Recommendations For Vegetable Intake Research Articles

Identifying the barriers and facilitators to fruit and vegetable consumption in rural Australian adults

Within rural Australia, only 47% and 9% of adults meet recommendations for fruit and vegetable intake, respectively, which is a leading contributor to the increased risk of non-communicable disease. Previous literature has identified barriers and facilitators to increasing fruit and vegetable intake in rural Australian settings, such as having greater access to fresh produce(1). However, this literature is limited by observing fruit and vegetables as a single food group and small sample sizes. This study aimed to determine the barriers and facilitators to meeting fruit and vegetable recommendations (as separate food groups) in rural Australian adults. It was hypothesised that barriers and facilitators to consumption of fruits and vegetables would be identified at the individual, social-environmental and physical-environmental levels of a socio-ecological framework and these would differ between fruit and vegetables(2). Data from the 2019 Active Living Census were used, completed in the Loddon Campaspe region of north-west Victoria, Australia. Data were available at the level of the individual (socio-demographic characteristics, health behaviours, education level, financial stability), social-environment (household size), and physical-environment (use of community gardens). Information on fruit and vegetable consumption was collected using two open-ended questions asking how many serves were consumed each day. Survey weighting was used to account for the survey design. Descriptive statistics were reported for continuous (mean and standard errors [SE]) and categorical (frequencies) data. Multivariate logistic regression analyses were used to determine odds ratios (OR) and 95% confidence intervals (CI) for meeting fruit and vegetables recommendations according to barriers and facilitators at the individual, social-environmental and physical-environmental level. A total of 13,464 adults with complete data were included in the analysis (51% female; mean age 48 (0.17) years). Mean fruit intake was 2.85 (0.02) serves per day and mean vegetable intake was 1.56 (0.01) serves per day. A total of 48% of participants consumed the recommended two serves of fruit daily, while 19% consumed the recommended five serves for vegetables. Multivariate analyses determined distinct barriers and facilitators to consumption between fruit and vegetables. For example, a larger household size facilitated meeting vegetable recommendations (OR: 1.41; 95% CI: 1.22, 1.63), but not fruit, and greater alcohol consumption was a barrier to meeting fruit recommendations (OR: 1.47; 95% CI: 1.31, 1.64), but not vegetables. Common facilitators across both fruit and vegetables included higher age, lower BMI, being a non-smoker, and engaging in more vigorous activity. The results of this research will help inform future policies to increase both fruit and vegetable intake in rural communities, therefore contributing to efforts to improve the health of rural Australians.

