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Diet Quality, Food Environment and Diet Diversity

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutritional Policies and Education for Health Promotion".

Deadline for manuscript submissions: closed (15 January 2023) | Viewed by 75528

Special Issue Editor

Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA
Interests: food security; underserved populations; food access; physical activity
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Food insecurity in Western societies has been linked to poor diet quality, resulting from limited access due to several issues including affordability, transportation, marketing, and easy access to unhealthy foods. These poor food environments have resulted in exacerbation of the obesity epidemic and a significantly greater risk of chronic disease for low-income populations in these communities. Various efforts at the local level, from policy changes to nutrition education and collaboration with local food organizations to improve access, have been implemented to address these concerns. This Special Issue will highlight recent innovative research in this area, with implications for best practices and recommendations for future work.

Dr. Michael J. Puglisi
Guest Editor

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Keywords

  • food security
  • food environment
  • obesity
  • diet quality

Published Papers (23 papers)

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24 pages, 522 KiB  
Article
Can Ordering Groceries Online Support Diet Quality in Adults Who Live in Low Food Access and Low-Income Environments?
by Daniela C. Avelino, Valerie B. Duffy, Michael Puglisi, Snehaa Ray, Brenda Lituma-Solis, Briana M. Nosal, Matthew Madore and Ock K. Chun
Nutrients 2023, 15(4), 862; https://0-doi-org.brum.beds.ac.uk/10.3390/nu15040862 - 08 Feb 2023
Cited by 1 | Viewed by 2028
Abstract
During the COVID-19 pandemic, U.S. food assistance programs allowed the use of program benefits to order groceries online. We examined relationships between the food environment, food assistance, online grocery ordering, and diet quality among adults from one low-income, low food access community in [...] Read more.
During the COVID-19 pandemic, U.S. food assistance programs allowed the use of program benefits to order groceries online. We examined relationships between the food environment, food assistance, online grocery ordering, and diet quality among adults from one low-income, low food access community in Northeastern Connecticut during the pandemic. Via online survey, adults (n = 276) reported their perceived home and store food environments, food assistance participation, whether they ordered groceries online, and consumption frequency and liking of foods/beverages to calculate diet quality indices. Those who ordered groceries online (44.6%) were more likely to participate in food assistance programs and report greater diet quality. Perceived healthiness of store and home food environments was variable, with the ease of obtaining and selecting unhealthy foods in the neighborhood significantly greater than healthy foods. Healthier perceived home food environments were associated with significantly higher diet qualities, especially among individuals who participated in multiple food assistance programs. Ordering groceries online interacted with multiple measures of the food environment to influence diet quality. Generally, the poorest diet quality was observed among individuals who perceived their store and home food environments as least healthy and who did not order groceries online. Thus, ordering groceries online may support higher diet quality among adults who can use their food assistance for purchasing groceries online and who live in low-income, low-access food environments. Full article
(This article belongs to the Special Issue Diet Quality, Food Environment and Diet Diversity)
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12 pages, 280 KiB  
Article
Canadians Adults Fail Their Dietary Quality Examination Twice
by Gerard Ngueta, Caty Blanchette, Myrto Mondor, Jean-Claude Moubarac and Michel Lucas
Nutrients 2023, 15(3), 637; https://0-doi-org.brum.beds.ac.uk/10.3390/nu15030637 - 26 Jan 2023
Cited by 2 | Viewed by 2139
Abstract
For many years, dietary quality among Canadians has been assessed using an index that gives criticized scores and does not allow for comparison with Americans. In Canadians aged ≥19 years, we aimed to (1) determine the dietary quality by using a more widely [...] Read more.
For many years, dietary quality among Canadians has been assessed using an index that gives criticized scores and does not allow for comparison with Americans. In Canadians aged ≥19 years, we aimed to (1) determine the dietary quality by using a more widely used evidence-based index that has shown associations with health outcomes, the alternative Healthy Eating Index (aHEI-2010); (2) assess changes in aHEI-2010 score and its components between 2004 and 2015; and (3) identify factors associated with aHEI-2010 score. We relied on the Canadian Community Health Survey 2004 (n = 35,107) and 2015 (n = 20,487). We used adjusted linear models with a time effect to compare the total aHEI-2010 score and its components. The overall aHEI-2010 score increased from 36.5 (95%CI: 36.2–36.8) in 2004 to 39.0 (95%CI: 38.5–39.4) in 2015 (p < 0.0001). Participants with less than a high school diploma showed the lowest score and no improvement from 2004 to 2015 (34.8 vs. 35.3, p = 0.4864). In each period, higher scores were noted among immigrants than non-immigrants (38.3 vs. 35.9 in 2004, p < 0.0001; 40.5 vs. 38.5 in 2015 p < 0.0001), and lower scores were observed in current smokers (33.4 vs. 37.1 in 2004, p < 0.0001; 34.5 vs. 39.9 in 2015, p < 0.0001). The use of the aHEI-2010 tool suggests a lower score among Canadians than the previous index, more comparable to the score among Americans. Full article
(This article belongs to the Special Issue Diet Quality, Food Environment and Diet Diversity)
12 pages, 1464 KiB  
Article
Selective Daily Mobility Bias in the Community Food Environment: Case Study of Greater Hartford, Connecticut
by Ailing Jin, Xiang Chen, Xiao Huang, Zhenlong Li, Caitlin E. Caspi and Ran Xu
Nutrients 2023, 15(2), 404; https://0-doi-org.brum.beds.ac.uk/10.3390/nu15020404 - 13 Jan 2023
Cited by 1 | Viewed by 1920
Abstract
The community food environment has potential influences on community members’ dietary health outcomes, such as obesity and Type II diabetes. However, most existing studies evaluating such health effects neglect human mobility. In food patrons’ daily travels, certain locations may be preferred and patronized [...] Read more.
