scholarly journals An Examination of Demographic and Psychosocial Factors, Barriers to Healthy Eating, and Diet Quality Among African American Adults

Nutrients ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 519 ◽  
Author(s):  
Ingrid Richards Adams ◽  
Wilson Figueroa ◽  
Irene Hatsu ◽  
James Odei ◽  
Mercedes Sotos-Prieto ◽  
...  
Keyword(s):  
Social Support ◽  
African American ◽  
African Americans ◽  
Psychosocial Factors ◽  
Healthy Eating ◽  
Diet Quality ◽  
Self Efficacy ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
African American Adults

A healthy diet is associated with lower risk of chronic disease. African Americans generally have poor diet quality and experience a higher burden of many chronic diseases. We examined the associations of demographic and psychosocial factors and barriers to diet quality among African American adults. This cross-sectional study included 100 African American adults in a southeastern metropolitan area. Psychosocial factors (social support, self-efficacy), and barriers to healthy eating were assessed with validated measures. Diet quality was assessed using the Healthy Eating Index (HEI-2010). Nested linear regressions were used to examine the association between the variables of interest and HEI scores. Participants reported having social support (M (mean) = 2.0, SD (standard deviation) = 0.6, range 0–3), high levels of self-efficacy (M = 3.1, SD = 0.7, range 1–4), and low barriers (M = 1.4, SD = 0.6, range 0–4) to engage in healthy eating but total mean HEI scores needed improvement (M = 54.8, SD = 10.9, range 27.1–70.0). Participants consumed significantly higher empty calories and lower whole fruits, dairy, and total protein foods than the national average. Barriers to healthy eating (b = −12.13, p = 0.01) and the interaction between age and barriers (b = 0.25, p = 0.02) were most strongly associated with lower HEI scores. Younger African Americans with the highest barriers to healthy eating had the lowest HEI scores. Culturally appropriate interventions targeting empty calories, barriers to healthy eating, and knowledge of the Dietary Guidelines for Americans are needed for African Americans.

scholarly journals Defining Diet Quality: A Review of Diet Metrics as Applied to the Double Burden of Malnutrition (OR17-01-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Victoria Miller ◽  
Patrick Webb ◽  
Renata Micha ◽  
Dariush Mozaffarian
Keyword(s):  
Healthy Eating ◽  
Diet Quality ◽  
Fruits And Vegetables ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Healthy Diet ◽  
Food Groups ◽  
Policy Action ◽  
Double Burden ◽  
Meta Analyses

Abstract Objectives Meeting most of the UN Sustainable Development Goals (SGDs) will require a strong focus on tackling all forms of malnutrition─ addressing maternal and child health (MCH) as well as diet-related non-communicable diseases (NCDs). Yet, the optimal metrics to define a healthy diet remain unclear. Our aim was to comprehensively review diet metrics and assess the evidence on each metric's association with MCH and NCDs. Methods Using comprehensive searches and expert discussions, we identified metrics that i) are used in ≥3 countries to link diet to health, ii) quantify the number of foods/food groups consumed and/or iii) quantify recommended nutrient intakes. We reviewed and summarized each metric's development, components and scoring. For each identified metric, we systematically searched PubMed to identify meta-analyses or narrative reviews evaluating these metrics with nutrient adequacy and health outcomes. We assessed validity by grading the number of studies included and the consistency of the diet metric-disease relationship. Results We identified 6 MCH, 13 NCD and 0 MCH/NCD metrics. Most were developed for describing adherence to dietary guidelines or patterns, and others were developed for predicting micronutrient adequacy. On average, the metrics included 14 food groups/nutrients (range 4–45), with 10 food-group only metrics and 0 nutrient-only metrics. The most frequent metric components were grains/roots/tubers, fruits and vegetables. We identified 16 meta-analyses and 14 narrative reviews representing 102 metric-disease relationships (98 metric-NCD and 4 metric-MCH relationships, respectively). We found 5 metrics that have been consistently validated in meta-analyses and narrative reviews for NCDs, 1 metric with limited evidence for MCH, but 0 metrics for both. Of the metrics, the Alternative Healthy Eating Index (aHEI), Dietary Approaches to Stop Hypertension (DASH), Healthy Eating Index (HEI), and Mediterranean Diet Score (MED) were most commonly validated, especially for all-cause mortality and cardiovascular disease (Figure 1). Conclusions Few diet metrics have been used in multiple countries to define a healthy diet. This suggests a serious gap in global analyses of diet quality relating to malnutrition in all its forms, which hinders effective policy action. Funding Sources Gates Foundation. Supporting Tables, Images and/or Graphs

scholarly journals Sociodemographic and Psychosocial Factors Associated with Diet Quality Among Native American Adults: Baseline Data from the OPREVENT2 Study (P04-007-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Michelle Estradé ◽  
Angela Trude ◽  
Marla Pardilla ◽  
Joel Gittelsohn
Keyword(s):  
Native American ◽  
Psychosocial Factors ◽  
Healthy Eating ◽  
Diet Quality ◽  
Self Efficacy ◽  
Regression Models ◽  
Nutrition Knowledge ◽  
Food Assistance ◽  
Linear Regression Models ◽  
Dietary Interventions