Fruit and Vegetable Intake in Adults with Sickle Cell Disease

Introduction Patients with sickle cell disease (SCD) experience frequent disruptions to their daily lives from vaso-occlusive pain episodes and chronic organ complications, such as stroke. These acute and chronic complications negatively impact patients' ability to continue their educational and occupational obligations, making them vulnerable to socioeconomic challenges (PMID 30540112). In children with SCD, individual-level socioeconomic distress was associated with poor diet quality (PMID 34811867). In the non-SCD literature, food insecurity is characterized by a low fruit and vegetable diet intake and a greater risk of chronic kidney disease (PMID 24434743). The association of individual level socioeconomic distress with fruit and vegetable intake and, in turn, of fruit and vegetable intake with kidney function in adults with SCD is unclear. Methods We prospectively surveyed adults with SCD to investigate the association between individual level socioeconomic distress, fruit and vegetable intake, and kidney function. Between July 2022 and June 2023, we enrolled 81 adults with a diagnosis of SCD from an outpatient clinic at a Sickle Cell Center in an urban academic institution. We assessed fruit and vegetable intake using the National Cancer Institute's All Day Screener, a validated tool that estimates daily intake of fruit and vegetables. Markers of socioeconomic distress were measured using a modified short quantitative survey created by adapting the Centers for Disease Control's Behavioral Risk Factor Surveillance System Questionnaire. The distressed community index (DCI), a composite indicator that estimates the economic well-being of a community, was determined for each patient's residential address. The data were analyzed using descriptive statistics, and the association of fruit and vegetable intake with body mass index and kidney function was determined using linear regression, adjusting for age, sex, and SCD genotype. Results The median age of the cohort was 38 years (interquartile range [IQR], 31 - 45 years), 60% were female, 74% had Hb SS or Sβ 0-thalassemia genotype, and 47% were on hydroxyurea therapy. The median BMI of the cohort was 25 kg/m 2 (IQR, 21 - 30 kg/m 2). With respect to socioeconomic indicators, 33% (25/75) had high school or less education, 80% (59/74) did not own their residence, 48% (37/77) were unemployed or unable to work, and 71% (49/69) had income of < $35,000/year. The median DCI for our cohort was 90.8 (IQR, 68.9 - 94.9) with 65% (52/81) living in a distressed community (DCI > 80). The median fruit and vegetable servings consumed by the cohort was 1.95 serving sizes per day (IQR 1.05-3.04 servings), which is lower than the Centers for Disease and Control (CDC) Prevention daily dietary recommendation of 5 servings per day, and below the national and state-level (Illinois) average of 2.6 servings per day in the general population (PMID 34990439). Only 15% (11/75) of our cohort met the CDC daily recommendations of fruits and vegetables. Baseline demographics, including age, sex, SS/Sβ 0-thalassemia genotype, and hydroxyurea therapy use, were not different between those that met versus did not meet the daily fruit and vegetable intake requirements (Table). Similarly, we did not observe any differences in the socioeconomic indicators, DCI score, or proportion of patients living in a distressed tier in these two groups. On multivariable analyses, lower fruit and vegetable intake was associated with higher body mass index (natural log β 0.08 ± 0.03; P = 0.001) and higher urine albumin to creatinine ratios (natural log β 0.41 ± 0.2; P = 0.045). We did not observe any association of fruit and vegetable intake with systolic or diastolic blood pressure or with estimated glomerular filtration rate. Discussion In this prospective, cross-sectional study, adults with SCD experienced a high burden of socioeconomic distress. Although we did not observe an association between socioeconomic indicators and fruit and vegetable intake, only 15% of our cohort met the daily fruit and vegetable intake recommendations. Lower fruit and vegetable intake was associated with higher body mass index and albuminuria. Our findings highlight the need for further investigation to better understand barriers to a healthy diet in people with SCD. Furthermore, strategies to increase fruit and vegetable intake may represent a modifiable risk factor to improve SCD-related health.

Operationalization, characterization and validation of a healthy lifestyle index in 35 LMICs

Abstract Background For low- and middle-income countries (LMICs), there is no comprehensive and valid index reflecting overall lifestyle. This study aimed to operationalize, characterize, and validate a healthy lifestyle index (HLI), based on the World Health Organization (WHO) recommendations. Methods We used cross-sectional, complete-case data from individual-level, nationally representative surveys among non-pregnant adults in 35 LMICs, applying the WHO STEPwise approach to NCD risk factor surveillance (2009-2019; N = 125,607). The HLI was constructed based on WHO recommendations for fruit and vegetable intake, physical activity, smoking, and alcohol intake (unhealthiest = 0 points; healthiest = 16 points). We calculated the distributions of the HLI and its subcomponents across socio-demographic and geographic strata, accounting for the survey design and each country's World Bank population estimate. Partial Spearman correlations were calculated for the HLI with its subcomponents and cardio-metabolic risk markers. Results In this study (females: 51%, median age: 35.4 years), median HLI-score was 10.3 (interquartile range: 8.2-12.3), being highest in females (versus males) and low-income countries (versus middle-income countries). Twenty-two percent had at least five servings of fruits and vegetables per day (males: 20%, females: 24%); 82% exercised at least 600 MET-min/week (males: 87%, females: 78%); 69% never smoked (males: 40%, females: 97%); 64% were alcohol abstainers (males: 50%, females: 78%). Correlations of the HLI with its subcomponents were moderate and positive, ranging between r = 0.35 and r = 0.64; correlations with cardio-metabolic risk markers were weak, ranging between r = |0.02| and r =|0.12|. Conclusions The majority of adults in LMICs appear to live a healthy lifestyle, particularly women and individuals in low-income countries. Low fruit and vegetable intakes are a major concern. The HLI shows good content but poor construct validity. Key messages • There is an urgent need for interventions to promote fruit and vegetable consumption in LMICs. • The HLI is suitable to monitor lifestyles in LMICs on individual-, country- and WHO region-level.

Physical Activity, Sedentary Behavior, Fruit and Vegetable Consumption, and Sarcopenia in Older Chinese Adults: A Cross-Sectional Study.

