Food Behavior Change Research Articles

Physiology of pregnancy and nutrient metabolism

Pregnancy consists of a series of small, continuous physiologic adjustments that affect the metabolism of all nutrients. The adjustments undoubtedly vary widely from woman to woman depending on her prepregnancy nutrition, genetic determinants of fetal size, and maternal lifestyle behavior. Studies of protein and energy metabolism illustrate the potential of adjusting the use of those nutrients to conserve a fetal supply. Adjustments in the metabolism of nitrogenous compounds are in place by the second quarter of pregnancy. During the last quarter of pregnancy, when fetal demands are greatest, those adjustments allow a positive nitrogen retention. The energy requirement of basal metabolism is influenced by maternal prepregnant nutrition and by fetal size. If maternal energy reserves are low at conception, the basal metabolic rate is down-regulated to conserve energy. Also, women having larger babies tend to have greater increases in their basal metabolic rate and lower rates of maternal energy storage. Changes in maternal food and physical activity behaviors during gestation may augment the physiologic adjustments. However, the substantial variability in food intakes and physical activity makes it difficult to show those changes. Thresholds in the capacity to adjust nutrient use to the amount supplied exist for all nutrients. When intakes fall below the threshold, fetal growth and development is affected more than is maternal health. Efforts to achieve good maternal nutritional status preconception as well as throughout gestation best assure a good milieu for fetal growth and development.

Evaluating Diverse Weight Management Programs with a Standard Evaluation Questionnaire

Due to increasing pressures to document the effectiveness of educational programs, a project was undertaken to develop impact indicators and accompanying evaluation questionnaires for four of seven Dietary Guidelines for Americans. The results of field testing a 12-item knowledge and 16-item behavior change evaluation questionnaire for the “healthy weight” dietary guideline are presented. A pre-, post-, and 3- to 6-month delayed postassessment measurement design was selected to be used following completion of diverse multi-session weight management nutrition education programs designed by each participating state. Seven states in the Extension system collected and submitted both pre- and postdata; one state submitted pre-, post-, and delayed postdata. Results indicate small gains in knowledge and significant improvements in behaviors related to weight management in the broad categories of food behavior, exercise behavior, and behavior modification changes. However, a state by test interaction was identified for food behavior and behavior modification practices scores. States that showed no change for those measures tended to have higher pretest scores but the statistical results may have been affected by small numbers of participants in some states. This study suggests that use of a standard set of impact indicators, knowledge and behavior questionnaires to assess programming impact at different locations may be feasible. It would be important to consider programmatic similarities, such as program length and content, and differences in pre-entry data before aggregation of data occurs.

The Dietitians’ Philosophy and Practice in Multidisciplinary Weight Management

Dietitians are developing a philosophy and a practice protocol of weight management. A professional philosophy of weight management addresses questions about the social, psychological, and biological spectra of weight management: Should overweight be considered in terms of size acceptance or gluttony and sloth? How should emotional overeating and obsessive restriction be managed? Should obesity be considered a chronic disease, or should the idea that health at every size is possible be espoused? A professional practice protocol addresses another set of questions: Is obesity to be viewed as a short-term and long-term health challenge? Regarding the spectrum of antiobesity agents and antidieting approaches of weight management, what professional position and individual practice will be adopted? Should professional contact with patients be continuous or aimed toward self-care? What measures of successful outcomes will be used: weight change or life quality improvement? How should professional responsibility be balanced with personal concerns about eating and health behaviors that affect body weight? What are examples of closing the gap between the vision and the reality of the roles and goals of the dietitian on a weight management team? Dietitians are translating philosophy into practice. Because dietary control alone has a record of limited success in weight loss and less success in maintaining weight loss, the dietitian's expanded role includes helping patients manage weight with coping skills, motivation techniques, physical activity, and food behavior change. The challenge is integrating functional components of practice with dietitians’ unique food and nutrition skills that include selection of alternative foods, portion control, and preparing acceptable, tasty foods for lifelong weight management. J Am Diet Assoc. 1998;98(suppl 2):S49–S54.

