Diet And Health Knowledge Survey Research Articles

Trends and correlates in meat consumption patterns in the US adult population

Few studies have examined recent shifts in meat consumption (MC), differences among US population groups, and the influence of psychosocial-behavioural factors. Nationally representative data collected for US adults aged >or=18 years in the 1988-1994 and 1999-2004 National Health and Nutrition Examination Survey (NHANES) and the 1994-1996 Continuing Survey of Food Intakes by Individuals (CSFII) and Diet and Health Knowledge Survey (DHKS) were used. We found a U-shaped trend in MC, a decrease between 1988-1994 and 1994-1996, and an increase from 1994-1996 to 1999-2004. NHANES 1988-1994 and 1999-2004 indicate that MC did not change significantly, particularly for all meat, red meat, poultry and seafood. Between 1994-1996 and 1999-2004, average MC, including red meat, poultry, seafood and other meat products, increased in men. Women's total MC decreased, mainly due to decreased red meat and other meat products, except for increased seafood. Noticeable differences existed in the changes across population groups. Black men had the largest increase in consumption of total meat, poultry and seafood; Mexican American men had the smallest increase in poultry, seafood and other meat products. In 1999-2004, ethnic differences in MC became greater in women than among women in 1994-1996. Associations between MC and energy intake changed over time. Perceived benefit of dietary quality and food label use were associated with reduced red MC. Noticeable differences exist in the shifts in MC across population groups and surveys. MC increased in men but decreased in women in recent years.

4212 Taste and smell dysfunction in peadiatric oncology patients receiving chemotheraphy

To test the reliability and validity of scales on nutrition knowledge, social-psychological factors, and use of food labels developed from the 1995 Diet and Health Knowledge Survey (DHKS) questions.The 1995 DHKS questions within a section were pooled together as a scale and their reliability and validity were examined.US adults (≥ 20 years) in the 1995 DHKS who responded to questions selected for this study (n = 1196).Nutrition knowledge about the diet-disease relationship and nutrient content of products, perceived barriers and benefits of food labels, perceived ease of understanding food labels, food label use, and importance of healthful eating.Scales validity, Cronbach α, item total correlation, α if the item was deleted, and discriminant, convergence, and correspondence validity.Scales on perceived ease of understanding the food label, benefits of using food labels, food label use, and importance of healthful eating were reliable (Cronbach α = .78, .82, .91, and .82, respectively) and valid.Accurate findings and interpretation of survey data depend on the use of reliable and valid instruments. This study identified the scales in the DHKS that can substantiate the conclusion on which effective nutrition education strategies should be established.

Influence of a Pilot Nutrition Education Program on Dietary Knowledge among Undergraduate College Students

Objective and Participants: The objective of this study was to determine if a nutrition education program, Everyday Healthy Eating on Campus (EHEC), resulted in positive healthy eating perceptions and behaviors among 103 undergraduates. Methods: Students from eight dormitories (n = 42) and five classrooms (n = 61) completed a shortened Diet and Health Knowledge Survey (DHKS) prior to and one month after EHEC. Another 153 students from eight dormitories (n = 56) and five classrooms (n = 62) were the comparison group. Results: Students that completed EHEC increased their perceived value of eating a diet moderate in salt and sugar, low in saturated fat, adequate in fiber, eating a variety of foods, and consuming a diet with adequate carbohydrate containing foods (p < 0.05). No significant differences were found in comparison group surveys (p > 0.05). Conclusions: A simple one session college nutrition education program focusing on specific campus dining strategies appears to positively affect undergraduate students’ perceived value of healthy eating.