The community food environment has potential influences on community members’ dietary health outcomes, such as obesity and Type II diabetes. However, most existing studies evaluating such health effects neglect human mobility. In food patrons’ daily travels, certain locations may be preferred and patronized more frequently than others. This behavioral uncertainty, known as the selective daily mobility bias (SDMB), is less explored in community-food-environment research. In this paper, we aim to confirm the existence of the SDMB by systematically exploring the large-scale GPS-based restaurant-visit patterns in the Greater Harford region, Connecticut. Next, we explore the restaurant and neighborhood characteristics that are associated with the restaurant-visit patterns. Our primary results demonstrate that (1) most restaurant customers originate from areas outside of the census tract where the restaurant is located, and (2) restaurants located in socially vulnerable areas attract more customers in total, more customers from local areas, and more customers from other socially vulnerable areas. These results confirm the relevance of the SDMB to the community food environment, and suggest ways that the SDMB can be moderated by an uneven socio-economic landscape. The findings demonstrate the necessity of incorporating human-mobility data into the study of the community food environment. Full article
(This article belongs to the Special Issue Diet Quality, Food Environment and Diet Diversity)
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11 pages, 749 KiB  
Article
Diet Quality and Nutrition Behavior of Federal Nutrition Education Program Participants before and during the COVID-19 Pandemic
by Kavitha Sankavaram, Annie J. Roe, Jolene Whiteley and William J. Price
Nutrients 2023, 15(1), 141; https://0-doi-org.brum.beds.ac.uk/10.3390/nu15010141 - 28 Dec 2022
Viewed by 1944
Abstract
Despite challenges due to the COVID-19 pandemic, reports from regional and national meetings of the Expanded Food and Nutrition Education program (EFNEP) have provided anecdotal evidence that the program has persevered, pivoted, and continued to positively impact the lives of some of the [...] Read more.
Despite challenges due to the COVID-19 pandemic, reports from regional and national meetings of the Expanded Food and Nutrition Education program (EFNEP) have provided anecdotal evidence that the program has persevered, pivoted, and continued to positively impact the lives of some of the nation’s most vulnerable populations. However, there have been necessary changes to program delivery, inevitable changes in the lives of participants, and changes in the food environment that may have impacted program outcomes. This study compares national EFNEP data (demographics, behavior change data, and 24 h dietary recall data) of participants from two federal fiscal years, before the COVID-19 pandemic and during the pandemic. Linear mixed model analysis of variance and covariance were used to assess the effects of year on program outcomes. Results of this study provide quantitative evidence of the resiliency of EFNEP to facilitate positive behavior changes related to diet quality, physical activity, food safety, food resource management, and food security. Amidst changes in the food environment during the COVID-19 pandemic, these results emphasize the importance and value of federal nutrition education programs in any food environment. Full article
(This article belongs to the Special Issue Diet Quality, Food Environment and Diet Diversity)
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12 pages, 279 KiB  
Article
Relationships between Food Production Experience and the Behavior, Attitude, and Knowledge of Dietary Recommendations among Japanese Adults: A Cross-Sectional Study
by Daisuke Machida
Nutrients 2022, 14(17), 3639; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14173639 - 02 Sep 2022
Viewed by 1253
Abstract
The Japanese Ministry of Agriculture, Forestry, and Fisheries proposed to educate more people in food production as one of the objectives of the Basic Plan for Food and Nutrition Education Promotion. This cross-sectional study aims to elucidate the relationship between food production experience [...] Read more.
The Japanese Ministry of Agriculture, Forestry, and Fisheries proposed to educate more people in food production as one of the objectives of the Basic Plan for Food and Nutrition Education Promotion. This cross-sectional study aims to elucidate the relationship between food production experience (agricultural, forestry, and fishery experiences) and the behavior, attitude, and knowledge of dietary recommendations among Japanese adults. This study was conducted using data obtained from the “Survey on Dietary Habits and Agriculture, Forestry, and Fishery Experiences (2019)”. This survey was conducted by mailing paper questionnaires to respondents aged 20–69 years living in 17 regions across Japan. The independent variable was food production experience. The dependent variables were each of the 13 goals of the dietary guidelines in Japan, the total score for adherence to the 13 items (low scores indicate good adherence), adherence to a Japanese-style diet, and four items on the attitude and knowledge of dietary recommendations. I also examined the association between the point in life the food production experience occurred and the above outcomes. The data obtained from 3461 participants aged 20 to 69 years were used for multivariate logistic and linear regression analyses. Food production experience was positively associated with an improved behavior, attitude, and knowledge of dietary recommendations among adults in Japan. The study found a strong relationship with food production experiences in adulthood. Full article
(This article belongs to the Special Issue Diet Quality, Food Environment and Diet Diversity)
12 pages, 441 KiB  
Article
Household Income Is Related to Dietary Fiber Intake and Dietary Acid Load in People with Type 2 Diabetes: A Cross-Sectional Study
by Fuyuko Takahashi, Yoshitaka Hashimoto, Yukiko Kobayashi, Ayumi Kaji, Ryosuke Sakai, Takuro Okamura, Naoko Nakanishi, Saori Majima, Hiroshi Okada, Takafumi Senmaru, Emi Ushigome, Mai Asano, Masahide Hamaguchi, Masahiro Yamazaki, Wataru Aoi, Masashi Kuwahata and Michiaki Fukui
Nutrients 2022, 14(15), 3229; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14153229 - 07 Aug 2022
Viewed by 2450
Abstract
Household income was related to habitual dietary intake in general Japanese people. This cross-sectional study investigated the relationship between household income and habitual dietary intake in people with type 2 diabetes mellitus (T2DM). Household income was evaluated using a self-reported questionnaire and categorized [...] Read more.
