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NUTRITION

CHAPMAN, Katarzyna and OGDEN, Jane. How do people change their diet? : an exploration into mechanisms of dietary change. Journal of Health Psychology Vol 14, No 8 - November 2009: 1229-1242
Abstract: The present study explored how people change their diet over the course of their lifespan and what factors facilitate this process. Twenty participants' narratives were analysed using Interpretative Phenomenological Analysis. The participants' narratives indicated that diet changes can occur either with or without the individual's active involvement. We labelled these the active path and the passive path. Four themes emerged denoting the mechanisms of change: accumulation of evidence; trigger to action; imposed change; and seamless change. These results indicate that dietary changes may not be as infrequent and difficult as often assumed and highlight an array of new mechanisms which could be explored further to promote behaviour change.

CULLEN, Karen Weber and SMALLING, Agueda Lara and others. Creating healthful home food environments : results of a study of participants in the expanded food and nutrition program. Journal of Nutrition Education and Behavior Vol 41, No 6 - November/December 2009: 380-388
Abstract: Objective: To evaluate a modified curriculum for the 6-session Texas Expanded Food and Nutrition Education Program (EFNEP) promoting healthful home food environments and parenting skills related to obesity prevention. Design: Two-group randomized control trial; intervention versus usual EFNEP curriculum. Setting: Texas EFNEP classes. Participants: 1,104 EFNEP clients in 100 classes. Intervention: Six short videos, with goal setting, problem solving, guided discussion, and handouts, incorporated into existing EFNEP classes. Main Outcome Measures: Body mass index (BMI), diet, psychosocial variables with baseline measurements, immediately post, and 4 months later. Analysis: Mixed-model repeated measures analysis of variance. Results: 100 classes were randomized (54 intervention/46 comparison), with 1,006 participants at baseline (582 intervention, 424 comparison, 97% women, 89% Hispanic). Significant improvements over time were found for both groups' consumption of most food items and nutrients, and nearly all psychosocial variables, regardless of study group. Only the intervention group had a significant BMI decrease at post. Fidelity to the intervention class session structure was high, and comments from intervention staff and clients were positive. Conclusion and Implications: Existing EFNEP programs in local communities could have a significant impact on family dietary behaviors for populations at risk of obesity. Replication with similar populations is warranted.

MACKISON, D and WRIEDEN, W L and others. Making an informed choice in the catering environment : what do consumers want to know? Journal of Human Nutrition and Dietetics Vol 22, No 6 - December 2009: 567-573
Abstract: Background: Eating outside the home is common in the UK, but it remains difficult for consumers to make informed choices based on menu information. The present study examines the reported preferences for the provision of nutrition (salt, fat and energy) and ingredient information in six types of UK catering outlets. Methods: Participants completed a short postal survey, assessing their frequency of dining at specific catering establishments as well as their desire to see nutrition and ingredient information. Results: The responses from 786 adults aged >=18 years (of whom 65% claimed to be 'motivated to eat a healthy diet') indicated that over 40% reported eating at a catering outlet at least once a week. Over half said that they would wish to see information on ingredients and the salt content of menu items at all venues. Preference for information on energy and fat content was less popular and varied in the range 42-56% for energy and 47-59% for fat. It is notable that 43% of respondents said they would welcome information on energy content of menu items in restaurants. Conclusion: A significant proportion of consumers wish to see information on the ingredients and nutrition composition on menu items for sale in UK catering outlets. Such information is likely to raise an awareness and understanding of healthy food choices and assist the population in making informed choices about healthy eating.

MICHIE, Susan and ABRAHAM, Charles and others. Effective techniques in healthy eating and physical activity interventions : a meta-regression. Health Psychology Vol 28, No 6 - November 2009: 690-701
Abstract: Objective: Meta-analyses of behavior change (BC) interventions typically find large heterogeneity in effectiveness and small effects. This study aimed to assess the effectiveness of active BC interventions designed to promote physical activity and healthy eating and investigate whether theoretically specified BC techniques improve outcome. Design: Interventions, evaluated in experimental or quasi-experimental studies, using behavioral and/or cognitive techniques to increase physical activity and healthy eating in adults, were systematically reviewed. Intervention content was reliably classified into 26 BC techniques and the effects of individual techniques, and of a theoretically derived combination of self-regulation techniques, were assessed using meta-regression. Main Outcome Measures: Valid outcomes of physical activity and healthy eating. Results: The 122 evaluations (N = 44,747) produced an overall pooled effect size of 0.31 (95% confidence interval = 0.26 to 0.36, I2 = 69%). The technique, "self-monitoring," explained the greatest amount of among-study heterogeneity (13%). Interventions that combined self-monitoring with at least one other technique derived from control theory were significantly more effective than the other interventions (0.42 vs. 0.26). Conclusion: Classifying interventions according to component techniques and theoretically derived technique combinations and conducting meta-regression enabled identification of effective components of interventions designed to increase physical activity and healthy eating.

PHILLIPS, Frankie. The functions of vitamin D. Practice Nurse Volume 38, No 10 - 11 December 2009: 26-29
Abstract: Everyone knows that vitamin D is 'good for your bones'. Now research in other areas of health, such as ageing, may lead us to see this essential nutrient in a new light.

