Food-related Knowledge Research Articles

Salt-related knowledge, attitudes and practices and their relationship with 24-h urinary sodium and potassium excretions among a group of healthy residents in the UAE: a cross-sectional study.

This study aimed to measure urinary sodium and potassium as a measure of sodium and potassium intake concerning the knowledge, attitude and practice towards sodium intake among a group of healthy residents in the UAE. A cross-sectional study on a sample of healthy adults in the UAE. In addition to the knowledge, attitude and practice questionnaire, sodium and potassium excretions and food records were taken. The UAE. A sample of 190 healthy individuals aged between 20 and 60 years. The mean (± sd) age of the sample was 38·6 (± 12·5) years, and 50·5 % were females. The mean urinary sodium and potassium intake were 2816·2 ± 675·7 mg/d and 2533·3 ± 615 mg/d, respectively. The means were significantly different compared with the WHO recommendation of sodium and potassium (P < 0·001). About 65 % of the participants exceeded the WHO recommendations for salt intake, and participants' knowledge classification for health-related issues was fair, while food-related knowledge was poor (P = 0·001). A two-stage stepwise multiple regression analysis revealed that knowledge, attitude and practice scores were negatively associated with urinary sodium excretion (r = -0·174; P = 0·017) and those older participants and females had lower urinary sodium excretion (P < 0·001). These findings may suggest an increase in the risk of hypertension in the UAE population. Moreover, these findings emphasise the need to establish education and public awareness programmes focusing on identifying the sodium contents of foods and establishing national regulations regarding food reformulation, particularly for staple foods such as bread.

“New food cultures” and the absent food citizen: immigrants in urban food policy discourse

AbstractMulticultural cities in the Global North are rapidly developing and releasing urban food policies that outline municipal visions of sustainable food systems. In turn, these policies shape conceptions of food citizenship in the city. While these policies largely absorb activities previously associated with “alternative” food systems, little is known about how they respond to critical food and race scholars who have noted that these food practices and spaces have historically marginalized immigrants. A critical discourse analysis of 22 urban food policies from Global North cities reveals that most policies do not meaningfully consider immigrant foodscapes, foodways, and food-related labour. Many promote hegemonic and/or ethno-nationalistic understandings of “healthy” and “sustainable” food without recognizing immigrants’ food-related knowledge and skills. Policies largely fail to connect the topic of immigrant labour with goals like shortening supply chains, subject immigrant neighbourhoods to stigmatizing health discourses, and lack acknowledgement of the barriers immigrants may face to participating in sustainable food systems. Relatedly, policy discourses articulate forms of food citizenship that emphasize individual obligations over rights related to food. This jeopardizes the potential for immigrants to be seen as belonging to dominant political urban food communities and benefitting from the symbolic and material rewards associated with them.

Evaluation of a pilot food education program delivered for children in grade four attending a school located in a disadvantaged area in greater Melbourne

Primary school aged children (aged 4-12 years) in Australia consume approximately 40% of daily energy from energy-dense, nutrient poor foods and fewer than 5% meet the recommended guidelines for vegetables and fruit (ABS 2018). Poor eating habits in children can track into adulthood increasing the risk of non-communicable diseases later in life (Nicklaus 2013). Children spend a large amount of time at school where they are provided with social contexts which influence behaviour development (FAO, 2022) and thus are ideal settings for teaching children about food and nutrition (FAO, 2022; WHO 2017). This pilot study was designed in response to a call to action from a local primary school in southeast Melbourne facing disadvantage. Anecdotally, the school reported poor food literacy with many students bringing unhealthy lunches. The school asked us to design, pilot, and evaluate a student education program enabling healthier lunches among these children. The aim of the study was to explore the effectiveness of a 4-week food and nutrition education program delivered to grade 4 students within a disadvantaged area targeting, children’s food-related knowledge, behaviours and self-efficacy (confidence) to pack a healthy lunch. The program delivered weekly 1-hour interactive sessions over four weeks (October-November 2022). Topics included healthy eating, designing healthy lunches and food safety and were delivered using interactive games, activities, quizzes and food tasting. Students completed an online survey measuring their knowledge, self-efficacy and behaviour (e.g. foods packed in their lunchbox) pre- and post- program. A comparative analysis of the pre- and post-survey responses was performed using McNemar Tests in SPSS version 29.0. Sixty students completed both the pre- and post-surveys. A significant increase (p&lt;0.001) in knowledge of recommended daily serves of fruit (pre 43%, post 80%) and vegetables (pre 17%, post 54%) was observed. There was also a significant (p&lt;0.001) increase in student’s ability to identify ‘sometimes food’. No changes were observed in identification of ‘everyday food’, sources of protein and sources of dairy food or safety knowledge. Children’s confidence to make healthy food swaps significantly increased from pre- to post- program (27%45%, p = 0.035). We observed significant increases in children’s food and nutrition related knowledge for some topics and confidence to make healthy food swaps following completion of the program. A program of longer duration may be beneficial to observe additional improvements in knowledge as well as behaviour change, including foods packed in school lunches.

