Healthy Food Selection Research Articles

Assessment of Knowledge and Attitude of Medical Students Towards Nutrition and Health: A Cross-Sectional Study.

Students' health and well-being generally depend on their nutritional intake. Medical students, in particular, must be physically and mentally fit to perform better academically and to treat their patients holistically. Consuming a nutritious diet and maintaining good health requires an adequate understanding of nutrition and related diseases. Thus, this study used a validated general nutrition knowledge questionnaire to evaluate nutritional knowledge and aimed to assess medical students' knowledge and attitudes about health and nutrition-related diseases. A cross-sectional study was conducted on 123 medical students between July 2023 and June 2024. A general nutrition knowledge questionnaire was used for the online survey, which consisted of questions on nutrition knowledge, individual dietary choices, thoughts about expert advice and awareness about health problems and diseases related to weight management and diet. The responses obtained were put in an Excel (Microsoft, Redmond, WA, USA) spreadsheet, and the data obtained was transformed into bar graphs and pie charts by using SPSS version 20 (IBM Corp., Armonk, NY, USA). For the statistical analysis of data, percentages were calculated. The mean age of the study participants was 18.56 ± 1.16 years. The gender-wise distribution of participants shows around 47.7% (50) male and 57.3% (66) female. 39.8% of students answered correctly the precise requirement of macronutrients. 21.1%of students were unsure about the content of added sugar, salt and fibre requirements. The majority of students made healthy dietary choices, while many students were unaware of the expert's advice and diet-related diseases. It was discovered in the current study that students' general understanding of a nutritious diet was good, but they lacked knowledge regarding the nutrient content. Students showed a sufficient level of understanding of the healthy food selections, but they were not aware of the healthy cooking methods. Students were unaware of the advice given to the patients, while awareness of nutrition-related diseases was acceptable. Inadequate understanding and lack of awareness are attributed to the limited nutrition-related curriculum in medical schools.

Customer Perceptions of a Restaurant-Based Healthy Eating Program and Factors Associated with Healthy Food Selection in Restaurants

ABSTRACT Background Restaurant-based interventions are a promising strategy to improve community food environments and customer food choices. Purpose Describe the extent to which a restaurant-based program, Ochsner Eat Fit (EF), may influence healthier food choices, and identify factors associated with EF food item selection. Methods Cross-sectional intercept surveys with 608 customers in 34 EF restaurants. Results Of 608 respondents, 17.3% ordered an EF item. Of 307 respondents familiar with EF, 89.6% believed EF can help them make healthier food choices. Respondents who agreed the restaurant environment supported healthy choices were 3.4 times more likely to order EF than those who did not agree (95%CI:1.5–7.7, p = .003); African American respondents were 2.1 times more likely than White respondents (95%CI:1.1–3.7, p = .017); and customers trying to make dietary changes were 4 times more likely than those who were not (95%CI:1.2–13.1, p = .024). Discussion Customers believed EF can positively influence food choices. Race, desire to make dietary changes, beliefs about healthy foods, and perceptions of the restaurant environment were associated with food choices. Future programming efforts should consider increasing the number and promotion of healthy options to support healthy decision-making. Translation to Health Education Practice Findings can be used to inform the development of restaurant-based healthy eating programs.

Food and beverage selection in children's sports arenas in Norway: a cross-sectional study.

To assess the selection of foods and beverages in children's sports arenas in Norway. A cross-sectional study design with a digital questionnaire was used. Descriptive statistics were used to present the results. Moreover, Pearson's χ2 tests examined the factors that could aid in distinguishing clubs with healthy or unhealthy consumables. Children's sports clubs in Norway. Representatives from 301 children's sports clubs in Norway answered the questionnaire between September and November 2021. In total, 89·4% of the participating sports clubs (n 301) offered soda drinks with sugar. Most of the sports clubs (88 %) reported to offer batter-based cakes such as pancakes and waffles and 63·8 % offered cakes. Furthermore, 47·5% sold hot dishes with processed meat, such as hamburgers and hot dogs. More than 80% of the sports clubs offered sweets and snacks, while 44·5% did not offer fruits, vegetables and/or berries. Notably, the important factors that distinguished sports clubs with healthier food selections from those with unhealthier selections were the presence of guidelines for the food offered and purchase agreements with food suppliers. Educational, governmental guidelines for the promotion of healthy eating and establishing agreements with suppliers of healthier foods could help to overcome barriers to unhealthy food selection.

