Nutrition-related Decisions Research Articles

Women’s empowerment in integrated cattle-farming systems in Indonesia

ABSTRACT Women play active roles in livestock rearing and household finances in low-middle-income countries, including Indonesia. Investing in women within smallholder supply chains is beneficial but challenging because of the complex production and market systems. To overcome these challenges, a holistic approach considering social, cultural, economic, institutional, environmental, political, and demographic factors is essential for effective technology adoption and scaling. This article uses farm-level surveys in West Nusa Tenggara (NTB) and South Kalimantan to assess women’s empowerment in Indonesia’s livestock sector. A customized tool, adapted from the Women’s Empowerment in Livestock Index (WELI), was used to interview 754 male and female respondents. The index covered decisions about agricultural production, nutrition-related decisions, access to and control over resources, control and use of income, access to and control of opportunities, and workload and control over own time. Results showed that only 3.6% of women are empowered in livestock production, compared to 33.34% in agriculture. Sumbawa in NTB had the highest livestock empowerment at 5.7%, followed by South Kalimantan (4.6%) and Lombok (1.1%). Key drivers of empowerment were income control, resource access, and control over workload. These findings highlight the need for tailored capacity-building strategies to enhance technology adoption and improve household well-being.

A Novel Method to Determine a Custom Sample Size for Image-Based Instagram Content Analysis

Abstract Objectives Most Instagram users are young people, and social media is often used to search nutrition information. Health interventions aimed at young people should consider such information sources. Content analyses of Instagram images offer insights into types of content that may influence nutrition-related decision making and health behaviors. However, the number of analyzed images in existing studies has varied, and methods to determine data-specific sample sizes to reach saturation have not been explored. We aimed to develop a method to determine sample sizes for image-based content analyses on Instagram. We piloted the method and determined the reliability by identifying the saturation point for content categorized under two separate nutrition-related hashtags. Methods Instagram ‘top posts’ for a 21-year-old user were searched using hashtags ‘mindfuleating’ and ‘intuitiveeating’. 1200 images from each were extracted. Hashtag-specific coding frameworks were constructed inductively by two authors, initially coding the image- and text-based elements of the first 90 images collaboratively. Next, increments of 45 images were coded independently, then compared, solving disagreements by discussion. The process was repeated until saturation occurred when no new codes emerged. This was repeated seven weeks later to determine reliability. Results The coding frameworks constructed for #mindfuleating at first and second capture comprised 63 and 74 distinct codes, with saturation occurring at 360 and 405 images, respectively. The #intuitiveeating frameworks comprised 83 and 86 codes, with saturation at 450 and 495 images, respectively. The codes captured detailed pictorial content (e.g., ‘female’, ‘White’, ‘young adult’) and text (e.g., ‘nutrition information’, ‘relationship with food’). For both hashtags, the number of image-based codes decreased while text-based codes increased between coding. Conclusions Variations in coding frameworks and sample sizes over a short timeframe reflect the dynamic nature of Instagram content. Assessment of diet trends on social media requires accurate sampling to ensure nuances of a specific topic are captured, while research efficiency benefits from reduced data redundancy. Funding Sources NHMRC Peter Doherty Early Career Fellowship; Sydney Medical School Foundation, The University of Sydney.

Associations between socio-demographics, nutrition knowledge, nutrition competencies and attitudes in community-dwelling healthy older adults in Singapore: findings from the SHIELD study

BackgroundNutrition literacy refers to an individual’s knowledge, motivation and competencies to access, process and understand nutrition information to make nutrition-related decisions. It is known to influence dietary habits of individuals including older adults. This cross-sectional study was designed to: (1) understand the nutrition knowledge, competencies and attitudes of community-dwelling older adults in Singapore, (2) examine the differences between their nutrition knowledge, and socio-demographic factors, competencies and attitudes and (3) identify factors associated with better nutrition knowledge in older healthy adults in Singapore.MethodsA total of 400 (183 males and 217 females) nourished community-dwelling older adults aged 65 years and above took part in this study. Malnutrition Universal Screening Tool (MUST) was used to determine individuals who were at low risk of undernutrition. Nutrition knowledge, competencies, attitudes and sources of nutrition information were measured using a locally developed scale. Nutrition knowledge scores were summed to form the nutrition knowledge index (NKI). Associations between NKI, competencies, attitudes and socio-demographic variables were examined using Chi-square and Fisher’s exact tests. Factors associated with NKI were determined using a stepwise regression model with resampling-based methods for model averaging.ResultsBivariate analyses found significant differences in NKI scores for gender, monthly household earnings, type of housing, the self-reported ability to seek and understand nutrition information and having access to help from family/friends. Females had higher NKI scores compared to males (p < 0.001). Compared to females, more males left food decisions to others (p < 0.001), and fewer males reported consuming home-cooked food (p = 0.016). Differences in educational level were found for competencies like the self-reported ability to seek (p < 0.001) and verify nutrition information (p < 0.001). Stepwise regression analysis showed that being female, Chinese, self-reported ability to understand nutrition information and having access to help from family/friends were associated with higher NKI scores.ConclusionsOur study revealed that nutrition knowledge of older males in Singapore was lower than females and more left food decisions to others. Nutrition education programs could be targeted at both the older male, their caregivers and minority ethnic groups.Trial Registration This study was registered on 7 August 2017 at clinicaltrials.gov (ref. NCT03240952).