Smart shopper feelings in the case of store brands: the role of human capital as a key antecedent and the implications for store loyalty

ABSTRACT This paper asks the questions ‘how do store brands create smart shopper feelings?’, ‘what are the antecedents to this form of ego expressive benefits?’ and ‘what are the consequences for store loyalty if any?’ The findings reveal that ego expressive smart shopper feelings emerge from the interaction between shoppers’ food related human capital, in the form of information and knowledge capital, and retailers’ store brand products. As such, it draws attention to yet another element that contributes to the in-store value that some shoppers enjoy as part of the shopping process. While smart shopper feelings have typically been related directly to saving money, our findings find no such support: checking and engaging in price comparisons are not found to yield store brand smart shopper feelings. That store brands are cheaper appears to be taken as given. Rather, we find that food-related knowledge capital in the form of search skills and the ability to deal with more complicated forms of on-pack information coupled with food-related information capital are the antecedents to these ego-expressive benefits. Through ability and information, some shoppers experience these benefits to a greater extent. The consequence for retailers is that store brand smart feelings encourage loyalty to store brands in general rather than to a particular retailer, fostering store brand promiscuity rather than store loyalty.

Changing Consumption Patterns of Bamboo shoots: A Case Study of Traditional Food-Related Knowledge Systems

Bamboo shoots form an integral part of the local diet of the Northeastern states of India. Fermented shoots have been consumed by tribal communities since ancient times. However, with increasing globalization and fast-food consumption, the traditional knowledge and skills of processing bamboo shoots seem to be changing. This paper highlights the changes in processing ways over the years in the younger generation. Data were collected using an unstructured interview schedule and observation through home visits from Adi women of four villages namely Balek, Sibut, Runne, and Mirbuk in Pasighat Block of Arunachal Pradesh. It was observed that some newer practices of processing bamboo shoots had been adopted while ignoring the traditional practices which emphasized eliminating toxicity in bamboo shoots.

Food Literacy and Dietary Intake in German Office Workers: A Longitudinal Intervention Study.

Widespread patterns of poor dietary behavior are a key factor causing the increasing prevalence of chronic diseases around the world. Research has provided initial insights into the potential of food literacy (FL) to empower individuals to improve their dietary behavior. However, studies on FL interventions in working adults are scarce. The intervention delivered in this study was a comprehensive 3-week full time education-based workplace health promotion program (WHPP) that provided the participants with in-depth knowledge and skills regarding nutrition and health. We aimed to investigate the short- and long-term effects of the WHPP on FL and dietary intake (DI) and to examine the association between FL and DI in a sample of 144 German office workers (30.0% female). Using two random intercept mixed linear regression models, we found significant strong improvements for both FL (β = 0.52, p < 0.0001) and DI (β = 0.63, p < 0.0001) after the WHPP when compared to baseline. Significant long-term improvements at 18 months were strong for FL (β = 0.55, p < 0.0001) and weak for DI (β = 0.10, p < 0.0001). FL showed a significant moderate effect on DI across all measurement time points (β = 0.24, p < 0.0001). We conclude that well-designed WHPPs can induce long-term improvements in FL and DI, and that FL can be viewed as an asset to further expand food-related knowledge and skills and to enhance dietary behavior. Our study fills a gap of long-term findings regarding the role of FL in WHPPs and supports the idea of implementing FL in the development of comprehensive WHPPs to improve DI.