Household income was related to habitual dietary intake in general Japanese people. This cross-sectional study investigated the relationship between household income and habitual dietary intake in people with type 2 diabetes mellitus (T2DM). Household income was evaluated using a self-reported questionnaire and categorized into high and low household income. Nutritional status was assessed using a brief-type self-administered diet history questionnaire. Among 128 men and 73 women, the proportions of participants with low household income were 67.2% (n = 86/128) in men and 83.6% (n = 61/73) in women. Dietary fiber intake (11.3 ± 4.2 vs. 13.8 ± 6.0 g/day, p = 0.006) was lower, and dietary acid load, net endogenous aid production score (NEAP) (51.7 ± 10.5 vs. 46.8 ± 10.4 mEq/day, p = 0.014) and potential renal acid load score (PRAL) (9.5 ± 10.7 vs. 3.7 ± 14.1 mEq/day, p = 0.011) were higher in men with low household income than in those without. Multivariable linear regression analyses demonstrated that log (dietary fiber intake) in men with low household income was lower than that in those with high household income after adjusting for covariates (2.35 [2.26–2.44] vs. 2.52 [2.41–2.62], p = 0.010). Furthermore, NEAP (54.6 [51.7–57.4] vs. 45.8 [42.5–49.2], p <0.001) in men with low household income were higher than in those with high household income after adjusting for covariates. Contrastingly, household income was not related to diet quality in women. This study showed that household income was related to dietary fiber intake and dietary acid load in men but not in women. Full article
(This article belongs to the Special Issue Diet Quality, Food Environment and Diet Diversity)
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11 pages, 923 KiB  
Article
The Association between Diet Quality and Health Status in Mobile Food Pantry Users in Northeastern Connecticut
by Dalia Marmash, Kyungho Ha, Junichi R. Sakaki, Isabella Gorski, Brazil Rule, Michael Puglisi and Ock K. Chun
Nutrients 2022, 14(6), 1302; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14061302 - 19 Mar 2022
Cited by 5 | Viewed by 2534
Abstract
Low-income Americans tend to have poor diet quality and disease prevalence overall. Mobile food pantries aim to improve these outcomes, and have rarely been studied. This cross-sectional study aimed to evaluate the association between diet quality and health status in mobile food pantry [...] Read more.
Low-income Americans tend to have poor diet quality and disease prevalence overall. Mobile food pantries aim to improve these outcomes, and have rarely been studied. This cross-sectional study aimed to evaluate the association between diet quality and health status in mobile food pantry users. Data were collected from two mobile food pantry sites in Northeastern Connecticut (n = 83). Sociodemographic food security and diet quality data were collected. Overall, diet quality was low among all participants with intakes of fruits, vegetables, and whole grains of concern. Participant adherence to the 2020–2025 US Dietary Guidelines were low, with no participants meeting recommendations for whole grains. Obesity, diabetes, and hypertension prevalence in this population exceeded national averages. After adjusting for covariates, hypertension was associated with higher dairy and added sugar intake, as well as a greater intake of added sugar from sugar-sweetened beverages (p < 0.05). Although results were not statistically significant, participants with obesity, diabetes, and hypertension showed a trend of having lower adherence to the guidelines than those without these chronic diseases. Questions assessing participant interest in changing their diets were also posed, indicating overall high interest in learning about current diet quality and weight improvement. Full article
(This article belongs to the Special Issue Diet Quality, Food Environment and Diet Diversity)
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10 pages, 243 KiB  
Article
Stakeholders’ Perspectives on the Current Status of Partnerships between the Food Banking and Healthcare Systems to Address Food Insecurity in the U.S.
by Eminet Abebe Gurganus, Nana Yaa A. Marfo, Marlene B. Schwartz and Kristen Cooksey Stowers
Nutrients 2021, 13(12), 4502; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13124502 - 16 Dec 2021
Cited by 5 | Viewed by 2710
Abstract
One in eight people in the U.S. experience food insecurity (FI). To date, the food banking sector has been at the forefront of efforts to address FI, but the healthcare sector is becoming increasingly involved in such efforts. The extent of collaboration between [...] Read more.
One in eight people in the U.S. experience food insecurity (FI). To date, the food banking sector has been at the forefront of efforts to address FI, but the healthcare sector is becoming increasingly involved in such efforts. The extent of collaboration between the two sectors remains unclear. We explored food banking stakeholders’ views on the current state of partnerships between the two sectors. We used purposive sampling to recruit ten key informants for semi-structured interviews. We also conducted a national online survey to gather data from food bank directors (n = 137). Thematic analysis generated two major themes: (1) Healthcare and food banking stakeholders are coordinating to achieve collective impact, and (2) Food banking-healthcare partnerships are leveraging various resources and vested interests within the medical community. We found evidence of ongoing partnerships between the two sectors and opportunities to strengthen these partnerships through the support of backbone organizations. Full article
(This article belongs to the Special Issue Diet Quality, Food Environment and Diet Diversity)
12 pages, 504 KiB  
Article
Organic Food in the Diet of Residents of the Visegrad Group (V4) Countries—Reasons for and Barriers to Its Purchasing
by Andrzej Soroka, Anna Katarzyna Mazurek-Kusiak and Joanna Trafialek
Nutrients 2021, 13(12), 4351; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13124351 - 02 Dec 2021
Cited by 4 | Viewed by 2214
Abstract
This study aimed to determine the differences in the frequency of, reasons for, and barriers to purchasing organic food among the inhabitants of the Visegrád Group member states. The selection of the countries for the study was dictated by the fact that the [...] Read more.
