Measurement of Fruit and Vegetable Intake Incorporating a Diversity, Equity, and Inclusion Lens. Comment on Di Noia, J.; Gellermann, W. Use of the Spectroscopy-Based Veggie Meter® to Objectively Assess Fruit and Vegetable Intake in Low-Income Adults

Disparities in fruit and vegetable intake (FVI) and diet-related diseases exist among low-income and racial/ethnic minority populations [1,2,3,4]. Intervention approaches to eliminate FVI disparities frequently utilize dietary assessment to measure impact. Studies measure FVI in varying ways, but do not fully account for diversity, equity, and inclusion (DEI)

A Cross-Sectional Exploration of Food Security, Depression, and CHAOS in Low-Income Households with Children

Depression has been linked to food security, particularly among low-income mothers. However, less is known about the relationship between CHAOS (Confusion, Hubbub, and Order Scale), a measure of family functioning such as timeliness and order, and varying levels food security. The purpose of this paper was to evaluate the relationship between depression, CHAOS, and sociodemographics on the level of food insecurity in a cross-sectional sample of low-income households with children, ages 0-18 years. Participants were recruited from low-income communities in a medium sized Midwestern city in the United States. Eligible participants were ≥19 years of age, a parent or primary caregiver to at least one child, and English- or Spanish- speaking. Survey items included participation in the Supplemental Nutrition Assistance Program (SNAP), food security, depression, CHAOS, and sociodemographics/family characteristics. Descriptives and Chi-square tests were conducted for all variables. Potential covariates were assessed (e.g., age, income, education, race/ethnicity, sex, SNAP participation, number of children and adults in the household, and marital status) and included in the final logistic regression model through backward elimination. All statistics were conducted using SAS (version 9.4, SAS Institute Inc., Cary, NC). Participants (N=252) were 75% female, 42% Non-Hispanic Black, 31% Non-Hispanic White, 12% Hispanic, and 15% other race categories. The mean number of children in households was 2.33 (SD=1.58), and half of the respondents reported earning ≤$10,000/year. Chi-Square tests showed univariate relationships between study variables and varying household food security levels. Those in the “high” and “medium” groups for depression and CHAOS were both more likely than the “low” groups to experience low or very low food security. Income and education were also related to food security, with low levels of education and low income being associated with low or very low food security. Age, sex, race/ethnicity, and marital status were not associated with food security status. The fully adjusted logistic regression models of depression and CHAOS accounted for 10% and 14% of the variance in food security, respectively (depression: (OR=0.31, CI=0.15-0.65; pp In the current study, CHAOS demonstrated a stronger relationship with food security than depression, when controlling for sociodemographics. CHAOS is a measurement that has not been tested widely among food insecure populations, but has been shown to be an influencing factor on child development, and might help explain some of the stress experienced by low-income families. Understanding more about the psychological aspects of food insecurity may help inform the development of tailored interventions to alleviate food insecurity in low-income households, and ultimately improve health, achievement and related outcomes in children

Multidisciplinary approaches to address food insecurity and nutrition among youth and their families

Our aim in publishing this issue of JARC on nutrition and food insecurity is to understand the factors associated with nutrition and food insecurity in the U.S. and around the world; to elucidate the potential consequences of food insecurity on physical and mental health; and to raise awareness and identify solutions to address this complex issue. We also aim to encourage collaboration across disciplines in order to frame initiatives that reduce these threats to child health, well-being and success

What’s Next for Tobacco Control Efforts? Health Equity Related Lessons Learned from a National Qualitative Study on Tobacco Control and Prevention

Context: Despite gains in the tobacco prevention and control movement, tobacco products remain a threat, with specific populations at greater risk. Objective: The purpose of this paper is to examine the role that leaders in the tobacco prevention and control movement have played in progress achieved to date and identify recommendations for the future using a health equity framework. The purpose of this paper is to examine the role that leading organizations in the tobacco prevention and control movement have played in progress achieved to date, identify future recommendations within the context of current public health priorities (e.g., obesity prevention), and explore potential for tobacco prevention and control using a health equity framework. Design: Qualitative key informant interviews were conducted with representatives from four key tobacco prevention and control organizations and their partners. Setting: Interviews were conducted on-site at tobacco prevention and control organization offices or by telephone. Participants: Key informant interviews (n=87) were conducted during July-December of 2017. Main outcome measures: Interviewees describe their work in providing technical assistance to leading public health and policy efforts in tobacco prevention and control. Interviews were transcribed verbatim and coded for meaning units. This analysis was conducted November 2017-January 2018. This study was determined exempt from review by the University of Nebraska Medical Center Institutional Review Board. Results: Three overarching themes emerged from our analysis: (1) maintaining tobacco prevention and control as a public health issue, (2) the importance of health equity in tobacco prevention and control work, and (3) planning for the next generation of tobacco prevention and control advocates. Certain populations remain untouched by broad public health approaches to reduce tobacco use. Conclusions: Tailored, focused, and comprehensive approaches to address health equity in tobacco prevention and control work across specific communities are needed. Adopting a health equity lens across public health priority areas (e.g., obesity, opioids, and tobacco prevention and control) could reduce prevalence among vulnerable groups for multiple conditions

Monthly SNAP benefit duration and its association with food security, hunger-coping, and physiological hunger symptoms among low-income families