Learning Circles: A Collaborative Approach to Enhance Local, Healthy and Traditional Foods for Youth in the Northerly Community of Hazelton/Upper Skeena, British Columbia, Canada.

Youth health, long-term food sovereignty and the reclamation of traditional food-related knowledge are areas of concern within Indigenous communities in Canada. Learning Circles: Local Healthy Food to School (LC:LHF2S) built on an exemplar program in four predominantly Indigenous communities. In each, the initiative worked with interested community members to plan, implement and evaluate a range of activities aimed at enhancing access to local, healthy and traditional foods for schools and youth. This case study describes the context, process, outcomes and perceptions of implementation in one of the communities, Hazelton/Upper Skeena, located in northern British Columbia. Data were collected between 2016-2019 and included semi-directed interviews with community members and LCEF (n = 18), process reporting (e.g., LCEF reports, emails, conference calls and tracking data), photographs and video footage, and photovoice. Data were analyzed thematically. Hazelton/Upper Skeena has an active local and traditional food culture. Indigenous governance was supportive, and community members focused on partnership and leadership development, gardens, and food skills work. Findings point to strengths; traditional food, knowledge and practices are valued by youth and were prioritized. LC:LHF2S is a flexible initiative that aims to engage the broader community, and exemplifies some of the best practices recommended for community-based initiatives within Indigenous communities. Results indicate that a LC is a feasible venture in this community; one that can facilitate partnership-building and contribute to increased access to local and traditional food among school-aged youth. Recommendations based on community input may help the uptake of the model in similar communities across Canada, and globally.

Food Literacy Education During Nutrition Counseling for Patients With Diabetes: In-Depth Interviews With Registered Dietitians/Registered Dietitians Nutritionists

ObjectivesTo explore how food literacy is educated to patients with diabetes and related challenges encountered by the Registered Dietitians (RDs)/Registered Dietitian Nutritionists (RDNs) during nutrition counseling.MethodsA qualitative research approach was used to explore the perceptions of 15 RDs/RDNs who have worked or are currently working with patients with diabetes. Participants were recruited through connection or snowball sampling. They completed a brief demographics survey and then an online in-depth interview. The interview questions were created based on the food literacy framework by Vidgen and Gallegos which addresses food-related knowledge, skills, and behaviors associated with four domains including planning and managing, selecting, preparing, and eating food to meet individual needs to help determine adequate intakes. Descriptive statistics was used to summarize the demographics of participants using SPSS. The audio-recordings from the in-depth interviews were transcribed verbatim and a content analysis of the transcripts was conducted to identify themes using NVivo. Data reached a point of saturation during the interviews.ResultsEven though all domains were educated on, planning and managing was the most taught domain of food literacy, focusing on meal planning and carbohydrate counting. Selecting, preparing, and eating domains of food literacy were less frequently discussed. Lack of educational materials considering different cultures and languages were identified as one of major challenges in educating food literacy. RDs/RDNs identified multiple challenges that their patients face when trying to control their diabetes including limited budget, previously developed eating behaviors and unwillingness to change. They also mentioned that the COVID-19 pandemic potentially led to patients with diabetes having poorer diabetes self-management and greater HbA1c levels.ConclusionsThe findings suggested that RDs/RDNs provided education on food literacy during nutrition counseling for patients with diabetes; however, not all four domains of food literacy were evenly educated. In the future, creating culturally sensitive and relevant educational materials can promote education on food literacy and diabetes self-management during nutrition counseling.Funding SourcesNone.

