Misreporting of Dietary Intake Affects Estimated Nutrient Intakes in Low-Income Spanish-Speaking Women

Misreporting of dietary intake affects the validity of data collected and conclusions drawn in studies exploring diet and health outcomes. One consequence of misreporting is biological implausibility. Little is known regarding how accounting for biological implausibility of reported intake affects nutrient intake estimates in Hispanics, a rapidly growing demographic in the United States. Our study explores the effect of accounting for plausibility on nutrient intake estimates in a sample of Mexican-American women in northern California in 2008. Nutrient intakes are compared with Dietary Reference Intake recommendations, and intakes of Mexican-American women in a national survey are presented as a reference. Eighty-two women provided three 24-hour recalls. Reported energy intakes were classified as biologically plausible or implausible using the reported energy intakes to total energy expenditure cutoff of 1.24, with low-active physical activity levels used to estimate total energy expenditure. Differences in the means of nutrient intakes between implausible (n=36) and plausible (n=46) reporters of energy intake were examined by bivariate linear regression. Estimated energy, protein, cholesterol, dietary fiber, and vitamin E intakes were significantly higher in plausible reporters than implausible. There was a significant difference between the proportions of plausible vs implausible reporters meeting recommendations for several nutrients, with a larger proportion of plausible reporters meeting recommendations. Further research related to misreporting in Hispanic populations is warranted to explore the causes and effects of misreporting in studies measuring dietary intake, as well as actions to be taken to prevent or account for this issue

Interaction matters: Strategies to promote engaged learning in an online introductory nutrition course

Fostering interaction in the online classroom is an important consideration in ensuring that students actively create their own knowledge and reach a high level of achievement in science courses. This study focuses on fostering interaction in an online introductory nutrition course offered in a public institution of higher education in Hawai‘i, USA. Interactive features included synchronous discussions and polls in scheduled sessions, and social media tools for sharing of information and resources. Qualitative student feedback was solicited regarding the new course features. Findings indicated that students who attended monthly synchronous sessions valued live interaction with peers and the instructor. Issues identified included technical difficulties during synchronous sessions, lack of participation on the part of fellow students in discussion and inability to attend synchronous sessions due to scheduling conflicts. In addition, few students made use of the opportunity to interact via social media. While students indicated that the interactive components of the course were valuable, several areas in which improvement may be made remain. Future studies may explore potential solutions to issues identified with new features to further promote interaction and foster learning in the course. Recommendations for instructors who are interested in offering online science courses in higher education are provided

A Qualitative Analysis of a Caregivers’ Experience of Complementary Feeding in a Population of Native Hawaiian, Other Pacific Islander and Filipino Infants: The Timing of the Introduction of Complementary Foods, and the Role of Transgenerational Experience

The aim of this study was to investigate caregivers’ experiences of complementary feeding (CF) among the Native Hawaiian and Other Pacific Islander (NHPI), and Filipino populations. Research focused on the timing of CF commencement, and the influence of transgenerational experience on feeding practices. The experiences and practices of those who fed human milk exclusively (HME), were compared to those who included infant formula (F&HM). Caregivers of a subset of 32 infants who were participating in a larger longitudinal study relating to CF and diet diversity, took part in voluntary in-depth interviews relating to CF practices. Interviews were recorded and transcribed. Two researchers analyzed interview transcripts. Interrater reliability and saturation were established. Institutional Review Board exemption was confirmed prior to study commencement. Interviews with 29 caregivers of infants were included in this study. Only infants of the F&HM group had an early introduction to complementary foods (age). Caregivers reported receiving conflicting advice from healthcare professionals (HCPs) in relation to timing of the introduction of complementary foods. Nonetheless, the majority of caregivers reported following the advice of HCPs. Extended family (including grandparents) played less of a role in infant feeding, compared to previous generations. While transgenerational practices were valued and included, ultimately, the perceived health and safety of the practice for infants influenced decisions

Food Security and Diet Quality in Native Hawaiian, Pacific Islander, and Filipino Infants 3 to 12 Months of Age