Purpose The purpose of this study was to examine relationships between monthly Supplemental Nutrition Assistance Program (SNAP) benefit duration (i.e., the number of weeks each month a participants’ SNAP benefits provide food), and five primary outcome variables: food security, three hunger-coping behavior scales (rationing food supplies, financial strategies, making trade-offs), and physiological hunger symptoms, among a sample of families with children 0-18 years currently receiving SNAP benefits. Methods Baseline survey data were collected as part of a community-based intervention to alleviate child hunger. Participants included in the analytic sample were current SNAP recipients, parents (or caregivers), and 19 years of age and older (n=161). The survey assessed sociodemographics, household characteristics, food and financial assistance use, food security, three hunger-coping behavior scales, diet intake frequency, and one physiological hunger symptoms scale. The three hunger-coping scales and the physiological hunger scale were dichotomized into a “high” group (if above the sample median score) and a “low” group (if at or below the sample median score). Sociodemographic and family characteristics were included as covariates. Logistic regression models were used to assess relationships between monthly SNAP benefit duration and the five primary outcome variables in this study. Results Respondents were predominately mothers/female caregivers (78%), a majority reported annual family incomes below $10,000 (58%), and 80% were experiencing “low” or “very low” food security. The sample was 43% non-Hispanic black, 30% non-Hispanic white, 10% Hispanic/Latino, 17% American Indian or other racial/ethnic groups. Monthly SNAP benefit duration (M=2.8, SD=1.0) was not likely driven by allotment amount, because households’ percent of the federal poverty line (a proxy measure for allotment amount) was not associated with the number of weeks each month that benefits lasted (p=0.36). After controlling for relevant sociodemographic variables and household characteristics, the more weeks each month participants reported their SNAP benefits lasting, the lower their odds of experiencing “low” or “very low” food security (OR=0.444, 95%CI=0.259-0.761; p Conclusions These findings suggest that monthly SNAP benefit duration may be useful as a proxy for SNAP allotment adequacy in the context of food security and hunger. Families that were not able to make monthly benefits extend as long as other families were more likely to be food insecure and experience “high” levels of physiological hunger symptoms. While associations with hunger-coping behaviors were only significant in univariate analysis, they were in the direction expected and should be further examined in future studies as these behaviors may be exacerbate, buffer, or be symptoms of the experience of food insecurity and hunger among low-income families. Policies are needed to better tailor SNAP benefit allotments to the needs of disadvantaged families, and research and programming is needed to investigate ways these families can better utilize their current allotments as a potential path to address food insecurity and hunger

Psychosocial correlates of eating behavior in children and adolescents: a review

<p>Abstract</p> <p>Background</p> <p>Understanding the correlates of dietary intake is necessary in order to effectively promote healthy dietary behavior among children and adolescents. A literature review was conducted on the correlates of the following categories of dietary intake in children and adolescents: Fruit, Juice and Vegetable Consumption, Fat in Diet, Total Energy Intake, Sugar Snacking, Sweetened Beverage Consumption, Dietary Fiber, Other Healthy Dietary Consumption, and Other Less Healthy Dietary Consumption in children and adolescents.</p> <p>Methods</p> <p>Cross-sectional and prospective studies were identified from PubMed, PsycINFO and PsycArticles by using a combination of search terms. Quantitative research examining determinants of dietary intake among children and adolescents aged 3–18 years were included. The selection and review process yielded information on country, study design, population, instrument used for measuring intake, and quality of research study.</p> <p>Results</p> <p>Seventy-seven articles were included. Many potential correlates have been studied among children and adolescents. However, for many hypothesized correlates substantial evidence is lacking due to a dearth of research. The correlates best supported by the literature are: perceived modeling, dietary intentions, norms, liking and preferences. Perceived modeling and dietary intentions have the most consistent and positive associations with eating behavior. Norms, liking, and preferences were also consistently and positively related to eating behavior in children and adolescents. Availability, knowledge, outcome expectations, self-efficacy and social support did not show consistent relationships across dietary outcomes.</p> <p>Conclusion</p> <p>This review examined the correlates of various dietary intake; Fruit, Juice and Vegetable Consumption, Fat in Diet, Total Energy Intake, Sugar Snacking, Sweetened Beverage Consumption, Dietary Fiber, Other Healthy Dietary Consumption, and Other Less Healthy Dietary Consumption in cross-sectional and prospective studies for children and adolescents. The correlates most consistently supported by evidence were perceived modeling, dietary intentions, norms, liking and preferences. More prospective studies on the psychosocial determinants of eating behavior using broader theoretical perspectives should be examined in future research.</p

Emotional eating in adults:The role of socio-demographics, lifestyle behaviors, and self-regulation- Findings from a US national study

Background: Emotional eating, the tendency to overeat in response to negative emotions, has been linked to weight gain. However, scant evidence exists examining the prevalence and correlates of emotional eating among large samples of adults in the United States (U.S.). Hence, we examine the relationship among individual and socioeconomic factors, health behaviors, and self-regulation with emotional eating patterns among U.S. adults. Methods: Cross-sectional analysis of 5863 Family Health Habits Survey participants. Multivariable, ordered, logistic regression was employed to examine the relationship between the frequency of the desire to eat when emotionally upset (never, rarely, sometimes, often, and very often) and the independent variables. Results: Analysis reveals that 20.5% of the sample tended to emotionally eat often or very often. Being female, non-Hispanic White, and of younger age were all related to a higher likelihood of emotional eating. Additionally, inability to delay gratification (impatience) was related to an 18% increased likelihood (95% confidence interval (CI) 1.05–1.33) for emotional eating. Finally, emotional eating was significantly related to more frequent fast-food consumption. Conclusions: Program planners might need to develop targeted interventions aimed at enhancing emotional regulation skills while addressing these less healthful behaviors (e.g., fast-food intake) with the goal of obesity and chronic disease prevention