Rapid review of research on dietary attitudes, beliefs and practices in Ghana 1990-2020

Food-related beliefs and attitudes influence dietary behaviors and are important drivers of nutrition outcomes. Understanding beliefs and attitudes that drive dietary behaviors, as part of the process for developing Food-based Dietary Guidelines is critical for targeting messages to motivate healthy dietary diets. This rapid review was undertaken to summarize readily available local evidence on food-related beliefs, attitudes, and associated practices in Ghana. A rapid review of 39 peer-reviewed publications and graduate-level theses on the dietary behaviors of Ghanaians was conducted between November and December 2020. The study only included articles published between 1990 and 2020 involving apparently healthy populations living in Ghana. Documents were identified through a systematic literature search of Google Scholar and PubMed. Data on food-related knowledge, beliefs, attitudes, and practices were extracted into an excel template and analyzed using thematic content analysis. The sampled research included primarily cross-sectional studies of urban, rural, peri-urban and mixed localities throughout Ghana: one was a prospective research. A range of food-related taboos were identified and classified as taboos for the general population, pregnancy-related, or child-related. Although awareness of food-related taboos was common, they were not extensively practiced. Energy-giving and nutrient-dense foods are commonly promoted during pregnancy. Culturally prescribed pre-lacteal feeds and other infant and young child feeding (IYCF) behaviors reported in the studies were not aligned with IYCF recommendations. A 3-meals-a-day pattern was observed, commonly, across all age groups; most adult meals, particularly supper, was prepared at home. However, ready-to-eat meals were regularly purchased by adults and adolescents. Adolescents frequently reported snacking and skipping meals; breakfast was the most frequently skipped meal. Fruits and vegetables were the least consumed food groups across all age groups. Muslim faith was associated with consuming more diverse diets and greater fruit and vegetable consumption. The findings of this review provide an overview of food-related beliefs and practices of Ghanaians and can inform decisions on areas to emphasize in food-based dietary guidelines and associated nutrition education messages to promote healthy diets in the Ghanaian population. Effective nutrition education is needed to dispel harmful food beliefs and practices and promote healthy food choices across the life cycle. Dietary patterns in Ghana are linked with cultural and religious practices that are often unique to particular subgroups, although there are common strands of beliefs across ethnic groups. These beliefs can result in either adverse or beneficial outcomes, depending on what eating patterns it determines. Key words: food prohibitions, dietary practices, dietary pattern, Nutrition, Ghana

현대 소비자의 식생활 라이프스타일 이해를 통한 조리역량 강화 방안

Purpose: This study attempted to discuss ways to enhance the concept of cooking in the modern consumers’ dietary life and strengthen consumer cooking competencies from the perspective of education and research carried out by food and nutrition experts. Main issue: With the rapid change in modern lifestyle, cooking in modern households has been declining, and individual cooking skills, food-related knowledge, and utilization are significantly decreasing. In addition, the degree and level of understanding of cooking vary greatly depending on generation, gender, and family characteristics. From the standpoint of experts, it is imperative to enhance the concept of cooking in modern consumers’ food-related lifestyles and find ways to strengthen their cooking competencies. Therefore, this paper examined the process of cooking and food experience and suggested strategies to strengthen the essential cooking competencies for modern consumers at each stage. As a result, six topics were decided, and detailed action plans for each topic were discussed. The topics included 1) choosing good quality ingredients, 2) cooking for the modern lifestyle, 3) experiencing the joy of cooking, 4) enjoying real taste, 5) reducing food-related waste, and 6) sharing and evaluating the right food-related information. Conclusion: Strengthening consumers’ cooking competencies means increasing their ability to positively connect to food within the food system through the skills and understanding of choosing, cooking, and consuming better food. In addition, it can be said that it implies becoming a ‘food citizen’ with food literacy that includes the cultivation of decision-making ability to support an individual’s health and society’s sustainable food system. Therefore, related researchers and educators should continue to present and educate consumers on ways to strengthen their natural and easy-to-practice cooking capabilities by considering consumers’ food literacy level and the cooking and food experience process.

