Journal of the Academy of Nutrition and Dietetics最新文献

{"title":"The Healthfulness of Foods Purchased at Dollar Stores: Insights from Household Scanner Data from 2008 to 2020","authors":"Wenhui Feng PhD, MPP ,&nbsp;Elina T. Page PhD ,&nbsp;Bangyao Sun ,&nbsp;Sean B. Cash PhD, MA","doi":"10.1016/j.jand.2025.07.001","DOIUrl":"10.1016/j.jand.2025.07.001","url":null,"abstract":"<div><h3>Background</h3><div>Dollar stores are the fastest-growing food retailer over the past decade. Although their offerings are less nutritious, the relationship between dollar store food purchase behavior and the overall healthfulness of household food purchases from all retail formats is unknown.</div></div><div><h3>Objective</h3><div>This study analyzed the healthfulness and energy content of foods purchased in dollar stores compared with other retail channels.</div></div><div><h3>Design</h3><div>This repeated, cross-sectional study analyzed yearly, nationally representative household consumer purchase records (2008-2020) from the Circana Consumer Network.</div></div><div><h3>Participants/setting</h3><div>Participants included 183 283 households from 2008 to 2020 for calorie calculations, and 76 520 households from 2017 to 2018 for Healthy Eating Index 2015 (HEI-2015) calculations.</div></div><div><h3>Main Outcome Measures</h3><div>Household-level calorie shares in dollar stores from 2008 to 2020 and HEI-2015 scores from 2017 to 2018 for household food purchases are the main outcome measures.</div></div><div><h3>Statistical Analyses Performed</h3><div>The statistical analyses included summarizing how the share of calories purchased in dollar stores changed over time, performing a fractional logistic regression to estimate factors associated with more calories purchased in dollar stores, and comparing the healthfulness of foods purchased in dollar stores and other retail channels, controlling for multiple sociodemographic characteristics. Data extraction was performed in SQL and R. HEI-2015 calculation was performed in SAS. All statistical analyses were performed in Stata 18.</div></div><div><h3>Results</h3><div>Dollar stores’ share of household calorie purchases increased from 3.4% (2008) to 6.5% (2020). More calories purchased in dollar stores were associated with multiple factors, including race/ethnicity, rurality, and income. Foods purchased in dollar stores were generally less healthy compared with other outlets. The overall healthfulness of household food purchases was similar between those who shopped at dollar stores and those who did not, with average HEI-2015 scores of 50.5, 48.2, and 46.3 across households with no, moderate, or substantial shares of purchases in dollar stores, respectively.</div></div><div><h3>Conclusions</h3><div>The rise of dollar stores depicts a major change in the food retail landscape. Although foods purchased in dollar stores are less healthy, households may compensate through healthier purchases elsewhere.</div></div>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"125 11","pages":"Pages 1736-1745.e6"},"PeriodicalIF":4.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Caffeinated Beverages Sold in a National Sample of US Middle and High Schools","authors":"Leah Elizabeth Chapman PhD, MPH ,&nbsp;Erin R. Hager PhD ,&nbsp;Shu Wen Ng PhD ,&nbsp;Nan Dou PhD, MS ,&nbsp;Juliana F.W. Cohen ScD, ScM, RD","doi":"10.1016/j.jand.2025.06.273","DOIUrl":"10.1016/j.jand.2025.06.273","url":null,"abstract":"<div><h3>Background</h3><div>According to recommendations, adolescents should limit caffeine intake to no more than 100 mg/d. High schools (but not middle or elementary schools) participating in the US Department of Agriculture National School Lunch Program and School Breakfast Program are allowed to sell beverages with added caffeine to students, but the amount of caffeine is not regulated. The prevalence of caffeinated beverages sold to students and the amount of caffeine these beverages contain are unknown.</div></div><div><h3>Objective</h3><div>To determine the prevalence and types of caffeinated beverages in US middle and high schools, the amount of caffeine, and whether caffeinated beverage availability and caffeine content varied by school characteristics.</div></div><div><h3>Design</h3><div>Cross-sectional.</div></div><div><h3>Participants/setting</h3><div>A national sample of 45 middle schools and 45 high schools.</div></div><div><h3>Main outcome measures</h3><div>The amount of caffeine (in milligrams) per item, determined from manufacturer websites and photographs of ingredient labels for all products sold in schools.</div></div><div><h3>Statistical analyses performed</h3><div>Descriptive statistics and 2-sample <em>t</em> tests were used to examine average caffeine levels. Multivariate analyses examined whether caffeinated beverage availability and caffeine amounts varied by school demographics using multilevel mixed-effects logistic and linear regression models, with random intercepts for school district and schools nested within districts.</div></div><div><h3>Results</h3><div>More than half (55.6% [n = 25]) of high schools and 4.4% (n = 2) of middle schools sold caffeinated beverages. On average, caffeinated beverages contained 63 mg of caffeine. The most common caffeinated beverages were sodas, but coffee (103 ± 25 mg) and energy drinks (95 ± 14 mg) contained the highest caffeine levels. High schools had a significantly higher odds of selling caffeinated beverages than middle schools (odds ratio, 18.30; <em>P</em> &lt; .01). Beverages were predicted to be 14 mg higher in caffeine in high schools than in middle schools (<em>β</em> = 13.88; <em>P</em> &lt; .01).