The mitigating influence of time preference on the relation between smoking and BMI scores

Prior studies have found a strong negative relation between smoking and body mass index (BMI). Smoking and unhealthy eating both imply a preference for utility in the present at the expense of future consumption. This analysis seeks to proxy this preference through a composite index of equally weighted intertemporal behaviors to isolate the impact of smoking upon BMI independent of time discounting. Ordinary least squares regression is used to analyze BMI score based on a number of key independent variables. A total of 2970 individuals who provided data for the United States Department of Agriculture's (USDA) Continuing Survey of Food Intakes by Individuals (CSFII) 1994-1996, as well as the Diet and Health Knowledge Survey (DHKS). Adding time preference to a multivariate model inflates the magnitude of the smoking effect, consistent with discounted utility theory. Results suggest that full effect of the non-intertemporal aspects of smoking (e.g., the substitution of cigarettes for food) on BMI scores may be underestimated in previous studies that fail to account for the mitigating influence of time preference.

How do socio-economic status, perceived economic barriers and nutritional benefits affect quality of dietary intake among US adults?

Socio-economic factors may affect diet quality, perhaps differentially across gender and ethnicity. The mechanism of this association is still largely unknown. We examined the independent effects of socio-economic status (SES), perceived barrier of food price (PBFP) and perceived benefit of diet quality (PBDQ) on diet quality indicators and indices (DQI(j,k)), across gender and ethnicity. Additionally, we estimated the mediation proportion of the effect of SES on DQI(j,k) through PBFP and PBDQ. Data from two cross-sectional surveys, the Continuing Survey of Food Intakes by Individuals (CSFII) and Diet and Health Knowledge Survey (DHKS) 1994-96 were used. Our sample consisted of 4356 US adults aged 20-65 years. With principal components analysis, SES (an index) was measured using household income per capita and education, and PBDQ was measured using an 11-item scale. PBFP was defined as the ratio of importance of food price score relative to nutrition. DQI(j,k) were assessed by a set of indicators and two indices including the Healthy Eating Index. The associations between SES, PBFP, PBDQ and DQI(j,k) varied significantly across gender and ethnic groups. PBFP acted as a mediator in the association between SES and selected DQI(j) indicators, namely energy, fat intake, sodium and simple sugar consumption (mediation proportion >10%), but not PBDQ. SES, PBFP and PBDQ all affect dietary intake, and vary by ethnicity and gender. Positive effect of SES on DQI(j,k) may be mediated by PBFP but not PBDQ which is an independent protective factor. Nutrition education is important to promote healthy eating.

How do socio‐economic status (SES), perceived economic barriers and nutritional benefits affect quality of dietary intake among US adults?

We examined independent effects of SES, perceived barriers of food price (PBFP) and benefits of diet quality (PBDQ) on diet quality indicators and indices (DQI), across gender and ethnicity using nationally representative data from the Continuing Survey of Food Intakes by Individuals (CSFII) and Diet and Health Knowledge Survey (DHKS) 1994–96 for 4,356 individuals aged 20–65 y. Diet was assessed using two 24-hour recalls. By principal components method, SES was constructed with household income per capita and education; and PBDQ, using an 11-item scale. PBFP is the ratio of importance of food price score relative to nutrition. Several DQI indicators and indices were considered. PBDQ z-score improved diet quality (β= −31 for energy, −0.34 for fat (% of energy), and 0.37 for fiber p<0.05). SES z-score among Whites, unlike African-Americans, reduced fat intake by β= −0.71 (p<0.05) and saturated fat by β= −0.43 (p<0.05) with a significant SES×ethnicity interaction. SES positively associated with fiber intake and was significantly stronger among women (β=0.95 vs. 0.72, p<0.05). Structural equation models revealed significant mediation of SES effects on diet quality through PBFP but not through PBDQ (mediation proportion>10%) for energy, total fat, sodium and sugar intakes. In conclusion, the effect of SES on diet quality varied by ethnicity and gender, and there was mediation of the effect of SES on diet quality by PBFP.