Improved food literacy among schoolchildren as an effect of a food camp intervention: Results of a controlled effectiveness trial

Food literacy (FL) refers to an individual's prerequisites for their engagement with food. Schoolchildren's FL has been defined in terms of five competencies: “to know”(e.g food-related knowledge), “to do” (e.g cooking skills), “to sense” (e.g. less well-explored sensory experiences), “to care” (e.g. taking care of oneself and others) and “to want” (e.g. willingness to take a stand and act). A cluster-based quasi-experimental effectiveness trial on the effects of a school-based intervention, “FOODcamp,” on FL, health literacy, and school well-being was conducted. A total of 640 school children in grades 6 and 7 (mean age = 12 years) attended this one-week camp and participated in different food-related classes and activities. Linear mixed models controlling for the nested structure of data showed small but significant effects for the following FL dimensions: “to do (E = 0.098, CI (0.035–0.161), p = 0.002), “to sense” (E = 0.152, CI (0.073–0.232), p < 0.001), and “to know” (E = 0.086, CI (0.022–0.150), p = 0.009) as well as for overall FL (E = 0.078, CI (0.034–0.122), p = 0.001). No effects were found for the dimensions “to want” or “to care”. The intervention also had a small but significant effect on children's health literacy but not on school well-being. These findings demonstrate the value of FOODcamp and the positive impacts of a relatively brief intervention on children's FL.

The Good Food for Learning Universal Curriculum-Integrated Healthy School Lunch Intervention: Protocol for a Two-Year Matched Control Pre-Post and Case Study.

BackgroundGood nutrition affects children’s health, well-being, and learning, and schools offer an important setting to promote healthy behaviors that can last a lifetime. Once children reach school age, they spend more of their waking hours in school than in any other environment. Children’s eating habits may be easier to influence than those of adults. In Canada, households with children are more likely to experience food insecurity, and school food programs that are universally available to all children can support the development of healthy eating patterns across groups of varying socioeconomic status. There is a significant gap in the rigorous community-engaged academic research on the impact of school meal programs, especially universal ones.ObjectiveThe aim of this population health intervention research is to study the impact of a 2-year universal, curriculum-integrated healthy school lunch program in elementary schools in Saskatoon, Saskatchewan, Canada, on food consumption, dietary quality and food and nutrition-related knowledge, attitudes, and practices.MethodsThis population health intervention study will be conducted in 2 intervention elementary schools matched with 2 control schools. We will collect preintervention data, including objective measurements of food eaten at school and food-related knowledge, attitudes, and behaviors. This will be followed by the intervention itself, along with qualitative case studies of the intervention process in the 2 intervention schools. Then, we will collect postintervention data similar to the preintervention data. Finally, we will finish the data analysis and complete the ongoing sharing of learning from the project.ResultsThis study was funded in April 2020 but because of the COVID-19 pandemic, data collection did not begin until May 2021. The intervention will begin in September 2021 and end in June 2023, with end point data collection occurring in May and June 2023. The case study research will begin in September 2021 and will be ongoing for the duration of the intervention.ConclusionsThe opportunity we have to systematically and comprehensively study a curriculum-integrated school lunch program, as well as the promising practices for school food programs across Canada, is without precedent.International Registered Report Identifier (IRRID)DERR1-10.2196/30899

P50 Exploring the Experiences of Registered Dietitian Nutritionists (RDNs) who Educate Through Cooking and Food Preparation