This study aimed to determine the differences in the frequency of, reasons for, and barriers to purchasing organic food among the inhabitants of the Visegrád Group member states. The selection of the countries for the study was dictated by the fact that the countries of Central and Eastern Europe play the role of a niche market in the European organic food market. This research employed the method of a diagnostic survey and the discriminant function. A chi-squared test, ANOVA, and Fisher’s Post Hoc LSD test were also used to present differences in individual groups. This research shows that respondents from Poland, the Czech Republic, Hungary and Slovakia were guided by similar behaviors regarding the purchase of organic food. However, the attitudes of the respondents slightly differed between countries. In the case of the reasons for choosing organic food, the most important thing was that it is non-genetically modified food, especially for Polish consumers. The following were also mentioned: lack of chemical compounds (Slovaks and Czechs), high health value of such food (Czechs and Slovaks), and excellent taste (Hungarians). The most critical barriers against purchasing are the price (Poles and Hungarians), difficult access (Poles and Hungarians), and the short expiry time of such products (Slovaks). Full article
(This article belongs to the Special Issue Diet Quality, Food Environment and Diet Diversity)
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11 pages, 2316 KiB  
Article
An Exploratory Approach to Deriving Nutrition Information of Restaurant Food from Crowdsourced Food Images: Case of Hartford
by Xiang Chen, Evelyn Johnson, Aditya Kulkarni, Caiwen Ding, Natalie Ranelli, Yanyan Chen and Ran Xu
Nutrients 2021, 13(11), 4132; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13114132 - 18 Nov 2021
Cited by 5 | Viewed by 2719
Abstract
Deep learning models can recognize the food item in an image and derive their nutrition information, including calories, macronutrients (carbohydrates, fats, and proteins), and micronutrients (vitamins and minerals). This technology has yet to be implemented for the nutrition assessment of restaurant food. In [...] Read more.
Deep learning models can recognize the food item in an image and derive their nutrition information, including calories, macronutrients (carbohydrates, fats, and proteins), and micronutrients (vitamins and minerals). This technology has yet to be implemented for the nutrition assessment of restaurant food. In this paper, we crowdsource 15,908 food images of 470 restaurants in the Greater Hartford region on Tripadvisor and Google Place. These food images are loaded into a proprietary deep learning model (Calorie Mama) for nutrition assessment. We employ manual coding to validate the model accuracy based on the Food and Nutrient Database for Dietary Studies. The derived nutrition information is visualized at both the restaurant level and the census tract level. The deep learning model achieves 75.1% accuracy when compared with manual coding. It has more accurate labels for ethnic foods but cannot identify portion sizes, certain food items (e.g., specialty burgers and salads), and multiple food items in an image. The restaurant nutrition (RN) index is further proposed based on the derived nutrition information. By identifying the nutrition information of restaurant food through crowdsourced food images and a deep learning model, the study provides a pilot approach for large-scale nutrition assessment of the community food environment. Full article
(This article belongs to the Special Issue Diet Quality, Food Environment and Diet Diversity)
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13 pages, 929 KiB  
Article
Validation of a Home Food Environment Instrument Assessing Household Food Patterning and Quality
by Katherine J. Barrett, Sarah K. Hibbs-Shipp, Savannah Hobbs, Richard E. Boles, Susan L. Johnson and Laura L. Bellows
Nutrients 2021, 13(11), 3930; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13113930 - 03 Nov 2021
Viewed by 2252
Abstract
The home food environment (HFE) is associated with dietary intake; yet measuring HFE quality often requires burdensome collection of detailed inventories. This project evaluated the capacity of the Home Inventory to Describe Eating and Activity, version 2 (Home-IDEA2) to capture HFE quality by [...] Read more.
The home food environment (HFE) is associated with dietary intake; yet measuring HFE quality often requires burdensome collection of detailed inventories. This project evaluated the capacity of the Home Inventory to Describe Eating and Activity, version 2 (Home-IDEA2) to capture HFE quality by measuring the presence or absence of household foods. Validity was tested using a modified application of the Healthy Eating Index-2010 (HEI). Comparative data were drawn from the National Food Acquisition and Purchase Survey (FoodAPS) Food-at-Home Public Use File. HEI scores were calculated for 4202 households in FoodAPS using Home-IDEA2 inventories and full reported inventories. Paired t-tests compared: (1) estimated vs. total edible grams (EEG; TEG); (2) limited vs. all reported foods; and (3) EEG + limited foods vs. TEG + all reported foods. Sensitivity and range of scores were compared. Mean HEI scores for Home-IDEA2 were higher (p < 0.003) than FoodAPS: (1) 51.6 ± 16.1 vs. 49.6 ± 18.1 (food amounts); (2) 53.5 ± 15.8 vs. 49.8 ± 15.4 (food items); (3) 55.5 ± 15.7 vs. 49.8 ± 15.4 (full instrument); differences were small. Scores demonstrated comparable sensitivity and range. The study found that the Home-IDEA2 can capture HFE quality adequately with low data collection burden. Full article
(This article belongs to the Special Issue Diet Quality, Food Environment and Diet Diversity)
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10 pages, 264 KiB  
Article
Factors Associated with the Initiation of Added Sugar among Low-Income Young Children Participating in the Special Supplemental Nutrition Program for Women, Infants, and Children in the US
by Morium B. Bably, Rajib Paul, Sarah B. Laditka and Elizabeth F. Racine
Nutrients 2021, 13(11), 3888; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13113888 - 29 Oct 2021
Cited by 3 | Viewed by 2093
Abstract
Added sugar intake at a young age is associated with chronic diseases including cardiovascular diseases, asthma, elevated blood pressure, and overweight. The Dietary Guidelines for Americans 2020–2025 and the American Heart Association recommend delaying the introduction of added sugar until age 2. The [...] Read more.