Research Methods in Foodservice Industry

This paper discusses and presents a binary logit model used to identify factors affecting the decision to dine out. The purpose of this paper is to convey an understanding of the logit model and to facilitate use of the model for research related to the foodservice industry. Data used in the binary logit application come from the 1994-1996 Continuing Survey of Food Intakes by Individuals (CSFII) and the Diet and Health Knowledge Survey (DHKS). The results of the empirical study shows that income had a positive effect on the probability of dining out, and those who were employed full time, part time, or temporarily unemployedwere more likely to dine out than unemployed respondents. Household size and age of the respondents had a negative effect on the probability of dining out. Education and gender did not affect the probability of dining out, while race of the household manager had a significant effect on the probability. White household managers were more likely to dine out than non-white household managers. The effects of urbanization and region were not significant.

Food Label Use by Older Americans

This study examined older Americans' use of food labels as a tool to moderate dietary risk factors for heart disease. Data from the USDA's Continuing Survey of Food Intakes by Individual (CSFII) 1994-96 and the Diet and Health Knowledge Survey (DHKS) from 2,846 respondents aged 51 years and older was used. Indices were constructed to measure and correlate dietary intake, label use and understanding, and health status data. Understanding and use of food labels was lower among older age groups, while heart-related health problems increased. Use of food labels and percent energy intake from fat were inversely related (P< 0.01). Older Americans would benefit from education on food label use and interpretation to decrease their dietary risk factors for heart disease.

Factors associated with women's and children's body mass indices by income status

To describe associations between eating behaviors, dietary intake, physical activity, attitudes toward diet and health, sociodemographic variables and body mass index (BMI) among women and children, and differences by household income. Data from the 1994-1996 Continuing Survey of Food Intakes by Individuals (CSFII) and the Diet and Health Knowledge Survey (DHKS) were examined using multivariate regression to estimate the associations between BMI and behavioral and environmental variables among women and children. CSFII 1994-1996 is representative of the US population. DHKS surveyed CSFII respondents 20 y of age and over. Our samples consisted of 2419 adult women and 1651 school-age children. CSFII respondents reported 24 h recalls of all food intakes on 2 nonconsecutive days and their personal and household characteristics, including self-reported height and weight. DHKS collected data on knowledge and attitudes toward dietary guidance and health from CSFII adult respondents. Significant correlations between women's BMI and age, race, dietary patterns, TV watching, and smoking was observed among women from both low- and high-income households. Beverage consumption, eating out, the importance of maintaining healthy weight, and exercise were correlated with BMI only among women from high-income households. Among children, age, race, income, and mother's BMI were significantly correlated with child BMI. Among women, the associations between some behavioral and environmental factors and BMI differ by household income. Intervention programs need to target specific eating and physical activity behaviors to promote a healthy body weight.

Reliability and Validity of Nutrition Knowledge, Social-Psychological Factors, and Food Label Use Scales from the 1995 Diet and Health Knowledge Survey

Objective To test the reliability and validity of scales on nutrition knowledge, social-psychological factors, and use of food labels developed from the 1995 Diet and Health Knowledge Survey (DHKS) questions. Design The 1995 DHKS questions within a section were pooled together as a scale and their reliability and validity were examined. Participants US adults (≥ 20 years) in the 1995 DHKS who responded to questions selected for this study (n = 1196). Variables Nutrition knowledge about the diet-disease relationship and nutrient content of products, perceived barriers and benefits of food labels, perceived ease of understanding food labels, food label use, and importance of healthful eating. Analysis Scales validity, Cronbach α, item total correlation, α if the item was deleted, and discriminant, convergence, and correspondence validity. Results Scales on perceived ease of understanding the food label, benefits of using food labels, food label use, and importance of healthful eating were reliable (Cronbach α = .78, .82, .91, and .82, respectively) and valid. Conclusion and Implications Accurate findings and interpretation of survey data depend on the use of reliable and valid instruments. This study identified the scales in the DHKS that can substantiate the conclusion on which effective nutrition education strategies should be established.

