 1.3 higher than that of those born in another country, adjusting for sex and race/ethnicity. Intake of sweet drinks and meat was positively associated with BMI while intake of fruit was negatively associated with BMI. Age at arrival in United States (“generation”) was negatively associated with BMI, whereas greater acculturation was positively associated with BMI.

Conclusions

Food intake behaviors are probably related to place of birth, generation of migration to the United States, and acculturation. Direct measures of food intake added explanatory power to models, suggesting the importance of food intake to obesity. Further study of the influence of immigration, acculturation, and food intake on obesity using longitudinal study designs is warranted.     

无锡市成年居民膳食碘摄入量评估

目的评估无锡市成年居民膳食碘摄入量状况。方法利用该市2005和2010年居民膳食调查资料,中国食物成分表及盐碘和水碘监测数据,计算成年居民膳食碘摄入量,并与我国推荐的膳食碘摄入量标准进行比较。结果无锡市成年居民膳食碘平均摄入量为353.6μg/d,为推荐摄入量(RNI)和可耐受最高摄入量(UL)的235.7%和35.4%。其中食盐碘摄入量270.2μg/d,其贡献率为76.4%。总人群中膳食碘摄入量在RNI～UL之间的个体占97.4%,≥UL的个体仅占0.5%。剔除碘盐,膳食碘主要来源于食物和水,总人群膳食碘摄入量中位数为45.4μg/d,仅为RNI的30.3%。结论无锡市居民膳食碘摄入水平总体是适宜和安全的。     

Dietary Sodium Intake and Its Relation to Human Health: A Summary of the Evidence

Objectives: Relating food diversity, quality, and intake is one of the key aspects in understanding household food security. This paper aimed at marying food intake and quality, both being measurement for food security.

Methods: A household food consumption survey (n = 200) exploring food diversity, quality of foods, and their relation to food intake in Embo, a poor farming community in rural KwaZulu-Natal was carried out in November 2004 (period of insufficiency) and repeated in March 2005 (period of plenty). Household food intake strata were developed using matrices obtained from the Household Food Intake Index and nutritional adequacy ratios. Food quality was measured using food count and later using 5 food groups, namely, starches, vegetables and fruits,animal sourced foods, fats, and legumes.

Results: Single food count showed dietary diversity to be significantly different across households with different food intake during the period of plenty (P ≤ 0.000). During the period of plenty, vegetable and fruits contributed significantly different proportions of energy (P ≤ 0.000), protein (P ≤ 0.006), iron (P ≤ 0.020), and vitamin E (P ≤ 0.006) to household food intake strata. Intake of vitamin A was more elastic as its intake variation from legumes, fats, and animal sourced foods was (P ≤ 0.000), from starches (P ≤ 0.008) and from vegetable and fruits (P ≤ 0.064) during the second round. Starches are the most important food group to the community, whereas fats and animal sourced food groups are less important.

Conclusions: The current study has been able to include food quality in food security studies. Seasonality accounts for variation in food quality. The South African food-based dietary guidelines are relevant to the Embo community.     

Estimated Dietary Polyphenol Intake and Major Food and Beverage Sources among Elderly Japanese

Estimating polyphenol intake contributes to the understanding of polyphenols’ health benefits. However, information about human polyphenol intake is scarce, especially in the elderly. This study aimed to estimate the dietary intake and major sources of polyphenols and to determine whether there is any relationship between polyphenol intake and micronutrient intake in healthy elderly Japanese. First, 610 subjects (569 men, 41 women; aged 67.3 ± 6.1 years) completed food frequency questionnaires. We then calculated their total polyphenol intake using our polyphenol content database. Their average total polyphenol intake was 1492 ± 665 mg/day, the greatest part of which was provided by beverages (79.1%). The daily polyphenol intake differed largely among individuals (183–4854 mg/day), also attributable mostly to beverage consumption. Coffee (43.2%) and green tea (26.6%) were the major sources of total polyphenol; the top 20 food items accounted for >90%. The polyphenol intake did not strongly correlate with the intake of any micronutrient, suggesting that polyphenols may exert health benefits independently of nutritional intake. The polyphenol intake in this elderly population was slightly higher than previous data in Japanese adults, and beverages such as coffee and green tea contributed highly to the intake.     

Racial/Ethnic Differences in Dietary Intake among WIC Families Prior to Food Package Revisions

ObjectiveTo compare the diets of African American and Hispanic families in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) prior to the 2009 food package revisions.MethodsMother-child dyads were recruited from 12 WIC sites in Chicago, IL. Individuals with 1 valid 24-hour recall were included in the analyses (n = 331 children, n = 352 mothers).ResultsCompared to their African American counterparts, diets of Hispanic mothers and children were lower (P < .001) in percentage of calories from fat, added sugars, sodium, and sweetened beverages, but higher (P < .001) in vitamin A, calcium, whole grains, fruit, and total dairy. However, no groups met national recommendations for percentage of calories from saturated fat, fiber, sodium, whole grains, vegetables, and total dairy.Conclusions and ImplicationsThere are racial/ethnic differences in dietary intake, and future research is needed to determine whether diets improve as a result of package revisions and whether uptake of these changes varies by race/ethnicity.