Added sugar intake at a young age is associated with chronic diseases including cardiovascular diseases, asthma, elevated blood pressure, and overweight. The Dietary Guidelines for Americans 2020–2025 and the American Heart Association recommend delaying the introduction of added sugar until age 2. The aims of this study were to identify the timing of added sugar initiation; factors associated with added sugar initiation; and the top five added sugar foods and beverages consumed by infants and children at three age ranges (<7 months, 8–13 months, and 14–24 months). Data were from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Infant and Toddler Feeding Practices Study-2, a longitudinal, national population of WIC participants enrolled in WIC eligible clinics (n = 3835). The Cox proportional hazards model was used to examine the factors associated with introducing added sugar. About 25% of children were given added sugar at or before 7 months. Contributing factors were caregivers’ race/ethnicity, education, employment, weight status, parity, child sex, and premature birth (all p < 0.05). The top added sugar foods consumed between 1–24 months were cereal, crackers, apple sauce, dessert, yogurt, sweetened beverages, syrup and preserves, and cookies. Further research to examine the impact of early initiation of added sugar on health outcomes and taste preferences is warranted. Full article
(This article belongs to the Special Issue Diet Quality, Food Environment and Diet Diversity)
10 pages, 822 KiB  
Article
A Feasibility and Pilot Study of a Personalized Nutrition Intervention in Mobile Food Pantry Users in Northeastern Connecticut
by Dalia Marmash, Kyungho Ha, Junichi R. Sakaki, Rachel Hair, Emma Morales, Valerie B. Duffy, Michael Puglisi and Ock K. Chun
Nutrients 2021, 13(9), 2939; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13092939 - 25 Aug 2021
Cited by 4 | Viewed by 2627
Abstract
Objective: This pilot study assessed the effectiveness and acceptability of personalized nutrition intervention for mobile food pantry users. Methods: The 8-week intervention recruited 25 participants in the control (n = 13) and in the treatment (n = 12) groups (60% obese). [...] Read more.
Objective: This pilot study assessed the effectiveness and acceptability of personalized nutrition intervention for mobile food pantry users. Methods: The 8-week intervention recruited 25 participants in the control (n = 13) and in the treatment (n = 12) groups (60% obese). Personalized nutrition and health reports were generated based on baseline dietary intake and health status. The treatment group received weekly phone counseling and nutrition education, while the control group was only contacted to ensure compliance. The primary outcomes were 8-week changes in weight and diet quality score, assessed by the Healthy Eating Index. Results: The acceptability of the intervention was assessed by the eligibility rate, recruitment rate (62.5%), and drop-out rate (36%). Following the intervention, there was a significant decrease in weight (mean ± standard deviation, −2.3% ± 2.4%) among all participants (p < 0.05). Diet-quality improved (4.54% in treatment vs. 0.18% in control), but was ultimately non-significant (p = 0.284). Conclusions and Implications: A personalized nutrition education intervention in mobile food pantry users may be an acceptable and effective intervention to encourage weight loss through dietary improvements. Full article
(This article belongs to the Special Issue Diet Quality, Food Environment and Diet Diversity)
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10 pages, 310 KiB  
Article
Evaluation of the Effectiveness of Brazilian Community Restaurants for the Dimension of Low-Income People Access to Food
by Mateus Santana Sousa, Camila Silveira Silva Teixeira, Jamacy Costa Souza, Priscila Ribas de Farias Costa, Renata Puppin Zandonadi, Raquel Braz Assunção Botelho, Heesup Han, António Raposo, Antonio Ariza-Montes, Luis Araya-Castillo and Rita de Cássia Coelho de Almeida Akutsu
Nutrients 2021, 13(8), 2671; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13082671 - 31 Jul 2021
Cited by 2 | Viewed by 2196
Abstract
This study aimed to evaluate the effectiveness of community restaurants (CRs), managed by the Government of the State of Bahia/Brazil, for the dimension of access to food. The study used secondary data obtained from the public opinion survey Profile of users of community [...] Read more.