Food insecurity and other nutritional risks in infancy pose a lifelong risk to wellbeing; however, their effect on diet quality in Native Hawaiian, Pacific Islander, and Filipino (NHPIF) infants in Hawai‘i is unknown. In this cross-sectional analysis, the association between various indicators of food security and NHPIF infant diet quality were investigated in 70 NHPIF infants aged 3–12 months residing on O‘ahu, Hawai‘i. The dietary assessments of the infants were collected using a mobile food recordTM. Foods consumed across four days were categorized into seven food groups. Indicators for food security were examined through an adapted infant food security index and other indicators. Data were analyzed using chi-square tests, independent sample t-tests, multinomial logistic regression, and linear regression models. In models adjusting for age and sex, infants defined as food insecure by the adapted index were found to consume foods from more food groups and consume flesh foods on a greater proportion of days. Of the indicators examined, the adapted index was shown to be the best indicator for food group consumption. Further work is needed on a more representative sample of NHPIF infants to determine the impact that food security has on nutritional status and other indicators of health

Open Educational Resource Textbook Impact on Students in an Introductory Nutrition Course

Objective To determine if student outcomes, usage, perceptions, and engagement differ between introductory nutrition courses that used an open educational resource (OER) textbook compared with a traditional textbook. Design Cross-sectional. Setting College introductory nutrition course. Participants Students enrolled in introductory nutrition courses that used a traditional textbook or an OER textbook. Intervention Implementation of an OER textbook in all introductory nutrition courses during 1 semester. Main Outcome Measure(s) Usage, perceptions, and engagement with the textbook were evaluated by an online survey. Student outcome data (eg, grades) were collected from the learning management system at the end of the semester. Analysis Differences in student outcomes, usage, perceptions, and engagement were determined by t tests. Open-ended responses on textbook likes and dislikes were evaluated by thematic analysis. Results The number of students who completed the introductory nutrition course with a traditional textbook (n = 346) was higher than those who completed the course with an OER textbook (n = 311). There was no difference in student outcomes between textbooks. P values for student usage ranged from <.001 to .001, <.001 for engagement, and <.001 to .001 for perception with the OER textbook, with significantly better P values for outcomes than those with the traditional textbook. The $0 cost and place-based nature were noted as positive attributes of the OER textbook, whereas students appreciated the format and visual appeal of the traditional textbook. Conclusions and Implications Academic performance in introductory nutrition was not affected by an OER textbook. An OER textbook for introductory nutrition may be an appropriate solution for institutions seeking to reduce student costs

Recruitment Strategies and Lessons Learned from the Children's Healthy Living Program Prevalence Survey

The US Affiliated Pacific region's childhood obesity prevalence has reached epidemic proportions. To guide program and policy development, a multi-site study was initiated, in collaboration with partners from across the region, to gather comprehensive information on the regional childhood obesity prevalence. The environmental and cultural diversity of the region presented challenges to recruiting for and implementing a shared community-based, public health research program. This paper presents the strategies used to recruit families with young children (n = 5775 for children 2 - 8 years old) for obesity-related measurement across eleven jurisdictions in the US Affiliated Pacific Region. Data were generated by site teams that provided summaries of their recruitment strategies and lessons learned. Conducting this large multi-site prevalence study required considerable coordination, time and flexibility. In every location, local staff knowledgeable of the community was hired to lead recruitment, and participant compensation reflected jurisdictional appropriateness (e.g., gift cards, vouchers, or cash). Although recruitment approaches were site-specific, they were predominantly school-based or a combination of school- and community-based. Lessons learned included the importance of organization buy-in; communication, and advance planning; local travel and site peculiarities; and flexibility. Future monitoring of childhood obesity prevalence in the region should consider ways to integrate measurement activities into existing organizational infrastructures for sustainability and cost-effectiveness, while meeting programmatic (e.g. study) goals

An Active Image-Based Mobile Food Record Is Feasible for Capturing Eating Occasions among Infants Ages 3&ndash;12 Months Old in Hawai&lsquo;i