The purpose of this study was to investigate the association between moderate to vigorous physical activity (MVPA), sedentary behavior, fruit and vegetable intake, and the risk of sarcopenia among older Chinese adults. This cross-sectional study enrolled 5418 older Chinese adults who participated in the Study on Global Aging and Adult Health (SAGE). Participants reported information about their physical activity, sedentary behavior, and dietary habits (fruit and vegetable intake). Sarcopenia was defined as the presence of low skeletal muscle mass and either a slow gait speed or weak handgrip strength. A multiple logistic regression model was employed to determine the relationship between MVPA, sedentary behavior, fruit and vegetable intake, and the risk of sarcopenia. Only 32.63% of participants met all three recommendations (for MVPA, sedentary behavior, and fruit and vegetable intake). Compared with meeting none of the recommendations, meeting all three recommendations was associated with a lower risk of sarcopenia (OR = 0.63, 95% CI = 0.41-0.98). Moreover, meeting the recommendation for sufficient fruit and vegetable intake (OR = 0.69, 95% CI = 0.58-0.83), MVPA and fruit/vegetable intake (OR = 0.67, 95% CI = 0.52-0.86), and sedentary behavior and fruit/vegetable intake (OR = 0.69, 95% CI = 0.48-0.98) was associated with a lower risk of sarcopenia. Our findings indicate that in this large representative sample of older Chinese adults, meeting lifestyle recommendations for MVPA, sedentary behavior, and fruit and vegetable intake protected against sarcopenia.

Pre-Season Nutritional Intake and Prevalence of Low Energy Availability in NCAA Division III Collegiate Swimmers.

There is limited information regarding the dietary habits and energy availability (EA) of collegiate athletes. Therefore, the purpose of the present study is to assess the nutrient intakes, dietary habits, and prevalence of low EA (<30 kcals/kg FFM) in a group of National Collegiate Athletic Association (NCAA) Division III male and female swimmers. Energy and nutrient intake, body composition, and exercise energy expenditure was assessed in 30 (n = 15 males, n = 15 females) NCAA Division III swimmers during pre-season using three-day diet and seven-day activity records alongside multi-frequency, bioelectric impedance analysis. A validated screening tool was used to assess for low EA in the female swimmers. Mean EA in male and female athletes was 32.7 ± 12 and 34.9 ± 13.7 kcals/kg FFM, respectively, and was not significantly different between the sexes (p = 0.65). Twenty percent of swimmers (n = 3 males, n = 3 females) presented with optimal EA, 37% (n = 5 males, n = 6 females) presented with sub-optimal EA, and 43% (n = 7 males, n = 6 females) presented with low EA. Swimmers who presented with a low EA consumed significantly less calories, carbohydrates, and proteins than non-low EA swimmers (p < 0.02). The validated screening tool failed to classify 50% of female swimmers who presented with low EA. Only eight athletes achieved the USDA MyPlate recommendation for fruits, whereas three athletes achieved the recommendation for vegetables, with no differences between the sexes (p > 0.05). The present findings show that there was a high prevalence of low EA during the pre-season among male and female collegiate swimmers that was not fully captured using a validated screening tool for females. Low EA occurred alongside lower intakes of calories, carbohydrates, and proteins, and the majority of swimmers did not meet the United States Department of Agriculture recommendations for fruit and vegetable intake. These data stress the need for improved dietary intakes in NCAA Division III collegiate swimmers.

NEWSTART: An 8-Week Faith-Based Health Promotion Program to Reduce Chronic Disease Risk Factors in the US.

This single-group experimental study examined the effectiveness of NEWSTART, an 8-week health promotion program among adults in an Adventist Faith Community. Participants had a significant reduction in diastolic blood pressure [Formula: see text] with a moderate effect size (Cohen d = 0.68), reduction of daily sugar-sweetened beverage intake [Formula: see text] with a large effect size (Cohen d = 0.96), and an improvement in weekly moderate intensity exercise [Formula: see text] with a large effect size (Cohen d = .83). Participants met the fruit and vegetable intake recommendations and applying program principles to reduce chronic disease risk factors.

Parental Information Needs and Intervention Preferences for Preventing Multiple Lifestyle Risk Behaviors Among Adolescents: Cross-sectional Survey Among Parents.

