Journal of the Academy of Nutrition and Dietetics最新文献

{"title":"Vegetarian Diets During Pregnancy: With Supplementation, Ovo-Vegetarian, Lacto-Vegetarian, Vegan, and Pescatarian Adaptations of US Department of Agriculture Food Patterns Can Be Nutritionally Adequate.","authors":"Julie M Hess, Madeline E Comeau, Jane Lankes Smith, Kylie Swanson, Cindy M Anderson","doi":"10.1016/j.jand.2024.08.001","DOIUrl":"10.1016/j.jand.2024.08.001","url":null,"abstract":"<p><strong>Background: </strong>The 2020-2025 Dietary Guidelines for Americans (DGA) includes a lacto-ovo vegetarian pattern (the healthy vegetarian dietary pattern [HVDP]) as a recommended dietary pattern during pregnancy.</p><p><strong>Objective: </strong>To adapt the HVDP for vegan, ovo-vegetarian, lacto-vegetarian, and pescatarian diets during pregnancy.</p><p><strong>Design: </strong>Using food pattern modeling, 4 adaptations of the HVDP were developed at energy levels that may be appropriate during pregnancy (1800, 2000, 2200, 2400, and 2600 kcal/day). Models were run both with and without the addition of a composite prenatal supplement.</p><p><strong>Main outcome measures: </strong>Main outcome measures were macro- and micronutrient adequacy without exceeding recommendations for saturated fat and added sugar.</p><p><strong>Statistical analysis performed: </strong>The 2020-2025 DGA Food Pattern Modeling Report was used to define food groups and nutrients in the HVDP. The HVDP was revised to remove dairy and/or eggs or to add seafood.</p><p><strong>Results: </strong>Across all examined energy levels (1800, 2000, 2200, 2400, and 2600 kcal per day), modeled dietary patterns provided sufficient macronutrients. Without prenatal supplements, each dietary pattern met most, but not all, micronutrient recommendations. Micronutrients that were below recommendations in patterns without supplements included vitamin D, iron, vitamin E, sodium, and choline. With the addition of a composite prenatal supplement to these patterns, the nutrients below 100% of recommendations were vitamin D, choline, and sodium.</p><p><strong>Conclusions: </strong>Overall, these results show that a HVDP and similar diets without meat, eggs, dairy, and/or seafood can provide most nutrients needed during pregnancy, albeit with some micronutrient challenges similar to those diets that include meat and other animal products.</p>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":" ","pages":"204-216.e17"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970280","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":"Parental Weight Stigma Associated with Self-Directed Weight Talk and Use of Health-Related Restrictive Feeding Practices.","authors":"Kendrin R Sonneville, Natasha A Schvey, Heidi M Weeks, Michelle E Clayson, Katherine W Bauer","doi":"10.1016/j.jand.2025.01.012","DOIUrl":"https://doi.org/10.1016/j.jand.2025.01.012","url":null,"abstract":"<p><strong>Background: </strong>Parents are important conduits of weight- and health-related messaging. Weight-related communication and approaches to child feeding used by parents may reflect their past experiences with weight stigma and are understudied pathways through which intergenerational weight stigma may be transmitted.</p><p><strong>Objective: </strong>To examine how experienced and internalized weight stigma among parents of children with higher weights are associated with weight-related communication and the feeding practices they use.</p><p><strong>Design: </strong>The Listening to Parents study is a cross-sectional study of 103 parent-child dyads who completed in-person study visits at the University of Michigan in Ann Arbor, Michigan between November 2022 through June 2023.</p><p><strong>Participants/setting: </strong>Participants were parents of children (ages 6 to 14 years, identified by parents as \"heavier or overweight\") who completed the Stigmatizing Situations Inventory Brief (SSI-B) and Weight Bias Internalization Scale-Modified (WBIS-M), as well as questions about weight-related communication and the Comprehensive Feeding Practices Questionnaire (CFPQ).</p><p><strong>Main outcome measures: </strong>Outcomes included 5 items corresponding to parental weight-related communication (self-directed, other-directed, and child-directed weight talk, child-directed weight teasing, and child-directed encouragement to lose weight) and 3 CFPQ subscales (Monitoring, Restriction for Health, and Restriction for Weight Control).