<h3>Background</h3> Registered Dietitian Nutritionists (RDNs) often provide guidance on preparing healthy meals. Although food science and culinary skills are addressed in coursework to become a RDN, those involved in nutrition education do not universally incorporate hands-on cooking in their practice. Cooking skills, knowledge and confidence have declined among the public, while rates of obesity and chronic disease are on the rise. RDNs can play a central role in teaching essential cooking skills and food-related knowledge. This calls for exploration on the perspectives and characteristics of RDNs drawn to culinary education. Few studies have investigated the personal experiences and viewpoints of RDNs involved in teaching the public how to cook. <h3>Objective</h3> To explore the perspectives of RDNs who teach cooking and food preparation, to better understand their experiences learning to cook and teaching others. Cooking-related knowledge/skills perceived as lacking among the public and necessary to perform their role are compared with competencies outlined by the Academy of Nutrition and Dietetics' Food and Culinary Professionals (FCP) Dietetic Practice Group. <h3>Study Design, Setting and Participants</h3> The research design is cross-sectional and qualitative. Face-to-face semi-structured interviews are conducted remotely via Microsoft Teams. A convenience sample is recruited from community settings, including private practice, worksite wellness, supermarkets, Expanded Food and Nutrition Education Program, and SNAP-Ed. <h3>Analysis</h3> Interviews are recorded, transcripts are coded, and recurring themes are summarized. <h3>Results</h3> Analysis of pilot data (n = 14) on experiences learning to cook indicate cooking at home with parents while growing up, food science coursework, and personal interest in cooking. Emerging themes mirrored several FCP competencies, including communication skills, knife skills, ingredient substitution, time management, meal planning and food safety. <h3>Conclusion</h3> This pilot study examines the perspectives of RDNs who teach hands-on cooking, thereby providing insights on the competencies needed to teach others and best serve the public. Our findings merit research with a larger sample to further compare with FCP competencies, and potentially inform dietetics education programs preparing students for careers as RDNs.

Food and nutrition education in Australian primary schools: parents' views

PurposePrimary schools provide continuous, intensive contact with large numbers of children starting from a young age, thus providing an appropriate setting for the promotion of healthy eating through food and nutrition education (FNE). This qualitative study explores the views of Australian primary school parents about FNE in primary schools.Design/methodology/approachIn total, 19 parents of primary school children from Victoria participated in semi-structured interviews. Audio recordings were transcribed and underwent thematic analysis using Nvivo. A total of three themes emerged: FNE topics currently taught in primary schools, essential food skills and knowledge for primary school children and the importance of FNE.FindingsMost parents thought that FNE is as important as the core subjects of primary school. Parental support for FNE, which is delivered over a prolonged period, and expanded by hands-on content such as cooking and gardening classes was evident. Parents viewed these classes as likely to improve children's food-related knowledge and healthy eating behaviours. Parents expressed appreciation for schools' emphasis on food sustainability and its alignment with school policies and practices. Parents were keen to see more sustainability included in the curriculum.Practical implicationsThese results may have implications for curriculum developers and schools, as the findings can assist the design of food and nutrition curricula for primary schools which can empower children as well as their families to make better food-related decisions.Originality/valueAustralian parents' views of FNE in primary schools have been under examined.

Food environment intervention improves food knowledge, wellbeing and dietary habits in primary school children: Project Daire, a randomised-controlled, factorial design cluster trial

BackgroundEvidence suggests that dietary intake of UK children is suboptimal. As schools provide an ideal natural environment for public health interventions, effective and sustainable methods of improving food knowledge and dietary habits in this population must be identified. Project Daire aimed to improve children’s health-related quality of life, wellbeing, food knowledge and dietary habits via two multi-component interventions.MethodsDaire was a randomised-controlled, factorial design trial evaluating two interventions across four arms. Primary schools in Northern Ireland were randomised to one of four 6-month intervention arms: i) ‘Nourish’, ii) ‘Engage’, iii) ‘Nourish’ and ‘Engage’ and iv) Control (Delayed). ‘Nourish’ was an intervention aiming to alter the whole-school food environment, provide food-related experiences and exposure to locally produced foods. ‘Engage’ was an age-appropriate, cross-curricular educational intervention on food, agriculture, nutrition science and related careers. Primary outcomes were emotional and behavioural wellbeing and health-related quality of life. A number of secondary outcomes, including dietary intake, cooking competence and food-related knowledge, were also measured.ResultsFifteen schools from areas of varying socio-economic status participated in the randomised trial. A total of 903 (n = 445 aged 6–7 years and n = 458 aged 10–11 years) primary school pupils took part. Total Difficulties Score improved in all pupils (6–7 and 10–11 year old pupils) who received the ‘Nourish’ intervention compared with those that did not (adjusted difference in mean = − 0.82; 95% CI -1.46, − 0.17; P < 0.02). No statistically significant difference in Health-Related Quality of Life was observed. The ‘Nourish’ intervention also produced some changes in school-based dietary behaviour, which were most apparent in the 10–11 year old pupils. The ‘Nourish’ intervention also produced improvements in understanding of food labels (adjusted difference in mean = 0.15; 95% CI 0.05, 0.25; P < 0.01) and knowledge of vegetables in season (adjusted difference in mean = 0.29; 95% CI 0.01,0.56; P = 0.04) whilst an increased willingness to try new foods and improved perceived cooking competence was also observed.ConclusionsImprovements in childhood emotional and behavioural wellbeing, dietary intake, knowledge about food, cooking skills and willingness to try new foods were associated with the ‘Nourish’ whole-school food environment intervention. Exploration of the sustainability and long-term effectiveness of such whole-school food interventions should be conducted.Trial registrationNational Institute of Health (NIH) U.S. National Library of Medicine Clinical Trials.gov (ID: NCT04277312).