Adolescents' experiences with the food selection at the sports arena in the area of Oslo, Norway: a focus group study.

To investigate adolescents' experiences with the food selection at the sport arena. Four focus group interviews were conducted with 4-6 participants each. Interviews were recorded and transcribed verbatim. The transcripts were coded in NVivo and the analysis was guided by thematic analysis. Adolescents from handball and football clubs in Oslo and Viken, Norway, participated in the study. A total of nine boys (11-14 years old) and ten girls (11-14 years old) participated in the study. We identified four main themes: interest for healthy food; experiences with the food selection at the sports arena; factors influencing participants' food choices at the sports arena and expectations related to a healthy food selection at the sports arena. Adolescents across the focus groups experienced the food selection at the sports arena as unhealthy. Price, marketing and availability of unhealthy food were important factors that influenced their food choices at the sports arena. The trainer appeared to motivate the participants to eat healthy. Participants wished for a healthier food selection at the sports arena. Cost of food emerged as a factor that influenced their food choices. Our study also indicates that marketing of unhealthy food and beverages should be restricted, to influence adolescence food choice towards healthier alternatives.

Abstract P175: Benefits Of Gardening For Self-management Of Hypertension Among African-American Men: A Mixed-Methods Analysis

Background: African American men are disproportionately affected by hypertension compared to other racial/ethnic groups. Self-management practices such as following a diet rich in fruits and vegetables can lead to improved hypertension control. However, healthy options may be inaccessible for some African American men, Gardening may provide easy access to fruits and vegetables. Methods: We conducted a mixed-methods study exploring African American men’s experiences with hypertension from Tennessee who regularly engaged in personal or community gardening and their gardening benefits (diet, physical activity, stress management), preferred diets and food selection. Participants completed semi-structured interviews and the Dietary Approaches to Stop Hypertension (DASH) diet questionnaire which was compared to the U.S. Department of Agriculture (USDA) MyPlate. Results: Participants (N=9, mean age 65 [SD 5.4] years) reported that gardening improved their regular physical activity, stress management, and satisfaction with providing for others. Several themes emerged including that participants preferred to manage their hypertension through diet modification by alternating traditional diets (high fat/sodium) with heart-healthy (low fat/sodium) meals and that they recognized the continuous nature of healthy food selection. Diet questionnaire responses revealed mean daily fruit (2.9 [SD 1.7]) and vegetable (2.8 [SD 1.1]) servings were below DASH diet recommendations but above MyPlate guidelines. Further, mean daily meat/protein (3.7[SD 1.1]) and fat/oil intake (6.4 [SD 7.2]) servings exceeded both recommendations. Conclusion: Our study suggests that personal and community gardening may provide a means for African American men to improve hypertension self-management practices through physical activity, stress relief, and healthy food access. Further studies of gardening interventions on blood pressure control among this group are warranted.

Nutrition and Health Programming and Outreach in Grocery Retail Settings: A Community Coalition in Action.

Grocery stores can provide a conducive environment for interventions targeting healthy eating and access to health services, particularly in low-income communities. A wide array of organizations deliver nutrition and related programs in community settings, but rarely in a coordinated fashion. Collaboration of local health promotion organizations with grocery stores could increase consumers' access to and selection of healthy foods and related services. This evaluation of the In-Store Programming and Outreach Coalition (IPOC) uses thematic analysis of first-person accounts from coalition members. To our knowledge, this is the first study of such a coalition. We present perspectives from six stakeholders about the IPOC strengths, challenges, and recommendations for strengthening the delivery of in-store interventions. Themes identified include partnership, increased client reach and cross-referrals, conflicting work schedules, leadership, and recommendations to identify coalition leaders and expand services to other grocery stores. We conclude that grocery stores can offer a suitable setting for programming and community outreach through coalitions.