Abstract Objectives To identify sociodemographic and psychosocial factors associated with diet quality among Native American adults. Methods Cross-sectional data from the baseline assessment of a cluster-randomized obesity prevention trial (OPREVENT2) of 580 Native American adults from six tribal communities in the Midwest and Southwest. The Healthy Eating Index (HEI-2015) was used to define diet quality, calculated from a semi-quantitative food frequency questionnaire (modified Block FFQ). Sociodemographic (age, sex, education, food assistance) and psychosocial factors (nutrition knowledge, self-efficacy, health eating intentions) were assessed via questionnaires administered by trained data collectors. One-way ANOVA, linear regression models, and two-tailed t-tests assessed compared mean total HEI scores among sociodemographic categories. Bivariate linear regression models assessed the relation between psychosocial factors and diet quality. Results Overall diet quality was low, with a mean HEI-2015 score of 49 (SD + 8), which is 10 points lower than in the general U.S. population. The HEI scores of smokers were an average of 3 points lower than those of non-smokers (P < 0.001), and females had better diet quality (2.2 points higher) than males (P < 0.01). Those receiving commodity food assistance had mean total HEI scores 2.7 points lower than those who did not receive commodities (P < 0.005), and no other source of food assistance was associated with HEI. Self-efficacy (b = 0.66; P < 0.001) and healthy eating intentions (b = 0.72; P < 0.001) were positively associated with mean HEI. Conclusions While nutrition knowledge has been a key focus of many dietary interventions, it does not appear to be associated with better diet quality among Native Americans. This finding suggests that it is necessary to focus interventions on factors other than nutrition knowledge that may impact food choice. Because higher self-efficacy and healthy eating intentions were associated with better diet quality, a social-cognitive approach to dietary interventions may be more effective in Native American populations. Funding Sources OPREVENT2 is funded by a grant from the National Heart, Lung, and Blood Institute.

scholarly journals Social Support, but Not Perceived Food Environment, Is Associated with Diet Quality in French-Speaking Canadians from the PREDISE Study

Nutrients ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 3030 ◽  
Author(s):  
Elise Carbonneau ◽  
Benoît Lamarche ◽  
Julie Robitaille ◽  
Véronique Provencher ◽  
Sophie Desroches ◽  
...  
Keyword(s):  
Social Support ◽  
Healthy Eating ◽  
Diet Quality ◽  
Food Environment ◽  
Healthy Eating Index ◽  
Linear Regression Models ◽  
Healthy Foods ◽  
French Speaking ◽  
Food Recalls ◽  
At Home

The objectives were to assess whether social support for healthy eating and perceived food environment are associated with diet quality, and to investigate if sociodemographic characteristics moderate these associations. A probability sample of French-speaking adults from the Province of Québec, Canada, was recruited in the context of the PREDISE study. Participants reported their perceptions of supportive and non-supportive actions related to healthy eating from close others at home and outside of home (n = 952), and of the accessibility to healthy foods (n = 1035). The Canadian Healthy Eating Index (C-HEI) was calculated based on three Web-based 24 h food recalls. Multiple linear regression models showed that supportive (B = 1.50 (95% CI 0.46, 2.54)) and non-supportive (B = −3.06 (95% CI −4.94, −1.18)) actions related to healthy eating from close others at home were positively and negatively associated with C-HEI, respectively, whereas actions from close others outside of home were not. The negative association between non-supportive actions occurring at home and C-HEI was stronger among participants with lower (vs. higher) levels of education (p interaction = 0.03). Perceived accessibility to healthy foods was not associated with C-HEI (p > 0.05). These results suggest that the social environment may have a stronger influence on healthy eating than the perceived physical environment. This adds support for healthy eating promotion programs involving entire families, especially for more socioeconomically disadvantaged individuals, whose efforts to eat healthily may be more easily thwarted by non-supportive households.

scholarly journals Associations of psychosocial factors with fruit and vegetable intake among African-Americans