Video Lessons are Effective in Changing Food-Related Behaviors and Intake of Low-Income Homemakers

The purpose of this study was to evaluate the effectiveness of a video lesson series for improving the dietary intakes and food behaviors of low-income homemakers. One hundred and five non-pregnant homemakers (mean age=28; range=15-52) who were new enrollees in the Expanded Food and Nutrition Education Program or the Food Stamp Nutrition Education Program participated in the study. All subjects had a household videocassette recorder, telephone access, and were eligible for food stamps. Subjects were randomly assigned to receive traditional face-to-face lessons (Traditional Group) or a video lesson series with follow-up telephone discussions and intermittent home visits (Video Group). Dietary intake and food behavior changes were assessed using 24-hr dietary recalls and a 14-item food behavior checklist. Analytic measures included Multivariate Analysis of Variance, Analysis of Variance, t-tests, and chi-square ( χ 2) tests of association. Experiment-wise significance was set at p≤0.05 with correction using the Bonferroni Method. Seventy-three subjects completed the study. For both groups, significant ( p≤0.0028) improvements were observed for intakes of vitamin C, Fruit Group servings, and food behavior checklist scores. The Traditional Group also increased their intakes of vitamins A and B 6, calcium, and fiber ( p≤0.0028). There was no significant difference between the groups on overall change of dietary intakes (F=1.2554, p=0.2595). Cost of the video lesson series, based on the average yearly caseload of 72 graduating homemakers for one PA, was substantially lower ($6,397) than that of the traditional lessons ($15,548). Due to its effectiveness and lower cost, a video lesson series combined with follow-up telephone discussions and limited home visits may be a viable alternative for delivering nutrition education to low-income homemakers.

A Study of the Nutrition-Related Attitudes, Practices, and Perceived Needs of Food Stamp Clients

LEARNING OUTCOME: To demonstrate a clear understanding of the food and nutrition-related attitudes, practices, and perceived needs of persons receiving food stamps. In order for nutrition education programs to specifically target food stamp clients, the food and nutrition-related attitudes, practices, and perceived needs of this population must be recognized. To obtain this information, six focus group interviews with food stamp clients were conducted throughout the state of Virginia. Expanded Food and Nutrition Education Program paraprofessionals from 6 different counties recruited 26 food stamp recipients based on predetermined criteria. Topics addressed during the focus group meetings were meal planning and purchasing, food resources, food behavior change, interests in nutrition information, and preferred ways of receiving information. Transcripts of the meetings were analyzed separately by two investigators for common themes prevalent in all the focus group interviews. Any discrepancies in identified themes were then discussed until a consensus was reached. A key finding was that a majority of food-related decisions were made while in the grocery store. Lack of food resources was admitted to be a problem experienced at least once by many participants. Explanations for scarcities included the belief that the amount of food stamps was insufficient and that poor food purchasing decisions had been made. Some form of food behavior change had been attempted in the past by a majority of the participants. The predominant behaviors identified were decreasing fat consumption, fried foods, and portion sizes. Most of the reasons stated for attempting behavior change involved a desire for weight loss. The most prevalent nutrition education interests involved low-fat cooking and child nutrition. No consensus was reached on preferred ways of receiving information due to a broad range of responses. The results illustrated trends in a lack of meal planning, specific behavior changes attempted, and specific interests in nutrition education among a diverse group of food stamp clients. This information may be useful in the planning of nutrition education programs for this population.

Chinese Food Habit Perspectives

ABSTRACTThe purpose of this study was to assess changes in food behaviors of a Chinese population by investigating a group of 32 mature students before and after they came to study in the United States. Using a modified version of the National Cancer Institute's Health Habits and History Questionnaire, data was collected to measure food acculturation, food behaviors, and frequency of consumption for more than one hundred foods. Results show considerable dietary change. Food intake decreased significantly in the “Bread and cereal” food group and in the “Vegetable” food group in the United States compared to intake in China. In contrast, foods in the “Fruit,” “Meat,” and “Dairy products” food groups increased significantly in the United States compared to in China. Intake of many individual items increased significantly including snacks and sweets, ice-cream, whole milk, non-dairy creamers, orange juice, white bread, and soda. The most significant decrease was in the consumption of rice. Other food behavior...