Young Children's Food-Related Knowledge: Kindergartners’ Free Categorization of Food Items

ObjectiveStudies concerning young children's food-related knowledge have dealt mostly with specific types of knowledge or with researchers’ predetermined categories. This approach may neglect certain aspects of children's knowledge and may limit the understanding of its general structure. The present study aimed to examine and analyze a wide scope of young children's constructed food-related knowledge. MethodsQualitative thematic analysis of 40 kindergartners’ free categorizations of food items. ResultsChildren's food-related knowledge was broad and derived from 3 primary sources: personal experience, environmental experience, and perceived messages. Novel aspects of knowledge were found, such as different treatments of food and partial familiarity with nutrients. Conclusions and ImplicationsThe findings demonstrated the existence of various types of young children's food-related knowledge. Attention to the broad spectrum of their knowledge and its possible sources may contribute to the design of relevant and effective nutrition education interventions aimed at young children.

School-based interventions for promoting food and nutrition literacy (FNLIT) in elementary school children: a systematic review protocol

BackgroundFood and nutrition literacy is a newly emerged concept to connect food-related knowledge and skills to healthy diets. Its promotion is important to protect children as they eat too many low-nutrient, high-energy foods. Food and nutrition literacy promotion needs multi-dimensional interventions. In the process of developing an intervention to promote food and nutrition literacy, the present review protocol aims to critically examine the evidence in the area of school-based interventions for promoting food and nutrition literacy (FNLIT) in elementary school children.MethodsWe will search PubMed/MEDLINE, EMBASE, Web of Science, CENTRAL, and ProQuest (from inception onwards). Additional studies will be identified through manual searching of reference lists. Quantitative studies (e.g., randomized controlled trial, quasi-randomized trials, and cluster randomized trials) evaluating the effect of interventions to promote food and nutrition literacy in elementary school children (5–12 years old) will be included. Main outcomes will be food and nutrition literacy at functional, interactive, and critical levels. Secondary outcomes will be dietary intake indicators (e.g., healthy eating index, DDS) and health outcome measures (e.g., reduction in BMI and less weight gain). Two reviewers will independently screen all citations, full-text articles, and abstract data. Potential conflicts will be resolved through discussion. The study methodological quality (or bias) will be appraised using appropriate tools. If feasible, we will conduct random effects meta-analysis. The quality of the included studies will separately evaluate using the validated Quality Assessment Tool for Quantitative Studies, developed by the Effective Public Health Practice Project (EPHPP). Data will be extracted by two reviewers from the identified relevant literature. Standard data synthesis and analysis will be used for the review.DiscussionThis systematic review will summarize the evidence regarding the components, implementation methods, and effectiveness of the interventions of food and nutrition literacy promotion in elementary school children. The results of this review will provide a useful reference for policymakers and curriculum developers to assess education curricula and develop practical learning and teaching strategies to improve students’ food and nutrition literacy.Systematic review registrationPROSPERO (CRD42019135118)

P194 Validity and Reliability of Knowledge, Attitude, Perception and Behaviors on Healthy Feeding in School-Age Children in Panama