2007 ◽  
Vol 10 (7) ◽  
pp. 701-711 ◽  
Author(s):  
Joanne L Watters ◽  
Jessie A Satia ◽  
Joseph A Galanko
Keyword(s):  
African American ◽  
African Americans ◽  
Psychosocial Factors ◽  
Self Efficacy ◽  
Vegetable Intake ◽  
African American Men ◽  
Predisposing Factors ◽  
Fruit And Vegetable Intake ◽  
Fruit And Vegetable ◽  
Enabling Factors

AbstractObjectiveTo examine associations of various psychosocial factors with fruit and vegetable intake in African-American adults.MethodsA cross-sectional survey of a population-based sample of 658 African-Americans, aged 18–70 years, in North Carolina. Information was collected on diet-related psychosocial (predisposing, reinforcing and enabling) factors based on the PRECEDE (Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation) planning framework; demographic, lifestyle and behavioural characteristics, and fruit and vegetable intake.ResultsThe mean participant age was 43.9 years (standard deviation 11.6), 57% were female and 76% were overweight/obese. Participants expressed healthy beliefs regarding many of, but not all, the psychosocial factors. For example, although half of the respondents believed it is important to eat a diet high in fruits/vegetables, only 26% knew that ≥ 5 daily servings are recommended. The strongest associations of the psychosocial factors with fruit/vegetable intake were for predisposing factors (e.g. belief in the importance of a high fruit/vegetable diet and knowledge of fruit/vegetable recommendations) and one reinforcing factor (social support), with differences between the healthiest and least healthy responses of 0.5–1.0 servings per day. There was evidence of effect modification by gender in associations between psychosocial factors and fruit/vegetable consumption (e.g. self-efficacy was only significant in women), with higher intakes and generally healthier responses to the psychosocial variables in women than men.ConclusionsInterventions to increase fruit/vegetable intake in African-Americans may be more effective if they focus primarily on predisposing factors, such as knowledge, self-efficacy and attitudes, but not to the exclusion of reinforcing and enabling factors. The psychosocial factors that are targeted may also need to be somewhat different for African-American men and women.

scholarly journals Racial/Ethnic Differences in Diet Quality and Eating Habits Among WIC Pregnant Women: Implications for Policy and Practice

2019 ◽  
Vol 34 (2) ◽  
pp. 169-176 ◽  
Author(s):  
Alla M. Hill ◽  
Danielle L. Nunnery ◽  
Alice Ammerman ◽  
Jigna M. Dharod
Keyword(s):  
African American ◽  
Pregnant Women ◽  
African American Women ◽  
Healthy Eating ◽  
Diet Quality ◽  
Low Income ◽  
Eating Behaviors ◽  
Dietary Habits ◽  
Healthy Eating Index ◽  
American Women

Purpose: One of the major federal food assistance programs, the Special Supplemental Program for Women, Infants, and Children (WIC), serves approximately 1.5 million low-income pregnant women per year; however, limited information is available on their dietary habits. This is critical because low-income women are at higher risk of gaining excess weight during pregnancy. Thus, the study objectives were to (1) determine the overall diet quality of WIC pregnant women and (2) examine diet quality and eating behaviors by race/ethnicity and other sociodemographics. Design: This was a cross-sectional study. Setting: One of the 3 WIC offices in a north-central county in North Carolina, USA. Sample: Pregnant women (n = 198) in the second trimester. Measures: Interviews included sociodemographics, food security, diet, and eating behaviors. Diet quality was assessed by the Healthy Eating Index (HEI) 2010 scores. Analysis: Descriptives, bivariate analysis, and multivariate analysis. Results: Average participant age was 26 years, and the mean HEI-2010 score was 56 of maximum score of 100. Specifically, African American women consumed significantly lower servings of whole grains (β = −1.71; 95% CI: −3.10 to −0.32; P < .05) and dairy (β = −1.42; 95% CI: −2.51 to −0.33; P < .05) compared with non-Hispanic white women. Hispanic women scored higher in daily intake of fruits (β = 0.98; 95% CI: 0.17-1.79; P < .05) and for consuming empty calories in moderation (β = 1.57; 95% CI: 0.06-3.09; P < .05). Frequency of intake of fast foods/outside meals was higher among African American women (57%, P = .025). Conclusion: Efforts are warranted to promote optimal nutrition among WIC pregnant women. Specifically, African American women are highly vulnerable to poor dietary habits during pregnancy. Further investigation of barriers/facilitators for healthy eating is necessary to address nutrition disparities among WIC pregnant women.