</p><p><strong>Statistical analyses performed: </strong>Linear regression models were used to examine associations between mean scored parent- experienced and parent-internalized weight stigma and weight-related communication and feeding practices. Models were adjusted for child gender, parent-perceived child weight status, parental race/ethnicity, parental body mass index, and household income-to-needs ratio.</p><p><strong>Results: </strong>In covariate-adjusted models, parent-internalized weight stigma was positively associated with self-directed weight talk (β=0.20, SE=0.078, p=0.01) and greater use of health-related restrictive child feeding practices (β=0.16, SE=0.070, p=0.02). No other significant associations in covariate-adjusted models were observed.</p><p><strong>Conclusions: </strong>While parents with greater internalized weight stigma may engage in more self-directed weight talk, they may also be more attuned to the harms of weight stigma and seek to minimize child-directed weight talk and weight teasing.</p>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143027482","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":"Water insecurity is associated with sugar-sweetened beverage consumption in a small-scale population in Lowland Bolivia experiencing lifestyle changes.","authors":"Siddhi M Deshpande, Tomas Huanca, Esther Conde, Asher Y Rosinger","doi":"10.1016/j.jand.2025.01.010","DOIUrl":"https://doi.org/10.1016/j.jand.2025.01.010","url":null,"abstract":"<p><strong>Background: </strong>Emerging evidence indicates water insecurity (WI) is detrimental to nutritional outcomes and dietary choices.</p><p><strong>Objective: </strong>This study measured WI experiences alongside market and traditional sugar-sweetened beverage (SSB) consumption in a small-scale society experiencing early stages of the nutrition transition (i.e., lifestyle and dietary changes away from traditional foods) to test how they are associated.</p><p><strong>Design: </strong>The twelve-item Household Water Insecurity Experiences (HWISE) Scale was implemented along with a cross-sectional retrospective survey of beverage intake and sociodemographics across five communities at varying distance to a market town.</p><p><strong>Participants/setting: </strong>Tsimane' forager-horticulturalist adults aged ≥16 years (n=455; 47% women) in Lowland Bolivia, April-May, 2019.</p><p><strong>Main outcome measure: </strong>Sugar-sweetened beverage and traditional beverage consumption.</p><p><strong>Statistical analyses performed: </strong>Multivariate logistic and poisson regressions adjusting for possible confounding variables, including age, gender, income, household water needs, and community residence.</p><p><strong>Results: </strong>Using logistic regressions, each point higher WI (HWISE) score was associated with 23% (95% CI: 1.01-1.50; P=0.035) and 27% (95% CI: 1.06-1.52; P=0.008) higher odds of consuming an SSB in the past week for men and women, respectively. For men, each point higher HWISE score was associated with 13% (95% CI: 1.10-1.16; P<0.001) higher odds of drinking chicha fuerte (a traditional, homemade fermented beverage with antibacterial properties) and 16% (95% CI: 1.02-1.32; P=0.022) higher odds of consuming liquor. SSB consumption was highest in the closest communities to the market town and declined significantly with distance; while traditional beverages such as chicha dulce (a sugar-sweetened, unfermented homemade chicha) were lowest in the close communities and increased with distance to the market town.</p><p><strong>Conclusions: </strong>Among Tsimane' adults living in the Bolivian Amazon experiencing the nutrition transition, WI was associated with greater SSB intake. Distance to the main market town shaped access and preferences as it was associated with SSB and traditional beverage consumption.</p>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142997917","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":"Social and economic patterning in UPF intake in toddlerhood and middle childhood: longitudinal data from the UK Gemini cohort.","authors":"Gabriella N Heuchan, Rana E Conway, Harry Tattan-Birch, Lisa Heggie, Clare H Llewellyn","doi":"10.1016/j.jand.2025.01.004","DOIUrl":"https://doi.org/10.1016/j.jand.2025.01.004","url":null,"abstract":"<p><strong>Introduction: </strong>Children's consumption of ultra-processed food (UPF) may contribute to inequalities in obesity and wider health. Socioeconomic patterning in younger UK children's UPF intake is unknown.</p><p><strong>Objective: </strong>To investigate socioeconomic patterning of UK toddlers' (21-months) and children's (7-years) UPF intake across several household and neighbourhood indicators.</p><p><strong>Design: </strong>Secondary analysis of data from a prospective longitudinal cohort study using parent-report sociodemographic data and 3-day diet diaries.