The ability to comprehensively assess the diet of infants is essential for monitoring adequate growth; however, it is challenging to assess dietary intake with a high level of accuracy. Infants rely on surrogate reporting by caregivers. This study aimed to determine if surrogate reporters (e.g., caregivers) could use an image-based mobile food record adapted (baby mFR) to record infants&rsquo; eating occasions, and via caregiver feedback, could assess the usability and feasibility of the baby mFR in recording infants&rsquo; diets. This was a cross-sectional study in which surrogate reporters (e.g., caregivers) recorded all food and beverage intake (including human milk) of the infant over a 4-day period. Trained research staff evaluated all images submitted during data collection for different indicators of quality. All surrogate reporters were asked to complete a usability questionnaire at the end of the 4-day data collection period. Basic descriptive analyses were performed on the infants 3&ndash;12 months of age (n = 70). A total of 91% (n = 64) of surrogate reporters used the baby mFR to record their infants&rsquo; eating occasions. The mean number of images submitted daily per participant via the mFR was 4.2 (SD 0.2). A majority of submitted images contained the fiducial marker and the food and/or beverage was completely visible. The mFR was found to be easy to use; however, suggestions were provided to increase utility of the application such as the inclusion of a bottle button and reminders. An image-based dietary assessment method using a mobile app was found to be feasible for surrogate reporters to record an infant&rsquo;s food and beverage intake throughout the day

Fostering Interaction in an Online Introductory Nutrition Course

— Fostering interaction in the online classroom is an important consideration in ensuring that students actively create their own knowledge and reach a high level of achievement. This study focuses on fostering interaction through course features selected for this purpose in an online introductory nutrition course offered in a public institution of higher education in Hawai‘i, USA. Features included synchronous discussions and polls in scheduled sessions, and social media tools for sharing of information and resources. Qualitative student feedback was solicited in response to the new course features. Findings indicated that students who attended monthly synchronous sessions valued live interaction with peers and the instructor. Issues identified included technical difficulties during synchronous sessions, lack of participation on the part of fellow students during group discussion and inability to attend synchronous sessions due to scheduling conflicts. In addition, few students made use of the opportunity to interact via social media. While students indicated that there was value in the interactive components of the online introductory nutrition course, several areas in which improvement may be made remain. Future studies may explore potential solutions to the issues identified with new course features to further promote interaction in the online introductory nutrition course

Associations between Cultural Identity, Household Membership and Diet Quality among Native Hawaiian, Pacific Islander, and Filipino Infants in Hawaiʻi

Public health efforts to reduce diet-related health disparities experienced by indigenous peoples could be enhanced by efforts to improve complementary infant feeding practices. The latter is possible through interventions informed by cultural determinants. This cross-sectional secondary analysis explored possible determinants of the complementary feeding practices of Native Hawaiian, Pacific Islander, and/or Filipino infants (NHPIF) in Hawaiʻi, ages 3–12 months. The objective was to determine the association between caregiver cultural identity and infant household membership with indicators of infant diet healthfulness. The cultural identities, infant household memberships, early infant feeding practices and additional demographic information (infant age and sex, household income) were assessed via an online questionnaire. Surrogate reporting of the infants’ diets over four days was evaluated using an image-based mobile food record (mFR). Data collected by the mFR were evaluated to derive the World Health Organization’s minimum dietary diversity (MDD) indicator and food group consumption. Data were summarized by descriptive statistics and analyzed using multivariate linear and logistic regressions. Seventy infant participants, ages 3–12 months, and their primary caregivers completed the study. Of these, there were 56 infant participants between the age of 6–12 months. Approximately 10% of infants, ages 6–12 months, met MDD for all four days. Meeting MDD and the number of food groups consumed were significantly associated with age. Caregiver cultural identity, infant household membership and infant sex had non-significant associations with indicators of infant diet quality. Findings inform the influences shaping dietary patterns of Native Hawaiian, Pacific Islander and Filipino infants in Hawaiʻi