scholarly journals Greater Adherence to Dietary Guidelines were Associated with Lower Risk of Cardiovascular Diseases in Chinese Patients with Type 2 Diabetes: A Case-Control Study

2020 ◽  
Author(s):  
Shang-Ling Wu ◽  
Yan-Bin Ye ◽  
Long-Yun Peng ◽  
Yu-Ming Chen ◽  
Fang-Fang Zeng ◽  
...  
Keyword(s):  
Healthy Eating ◽  
Diet Quality ◽  
Lower Risk ◽  
Case Control Study ◽  
Case Control ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Chinese Patients ◽  
Control Study

Abstract Background The evidence regarding the impact of the healthy eating index on the risk of cardiovascular events among patients with type 2 diabetes (T2D) is limited. To examine the associations of adherence to the Chinese and American dietary guidelines and the risk of cardiovascular disease (CVD) among Chinese individuals with T2D. Methods This 1:1 matched case-control study included 419 enrolled pairs hospital-based CVD cases and controls who were matched by age and sex, in Guangdong province, China, all of whom had T2D. A structured questionnaire and a 79-item food-frequency questionnaire was used to collect general information and dietary intake information. Diet quality scores were calculated according to the Chinese Healthy Eating Index (CHEI) and the Healthy Eating Index-2015 (HEI-2015). Results After adjustment for various confounding factors, the higher diet quality scores on the CHEI and HEI-2015 showed a significant association with a lower risk of CVD. The odds ratios (95% confidence interval) per 5-score increment were 0.88(0.83,0.92) in the CHEI and 0.80(0.74,0.88) in the HEI-2015, respectively. In stratified analyses, the protective associations remained significant in the subgroups of sex, smoking status, tea-drinking, hypertension state, dyslipidemia state, BMI, and T2D duration, but not among the drinkers in CHEI. Conclusion Greater adherence to the most recent Chinese or American dietary guidelines were associated with a lower risk of CVD incidents among Chinese patients with T2D.

scholarly journals Is The Healthy Eating Index-2015 Associated With Rheumatoid Arthritis?

2021 ◽  
Author(s):  
Atiyeh Nayebi ◽  
Davood Soleimani ◽  
Shayan Mostafaei ◽  
Negin Elahi ◽  
Homayoun Elahi ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Healthy Eating ◽  
Diet Quality ◽  
Linear Trend ◽  
Cross Sectional Study ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
P Value ◽  
Cross Sectional

Abstract Objective: Healthy Eating Index-2015 (HEI-2015) is a multidimensional criterion of diet quality utilized to evaluate how well people’s dietary behaviors align with major recommendations of the 2015–2020 Dietary Guidelines for Americans. We aim to investigate the association between the diet quality and Rheumatoid arthritis (RA) activity.Design: Cross-sectional studySetting: This study was done on 184 patients with RA in rheumatology clinic in Kermanshah city, Iran, in 2020. RA was diagnosed according to the criteria of the 2010 American College of Rheumatology/ European League against Rheumatism. The overall quality diet was extracted from a validated 168-item food frequency questioner (FFQ) to calculate the HEI-2015 score. RA disease activity was assessed using Disease Activity Score 28 (DAS28) scores. One-way ANOVA and ANCOVA were done to find the associations.Participants: RA patientsResults: Individuals in the highest HEI-2015 quartile had a lower mean Erythrocyte Sedimentation Rate (ESR) than those in the lowest quartiles of the HEI scores (P-value: 0.014). A linear trend towards decreasing waist circumference in patients was observed with increasing quartiles of the HEI-2015 scores (P-value= 0.005). After controlling for all potential confounders, patients in the highest HEI-2015 quartile had the lowest DAS28 scores than those in the lowest quartile of the HEI-2015 scores (Q1= 3.65; 95% CI= 3.29 – 4.02 vs. Q4= 2.35; 95% CI= 1.94 - 2.67; P-value<0.001).Conclusion: Our results indicated that following a high diet quality might be one of the therapeutic strategies to control or reduce the disease activity in RA patients.

scholarly journals Serum Metabolites Associated with Healthy Diets in African Americans and European Americans

2020 ◽  
Vol 151 (1) ◽  
pp. 40-49 ◽  
Author(s):  
Hyunju Kim ◽  
Emily A Hu ◽  
Kari E Wong ◽  
Bing Yu ◽  
Lyn M Steffen ◽  
...  
Keyword(s):  
African Americans ◽  
Healthy Eating ◽  
Diet Quality ◽  
Healthy Eating Index ◽  
P Value ◽  
Dietary Intakes ◽  
Serum Metabolites ◽  
European Americans ◽  
Healthy Diets ◽  
Participant Characteristics