This study aimed to evaluate the effectiveness of community restaurants (CRs), managed by the Government of the State of Bahia/Brazil, for the dimension of access to food. The study used secondary data obtained from the public opinion survey Profile of users of community restaurants in Salvador. The nutritional information was accessed through the analysis of CRs’ menus. Adequate effectiveness of access to food was considered when the CR served meals to 50% to 70% of the users considered the target audience (individuals served by the two CRs located in the city of Salvador/Bahia/Brazil). The participants (n = 1464; 778 as low-income individuals) were adult CR users from Salvador/Brazil. Most of the respondents were male, 40 to 54 years old, not white, had up to 9 years of formal education, without a partner, and living in the municipality of Salvador. The evaluated CRs are effective in serving 53.1% of the target population in their total service capacity. Meal provision only reached an estimated 0.7% of the socially vulnerable community in the district. The average energy value of the meal served by the CR units was 853.05 kcal/meal, with a mean energy density composition classified as average (1.15 kcal/g). The effectiveness of the evaluated community restaurants showed that these instruments were minimally effective in promoting access to food for the low-income population within their total daily service capacity, and the current quantity of these facilities was insufficient. However, these instruments stand out in the fundamental role of promoting the daily distribution of meals to the Brazilian population with the highest social vulnerability levels. Full article
(This article belongs to the Special Issue Diet Quality, Food Environment and Diet Diversity)
15 pages, 274 KiB  
Article
Diet Quality, Nutritional Adequacy, and Sociodemographic Characteristics of Mobile Food Pantry Users in Northeastern Connecticut
by Dalia Marmash, Kyungho Ha, Junichi R. Sakaki, Isabella Gorski, Brazil Rule, Jaime Foster, Michael Puglisi and Ock K. Chun
Nutrients 2021, 13(4), 1099; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13041099 - 27 Mar 2021
Cited by 6 | Viewed by 2606
Abstract
Poor diet quality among low-income populations is a major contributing factor to their poor health and wellbeing, and thus is a focus of many government aid programs. Mobile food pantries are an increasingly popular method of emergency food assistance, targeting the communities most [...] Read more.
Poor diet quality among low-income populations is a major contributing factor to their poor health and wellbeing, and thus is a focus of many government aid programs. Mobile food pantries are an increasingly popular method of emergency food assistance, targeting the communities most affected by food insecurity; however, little is known about the dietary characteristics of mobile food pantry users. This study aims to characterize the diet quality and nutrient adequacy level and examine its association with sociodemographic characteristics among mobile food pantry users in Windham County, Connecticut. Surveys to assess food insecurity, diet composition, and sociodemographic characteristics were administered to 83 adult food pantry users. Participants (n = 40) completed a three-day dietary record for analysis of diet quality, and were found to have inadequate intakes of fruits, vegetables, whole grains and dairy, as well as some related micronutrients. At least 30% of participants had intakes below the Estimated Average Requirement (EAR) for vitamins A, C, E, calcium, zinc, magnesium, and folate. Intakes of added sugar, sugar sweetened beverages, and saturated fat were also above recommendations according to the United States Dietary Guidelines. Certain sociodemographic factors affected diet quality among this sample. For example, being male was associated with increased sugar-sweetened beverage and added sugar intake. This characterization of mobile pantry users will serve as a reference for developing nutrition education and determining the effectiveness of future interventions. Full article
(This article belongs to the Special Issue Diet Quality, Food Environment and Diet Diversity)
16 pages, 311 KiB  
Article
Heterogeneities in Consumer Diet Quality and Health Outcomes of Consumers by Store Choice and Income
by Chandra K. Dhakal and Savin Khadka
Nutrients 2021, 13(4), 1046; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13041046 - 24 Mar 2021
Cited by 13 | Viewed by 3082
Abstract
Obesity and other diet-related health conditions have received much attention in the public health literature over the past two decades. This study investigates the relationship between household food budget shares at different food outlets with diet quality and weight-related health outcomes in the [...] Read more.
Obesity and other diet-related health conditions have received much attention in the public health literature over the past two decades. This study investigates the relationship between household food budget shares at different food outlets with diet quality and weight-related health outcomes in the United States. Our analysis used event-level food purchase data from the national household food acquisition and purchases survey (FoodAPS). We find that, after controlling for observables, food purchase location is significantly associated with diet quality and body mass index (BMI). Our findings indicate that larger food budget shares at convenience stores and restaurants are linked with poor diet quality based on the healthy eating index-2015 (HEI-2015) scores and higher BMI. We further explored potential heterogeneity on outcomes of interest across income groups. Results suggest heterogeneous effects may exist across income groups: low-income households, who spent a larger share of their food budget at convenience stores and fast-food restaurants are related to poor diet quality and more likely to be obese. Our findings will help improve understanding of the causes of diet-related health problems and may illuminate potential avenues of intervention to address obesity. Full article
(This article belongs to the Special Issue Diet Quality, Food Environment and Diet Diversity)
10 pages, 268 KiB  
Article
Micronutrient Adequacy in the Diet of Reproductive-Aged Adolescent Girls and Adult Women in Rural Bangladesh
by Rumana Akter, Hiroaki Sugino, Nasima Akhter, Christopher L. Brown, Shakuntala H. Thilsted and Nobuyuki Yagi
Nutrients 2021, 13(2), 337; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13020337 - 23 Jan 2021
Cited by 10 | Viewed by 3371
Abstract
Micronutrient deficiencies remain a serious nutritional concern in Bangladesh, especially among rural women of reproductive age (WRA). This study assesses the diet quality of reproductive-aged adolescent girls and adult women (referred to together as WRA in this study), including socio-demographic factors associated with [...] Read more.