Parents play an influential role in the health behaviors of their children, such as physical activity, dietary intake, sleep, screen time, and substance use. However, further research is needed to inform the development of more effective and engaging parent-based interventions targeting adolescent risk behaviors. This study aimed to assess parents' knowledge about adolescent risk behaviors, barriers and facilitators to engaging in healthy behaviors, and preferences for a parent-based prevention intervention. An anonymous web-based survey was conducted from June 2022 to August 2022. Eligible participants were parents of children aged 11 to 18 years and were residing in Australia at the time of this study. The survey assessed the parents' perceived and actual knowledge about Australian health guidelines for youth, parent and adolescent engagement in health behaviors, parenting style and attitudes, barriers and facilitators to engaging in healthy behaviors, and delivery and component preferences for a parent-based preventive intervention. Descriptive statistics and logistic regressions were conducted to analyze the data. A total of 179 eligible participants completed the survey. The mean age of the parents was 42.22 (SD 7.03) years, and 63.1% (101/160) were female. Parent-reported sleep duration was high for both parents (mean 8.31, SD 1.00 hours) and adolescents (mean 9.18, SD 0.94 hours). However, the proportion of parents who reported that their child met the national recommendations for physical activity (5/149, 3.4%), vegetable intake (7/126, 5.6%), and weekend recreational screen time (7/130, 5.4%) was very low. Overall, parents' perceived knowledge of health guidelines was moderate, ranging from 50.6% (80/158) for screen time to 72.8% (115/158) for sleep guidelines (for children aged 5-13 years). Actual knowledge was lowest for vegetable intake and physical activity, with only 44.2% (46/104) and 42% (31/74) of parents reporting correct guidelines for these behaviors, respectively. The key issues of concern reported by parents were excessive use of technology, mental health, e-cigarette use, and negative peer relationships. The top-rated delivery method for a parent-based intervention was via a website (53/129, 41.1%). The highest rated intervention component was opportunities for goal-setting (89/126, 70.7% rated very or extremely important), and other important program features were ease of use (89/122, 72.9%), paced learning (79/126, 62.7%), and appropriate program length (74/126, 58.8%). The findings suggest that such interventions should be brief and web based and should aim to increase parental knowledge of health guidelines; provide opportunities for skill-building, such as goal-setting; and include effective behavior change techniques, such as motivational interviewing and social support. This study will inform the development of future parent-based preventive interventions to prevent multiple lifestyle risk behaviors among adolescents.

Risk factors associated with overweight and obesity in people with severe mental illness in South Asia: cross-sectional study in Bangladesh, India, and Pakistan.

Obesity is one of the major contributors to the excess mortality seen in people with severe mental illness (SMI) and in low- and middle-income countries people with SMI may be at an even greater risk. In this study, we aimed to determine the prevalence of obesity and overweight in people with SMI and investigate the association of obesity and overweight with sociodemographic variables, other physical comorbidities, and health-risk behaviours. This was a multi-country cross-sectional survey study where data were collected from 3989 adults with SMI from three specialist mental health institutions in Bangladesh, India, and Pakistan. The prevalence of overweight and obesity was estimated using Asian BMI thresholds. Multinomial regression models were then used to explore associations between overweight and obesity with various potential determinants. There was a high prevalence of overweight (17·3 %) and obesity (46·2 %). The relative risk of having obesity (compared to normal weight) was double in women (RRR = 2·04) compared with men. Participants who met the WHO recommendations for fruit and vegetable intake had 2·53 (95 % CI: 1·65-3·88) times greater risk of having obesity compared to those not meeting them. Also, the relative risk of having obesity in people with hypertension is 69 % higher than in people without hypertension (RRR = 1·69). In conclusion, obesity is highly prevalent in SMI and associated with chronic disease. The complex relationship between diet and risk of obesity was also highlighted. People with SMI and obesity could benefit from screening for non-communicable diseases, better nutritional education, and context-appropriate lifestyle interventions.

Fruit and Vegetable Shopping Behavior and Intake among Low-Income Minority Households with Elementary-Aged Children.

Low-income children and families do not meet the recommendations for fruit and vegetable (FV) intake. This study aimed to assess the association between FV shopping behavior and child FV intake through a cross-sectional study design analyzing self-reported surveys (n = 6074) from adult-child dyads of Hispanic/Latino and African American participants enrolled in the Brighter Bites co-op program. Through quantitative mixed effects linear regression models, accounting for school-level clustering and adjusting for covariates, child FV intake was positively associated with shopping for FV at large chain grocery stores (p < 0.001), natural/organic supermarkets (p < 0.001), warehouse club stores (p = 0.002), discount superstores (p < 0.001), small local stores/corner stores (p = 0.038), convenience stores (p = 0.022), ethnic markets (p = 0.002), farmers’ markets/co-op/school farm stands (p < 0.001), and gardens (p = 0.009) among Hispanic/Latinos participants. Among African American participants, there was significant positive association between child FV intake and shopping for FV at natural/organic supermarkets (p < 0.001), discount superstores (p = 0.005), and convenience stores (p = 0.031). The relationship between location and frequency of shopping for FV and child FV intake varied between races. Further research is needed to better understand the influence of cultural and physical environmental factors. Nutrition education programs are vital to encouraging families to make healthier food choices and purchases to improve child FV consumption.