ABSTRACT Background High diet quality is associated with a lower risk of chronic diseases. Metabolomics can be used to identify objective biomarkers of diet quality. Objectives We used metabolomics to identify serum metabolites associated with 4 diet indices and the components within these indices in 2 samples from African Americans and European Americans. Methods We studied cross-sectional associations between known metabolites and Healthy Eating Index (HEI)-2015, Alternative Healthy Eating Index (AHEI)-2010, the Dietary Approaches to Stop Hypertension Trial (DASH) diet, alternate Mediterranean diet (aMED), and their components using untargeted metabolomics in 2 samples (n1 = 1,806, n2 = 2,056) of the Atherosclerosis Risk in Communities study (aged 45–64 y at baseline). Dietary intakes were assessed using an FFQ. We used multivariable linear regression models to examine associations between diet indices and serum metabolites in each sample, adjusting for participant characteristics. Metabolites significantly associated with diet indices were meta-analyzed across 2 samples. C-statistics were calculated to examine if these candidate biomarkers improved prediction of individuals in the highest compared with lowest quintile of diet scores beyond participant characteristics. Results Seventeen unique metabolites (HEI: n = 6; AHEI: n = 5; DASH: n = 14; aMED: n = 2) were significantly associated with higher diet scores after Bonferroni correction in sample 1 and sample 2. Six of 17 significant metabolites [glycerate, N-methylproline, stachydrine, threonate, pyridoxate, 3-(4-hydroxyphenyl)lactate)] were associated with ≥1 dietary pattern. Candidate biomarkers of HEI, AHEI, and DASH distinguished individuals with highest compared with lowest quintile of diet scores beyond participant characteristics in samples 1 and 2 (P value for difference in C-statistics &lt;0.02 for all 3 diet indices). Candidate biomarkers of aMED did not improve C-statistics beyond participant characteristics (P value = 0.930). Conclusions A considerable overlap of metabolites associated with HEI, AHEI, DASH, and aMED reflects the similar food components and similar metabolic pathways involved in the metabolism of healthy diets in African Americans and European Americans.

scholarly journals Association of the Healthy Eating Index (HEI) Score of Children Enrolled in School Lunch and Breakfast Program and Frequency of Meals at School: NHANES 2015–2016

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 278-278
Author(s):  
Kavitha Shankaranarayanan ◽  
Derek Miketinas
Keyword(s):  
Children And Adolescents ◽  
Healthy Eating ◽  
Diet Quality ◽  
School Lunch ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
School Meals ◽  
Obesity Epidemic ◽  
Texas Woman's University ◽  
School Breakfast

Abstract Objectives Nutritious and well-balanced school meals are critical to curbing the obesity epidemic in school-aged children while also providing adequate nutrition to sustain healthy growth and development. The school lunch program underwent a significant revamp in 2012 to align the menu with the US Dietary Guidelines. The Healthy Eating Index (HEI) is a metric that measures this alignment. The purpose of this study is to calculate usual HEI scores for children and compare HEI scores across frequency of school meals consumed using NHANES 2015–2016. Methods Children 18y and younger were included in the analyses and categorized into one of five groups for breakfast and lunch, each. Either consuming no school breakfast/lunch or consuming school breakfast/lunch 1–5 times daily. Usual HEI scores and standard errors were determined using the NCI method. Independent samples t-tests were computed for pairwise comparisons between no school breakfast/lunch consumption and increasing frequency of consumption. All analyses were performed using SAS version 9.4. Results Mean HEI scores for children consuming 0, 1, 2, 3, 4, 5 school breakfasts per week was 44.7 ± 0.8, 44 ± 1.9, 41.4 ± 2.4, 43.9 ± 1.4, 40.8 ± 2.3, 42.7 ± 1.0 and the mean HEI score for children consuming 0, 1, 2, 3, 4, 5 lunches per week was 44.7 ± 0.8, 46.7 ± 0.8, 42.3 ± 2.5, 45.0 ± 0.9, 46.1 ± 0.9, 43.3 ± 0.8, respectively. These results indicate that there are no significant differences across children who consumed these meals at various frequencies with those that do not consume school meals. Although there were no observed differences, overall diet quality was poor for those who do and do not consume school breakfast/lunch. Conclusions Although children and adolescents who consumed school breakfast/lunch did not appear to have greater diet quality than those who did not, overall diet quality was poor for all groups. Therefore, additional efforts are needed to improve diet quality in children and adolescents. Funding Sources Texas Woman's University.

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