Micronutrient deficiencies remain a serious nutritional concern in Bangladesh, especially among rural women of reproductive age (WRA). This study assesses the diet quality of reproductive-aged adolescent girls and adult women (referred to together as WRA in this study), including socio-demographic factors associated with their diet quality. The diet quality of adolescent girls was compared with that of adult women to assess which group was most at risk. The diet quality was measured by calculating the nutrient adequacy ratio (NAR), using the preceding 24 h dietary recall method. The mean adequacy ratio (MAR) was calculated as an overall measure of diet quality using the NAR. Nearly three quarters of WRA (adolescents: 73.1–88.5%; adult women: 72.9–86.4%) had an inadequate intake of calcium, vitamin A, folic acid, and vitamin B12. The prevalence of inadequate dietary intakes of calcium, zinc, and energy was significantly higher in adolescent girls (p < 0.001) than in adult women. Overall diet quality was significantly better in adult women (0.51 ± 0.21, p < 0.001) than in adolescent girls (0.49 ± 0.22). Age, marital status, educational level, and monthly household income were important factors associated with the diet quality of WRA. Micronutrient inadequacy is widely prevalent in the diets of WRA in Bangladesh, and adolescent girls with poor socio-economic status and lower educational levels are at higher risk. Full article
(This article belongs to the Special Issue Diet Quality, Food Environment and Diet Diversity)
10 pages, 452 KiB  
Article
Orders of Healthier Adult Menu Items in a Full-Service Restaurant Chain with a Healthier Children’s Menu
by Megan P. Mueller, Eleanor T. Shonkoff, Sara C. Folta, Stephanie Anzman-Frasca and Christina D. Economos
Nutrients 2020, 12(11), 3253; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12113253 - 23 Oct 2020
Cited by 5 | Viewed by 2252
Abstract
This study evaluated orders of adult menu items designated as healthier at the Silver Diner, a regional full-service restaurant chain serving over 4 million customers annually. This restaurant implemented a healthier children’s menu in April 2012. Orders of adult menu items were abstracted [...] Read more.
This study evaluated orders of adult menu items designated as healthier at the Silver Diner, a regional full-service restaurant chain serving over 4 million customers annually. This restaurant implemented a healthier children’s menu in April 2012. Orders of adult menu items were abstracted from before (September 2011–March 2012; PRE; n = 1,801,647) and after (September 2012–March 2013; POST; n = 1,793,582) the healthier children’s menu was introduced. Entrées, appetizers, and sides listed as healthier options on the menu were coded as healthier. PRE to POST changes in the percentage of orders of healthier items, soda, and dessert were evaluated using McNemar tests of paired proportions. Orders of healthier entrées, appetizers, and sides on the adult menu increased PRE to POST (8.9% to 10.4%, 25.5% to 27.5%, and 7.3% to 9.3%, respectively), and soda and dessert orders decreased (23.2% to 21.7% and 29.0% to 28.3%, respectively). All shifts were statistically significant (p < 0.0001). Our findings demonstrate improvements in orders of healthier adult menu options during the same time frame as a healthy children’s menu change. Future research can help elucidate mechanisms to inform future health promotion efforts in restaurants in ways that have the potential to impact both adults and children. Full article
(This article belongs to the Special Issue Diet Quality, Food Environment and Diet Diversity)
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Review

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17 pages, 1098 KiB  
Review
Food Environment around Schools: A Systematic Scope Review
by Fabiana Chagas Oliveira de França, Iziane da Silva Andrade, Renata Puppin Zandonadi, Karin Eleonora Sávio and Rita de Cassia Coelho de Almeida Akutsu
Nutrients 2022, 14(23), 5090; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14235090 - 30 Nov 2022
Cited by 6 | Viewed by 3066
Abstract
The present systematic scope review intended to compile state-of-the-art information about the food environment around schools, exploring the main methods used to describe the food environment around schools as well as the possible effects that this environment can promote on the health of [...] Read more.
The present systematic scope review intended to compile state-of-the-art information about the food environment around schools, exploring the main methods used to describe the food environment around schools as well as the possible effects that this environment can promote on the health of children and adolescents. The preferred reporting items for systematic reviews and meta-analyses—extension for scoping reviews (PRISMA-ScR) checklist and guidelines were followed to ensure a robust and repeatable methodological process. A systematic search was performed in the following electronic databases: MEDLINE, Embase, Science Direct, Web of Science, LILACS, and Scopus, as well as in related articles, a manual search of reference lists and gray literature. Forty-six studies were selected. There was no standardization regarding distances from food establishments to schools, methods of analysis, and software used. The food environment around the schools was characterized by the wide availability of food establishments, especially fast food, convenience stores, supermarkets, and grocery stores known for offering a wide variety of unhealthy foods. Regarding the correlations with the health of children and adolescents, the evidence points to possible interferences of the food environment known as obesogenic, but it cannot be related only to the school environment since most of the acquisition and consumption of food usually happens around family homes. Conducting standardized and comprehensive studies evaluating food choices in the school environment and their interrelationships is very important to ensure children’s food and nutrition security and minimize negative health outcomes in the medium and long term. Full article
(This article belongs to the Special Issue Diet Quality, Food Environment and Diet Diversity)
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13 pages, 693 KiB  
Review
Increasing Access to Healthy Foods through Improving Food Environment: A Review of Mixed Methods Intervention Studies with Residents of Low-Income Communities
by Dea Ziso, Ock K. Chun and Michael J. Puglisi
Nutrients 2022, 14(11), 2278; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14112278 - 29 May 2022
Cited by 12 | Viewed by 8313
Abstract
Food insecurity is a broad and serious public health issue in the United States, where many people are reporting lack of access to healthy foods. The reduced availability of healthy, affordable foods has led to increased consumption of energy-dense and nutrient-poor foods, resulting [...] Read more.