Can Undergraduate Students Help Change Older Adults' Confidence for Making Nutrition-Related Decisions in a 45-Minute Nutrition Workshop?

Purpose: The Social Cognitive Theory (SCT) suggests health behaviour can be modified by enhancing knowledge of health benefits and outcome expectations of changing behaviour, improving self-efficacy (confidence), and developing goals to overcome barriers to behaviour change. This study aimed to determine the impact of student-led nutrition workshops on participants' confidence related to SCT constructs for making dietary choices that align with evidence-based nutrition recommendations.Methods: Level-4 Science students developed and delivered 9 workshops on nutrition recommendations for the prevention and management of age-related diseases. Participants attending the workshops completed pre- and post-surveys to assess SCT constructs. For each SCT construct, participants rated their confidence on a 10-point Likert scale. The number (%) of participants who rated their confidence as ≥8/10 on the pre- and post-surveys were compared using the χ2 test.Results: Sixty-three community members (60% female, mean ± SD age 71 ± 7 years) attended the workshops. The number of participants rating confidence as ≥8/10 for each SCT construct increased after the workshops (P < 0.05).Conclusion: Undergraduate students can positively influence community members' confidence for making nutrition-related decisions. Involving students in interventions where SCT-structured workshops are used may help conserve health care resources and reach older adults who may not have access to dietitian services.

P119 Examining Predictors for Diet Quality: A Needs Assessment of Rural Versus Urban Older Adults

<h3>Background</h3> Diet and lifestyle are vital in maintaining good health and independence for older adults. Older adults living in rural areas are at risk for chronic disease, poor diet quality, and limited accessibility to healthy foods, compared to their urban counterparts. <h3>Objective</h3> To assess rural and urban older adults' diet quality, food insecurity, and self-efficacy for overcoming barriers to making informed nutrition-related decisions. <h3>Study Design, Setting, Participants</h3> From April-August 2019, a cross-sectional design was used to administer a self-reported survey to adults ≥50 years, in Maryland, participating at senior/community sites. Using convenience sampling, 475 participants (Urban, n = 215; Rural n = 260) were recruited prior to a nutrition education program (44 sites, 19 counties). <h3>Measurable Outcome/Analysis</h3> Participants completed a self-administered survey (41 items). Measurable constructs included diet quality assessed by the validated Dietary Screening Tool (DST), which evaluates nutritional risk in older adults. Perceived self-efficacy for healthy eating behaviors, food insecurity, and sociodemographic factors were also measured. Data were analyzed using SPSS version 24.0 (t-test, chi-square, and multiple linear regression). <h3>Results</h3> Participants were predominantly women (83.6%), white (54.0%), who lived alone (53.6%), with a median age of 74.5 (SD ± 8.5), and reported their health as somewhat good/very good (53.1%). Those in rural areas had significantly lower DST scores (<i>P</i> = .024), higher average number of chronic diseases (<i>P</i> = .004), and lower self-efficacy for changing health behaviors (<i>P</i> = .001) compared to urban/suburban counterparts. After controlling for other variables, rural and urban dwelling was not a significant predictor of diet quality. However, DST scores were significant predictors of food insecurity (B = −3.097, <i>P</i> < .05) and perceived self-efficacy (B = 1.145, <i>P</i> < .001) among older adults. <h3>Conclusions</h3> Although previous research reported rural dwellers were more at risk for poor diet quality than urban dwellers, our findings did not support this. However, our results did support the need for nutrition interventions addressing food insecurity and barriers to self-efficacy for improving diet quality of all older adults.