What young adults say about factors affecting their food intakea

Little research has been conducted examining the food choice behaviors of young adults. The few studies reported have been limited to college students and used survey questionnaire techniques. This study sought to describe a broader sample of young adults and to gather information about reasons for food choice behavior using a qualitative method. Fifty‐seven focus group interviews were conducted across seven states with 270 young adult participants. The interviews were focussed on discussions of food‐related behaviors. Across all states consistent responses were given regarding time constraints, financial barriers and health concerns impacting food choice. Varying responses between states seemed related to racial and ethnic differences among participants. These results suggest that the effectiveness of efforts to promote positive food behavior change among young adults may be improved by incorporating means to overcome common barriers.

Food Coloring and Behavior

The association between the ingestion of tartrazine synthetic food coloring and behavioral change in children referred for assessment of hyperactivity was investigated at the Royal Children’s Hospital, University of Melbourne, Australia.

Synthetic food coloring and behavior: A dose response effect in a double-blind, placebo-controlled, repeated-measures study

Objective: To establish whether there is an association between the ingestion of synthetic food colorings and behavioral change in children referred for assessment of "hyperactivity." Participants: From approximately 800 children referred to the Royal Children's Hospital (Melbourne) for assessment of suspected hyperactivity, 200 were included in a 6-week open trial of a diet free of synthetic food coloring. The parents of 150 children reported behavioral improvement with the diet, and deterioration on the introduction of foods noted to contain synthetic coloring. A 30-item behavioral rating inventory was devised from an examination of the clinical histories of 50 suspected reactors. Thirty-four other children (23 suspected reactors, 11 uncertain reactors) and 20 control subjects, aged 2 to 14 years, were studied. Design: A 21-day, double-blind, placebo-controlled, repeated-measures study used each child as his or her own control. Placebo, or one of six dose levels of tartrazine (1, 2, 5, 10, 20, 50 mg), was administered randomly each morning, and behavioral ratings were recorded by parents at the end of each 24 hours. Results: The study identified 24 children as clear reactors (19 of 23 "suspected reactors," 3 of 11 "uncertain reactors," and 2 of 20 "control subjects"). They were irritable and restless and had sleep disturbance. Significant reactions were observed at all six dose levels. A dose response effect was obtained. With a dose increase greater than 10 mg, the duration of effect was prolonged. Conclusion: Behavioral changes in irritability, restlessness, and sleep disturbance are associated with the ingestion of tartrazine in some children. A dose response effect was observed. (J PEDIATR 1994;125:691-8)

Pentagastrin as a factor of selective involvement of dorsal hippocampal neurons in the organization of food-motivated behavior

Various endogenous peptides affect the behavior of animals and men. In particular, intestinal peptide hormones, injected into the CNS, cause complex changes in food behavior. Cholecystokinin inhibits food intake by animals [i, 4, 5], whereas gastrin activates it [2]. The writers showed previously that realization of food motivation in the form of goal-directed behavior in response to electrical stimulation of the "hunger centers" in the lateral hypothalamus is impossible if peptide synthesis is blocked in the CNS [3]. Sensomotor cortical neurons of the rabbit brain cease to respond under these circumstances to motivation-inducing stimulation of the lateral hypothalamus.

Randomized controlled trial of a nonpharmacologic cholesterol reduction program at the worksite

Under experimental clinical conditions diet modification has been shown to reduce serum cholesterol levels. This paper reports such a positive response to a nonpharmacologic, behavioral education program at the worksite. Employees at the New York Telephone Company corporate headquarters were assigned randomly to treatment and control groups. Treatment consisted of an 8-week group cholesterol reduction program conducted during employee lunch hours. It comprised a multiple-treatment approach—food behavior change techniques combined with nutrition education, physical activity planning, and self-management skills. The treatment group showed substantial change compared with the control group at the program's completion. Those treated displayed a significant 6.4% reduction in total serum cholesterol (266 mg% average at baseline) as compared with control subjects with a corresponding decrease in high-density lipoprotein levels. A significant increase in nutrition knowledge and moderate weight loss were also documented for this group. The magnitudes of a participant's baseline serum cholesterol level and his/her reduction in percentage of ideal body weight were positively and independently correlated with percentage changes in serum cholesterol levels. Over the same period, decreases in high-density lipoprotein levels and no changes in serum cholesterol, weight, and nutrition knowledge were observed for the control group. Overall, participants in the treatment program successfully reduced the coronary heart disease risk factors of elevated cholesterol and weight. Directions for future study are suggested.