Abstract P480: Digesting Detention: Investigating Eating Patterns in Jails

Abstract

Background: Over 12 million people cycle through jails every year in the US. People incarcerated experience significant health inequities compared to the general population, including higher rates of hypertension, diabetes, and cardiovascular disease. Despite widespread acceptance of the association between diet and cardiovascular-related outcomes, research documenting dietary intake and nutritional status of individuals incarcerated in jail is limited. Food intake is notoriously difficult to measure, and current measurement tools are not designed for the jail setting. Objectives and Hypotheses: The objectives of this study were to 1) develop a food intake questionnaire for incarcerated adults; 2) document participants’ perceived accuracy of the instrument and 3) compare calorie, macronutrient, and micronutrient intake of people incarcerated in jail to the Acceptable Macronutrient Distribution Range (AMDR) and the 2020-2025 Dietary Guidelines for Americans (DGA). We hypothesized that participants would consume more sodium, added sugar, and saturated fat while incarcerated compared to the DGA and macronutrient consumption patterns of people incarcerated in jail would not meet the AMDR. Methods: Cycle menus were obtained from the jail administration to design a questionnaire that would allow study participants to accurately document the consumption of foods provided by the jail and purchased through commissary each day. Sixty-five (65) incarcerated adults (24 women and 41 men) were recruited from a northern Arizona county jail to complete the 4-day cross-sectional food intake questionnaire. Participants were asked to fill out the questionnaires in real time. Following the study period, questionnaires were collected, and participants provided feedback on the appropriateness and feasibility of the questionnaire via a group listening session. Daily total and mean calorie, macro- and micronutrient intake were calculated using the ASA24 and compared to the AMDR and the DGA. Results: Of 65 people recruited, 64 completed the questionnaire. Participants reported enjoying reflecting on their diets but indicated that institutional menu modifications during the study period led to confusion as the food items listed did not always match what was served. Average percent saturated fat of total calories (11.7%, 95% CI: 10.9, 12.4) and sodium (3723 mg, 95% CI: 3048, 4399) exceeded DGA recommendations. Macronutrient consumption was within recommended ranges. Conclusions: The results of this study can inform efforts to improve the food intake tracking tool which can be used in future research assessing nutritional status in jails and prisons, as well as other controlled food environments. These results will also provide the first observational evidence of nutritional status in jail settings, informing future institutional policy change and interventions.