</p><p><strong>Participants: </strong>/setting: Participants were children from the UK Gemini study of n=4,804 twins born in 2007. At 21-months and 7-years, n=2,591 and n=592 children had at least 2-days of dietary data, respectively.</p><p><strong>Main outcome measures: </strong>Percentage energy from UPF at 21-months and 7-years-of-age, classified using the NOVA system.</p><p><strong>Statistical analyses performed: </strong>Unadjusted linear regression models were run for household socioeconomic position (SEP) composite score, Index of multiple deprivation decile, income, occupation level, mother's age, education of mother and partner, child's ethnicity, sex, and age. Adjusted multivariable linear regression models were adjusted for ethnicity and all SEP indicators except SEP composite score (Adjusted 1), in addition to child sex and age (Adjusted 2). Missing data were addressed with multiple imputation and inverse probability weighting. Confidence intervals and P-values were adjusted to account for clustering within families.</p><p><strong>Results: </strong>Children of lower SEP had higher UPF intake across several indicators. Mother's education was the strongest predictor, with postgraduate education associated with 8.64% (95% CI -12.08 to -5.20; P<0.001) and 10.12% (95% CI -15.68 to -4.56; P<0.001) less energy from UPF at 21-months and 7-years, respectively, compared to no educational qualifications in Adjusted model 2.</p><p><strong>Conclusion: </strong>UK children from more disadvantaged backgrounds consumed a greater proportion of their energy from UPF. Mother's education seemed the most influential factor. Socioeconomic inequalities, particularly in maternal education, may drive disparities in diet quality and associated health outcomes. Addressing these gaps is essential to reduce childhood obesity and improve long-term health in socioeconomically disadvantaged populations.</p>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969193","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":"If not Food Deserts, then What? And, How will we Know?","authors":"Jacob Alex Klerman","doi":"10.1016/j.jand.2025.01.005","DOIUrl":"https://doi.org/10.1016/j.jand.2025.01.005","url":null,"abstract":"","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969190","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":"Effects of nutrition-specific interventions to prevent and control nutritional anemia in infants, children and adolescents: a systematic review and network meta-analysis of randomized controlled trials.","authors":"Ting Ren, Zhanjing Dai, Jing Yang, Yuhang Wu, Feng Chang, Sida Wang, Linyun Wang, Yuqiong Lu, Yun Lu","doi":"10.1016/j.jand.2025.01.002","DOIUrl":"https://doi.org/10.1016/j.jand.2025.01.002","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Anemia is a prevalent health issue among children and adolescents worldwide, with malnutrition being one of the most common causes. Nutrition-related anemia can be prevented or controlled through targeted interventions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to evaluate the effects of nutrition interventions on ferritin concentration, hemoglobin concentration, anemia prevalence, and nutritional anemia prevalence in infants, children, and adolescents-and to compare outcomes by intervention and age group using network meta-analysis of randomized controlled trials (RCTs).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Web of Science, PubMed, Scopus, EBSCO, the Cochrane Library, CNKI, VIP Database, and WANFANG Database were comprehensively searched to identify RCTs on the effects of nutrition interventions (micronutrient supplementation, macronutrient supplementation, and nutrition education) until September 30, 2023. Two groups of researchers screened the literature and extracted data based on set inclusion and exclusion criteria. Reviewers used the Cochrane tool for assessing risk-of-bias in RCTs and used the Grading of Recommendations, Assessment, Development, and Evaluation for evaluating the strength of evidence for inclusion in network meta-analysis. The study population was categorized into infants and preschool children (6-59 months), school-aged children (6-11 years), and adolescents (12-18 years). The study evaluated the mean difference, risk ratio, and 95% credible interval of outcomes for each intervention across different age groups using network meta-analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Sixty-one RCTs were included in this analysis. In network meta-analysis, micronutrient supplementation, macronutrient supplementation, and nutrition education were found to have significant effects on hemoglobin in infants and preschool children. Lipid-based nutrient supplementation resulted in the highest increase in hemoglobin, while multiple micronutrient supplementation resulted in the largest reduction in risk of anemia and iron deficiency anemia (IDA). In school-aged children, iron supplementation increased hemoglobin, while micronutrient supplementation also increased hemoglobin and reduced anemia risk. In adolescents, iron supplementation improved hemoglobin and lowered anemia risk.