Knowledge-based hybrid decision model using neural network for nutrition management

With the change in their social environment and life patterns, the eating habits of modern people have become more diverse. Eating habits are closely related to health, and diet management for individual healthcare is required in this era characterized by poor health and increased longevity. In this paper, we propose a knowledge-based hybrid decision model for nutrition management that uses neural networks. The proposed method is a food recommendation model to help users make dietary nutrition-related decisions on a health platform. It is a hybrid recommendation method that considers both physical and mental health. It selects foods that are positively related to users’ physical health as candidates and predicts users’ preferences through adaptive learning. A previously developed dietary nutrition service ontology is used to select foods that appear to affect the user’s health positively. Conventional preference prediction methods include collaborative, content-based, knowledge-based, and image-based filtering. These methods use a hybrid model or machine learning, data mining, and artificial intelligence methods to compensate for the disadvantages of each filtering type. For preference prediction, healthcare and food preference data are collected in an on/off line environment. The data consist of age, sex, body mass index, region, chronic disease, and food preferences. Food preferences include the dietary nutritional components of food, which makes it possible to infer the user’s preferences for foods containing calories, carbohydrates, protein, fat, sugars, sodium, cholesterol, saturated fatty acids, and trans fatty acids. The user’s preference for food is composed of output variables, and other variables are composed of input variables. The variables consist of 11 healthcare data variables, 2 preference data variables, 10 dietary nutrition data variables, 22 input variables, and 1 output variable. The variables that we constructed are used to arrange transactions and supervised learning is conducted in a neural network structure. In total, 3152 transactions, 80% of the collected data, were used as learning data and 788 transactions, 20% of the collected data, as test data. Using the test data, we evaluated the performance of four prediction models based on a learned neural network, user correlation, average replacement, and regression analysis, respectively. The result of the performance evaluation showed that the proposed method was superior to the conventional method in that it solved the cold-start and the sparsity problem. In addition, the user’s satisfaction evaluation result was 3.92 on a five-point scale, showing overall satisfaction. Therefore, on the platform it is possible to recommend dietary nutrition for people suffering chronic diseases according to their lifestyle and in consideration of their health status and preferences. The platform selects a suitable candidate food according to the health condition of the user and provides a recommendation for N foods using the Top-N of the user’s food preferences.

Food-Related Behaviors of Women in Substance Abuse Recovery: A Photo-Elicitation Study

The aim of this multi-method qualitative study was to explore the eating behaviors and food choices of nine purposively sampled low-income women aged 29 to 40 years who were engaged in a residential substance use disorders recovery program. Findings were limited to photo-elicitation interviews with the women that focused on nutritional choices and issues outside their family context. Consensual data analysis revealed a recovery process that began with cognitive reawakening and an increased focus on and desire for healthier nutrition-related decisions and lifestyle, particularly in the area of weight gain that many of the women experienced.

The nexus of knowledge and behavior for school-aged children: implementation of Health Education Programs and a Nutritional Symbol System

Health-related knowledge has been assumed to inform lifestyle choices for school-aged students. A ‘health-promoting school’ provides the conceptual framework for this intervention. A large boarding school developed, implemented and refined a Nutritional Symbol System for their dining hall. The effectiveness of this social marketing strategy and school-based Health Education Program was evaluated by interviewing students (n = 16) for nutritional knowledge and application of the Nutritional Symbol System (NSS) to food choices in a range of contexts within (for example, in the dining hall and canteen) and beyond the school. In-depth interview data were collected, recorded and analyzed manually and via the Leximancer text mining software. Results indicated that there was a lack of consistent and accurate student knowledge derived from the Health Education Programs. Recommendations include a greater alignment between the Nutritional Symbol System, the plate and all Health Education Program materials to enhance students' health literacy around informed nutrition-related decisions.

The use of negative themes in television food advertising

The ability of food advertising to trigger food consumption and influence social norms relating to food consumption has resulted in increasing attention being given to the prevalence and nature of food advertising. The present study investigated the use of negative themes in food advertisements aired on Australian television to determine the prevalence of depictions of violence/aggression, mocking, nagging, boredom, loneliness, food craving, mood enhancement, and the emotional use of food across 61days of programming time. The results suggest that advertisers are using negative themes to capture attention and invoke an emotional response in the target audience. Sixteen percent (14,611) of the 93,284 food advertisements contained negative themes, with mood enhancement and food craving being the most commonly depicted negative themes. Advertisements with negative themes were more likely to be for non-core foods and to be aired during children’s popular viewing times than at other times. The potential for negative themes in food advertising to promote unhealthy food consumption behaviors among children is likely to be of concern to policy makers. Building on this exploratory study, further research is needed to investigate how nutrition-related decision making is affected by exposure to food advertisements employing negative emotional themes.