Food Group, Macronutrient Intake, and Metabolic Status in the US-Affiliated Pacific’s Children’s Healthy Living (CHL) Program

The Children's Healthy Living study provided dietary intake information for understudied Native Hawaiian and Other Pacific Islander (NHOPI) young children. Our objective was to describe food group and macronutrient intakes of NHOPI children in the US-Affiliated Pacific region (USAP), overall and by jurisdiction, income level, and metabolic status. We evaluated 2-8-y-olds (n=3520) in a cross-sectional cluster sampled study using 2 d of dietary records completed by caregivers using provided tools, quantified by a specially developed food composition table and compared with US dietary recommendations. Overweight and obesity (OWOB) and acanthosis nigricans (AN) assessment (metabolic status) was completed by trained evaluators using standard tools. Demographic data were collected by questionnaire. Regression analysis identified differences in dietary component means by jurisdiction, World Bank income groups (WBIGs), and metabolic status, adjusted for age and sex. Few children met US recommendations for vegetable (2.4%) and milk (4.1%) food groups. US macronutrient recommendations were generally met. Food group and macronutrient intakes were significantly different by jurisdiction and WBIG. Means for food groups, except meats, and macronutrients, except protein, were higher in overweight/obese (OWOB) compared with healthy-weight children. Grain intake of 7.25 (SE: 0.08) oz was higher (P<0.05) and milk intake of 0.90 (SE: 0.05) cups was lower (P<0.05) in children with OWOB compared with those without OWOB [grains: 7.17 (SE: 0.07) oz; and milk: 0.96 (SE: 0.04) cups]. Monounsaturated fat intake of 11.68 (SE: 0.10) % energy was higher in those with OWOB, compared with healthy-weight children [11.56 (SE: 0.08) % energy, P<0.05]. Young children's diets in the USAP did not meet milk, vegetable, or fruit intake recommendations. There was variability in dietary patterns across the USAP and by WBIG. Grain intake and monounsaturated fat intake were lower and milk intake was higher in children with better metabolic status.

Body Composition and Metabolic Status of Italian and Spanish University Students: Relationship with Fruit and Vegetable Consumption.

Most university students do not follow recommendations for fruit and vegetable intake, with a consequent increase in the prevalence of cardiovascular disease (CVD) risk factors. The aim of this study was to compare obesity prevalence and biomarkers of metabolic status between Italian and Spanish university students, in relation with the consumption of fruits and vegetables. Food consumption, adherence to a Mediterranean diet (MD), level of physical activity (PA), blood glucose, total cholesterol, triglycerides and ketones, blood pressure, and body composition were evaluated. Among CVD risk factors, only glucose was significantly higher in Spaniards (SP), and only 3.1% of SP presented ketosis. SP had a higher percentage of energy from fat. Although adherence to MD and fruit and vegetable consumption did not differ between Italians and SP, students who consumed at least four servings of fruit and vegetables (FV group) showed better values for pressure and metabolic parameters than the no FV group. We observed an association between consumption of fruit and PA. Students who consumed more vegetables than fruit reported a better body composition profile and lower glucose concentrations. As previously suggested, in addition to PA, two servings of fruit and three servings of vegetables per day should be recommended.

Women’s well-being and experiences during the COVID-19 pandemic in the United States: A longitudinal mixed-methods approach

ABSTRACT This longitudinal mixed-methods study aimed to identify changes in women’s well-being and their lived experiences in the United States during the COVID-19 pandemic. Women (n = 124) recruited through snowball sampling completed surveys at two time points (March 2020 and April 2021) and follow-up interviews were conducted with 33 women in April 2021. Chi-square analyses, t tests, and multivariable modeling were used to assess changes in well-being variables. Overtime, participants experienced a significant decrease in stress and loneliness, an increase in meeting fruit and vegetable intake recommendations, and a decrease in physical activity. Four themes emerged through longitudinal qualitative analysis: (1) Role management and well-being, (2) From crisis to a desire for normal, (3) Politically divisive and ununified response, and (4) “A bit tarnished” silver lining. Results provide insights to the long-term experience of women within the on-going pandemic and can highlight opportunities for improvement in future public health crises.