Food insecurity is a broad and serious public health issue in the United States, where many people are reporting lack of access to healthy foods. The reduced availability of healthy, affordable foods has led to increased consumption of energy-dense and nutrient-poor foods, resulting in increasing the risk for many chronic diseases such as obesity, cardiovascular diseases, and type 2 diabetes mellitus. Thus, identifying promising approaches to increase access to healthy foods through improving the food environment is of importance. The purpose of this review article is to highlight how the food environment affects directly a person’s food choices, and how to increase access to healthy foods through improving environmental approaches. The literature search was focused on finding different approaches to improve food security, primarily those with an impact on food environment. Overall, potential solutions were gathered through multilevel environmental approaches, including nutrition education and peer education, community-based participatory research, and policy changes in supplemental nutrition programs. A recommendation to reduce food insecurity is learning to create meals with a variety of seasonal fruits and vegetables purchased from affordable farmers’ markets. Full article
(This article belongs to the Special Issue Diet Quality, Food Environment and Diet Diversity)
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24 pages, 1211 KiB  
Review
Recommendations for Integrating Evidence-Based, Sustainable Diet Information into Nutrition Education
by Graham E. Bastian, Danielle Buro and Debra M. Palmer-Keenan
Nutrients 2021, 13(11), 4170; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13114170 - 21 Nov 2021
Cited by 9 | Viewed by 7211
Abstract
The adoption of more sustainable diets (SD) has the capacity to meet the needs of individuals without compromising future generations’ abilities to do the same. Nutrition educators are ideal candidates for delivering SD education to consumers, yet evidence-based recommendations for the profession have [...] Read more.
The adoption of more sustainable diets (SD) has the capacity to meet the needs of individuals without compromising future generations’ abilities to do the same. Nutrition educators are ideal candidates for delivering SD education to consumers, yet evidence-based recommendations for the profession have not been crafted. The results of a thorough, narrative review of the literature performed in 2021 suggest there are five well-supported recommendations nutrition educators should consider incorporating in their work. They are (1) shift towards a plant-based diet, (2) mitigate food waste, (3) limit consumption of ultra-processed foods (UPF), (4) engage in local food systems, and (5) choose sustainable seafood. Each recommendation is discussed below in detail, to provide nutrition educators with a nuanced scope of the issue, after which suggestions for the inclusion of these recommendations, using an example of the authors’ experiences from the US Expanded Food and Nutrition Education Program (EFNEP), are provided. Full article
(This article belongs to the Special Issue Diet Quality, Food Environment and Diet Diversity)
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16 pages, 1003 KiB  
Review
The Complementary Roles for Plant-Source and Animal-Source Foods in Sustainable Healthy Diets
by Kevin B. Comerford, Gregory D. Miller, Wendy Reinhardt Kapsak and Katie A. Brown
Nutrients 2021, 13(10), 3469; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13103469 - 29 Sep 2021
Cited by 18 | Viewed by 6737
Abstract
There are approximately 100 countries with food-based dietary guidelines throughout the world, each of which aims to encompass the cultural, geographical, and health considerations unique to their country of origin. Common themes throughout these guides emphasize diverse and balanced intake of food groups [...] Read more.
There are approximately 100 countries with food-based dietary guidelines throughout the world, each of which aims to encompass the cultural, geographical, and health considerations unique to their country of origin. Common themes throughout these guides emphasize diverse and balanced intake of food groups from both plant- and animal-sources. With the globally recognized need to shift to more sustainable food systems, several countries and international food and health organizations have begun to incorporate sustainability recommendations into their dietary guidance. These sustainability recommendations are often based on food source (i.e., eat more plant-source and fewer animal-source foods), yet food source may not be the only useful or informative comparator for assessing healthy and sustainable diets. The purpose of this narrative review is to examine the roles of plant-source foods and animal-source foods in the context of sustainable healthy diets—with an emphasis on the contributions of the most commonly recommended food groups from global food-based dietary guidelines (i.e., fruits, vegetables, and dairy foods). Overall, plant and animal agriculture have complementary and symbiotic roles in healthy and sustainable food systems, and these abilities are largely dependent on various contextual factors (e.g., geography, production practices, processing methods, consumption patterns)—not just on whether the food originated from the plant or animal kingdom. Full article
(This article belongs to the Special Issue Diet Quality, Food Environment and Diet Diversity)
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15 pages, 1139 KiB  
Review
Fish Acquisition and Consumption in the African Great Lakes Region through a Food Environment Lens: A Scoping Review
by Julia de Bruyn, Joshua Wesana, Stuart W. Bunting, Shakuntala H. Thilsted and Philippa J. Cohen
Nutrients 2021, 13(7), 2408; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13072408 - 14 Jul 2021
Cited by 15 | Viewed by 5229
Abstract
Effective actions for the fishery and aquaculture sectors to contribute toward improving nutrition rely on an understanding of the factors influencing fish intake, particularly amongst vulnerable populations. This scoping review synthesises evidence from 33 studies in the African Great Lakes Region to examine [...] Read more.
Effective actions for the fishery and aquaculture sectors to contribute toward improving nutrition rely on an understanding of the factors influencing fish intake, particularly amongst vulnerable populations. This scoping review synthesises evidence from 33 studies in the African Great Lakes Region to examine the influence of food environments on fish acquisition and consumption. We identified only two studies that explicitly applied a food environment framework and none that linked policy conditions with the contribution of fish to diets. Economic access to fish was represented in the largest number of included studies (21 studies), followed by preferences, acceptability and desirability of fish (17 studies) and availability and physical access (14 studies). Positive perceptions of taste and low cost, relative to other animal-source foods, were drivers of fish purchases in many settings; however, limited physical and economic access were frequently identified as preventing optimal intake. In lakeside communities, fish were increasingly directed toward external markets which reduced the availability and affordability of fish for local households. Few studies considered intra-household variations in fish access according to age, gender or physiological status, which represents an important knowledge gap. There is also scope for future research on seasonal influences on fish access and the design and rigorous evaluation of programmes and policies that address one or more constraints of availability, cost, convenience and preferences. Full article
(This article belongs to the Special Issue Diet Quality, Food Environment and Diet Diversity)
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