Encouraging Healthy Eating at Restaurants: More Themes Uncovered Through Focus Group Research

Quantitative research alone cannot provide enough understanding of restaurant patrons' nutrition-related decisions. As the role of restaurants in contributing to the obesity epidemic is being examined, more information is needed to determine how healthier choices at restaurants can be encouraged. Focus group research was conducted to explore customer decision making and to uncover strategies which could be used by restaurants to encourage healthier choices. Seven themes emerged which provide insight into this issue. Four themes are discussed here: disconnect between healthy eating and restaurants, shock, compensation, and control and choice.

Configural Displays Can Improve Nutrition-Related Decisions: An Application of the Proximity Compatibility Principle

The nutrition label format currently used by consumers to make dietary-related decisions presents significant information-processing demands for integration-based decisions; however, those demands were not considered as primary factors when the format was adopted. Labels designed in accordance with known principles of cognitive psychology might enhance the kind of decision making that food labeling was intended to facilitate. Three experiments were designed on the basis of the proximity compatibility principle (PCP) to investigate the relationship between nutrition label format and decision making; the experiments involved two types of integration decisions and one type of filtering decision. Based on the PCP, decision performance was measured to test the overall hypothesis that matched task-display tandems would result in better decision performance than would mismatched tandems. In each experiment, a statistically significant increase in mean decision performance was found when the display design was cognitively matched to the demands of the task. Combined, the results from all three experiments support the general hypothesis that task-display matching is a design principle that may enhance the utility of nutrition labeling in nutrition-related decision making. Actual or potential applications of this research include developing robust display solutions that aid in less effortful assimilation of nutrition-related information for consumers.

From Research to Global Reality: The Micronutrient Story

The professional life history of E. V. McCollum exemplifies how sound nutrition-related laboratory research was translated into practical realities that influenced individual and national nutrition-related decisions. Public health and educational programs emerging in the first third of this century improved health and nutritional well-being in the United States. Characteristics that surrounded pioneering efforts early in the century are similar to those that have reinvigorated global micronutrient concerns in the last third of the century. Sound community-oriented scientific research revealed the true consequences of iodine, vitamin A and iron micronutrient malnutrition. Repositioning the image of these three micronutrients from that of a clinical problem affecting relatively few to one with consequences for individual, national and global development affecting many more, and disseminating these facts through high-level political forums incited attention, commitment and actions. As in the early days of McCollum and his contemporaries, current nutrition scientists played a significant role, interacting with politically oriented counterparts, in taking micronutrient research to reality for improving health and quality of life globally. Lessons learned from the process, both past and present, should guide future nutrition-oriented endeavours in moving research to reality for betterment of global community health.

Is it time for computer-assisted decision making to improve the quality of food and nutrition services?

Is it time for computer-assisted decision making to improve the quality of food and nutrition services?

The relationship between the ability to solve practical nutrition problems in an adult population and piagetian cognitive levels

Making food and nutrition related decisions has become an increasingly complex chore for consumers. Piagetian research suggests that the development of formal reasoning skills may be important in making many such decisions. The purpose of this study was to establish the relationship between an individual's ability to solve practical nutrition problems and his/her cognitive or reasoning level. Piagetian paper-and-pencil tasks, used to assess cognitive levels, were administered to 271 adults attending various community colleges. At a later time, they were given a practical nutrition test which required nutrition knowledge as well as reasoning skills. Other demographic information was also collected. The results indicated that an individual's cognitive level (nonformal, early formal and formal) has a correlation with his/her ability to answer knowledge questions, but is more highly correlated with the individual's ability to answer reasoning questions (p <.005 for correlations and ANOVA). The variables of age, gender, education level, high school math and science, college math and science, and food purchasing/meal preparation experience had little or no relationship either to the measurable cognitive level or to the scores on the nutrition test. Stepwise regression analysis showed that composite cognitive factors accounted for 44% of variance on the nutrition test while other variables accounted for 1% of variance. Nutritionists may need to take cognitive level factors into account to facilitate educating for better decision-making about food and nutrition.