</div></div><div><h3>Conclusions</h3><div>There is widespread availability of caffeinated beverages in US high schools.</div><div>The US Department of Agriculture could consider setting caffeine limits for beverages sold in schools to ensure students do not exceed 100 mg of caffeine daily.</div></div>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"125 11","pages":"Pages 1652-1663"},"PeriodicalIF":4.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144566915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teams, Partners, or Champions? A Mixed-Methods Exploration of Potential Pathways of Implementation Success for Wellness Initiatives in Schools Using the Quality Implementation Framework","authors":"Hannah G. Lane PhD ,&nbsp;Hannah G. Calvert PhD ,&nbsp;Michaela McQuilkin Lowe MSW ,&nbsp;Erin R. Hager PhD ,&nbsp;Lindsey Turner","doi":"10.1016/j.jand.2025.03.002","DOIUrl":"10.1016/j.jand.2025.03.002","url":null,"abstract":"<div><h3>Background</h3><div><span>Local wellness policies (LWPs) promote healthy eating and </span>physical activity practices in US schools. Achieving and sustaining quality implementation of LWPs is challenging, particularly in urban and rural schools which may lack implementation resources.</div></div><div><h3>Objective</h3><div>Describe implementation strategies and determinants for LWPs in “Wellness in Rural Elementary Schools” (WIRES), a national survey of US elementary schools across 4 phases using the Quality Implementation Framework.</div></div><div><h3>Design</h3><div>Convergent mixed-methods analysis.</div></div><div><h3>Participants/setting</h3><div>Five hundred fifty-nine informants (eg, principals, nurses, and teachers) from US urban and rural elementary schools completed surveys during February 2020; 50 informants (from 39 urban and rural schools) completed semistructured interviews from April to June 2020.</div></div><div><h3>Main outcome measures</h3><div>Surveys described implementation strategies and climate. Semistructured interviews explored implementation determinants across Quality Implementation Framework phases.</div></div><div><h3>Statistical analysis performed</h3><div>For surveys, we conducted descriptive statistics and Poisson logistic regression (adjusted for district clustering, stratification, and weighting). Interview data were analyzed deductively using the 4 Quality Implementation Framework phases: preparing for implementation, creating implementation structure, maintaining structure throughout implementation, and assessing future needs. Data were integrated through narrative weaving.</div></div><div><h3>Results</h3><div>For implementation strategies, 60% of survey respondents had “a wellness champion,” 59% had a “school-level policy representative,” and 37% had an “implementation team.” For Quality Implementation Framework Phase 1, schools with better wellness climates had higher odds of having an implementation team (odds ratio 1.18, 95% CI 1.09 to 1.29; <em>P</em> &lt; .001). In Phase 2, we identified key attributes (eg, intrinsic motivation) and recruitment strategies for wellness teams/champions and described facilitators of (eg, external partners) and threats to (eg, staff resistance) quality implementation. In Phases 3 and 4, monitoring approaches differed by implementation strategy (eg, 74% of policy representatives tracked goals compared with 43% of teams) and limited future action planning (eg, 25% integrated wellness goals into school improvement plans).</div></div><div><h3>Conclusions</h3><div>Findings identify how LWP implementation strategies form and are sustained and identify gap areas across implementation phases. Findings inform tailored support for urban and rural schools to initiate and carry out evidence-informed LWP implementation strategies.</div></div>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"125 10","pages":"Pages 1517-1533.e8"},"PeriodicalIF":4.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Young Children’s (Aged 3 to 8 Years) Food and Beverage Brand Exposure on YouTube and YouTube Kids: An Observational Study and Content Analysis","authors":"Frances Fleming-Milici PhD ,&nbsp;Haley Gershman MS ,&nbsp;Hanako O. Agresta MPH ,&nbsp;Melissa McCann MPH ,&nbsp;Jennifer Harris PhD, MBA","doi":"10.1016/j.jand.2025.05.010","DOIUrl":"10.1016/j.jand.2025.05.010","url":null,"abstract":"<div><h3>Background</h3><div>Children’s exposure to digital food marketing influences their preferences and consumption of unhealthy products. Young children increasingly spend time viewing YouTube videos on mobile devices, where food brands are promoted in popular children’s content. Research is needed to document young children’s exposure to branded food messages on YouTube.</div></div><div><h3>Objective</h3><div>To explore and categorize young children’s (aged 3 to 8 years) food brand exposure while viewing YouTube videos.</div></div><div><h3>Design</h3><div>Observational study and content analysis of brand exposures and videos viewed.</div></div><div><h3>Participants/setting</h3><div>Convenience sample of US parent-child dyads participating at home via Zoom, including 101 children (n = 53: 3 to 5 years; n = 48: 6 to 8 years) who regularly watch YouTube videos. Data were collected from June through October 2022.