Consumers' Restaurant Choice Behavior and the Impact of Socio-Economic and Demographic Factors

ABSTRACT This study investigates economic and socio-demographic factors influencing food facility choice for an evening meal. Multinomial logistic regression analysis was conducted using data from the 1994-1996 Continuing Survey of Food Intakes by Individuals (CSFII) and the Diet and Health Knowledge Survey (DHKS). Results indicate that income, age, household size, household composition (presence of a young child), urbanization, day of the week, and season of the year affect the choice of a particular foodservice facility for an evening meal. The demand for evening meals at full-service restaurants is likely to increase due to the aging of “baby boomers,” increasing household income, and decreasing household size. Quick-service restaurants, as they strive to maintain and grow market share, might consider focusing on the needs of households with young children.

The influence of individual choices and attitudes on adiposity.

To determine which dietary and lifestyle choices and which attitudes toward diet and health most contribute to adiposity and whether those factors differ by gender. Multiple regression was used to estimate the effect of energy intake, energy expenditure, resources, demographics, and attitudes toward diet and health on self-reported body mass index (BMI) in a nationally representative sample of the US population. This study used secondary data from the 1994-1996 Continuing Survey of Food Intakes by Individuals (CSFII) and its telephone follow-up, the Diet and Health Knowledge Survey (DHKS). CSFII is a nationally representative survey of individuals which obtained 24 h recalls of all food intake on two nonconsecutive days. The DHKS data set obtained information on knowledge and attitudes toward dietary guidance and health from individuals 20 y of age and over, who participated in the CSFII. Our sample consisted of responses from 5512 individuals. We found that many of the variables previously found to or hypothesized to influence body weight do so. Our analysis shows that choices and attitudes do matter for adiposity. Moreover, the analysis shows that the choices males and females make often have quite different effects on BMI. For females all the variables we constructed to represent energy intake, energy expenditure, and financial and human resources are significant. Most of the variables that characterize attitudes toward diet and health are significant. For males, far fewer variables are significant. Our tests for gender-related differences show that whether or not males believe their weight is predetermined has no influence on BMI. In contrast, women who do not believe that their weight is predetermined have lower BMI values than those who believe weight is genetically determined. While our qualitative conclusion--choices and attitudes affect BMI--is unsurprising, the quantitative aspects are important. The analysis shows that factors affecting BMI differ systematically by gender. Understanding these systematic differences is critical to the design of information campaigns. Our analysis suggests that entirely different campaigns are necessary to communicate the importance of diet and lifestyle choices to men and to women.

Food Label Use Modifies Association of Income with Dietary Quality

We analyzed the 1994-1996 Continuing Survey of Food Intake by Individuals and the Diet and Health Knowledge Survey (DHKS) to examine whether the relationship between income and dietary quality is modified by food label (FL) use among 20- to 60-y old DHKS respondents who were either household meal preparers, meal planners or food shoppers (n = 2952). Multivariate logistic regression results indicated that the influence of income on dietary quality is mediated by FL use. Those who were wealthier and used FL were significantly less likely to have a lower Healthy Eating Index (HEI) compared with the reference group formed by those in the lower income category who did not use FL [OR = 0.42; 95% confidence interval (CI): 0.31, 0.56]. By contrast, those who were wealthier but did not use FL were as likely as the reference group to have a low HEI (OR = 1.08; 95% CI: 0.74, 1.54). Those who were poorer but used FL were significantly less likely to have a low HEI compared with the reference group (OR = 0.62; 95% CI: 0.48, 0.80). Thus, FL use is associated with improved dietary quality among all income groups with a greater benefit of use among higher income individuals. Income is not associated with improved dietary quality in the absence of FL use.