Adults Meeting Fruit and Vegetable Intake Recommendations - United States, 2019.

The 2020-2025 Dietary Guidelines for Americans* advise incorporating more fruits and vegetables into U.S. residents' diets as part of healthy dietary patterns. Adults should consume 1.5-2 cup-equivalents of fruits and 2-3 cup-equivalents of vegetables daily.† A healthy diet supports healthy immune function (1) and helps to prevent obesity, type 2 diabetes, cardiovascular diseases, and some cancers (2); having some of these conditions can predispose persons to more severe illness and death from COVID-19 (3). CDC used the most recent 2019 Behavioral Risk Factor Surveillance system (BRFSS) data to estimate the percentage of states' adult population who met intake recommendations overall and by sociodemographic characteristics for 49 states and the District of Columbia (DC). Overall, 12.3% of adults met fruit recommendations, ranging from 8.4% in West Virginia to 16.1% in Connecticut, and 10.0% met vegetable recommendations, ranging from 5.6% in Kentucky to 16.0% in Vermont. The prevalence of meeting fruit intake recommendations was highest among Hispanic adults (16.4%) and lowest among males (10.1%); meeting vegetable intake recommendations was highest among adults aged ≥51 years (12.5%) and lowest among those living below or close to the poverty level (income to poverty ratio [IPR] <1.25) (6.8%). Additional policies§ and programs that will increase access to fruits and vegetables in places where U.S. residents live, learn, work, and play, might increase consumption and improve health.

Modelling the impact of compliance fruit and vegetable intake recommendations on mortality in Russia

Abstract Background Low fruit and vegetable intake is among the top ten selected risk factors for global mortality. The World Health Organization recommended daily fruit and vegetable intake is known to be 400 g/day. Despite strong evidence indicating that low fruit and vegetable intake relates to chronic diseases and mortality, most adults do not comply with dietary recommendations. According to the ESSE-RF epidemiological study, the prevalence of low fruit and vegetable consumption was 41.9%. The purpose of this study is to model the impact of following the national fruit and vegetables intake recommendations in decreasing N of death attributable to low fruit and vegetable intake. Methods A validated and transparent macrosimulation model, the PRIME (Preventable Risk Integrated ModEl) was used to estimate the cardiovascular and diet-related cancer death toll that could be prevented or delayed for the populations of Russia in a year. Data included in the model are a baseline scenario (actual F&amp;V intake), a counterfactual scenario (recommended intake), and age-and sex-specific mortality for cardiovascular and diet-related cancer diseases, together with the total population risk of a specific year. Monte Carlo analyses with 5000 iterations were performed to produce the 95% uncertainty intervals. Results In 2018, an estimated 52 725 deaths (95% CI: 33 474, 69 837) could be averted or delayed if Russians adhered to dietary recommendations on fruit and vegetable intake. Cardiovascular disease accounted for 97.8% of these deaths. The modelled reduction in deaths for coronary heart disease was 43 530 (95%CI: 24 782, 60 168), for stroke 8 063 (95%CI: 5 252, 10 715). The modelled reduction in deaths for lung cancer was 1132 (95%CI: 484, 1731). Conclusions The modelling illustrates the potentially large social benefits of compliance with national fruit and vegetable intake recommendations. Key messages Despite strong evidence indicating that low fruit and vegetable intake relates to chronic diseases and mortality, most adults do not comply with dietary recommendations. The modelling illustrates the potentially large social benefits of compliance with national fruit and vegetable intake recommendations.

Testing the Effects of Two Field-to-Fork Programs on the Nutritional Outcomes of Elementary School Students From Diverse and Lower-Income Communities.

The purpose of this quasi-experimental study was to evaluate the effects of two farm-to-school programs, specifically the Field-to-Fork Multi-visit Program (N = 264) and the Field-to-Fork After-school Club (N = 56), on nutritional outcomes of elementary school students (third to fifth grade) from urban, diverse, and lower-income communities. Data were collected via self-report surveys measuring: (a) knowledge of recommendations for daily fruit and vegetable intake; (b) fruit and vegetable consumption; (c) knowledge of cooking a healthy recipe using vegetables; and (d) desire for farm fresh foods at school. Statistical analyses included McNemar's and Wilcoxon signed rank tests. The proportion of students knowing how to cook a vegetable rich recipe increased with both programs (Multi-visit Program p < .001; After-school Club p = .002). Vegetable consumption increased with the After-school Club (p = .002). Farm-to-school programming can increase knowledge of cooking vegetable rich recipes and vegetable intake among elementary school students from diverse, urban, and lower-income communities.