Association between Home-Cooking Frequency and Nutrient Intake Adequacy among Working Women in Malaysia

Women, especially those already married, usually will manage most household chores, including cooking. However, more significant percentage of married women have worked for a living in addition to doing household chores now [1]. Due to the long hours of working, it is hard for the women to frequently prepare meals at home, resulting in a lower quality of nutrient intake. The convenience meals, fast food, and other foods cooked outside the house are linked with a significantly greater calorie, sodium, and fat intake and a poorer intake of micronutrients [2].
 This cross-sectional study aims to determine the association between home cooking frequency and nutrient intake adequacy among working women in Malaysia. A total of 131 working women in Malaysia aged 18 to 60 were recruited using a convenience sampling method after excluding 9 participants due to the underreported dietary intake. The participants must answer the questionnaire regarding the frequency of cooking at home in a week. The nutrient intake is determined based on the 24-hours dietary recall and analyzed using Nutritionist Pro™ version 5.4.0 software. The participants were able to track their daily nutrient intake and home cooking frequency within a week.
 The participants (median age: 27.0 ± 17 years) were aged between 18 to 60 years old, predominantly married (51.1%), Malay (96.9%), and full-time workers (92.4%), with monthly income for most of the participants (78.6%) are ≤ RM 4 850. Also, 52% of the participants work in the government sector and most current work at Terengganu (48.1%). Also, the majority of the participants do not have any children below 18 years old (70.2%). Most of them live together with their husband and children (41.2%), followed by parents (29%).
 Most participants reported that they only tended to cook at home between zero to twice a week. Nevertheless, this study indicates that the median energy consumption is somewhat lower, at 1362 kcal, compared to the median energy intake of women from the 2014 Malaysian Adult Nutrition Survey (MANS), which is 1445 kcal [3]. More than half of the individuals (54.2 %) had a poor diet, with scores of less than 51.
 
 To conclude, from this study, it is reported that most working women do not get a proper nutrient intake due to the long working hours and other responsibilities. This study revealed that adequate nutritional intake differed considerably between working women who regularly cooked throughout the week and those who did not. Understanding healthy food and ingredient selection along with healthy preparation may improve dietary habits while cooking food at home. Hence, simply devoting time to cooking food at home may not result in a healthy diet since other variables such as socioeconomic position, attitudes, and family preparation abilities may impact diet quality.

Low subjective social status is associated with daily selection of fewer healthy foods and more high-fat/high sugar foods

Socioeconomic status has been related to poorer eating behaviors, potentially due to feeling of lower status relative to peers. Despite experimental evidence that temporarily feeling of lower status can contribute to greater caloric intake, it remains unclear how feeling of lower social status relate to eating behavior in daily life. This study aimed to test whether lower subjective social status (SSS)—the feeling of having relatively lower social status—in American society and relative to college peers were related to daily food selection. A sample of 131 young adults (Mage = 20.3, SD = 0.8; 60% female; 46% Latinos; 34% European American; 15% Asian American; 5% of other ethnicities) reported their SSS in society and in college and completed 15 daily reports regarding the number of daily servings they had of fruits, vegetables, fried foods, fast foods, desserts, and sugary drinks. Multilevel models with days nested within individuals were used to test whether low SSS in society or college related to daily food intake. Next, we examined whether associations were driven by young adults' perceived stress and daily stressors. Analyses controlled for age, gender, ethnicity, family and personal income, and parents' education to test the unique associations between subjective status and food intake. Whereas SSS in society was not related to food intake, young adults with lower SSS in their college consumed fewer daily servings of healthy foods and more daily servings of high-fat/high-sugar foods. Although lower college SSS was related to greater perceived stress, perceived stress and daily stressors were consistently unrelated to daily food intake. Findings suggested that lower SSS in local environments (e.g., college) may impact young adults’ daily food choices through processes beyond heightened stress.

The impact of primary school nutrition policy on the school food environment: a systematic review.