Dietary Behaviors Associated With Total Fat and Saturated Fat Intake

Objective To estimate percentages of US adults who have adopted behaviors promoted by dietary guidance about how to reduce fat intake, and to assess relationships between these behaviors and intake of energy from total and saturated fat. Design Relationships were examined between intake of total and saturated fat from two 24-hour recalls in the US Department of Agriculture's 1994–1996 Continuing Survey of Food Intakes by Individuals and responses to 19 fat-related behavior questions on the follow-up Diet and Health Knowledge Survey (DHKS). Subjects Data are from a national sample of 5,649 individuals 20 years of age and older. Statistical analyses performed Multiple regression models are used to identify dietary behaviors, demographic factors, and personal characteristics that are determinants of fat intake. Results In this study, the percentage of US adults who consistently followed the low-fat behaviors ranged from 8% to 70%. The most highly adopted behaviors (45% or more of adults) included trimming fat from meat, removing skin from chicken, and eating chips infrequently. The least highly adopted behaviors (15% or less of adults) included eating baked or boiled potatoes without added fat, avoiding butter or margarine on breads, eating low-fat instead of regular cheeses, and having fruit for dessert when dessert is eaten. Together, the 19 fat-related behavior questions on the DHKS formed a statistically significant predictor for total fat and saturated fat intake, expressed as a percent of energy ( P<.0001). Key behaviors in terms of their predicted effect on lowering both total and saturated fat intake were never adding fat to baked or boiled potatoes, not eating red meats, eating less than 3 eggs per week, and never eating chicken fried. Predicted effects of these key behaviors in terms of lowering fat intake as a percentage of energy were ⩾1.5 percentage points for total fat and ⩾0.5 percentage point for saturated fat. Conclusions Results have applications for designing brief fat assessment instruments and for identifying key nutrition education messages that promote important fat-lowering behaviors. J Am Diet Assoc. 2002;102:490–496, 501–502.

Food Label Use, Self‐Selectivity, and Diet Quality

Food labels provide measurable benefits by improving diet quality of Americans by as much as four to six points on a 100‐point Healthy Eating Index scale. Among nutritional panels, serving sizes, nutrient content claims, list of ingredients, and health claims, the use of health claims on food labels provides the highest level of improvement in diet quality. The data source for this analysis is the 1994 to 1996 Continuing Survey of Food Intakes for Individuals (CSFII) and the accompanying Diet and Health Knowledge Survey (DHKS).

Perceived Adequacy of Diet: Comparison of a Special Population With the Third Report on Nutrition Monitoring in the United States

The purpose of this study was to assess nutrition attitudes and perceptions in a representative military population and compare them with the most recent published results of a national nutrition surveillance study. Military individuals are excluded from all nationwide surveys including the Diet and Health Knowledge Survey (DHKS). We designed a survey incorporating questions used in previous nationwide surveys to allow for comparisons between the military population and respondents to the 1989-91 DHKS (n=1920) reported in NHANES III. The survey was completed by a sample population (n=3066) representing the structure of the Army by race, gender, and rank at 30 Army bases worldwide. When responses were compared by gender, a higher percentage of women than men thought their diet should be lower in fat (55% vs 51%), saturated fat (49% vs 45%), and salt or sodium (30% vs 25%), but percentages were lower for cholesterol (30% vs 37%). These were similar to responses by gender in DHKS for fat (55% vs 52%) and saturated fat (45% vs 42%), but differed for cholesterol (42% vs 39%) and salt or sodium (32% vs 33%). More military women than men also reported the need for a higher intake of calcium (51% vs 30%), iron (53% vs 20%), vitamin C (35% vs 28%), and fiber (43% vs 34%). These responses were similar to DKHS for vitamin C for women but higher for men (34% vs 35%); fiber differed for both genders (39% vs 38%). Although there were similar gender differences in DKHS respondents when compared to military respondents for calcium (41% vs 25%) and iron (37% vs 24%), a substantially higher percentage of military women than DKHS women reported inadequacy. These data suggest that military men and women have some similarities to the general population in their perceptions about adequacy of their diets, but differ for several key nutrients. The reference data collected from this survey will assist the Army Surgeon General's nutrition planning, policy decisions, education programs, and direction for future research efforts.