Changes in Dietary Intake During COVID-19 Among Youth in Urban Communities: Insights From the COACHES Study

ObjectivesDisruption to nutrition education and school meal programs and widespread reports of increased food insecurity due to COVID-19 have raised concerns about the potential effect on the dietary quality of youth. Accordingly, this study sought to examine the impact of the pandemic on the dietary intake of youth participating in the Creating Opportunities for Adolescents through Coaching, Healthy Eating, and Sports (COACHES) program, an intervention using coaches trained in trauma-informed coaching strategies to improve health of youth from at-risk communities.MethodsThe COACHES program recruited 6th and 7th grade students from five schools in New Orleans, LA. Students (n = 67) completed an adapted version of the CoRonavIrus Health Impact Survey (CRISIS) for Youth (V0.3) to assess dietary intake and perception of health during the pandemic. Descriptive statistics were used to examine self-reported impact of the pandemic on eating behaviors.ResultsAmong the students who completed the CRISIS questionnaire (n = 67, 11.7+/−0.73 yrs, 55.2% female, 41.8% overweight/obese), 49.3% reported an overall physical health decrease during the pandemic, 65.6% were not meeting recommendations for daily fruit and vegetable intake, and 72.7% consumed sugary beverages two or more times daily. However, more than one-third actually reported increasing fruit and vegetable consumption during the pandemic, and more than one-quarter reduced their sugary beverage intake. Boys were more likely than girls to report increased fruit and vegetable intake, and youth who were overweight or obese were more likely to report maintaining or improving their overall diet, though results were only significant at the 90% level (P = 0.065).ConclusionsDespite challenges due to COVID-19, urban youth report improved dietary intake during the pandemic. These results highlight the importance of school-based intervention programs in meeting the nutrition needs of at-risk youth.Funding SourcesDepartment of Health and Human Services, Office of Minority Health.

Correlations between Self-Reported Cooking Confidence and Creativity and Use of Convenience Cooking Products in an Australian Cohort.

Background: Most Australians do not meet vegetable intake recommendations. Vegetables are most often consumed in evening meals. However, they often require preparation and therefore cooking skills. Convenience cooking products such as meal bases/concentrates and ready-made sauces are increasingly common and popular and may help address the barriers to vegetable consumption in terms of cost and time. These products also typically provide recipes, which include vegetables, and as such, may help address the barriers of cooking skills, confidence, and creativity. However, the relationships between the use of these products, cooking confidence, and cooking creativity remain unknown. Methods: Australian adults were surveyed (snowball recruitment, n = 842) on their use of convenience cooking products (meal bases/recipe concentrates, simmer sauces, marinades, and other cooking sauces), cooking confidence (7 item scale) and creativity (6 item scale), and demographic information. Results: Overall, 63.2% of participants reported using convenience cooking products. Those using these products had lower mean cooking skills confidence and creativity scores than those who did not, in all product categories assessed. Among users, those who reported "always" following the recipes provided had lower mean cooking confidence and creativity scores than those who followed the recipes less regularly. Conclusions: Therefore, improving the vegetable content of recipes provided with these products may be a tool to increase vegetable intake by users with lower cooking skills (confidence and creativity). This may complement traditional approaches such as education in improving vegetable intake.

Health-Risk Behaviors and Dietary Patterns Among Jordanian College Students: A Pilot Study.

Background/Aims: Health promotion and the incorporation of health-protective behaviors in people's lifestyles have a great role in enhancing individuals' overall health and well-being. College students are at increased risk of developing unhealthy dietary and lifestyle behaviors. A cross-sectional pilot study was conducted to assess the health-risk behaviors among undergraduate college students at Jordan University of Science and Technology.Methods: The final sample included 136 students, with a mean age of 21.1 ± 2.37 years, mostly females (69%). A self-reported questionnaire was used for data collection about dietary and lifestyle behaviors among college students. The questionnaire consisted of four parts: sociodemographic characteristics, body weight classifications, lifestyle behaviors, and dietary patterns and intake, and eating behaviors.Results: Most of the students did not meet the daily recommendations for fruit (76%) and vegetable (82%) intake. Males were significantly consuming fast food more frequently (p = 0.019), and smoked cigarettes (p < 0.001) or hookah (p = 0.015) more frequently than did females. Further, the majority met the recommendations for physical activity (81%), but exceeded recommendations for sedentary behavior. Females were more likely to have normal weight or be underweight (OR = 4.865), to have a fear of weight gain (OR = 3.387), and to have the recommended sleeping hours (OR = 7.685) than were males.Conclusion: The results indicate the health-risk behaviors and the gender-related differences among college students.