</div></div><div><h3>Main outcome measures</h3><div>Percentage of children exposed to food brands during 30 minutes of viewing YouTube videos on their mobile devices and mean number of exposures by type (appearances in videos, in thumbnails, and traditional ads).</div></div><div><h3>Statistical analyses</h3><div>Differences by child age and YouTube platform, including percent exposed to food brands (χ² tests) and mean number of food brand exposures (<em>t</em> tests).</div></div><div><h3>Results</h3><div>Most children aged 6 to 8 years (75%) and 36% of children aged 3 to 5 years were exposed to branded food content while watching videos, with significantly higher exposures for slightly older children (mean ± SD = 8.7 ± 8.2 [6 to 8 years] vs 4.1 ± 6.0 [3 to 5 years]) and YouTube vs YouTube Kids viewers (mean ± SD = 7.7 ± 8.2 vs 3.8 ± 3.2). The majority of exposures (61%) were branded foods embedded within videos, followed by thumbnails (23%) and ads (17%). Candy, sugar-sweetened drinks, fast food, and sweet or salty snacks represented 74% of exposures, and lifestyle videos (including influencers) contributed 77% of exposures within videos. No videos embedded with branded foods disclosed food company-sponsored content.</div></div><div><h3>Conclusions</h3><div>Most young children were exposed to unhealthy food brands while viewing YouTube videos, primarily brand appearances embedded within video content that blurred food promotion with entertainment. Additional policies are needed to protect children from unhealthy food marketing in digital media that they commonly view.</div></div>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"125 10","pages":"Pages 1482-1493.e2"},"PeriodicalIF":4.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Registered Dietitian/Nutritionist Workforce Scope of Practice Expansion","authors":"L. Maria ,&nbsp;N. Munoz ,&nbsp;C. County","doi":"10.1016/j.jand.2025.06.051","DOIUrl":"10.1016/j.jand.2025.06.051","url":null,"abstract":"<div>Continuous Glucose Monitoring (CGM) is associated with improved glycemic control, reduced glycemic-related emergency room visits, and hospitalizations among diabetic Veterans. Recent Patient Selection Criteria Guidance for CGMs expanded eligibility of CGM devices to Veterans using insulin. The U.S. Department of Veterans Affairs (VA) policy change expanding the scope of Registered Dietitian/Nutritionists (RDNs) to include CGM education underscores the importance of this shift. This quality</div>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"125 10","pages":"Page A15"},"PeriodicalIF":4.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardize Clinical Competency Validation for Your Staff-the Why and How?","authors":"B. Attwal","doi":"10.1016/j.jand.2025.06.053","DOIUrl":"10.1016/j.jand.2025.06.053","url":null,"abstract":"","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"125 10","pages":"Page A15"},"PeriodicalIF":4.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mixed Methods Meta-synthesis of Nutrition Education Programs for the Autism Spectrum Disorders’ Community","authors":"N. Palmer,&nbsp;D. Richards,&nbsp;J. Hinojosa","doi":"10.1016/j.jand.2025.06.110","DOIUrl":"10.1016/j.jand.2025.06.110","url":null,"abstract":"<div>Children diagnosed with autism spectrum disorder (ASD) often face significant nutritional challenges, primarily due to food selectivity or “picky eating”, which can lead to nutritional deficiencies during critical periods of growth and development. As the prevalence and diagnosis of ASD continue to rise, there is an urgent need for more research on evidence-based nutrition education interventions. These interventions are especially vital for the ASD community, considering the sensory and</div>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"125 10","pages":"Page A34"},"PeriodicalIF":4.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Research Literacy in Dietetic Education: Increasing the Knowledge and Application of Nutritional Sciences Research Techniques Through a Course-based Undergraduate Inquiry","authors":"E. Klingbeil","doi":"10.1016/j.jand.2025.06.060","DOIUrl":"10.1016/j.jand.2025.06.060","url":null,"abstract":"","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"125 10","pages":"Page A17"},"PeriodicalIF":4.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and testing of SPICE-Healthcare: A Novel Web-based Platform to Support Personalized and Inclusive Cuisines in Environments for Healthcare","authors":"H. Peters,&nbsp;J. Bakare,&nbsp;F. Zhou,&nbsp;V. Chikkamagaluru Lakshmikanth,&nbsp;L. Gatzke,&nbsp;M. Berry,&nbsp;I. Brooks,&nbsp;M. Teran-Garcia,&nbsp;N. Khan,&nbsp;M. Raj","doi":"10.1016/j.jand.2025.06.098","DOIUrl":"10.1016/j.jand.2025.06.098","url":null,"abstract":"","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"125 10","pages":"Page A31"},"PeriodicalIF":4.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of Targeted Training Programs Through Exploration of Barriers and Enablers for the Use of the Nutrition Care Process Among a Diverse Sample of Registered Dietitian/Nutritionists","authors":"I. Asare ,&nbsp;L. Wright ,&nbsp;C. Papoutsakis ,&nbsp;C. Colin","doi":"10.1016/j.jand.2025.06.099","DOIUrl":"10.1016/j.jand.2025.06.099","url":null,"abstract":"","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"125 10","pages":"Page A31"},"PeriodicalIF":4.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}