Background Given the growing problem of overweight among school-aged children in Panama, understanding their food related knowledge, attitudes, perceptions and behaviors (KAPB) through valid, reliable and culturally appropriate instruments is critical in addressing in a more comprehensive way the obesity epidemic. Objective To describe the development and validation of an instrument to assess food related KAPB in school children in Panama, which used as a conceptual foundation the recent national Food Based Dietary Guidelines (FBDGs). Study Design, Settings, Participants The instrument development and validation consisted on the following three-stage process: conceptualization and construction of the instrument, primarily based on the Panama FBDGs; expert reviews (n = 6); and phsycometric testing, including internal consistency and confirmatory factor analysis. For the psychometric testing, the sample size included 248 school-age children of 7-13 years old, from five elementary schools in Panama West Province. Measurable Outcome/Analysis A valid, reliable and culturally appropriate instrument to assess healthy eating related KAPB in school-children in Panama. Results The adequacy of the sample was acceptable of 0.8052, determined by The Kaiser-Meyer-Olkin index. The CFA yield four factors related to healthy eating habits and lifestyles, with good internal consistency (Cronbach alpha > 0.5). Conclusion This study provides a tested instrument, with acceptable psychometric properties, which can be potentially used to measure healthy eating habits and lifestyles in school-age children in Panama within the context of multi-sectoral childhood obesity prevention programs.

An interactive after-school nutrition and culinary education program for primary school students: The evaluation and efficacy of changing food-related knowledge, attitudes and behaviour

Objective: To evaluate the efficacy of a 10-week afterschool nutrition and culinary education program in changing the culinary and nutritional behaviour, attitudes and knowledge of its 9-11-year-old participants, as assessed by parents and children. &#x0D; Methods: Retrospective matched-pairs analysis of secondary pre-post survey data collected by Boîte à Lunch (BàL). Children (n=165-197; grades 4 and 5) and parents (n=53-57) who signed-up for the BàL workshops. The program was comprised of ten-week (2 hours/week) bilingual (French and English) themed sessions led by trained educators with focus on culinary skill development, nutrition education and hands-on cooking. Secondary objectives include: team-work, kitchen hygiene, compost, understanding of food systems. Workshops were held in community centres and schools in Montreal, Canada. Changes were analyzed using the expanded exact McNemar-Bowker test with a Bonferroni-adjusted significance level of 0.001631.&#x0D; Results: Culinary skill and knowledge improved based on all 23 measures (all p&lt;0.001631). Of the six measures assessed for change in attitude, three were significantly improved. Of the two items used to asses a change of behaviour, one was significantly improved. 2 stand-alone post-workshop questions suggest a positive trend for improvements in each.&#x0D; Conclusion: Knowledge and culinary skill of youth can be improved through nutrition education and hands-on cooking. Culinary and nutritional attitudes and behaviours may be improved; further research is needed.

Development of a Tool for Food Literacy Assessment in Children (TFLAC)

ObjectiveFood literacy provides a framework for food-related knowledge, skills, and behaviors. The aim of this study was to develop a Tool for Food Literacy Assessment in Children (TFLAC), grades 4–5. MethodsDevelopment of the TFLAC consisted of 3 phases: (1) content validity using a 2-round modified Delphi panel (n = 16) and content validity ratios (CVR); (2) pilot-testing (n = 38); and (3) assessment of internal consistency and test-retest reliability (n = 706) using Cronbach α and intraclass correlation coefficients, respectively. Statistical significance was set at P < .05. ResultsRound 1 (CVR = 0.40) and 2 (CVR = 0.70) Delphi panel feedback and the pilot test informed modifications to the TFLAC question format, wording, and difficulty. Food literacy domain-specific Cronbach α values were acceptable (range, .80–.98) except for cooking knowledge (.63), and intraclass correlation coefficients were 0.64–0.70 (P < .001). Conclusions and ImplicationsThe TFLAC meets basic psychometric standards and may serve as a foundation for nutrition education intervention design and evaluation. Further testing with a broader geographic audience may be warranted.