School nutrition policies that aim to address unhealthy diets have been introduced in many countries. This systematic review aimed to synthesize the international literature to determine the impact (overall and by socioeconomic position [SEP]) of primary school nutrition policies on the availability of foods and beverages in schools. Seven databases were searched using keywords and medical subject headings related to nutrition policies and schools. Studies that reported on the impact of implemented school nutrition policies on food and beverage availability within primary schools were included. Eighteen studies (reported across 20 papers) were included. Fifteen of the included studies reported some positive impacts of policies, including increased availability of healthier foods and decreased availability of less healthy foods. Five studies focused specifically on schools in low-income communities and a further three specifically compared schools by SEP, with mixed findings. Two studies reported on factors influencing policy implementation, reporting a lack of financial resources as a barrier to schools offering a wider selection of healthy foods and additional school resources as increasing the likelihood of offering healthy foods. School nutrition policies appear to be effective at improving the healthiness of foods and beverages available at schools. Furthermore, the results suggest that well-implemented school nutrition policies that improve the healthiness of foods available are unlikely to exacerbate the socioeconomic gradient of poor nutrition. However, the number of studies that reported results by SEP limits drawing strong conclusions regarding equity impacts and we strongly recommend further studies analyze their findings according to SEP.

The Effects of Social Distance and Food Packaging Claims on Healthy Food Selection

The Effects of Social Distance and Food Packaging Claims on Healthy Food Selection

Development of a Nudge Program at One Alaska Food Pantry.

Food pantry clients experience many health disparities, including elevated incidence of diabetes, heart disease, and other nutrition-related conditions. Nutrition education interventions in the form of a nudge can be an effective method to increase nutrition knowledge and healthy pantry food selection. Currently there is no nutrition education program at the largest food pantry in Alaska. The goal of this project was to develop a nutrition intervention in the form of a nudge to increase the selection of nutritious foods by pantry clients. Methods included the development of nudges, or environmental cues, within the pantry as well as client education handouts and recipes for clients to take home. Implications for practice include the potential to increase staff and client knowledge and nutrition education, as well as for impacting the overall health and food security of the clients and their families. Additional implications include the availability of the program and resources for other food pantries across the state to customize for use in their facilities. After the program has been implemented, it can be evaluated across each site and its efficacy determined to implement into policy.

A Qualitative Exploration of Parents’ Food Choices During Early Childhood

ObjectiveTo explore parents’ accounts of the goals they seek when choosing foods for their young children through the lens of goal-systems theory. DesignIn-depth interviews with parents of children aged from 6 months to 5 years. SettingMontevideo, Uruguay. ParticipantsForty-two parents (aged 19–44 years, 90% female). Phenomenon of InterestParents’ personal experiences, feelings, and opinions related to how they choose foods for their children. AnalysisContent analysis based on deductive-inductive coding. ResultsParents’ accounts confirmed they intended to pursue different goals when choosing foods for their children. Health-related goals mainly motivated the selection of healthy foods, but they also drove the selection of some ultra-processed products because of misconceptions about their healthiness. Pleasure and enjoyment motivated the selection of ultra-processed products, whereas stress avoidance was associated with selecting convenient foods. The selection of unhealthy foods raised conflicts between goals, which were solved using goal shielding, changes in risk perception and/or compensatory health beliefs. Conclusions and ImplicationsResults point to the need for communication campaigns and community-based interventions to introduce changes in how ultra-processed products are conceptualized and increase the associations between healthy foods and children's pleasure and enjoyment to promote healthier eating patterns during infancy and early childhood.