ROLNICK, Sharon J and CALVI, Josephine and others. Focus groups inform a web-based program to increase fruit and vegetable intake. Patient Education and Counseling Vol 77, No 2 - November 2009: 314-318
Abstract: Objective: To use focus groups to inform a web-based educational intervention for increased fruit and vegetable (FV) consumption. Methods: Twelve groups (participants = 137, aged 21-65) were recruited from four geographically diverse health systems. Four groups were stratified by gender and eight by race (white and African American) and gender. Questions included perceptions of healthy eating, factors that encourage or serve as barriers to FV consumption and features preferred for a web-based educational intervention. Results: Though knowledgeable about healthy eating, participants did not know how to achieve or always care about healthy nutritional choices. Motivators for FV consumption included being role models and health concerns. Barriers included: lack of time, expense and FV availability. Website preferences included: visuals, links, tailored materials, menu suggestions, goal setting assistance, printable summaries and built in motivation. The developers incorporated nearly all suggestions. Conclusion: Focus groups provided needs-based tactical strategies for an online, education intervention targeting factors to improve FV consumption. Practice implications: Focus groups can provide valuable input to inform interventions. Further, web-based programs’ abilities to offer information without time or geographic constraints, with capacity for tailoring and tracking progress makes them a valuable addition in the arsenal of efforts to promote healthy behaviors.

SNELLING, Anastasia and KENNARD, Teha. The impact of nutrition standards on competitive food offerings and purchasing behaviors of high school students. Journal of School Health Vol 79, No 11 - November 2009: 541-546
Abstract: Background: With adolescent obesity rates on the rise, the school food environment is receiving closer scrutiny. This study looks at the effects of nutrient standards as part of a wellness policy that was implemented in 3 public high schools in 1 county, by analyzing the nutritional value of competitive food offerings and purchases before and after the development of the standards. Methods: All food offerings and purchases were labeled based on their nutritional density using a stoplight approach of green, yellow, and red colours for the pre- and postperiod. The stoplight approach to ranking foods is on a continuum of nutrient density, with green foods being the healthiest choices and red foods offering minimal nutrient density. Results: Results showed that after the implementation of the standards, red foods made up 30% of offerings, down from 48% of offerings prior to the existence of the guidelines. The proportion of red food purchases also decreased, from 83% to 47%. Additionally, yellow food offerings increased from 18% to 48% and purchases increased from 6% to 34%. Conclusion: Results indicate that the nutrient standards as part of the wellness policy contributed to a positive shift in the nutritional value of competitive food purchases and offerings.

SOBAL, Jeffery and BISOGNI, Carole A. Constructing food choice decisions. Annals of Behavioral Medicine Vol 38, Supplement - 2009: S37-S46
Abstract: Food choice decisions are frequent, multifaceted, situational, dynamic, and complex and lead to food behaviors where people acquire, prepare, serve, give away, store, eat, and clean up. Many disciplines and fields examine decision making. Several classes of theories are applicable to food decision making, including social behavior, social facts, and social definition perspectives. Each offers some insights but also makes limiting assumptions that prevent fully explaining food choice decisions. We used constructionist social definition perspectives to inductively develop a food choice process model that organizes a broad scope of factors and dynamics involved in food behaviors. This food choice process model includes (1) life course events and experiences that establish a food choice trajectory through transitions, turning points, timing, and contexts; (2) influences on food choices that include cultural ideals, personal factors, resources, social factors, and present contexts; and (3) a personal system that develops food choice values, negotiates and balances values, classifies foods and situations, and forms/revises food choice strategies, scripts, and routines. The parts of the model dynamically interact to make food choice decisions leading to food behaviors. No single theory can fully explain decision making in food behavior. Multiple perspectives are needed, including constructionist thinking.

VENTER, C and HARRIS, G. The development of childhood dietary preferences and their implications for later adult health. Nutrition Bulletin Vol 34, No 4 - December 2009: 391-394
Abstract: The food fed to infants and young children not only determines their health in childhood but also predicts the foods that they eat in later life. Because adult dietary preferences are partially formed in childhood, the childhood diet inevitably contributes to the long-term health of the individual. We are all aware of preferences that have endured since childhood, and that our dietary habits only change if we have reason to adapt them, perhaps for a healthier lifestyle. Adopting a healthy diet in adulthood is likely to be considerably easier if we have developed healthy food preferences during our childhood. Current information shows that toddlers are fed diets high in fat, sugar and salt and that mothers are confused about what toddlers should be eating. A healthy diet for toddlers combines foods from all the five food groups. This combination involves mixing high-calorie and low-calorie foods. Healthy food options should be introduced from weaning, and offered repeatedly through the infant and toddler years. Furthermore, the whole family should model a healthy eating lifestyle in order to foster the acceptance of foods that constitute a well-balanced diet.

WETHINGTON, Elaine and JOHNSON-ASKEW, Wendy L. Contributions of the life course perspective to research on food decision making. Annals of Behavioral Medicine Vol 38, Supplement - 2009: S74-S80
Abstract: The life course perspective (LCP) has emerged as a powerful organizing framework for the study of health, illness, and mortality. LCP represents a ‘whole life’ analysis perspective which originated in the field of sociology. Its concepts are increasingly applied to understanding the development of chronic disease over long periods of time in the human life span. A missing link, however, in the adaptation of the LCP to health research, is the insight the LCP may offer into understanding the societal, social network, and family contexts that frame stability and change in dietary behavior. This paper reviews key concepts that comprise the LCP but primarily focuses on applications that have relevance to food decision making in social context. A case study of chronic work-family stress and perceived time scarcity as barriers to dietary improvement is included. Illustrative findings are presented on dietary behavior in a diverse sample of lower-income working parents. This paper also offers ideas on increasing the contributions of the LCP to nutritional research.

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