Comparison of pre-diagnosis dietary intake of women with gestational diabetes mellitus to dietary recommendations

The prevalence of Gestational Diabetes Mellitus (GDM) increased from 7% to 13.1% between 2013 and 2017 in NSW, Australia. Limited detail has been reported on dietary patterns prior to GDM diagnosis. AimTo evaluate adequacy of micronutrient intakes and contribution of nutrient-dense versus energy-dense, nutrient-poor food groups to total energy. MethodDietary intake of women with GDM was assessed over the six months prior to attending the first outpatient nutrition education group using the Australian Eating Survey: food frequency questionnaire with food group serves compared to the Australian Guide to Healthy Eating recommendations. Nutrient intakes compared to Estimated Average Requirements (EARs). Diet quality was evaluated using the Australian Recommended Food Score diet quality index. ResultsFifty women with a mean age of 30.8±4.6 years completed the Australian Eating Survey. Mean percentage (SD) energy intake derived from nutrient-dense versus energy-dense, nutrient-poor foods was 66.6% (12.4) and 33.4% (12.4); respectively. Median intakes of iron, calcium, fibre, iodine and folate were below EARs. Median (IQR) total Australian Recommended Food Score was 31(15) from a maximum 73 points. Adherence to the Australian Guide to Healthy Eating recommendations was low, with no participants meeting recommendations for serves of bread and cereals, 92% below dairy and dairy alternatives and 82% below vegetable intake recommendations. ConclusionsBefore being diagnosed with GDM, women derive a high percentage of total energy from energy-dense, nutrient-poor foods, have low dietary variety amongst nutrient-dense foods, and sub-optimal intakes of key pregnancy micronutrients. Poor dietary patterns require attention within medical nutrition therapy for GDM in order to optimise nutrition-related health outcomes.

Consumption of a Variety of Vegetables to Meet Dietary Guidelines for Americans' Recommendations Does Not Induce Sensitization of Vegetable Reinforcement Among Adults with Overweight and Obesity: A Randomized Controlled Trial.

Food reinforcement, or the motivation to obtain food, can predict choice and consumption. Vegetable consumption is well below recommended amounts for adults, so understanding how to increase vegetable reinforcement could provide valuable insight into how to increase consumption. We sought to determine whether daily consumption of the Dietary Guidelines for Americans (DGA) recommendations for vegetable intake induces sensitization of vegetable reinforcement in adults with overweight and obesity. Healthy adults with a BMI ≥ 25kg/m2 who consumed≤1 cup-equivalent of vegetables/day were randomly assigned to a vegetable intervention (VI; n=55) or an attention control (AC; n=55) group. The VI consisted of the daily provision of vegetables in the amounts and types recommended by the DGA (∼270g/day) for 8 weeks. Participants were followed for an additional 8 weeks to assess sustained consumption. Compliance was measured weekly by resonance Raman light-scattering spectroscopy (RRS). Vegetable reinforcement was tested at weeks 0, 8, 12, and 16 using a computer choice paradigm. In the VI group, RRS intensity increased from week 0 to 8 (from 22,990 to 37,220), returning to baseline by week 16 (27,300). No change was observed in the AC group. There was no main effect of treatment (P=0.974) or time (P=0.14) and no treatment x time interaction (P=0.44) on vegetable reinforcement. There was no moderating effect of sex (P=0.07), age (P=0.60), BMI (P=0.46), delay discounting (P=0.24), 6-n-propylthiouracil taster status (P=0.15), or dietary disinhibition (P=0.82) on the change in vegetable reinforcement. These findings suggest no effects of the provision of a variety of vegetables to meet DGA recommendations for 8 weeks on vegetable reinforcement and highlight the difficulty in increasing vegetable consumption in adults. This trial was registered at clinicaltrials.gov as NCT02585102.