Exploration of the definition and components of food and nutrition literacy among junior secondary school students: a qualitative study

BackgroundFood and nutrition literacy (FANLit) has been proposed to promote healthy diet behaviour and is believed to decrease the prevalence of overweight, obesity and chronic disease. However, the perspective of junior secondary school students, aged 12–15 years and stakeholders towards FANLit is not well-defined. Thus, this study aims to explore the definition and components of FANLit.MethodsThis qualitative study was carried out in Health region 2 including Phitsanulok, Sukhothai, Tak, Uttradit and Pethchboon. 49 participants from national and regional levels of Thailand were recruited. Data were collected by in-depth interview and focus group discussion using semi-structured questionnaire. Interview data were transcribed verbatim and analysed using thematic analysis.ResultsFANLit is defined as an individual’s level of knowledge and skills (fundamental, interactive and critical) that relates to food and nutrition for appropriate selection of food and nutrient. Four themes of FANLit were identified as follows: 1) food and nutrition knowledge (Subthemes: food knowledge, food understanding, nutrition knowledge and nutrition understanding), 2) functional food and nutrition literacy (Subthemes: accessing to food and nutrition information, food selection, food preparation, daily food and nutrition planning and management), 3) interactive food and nutrition literacy (Subthemes: communication with others, sharing and discussion), and 4) critical food and nutrition literacy (Subthemes: information used in decision making, healthy food selection and effective budgeting).ConclusionThe results presented beneficial information regarding FANLit definition which is the initial stage to develop the assessing instrument and the intervention to improve FANlit in the adolescent group.

Fatty Acid Profiles of Venus Clam (Marcia opima) and Blood Cockles (Anadara granosa) Harvested at Different Geographical Locations in the Northwest Coast of Sri Lanka

ABSTRACT The present study elucidated the effects of species and geographical location on the fatty acid profile and lipid indices of bivalves. Lipid profiles of venus clam (Marcia opima) and blood cockles (Anadara granosa) harvested from Naruvilikulam and Achchankulam situated on the northwest coast of Sri Lanka were determined, and lipid indices were calculated. The dominant fatty acid group found in bivalves was saturated fatty acids. Total n-3 and n-6 fatty acid contents were similar between the two species. Both bivalve species were identified as potential sources of docosahexaenoic acid. Bivalves from Naruvilikulam site had significantly abundant levels of linolenic and eicosapentaenoic acids (0.83% and 5.69%, respectively). Thrombogenicity index was not influenced by species and geographical location of bivalves. M. opima and bivalves from Naruvilikulam site were detected with lower atherogenicity indices and higher hypocholesterolemic/hypercholesterole-mic ratios than their counterparts and, therefore, can be recommended for consumers interested in healthy food selection.

Examining Elementary School Children's Knowledge about Food and Nutrition in Southwestern Ontario, Canada.

Purpose: Knowledge is fundamental to helping children make nutritional choices that support lifelong healthy behaviours. This study (i) investigates elementary school children's knowledge about food and nutrition and (ii) identifies sociodemographic factors influencing children's reported knowledge.Methods: In 2017-2019, a survey was administered to 2443 students (grades 5-8) at 60 schools across southwestern Ontario, Canada, and a parent survey was used to validate self-reported sociodemographics. Multiple regression was used to analyse children's knowledge scores and related sociodemographic factors. A total knowledge score was calculated by summing correct responses derived from 46 individual questions in the student survey.Results: Mean total knowledge score was 29.2 out of a possible 46 points (63.5% correct). Students demonstrated some knowledge and awareness of strategies to encourage fruit and vegetable consumption, healthy food selection, nutrition, and food preparation skills, although knowledge of food guide recommendations and locally sourced produce were limited. Female sex, family income, and rurality were associated with higher knowledge scores.Conclusions: Results provide insight regarding strengths and gaps in elementary-school children's food and nutrition knowledge. Poor performance of students on specific food guide-related questions suggests that the general guidance of the 2019 Canada's Food Guide might be better understood by children and adolescents.