Investigating Relationships Between Nutritional Knowledge, Attitudes and Beliefs, and Dietary Adequacy of the Elderly

A secondary analysis was conducted using a portion of the data obtained during the U.S. Department of Agriculture's (USDA) 1989-91 Continuing Survey of Food Intakes by Individuals (CSFH) and the Diet and Health Knowledge Survey (DHKS). People aged 65 years and older (n = 1113) who completed both portions of the survey were studied to determine whether diets met the RDA and what factors contributed to dietary adequacy. Diets were inadequate in 16.7% of the participants. Nutritional knowledge and the possession of positive attitudes and beliefs also contributed positively, but weakly, to increased dietary adequacy.

Comparison of Dietary Risk Factors for Cardiovascular Disease in African-American and White Women

Objective To compare African-American and white women's knowledge, attitudes, and energy and nutrient intakes related to cardiovascular disease risk. Design The 1989 through 1991 Continuing Survey of Food Intakes by Individuals and the Diet and Health Knowledge Survey (DHKS). Subjects A nationally representative sample of 2,684 white and 449 African-American women who completed the DHKS and provided 3 days of dietary information. Statistical analyses performed Comparisons between groups were made using t tests and χ 2 analyses. Analysis of covariance was used to adjust for age, percentage of poverty, and education. Results Significant differences in dietary risk for cardiovascular disease were identified. White women consumed significantly less cholesterol and more potassium than African-American women. African-American women had significantly lower knowledge scores, but they were more likely than white women to indicate that their diets should be lower in fat and salt and to consider nutrition very important when shopping. White women had more positive attitudes toward the impact of diet on health than African-American women. Accounting for differences between the groups in age, education, and income explained few differences between the groups. Applications This study identified differences in nutrient intake, knowledge, and attitudes about diet and health that can influence the willingness and ability of women to choose foods for a more healthful diet. Dietitians can use these findings to target strategies for changing behavior. For example, many African-American women acknowledge the need to change their current diets, so dietitians can help them design implementation plans or specific action plans to accomplish needed changes. J Am Diet Assoc. 1997;97: 1394-1400

Effect of The Knowledge, Attitude and Demographic Varialbes on Iron and Calcium Intake Among U.S. Women

LEARNING OUTCOME: To describe the influence of knowledge, attitudes, and demographics on iron and calcim intake. Calcium and iron are very important for women due to the hormonal changes of menstruation, pregnancy, lactation and menopause. In this study we examined the influence of knowledge, attitudes, and demographics on iron and calcium intake. Data were obtained from the 1990 - 91 Continuing Survey of Food Intakes by Individuals(CSFII) and Diet and Health Knowledge Survey (DHKS), a nationally representative study conducted by USDA. Data from 2009 women who completed 3 day diet records and DHKS were analyzed using correlation and ANOVA. Calcium and iron intake were found to be significantly positively correlated with income and education. A significant negative correlation was found between age and calcium intake, but age was not significantly correlated with iron intake. Knowledge of number of servings was significantly positively correlated with calcium intake but there was no relationship between knowledge and iron intake. Women who said that nutrition was not at all important while grocery shopping had significantly lower calcium intake than women who said it was important. Our findings suggest that women's knowledge, attitude and demographic characteristics may influence the consumption of these vital minerals. Therefore, an effort should be made to consider these attributes when designing effective education materials for women.

USDA's New Diet and Health Knowledge Survey: How Can it be Used for Theory-Based Research?

ABSTRACTResearch studies employing major theories of behavior change, such as the Health Belief Model, Rogers' Model of Diffusion of Innovation, and other theories, have added to our understanding of the relationship of knowledge and attitudes to food-related behavior. Unfortunately, many of the studies that employed these models have used small, local samples, limiting the generalizability of their findings. The new Diet and Health Knowledge Survey (DHKS), conducted by the U.S. Department of Agriculture, provides nationally-collected data on knowledge and attitudes concerning diet and health. Linked to dietary data collected from those individuals as a part of USDA's Continuing Survey of Food Intakes by Individuals, the DHKS data can be used to examine relationships between knowledge, attitudes, and food-related behavior, as postulated by behavior change theories, in a large, diverse, national sample of individuals. This article describes the DHKS, discusses its strengths and limitations as a data source...