Increasing Healthy Food Selection in a Campus Food Pantry through Redesign and Nutrition Education Nudges

Increasing Healthy Food Selection in a Campus Food Pantry through Redesign and Nutrition Education Nudges

Analysis of Food Expenditure in Perak

This study aims to analyze food expenditure among the community in Perak. There are three objectives targeted in this study including: 1) identify the level of food expenditure, 2) identify the relationship between demographic factors with food expenditure and 3) analyze the factors influencing food expenditure. This quantitative study used a set of questionnaire as an instrument to obtain the necessary information. A total of 206 respondents were involved in this study through snowball sampling. All selected respondents were heads of families living in the state of Perak. Descriptive analysis showed that the mean food expenditure was RM1,301.89. In addition, the findings of the study also showed that there was significant relationship between age and education with food expenditure. The significance value was 0.05, multiple regression analysis showed that consciousness, personal and religious factors were significantly positive while social factors were significantly negative. Media was found as the only factor that was not significant. In conclusion, food spending in the state of Perak is high and this situation is driven by many factors. This included the supply of food at affordable prices, the function of the authorities to promote food, high supply of ready and unfinished food and so on. The implications of the study have highlighted the importance of expenditure planning especially to every head of the family. This is important to ensure that the residents in Perak have sufficient knowledge on the selection of good healthy foods.

Evidence That Habit Moderates the Implicit Belief-Behavior Relationship in Health Behaviors.

Theory suggests that implicit beliefs are more likely to be associated with spontaneous, impulsive health behaviors (e.g., smoking, snacking), while controlled, consciously accessible beliefs are more likely to be associated with behaviors that require deliberation and reasoned decision-making (e.g., physical activity, healthy food selection). Consistent with these predictions, we proposed that as behaviors become habitual, they require less deliberation to enact and are thus more likely to be controlled by non-conscious processes, as indicated by stronger associations with implicit beliefs. The present study tested the moderating effect of habit on the effects of implicit beliefs on two health behaviors. Two samples of university students completed measures of attitude, habit, and implicit beliefs for free-sugar intake (sample 1) and heavy episodic drinking (sample 2) at an initial time point, with follow-up behavioral measures taken at 2 and 4 weeks later, respectively. Path analyses indicated that attitude and habit predicted behavior in both samples, and habit moderated the implicit belief-behavior relationship in both samples. The effect of implicit beliefs on behavior was larger among participants reporting strong habits. Implicit beliefs did not moderate the effect of explicit attitudes on behavior. Findings provide preliminary evidence that experiencing health behaviors as habitual is associated with a stronger implicit beliefs-health behavior relationship.

Erratum: Mediterranean Diet and its Benefits on Health and Mental Health: A Literature Review.

Mediterranean Diet (MD) is currently considered one of the most healthy dietary models worldwide. It is generally based on the daily intake of fruit and vegetables, whole grains, legumes, nuts, fish, white meats, and olive oil. It may also include moderate consumption of fermented dairy products, a low intake of red meat, and red/white wine during the main course. Even if the effect of MD on cancer prevention as well as on human metabolic and cardiovascular balance has been discussed, including the quality of life of the exposed population, the putative effects on mental health are still not properly investigated. This narrative review reports on some emerging pieces of evidence on the possible impact of MD on general health and the outcome of psychiatric disorders (e.g., major depression, anxiety) and encourages further studies to test the benefits of healthy food selection on the health of the general population.

Evaluation of the relationship between adolescents’ nutritional habits and school achievements

<p class="abstract"><strong>Background:</strong> This research was performed for the purpose of evaluating the relationship between adolescents’ nutritional habits and school achievements.</p><p class="abstract"><strong>Methods:</strong> This is a cross-sectional study and it was performed with the participation of adolescents. Research sample was composed of a total of 1,651 students selected via cluster sampling method from six high-schools and their equivalents chosen through simple random sampling in a manner to ensure that each high school type was represented in the sample from 46 high-schools. </p><p class="abstract"><strong>Results:</strong> The mean of students’ school achievement scores is 72.95±12.28. As per analysis of the correlation between means of scores obtained by students from nutrition exercise behavior scale (NEBS) sub-scales and means of students’ school achievement scores, it was found that students’ school achievement was positively correlated with sub-scales of healthy nutrition-exercise behavior and regularity of meal patterns.</p><p class="abstract"><strong>Conclusions:</strong> It was ascertained that, as scores obtained by students from NEBS increased, students’ school achievement scores went up. It is recommended that, through the cooperation to be established between health professionals, school staff and family, adolescents should be enticed to acquire the healthy food selection autonomy and to make it a part of their lifestyles as of early age.</p>