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The effectiveness of nutrition interventions in improving nutritional anemia varies across intervention types and age groups. Micronutrient and iron supplementation consistently improved hemoglobin levels and related indicators, with evidence quality ranging from low to moderate. MMN and LNS had positive effects on hemoglobin and anemia in infants and preschool children, which is supported by low to moderate quality evidence. For adolescents, while micronutrient and iron supplementation showed positive effects, the overall evidence quality was generally low, highlighting the need for further high-qu","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969187","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":"Home Visitation as an Intervention Opportunity to Prevent Childhood Obesity Within the First 2000 Days: A Scoping Review.","authors":"Jamie Zeldman, Danielle E Jake-Schoffman, Matthew J Gurka, Karla P Shelnutt, Amy R Mobley","doi":"10.1016/j.jand.2025.01.003","DOIUrl":"https://doi.org/10.1016/j.jand.2025.01.003","url":null,"abstract":"<p><strong>Background: </strong>Home visitation programs are uniquely positioned to reach young children during the first 2000 days of life (ages 0 to 5 years), a critical time period to prevent childhood obesity.</p><p><strong>Objective: </strong>This scoping review aimed to identify early childhood obesity prevention interventions implemented within home visitation during the first 2000 days of life, summarize outcomes assessed, and examine if and how nonmaternal caregivers and technology were included.</p><p><strong>Methods: </strong>Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews, three databases (PubMed, Web of Science, CINAHL) were searched from January 1980 to June 2023 for obesity prevention interventions that utilized home visitation as a treatment modality, targeted children ≤5 years old, reported on child weight outcomes, were experimental or quasi-experimental designs with a control or comparison arm, and had full-text available in English. The quality and risk of bias of included studies were rated using the Academy of Nutrition and Dietetics' Quality Criteria Checklist for Primary Research.</p><p><strong>Results: </strong>Of the 871 identified articles, 21 met inclusion criteria, and all reported at least one obesogenic behavioral outcome in the intervention group compared to the control group. Intervention duration ranged from 4 months to 3 years, and frequency of home visits varied from weekly, biweekly, monthly, or a designated number of home visits within a defined time frame. Three interventions partnered with an established home visiting program, but home visits in all interventions were conducted by either professional or paraprofessional individuals. Nine of the 21 studies targeted other caregivers in addition to the mother and 12 of 21 incorporated a form of technology.</p><p><strong>Conclusions: </strong>Several different early childhood obesity prevention interventions have been implemented within home visitation during the first 2000 days of life. Future research is needed to investigate the effectiveness of these interventions on weight- and behavioral-related outcomes, as well as explore the impacts of the interventionist type, program duration, inclusion of nonmaternal caregivers, and use of technology on childhood obesity-related outcomes.</p>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142963466","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":"Opportunities in programs and policies to address the underlying drivers of sugary drink and water consumption in the Washington DC metro area: a qualitative community-based system dynamics approach.","authors":"Michelle Estradé, Yeeli Mui, Lillian Witting, Rosalina Burgos-Gil, Larissa Calancie, Joel Gittelsohn, Uriyoán Colón-Ramos","doi":"10.1016/j.jand.2025.01.001","DOIUrl":"https://doi.org/10.1016/j.jand.2025.01.001","url":null,"abstract":"<p><strong>Background: </strong>Though the Dietary Guidelines for Americans recommend that individuals drink water instead of sugar-sweetened beverages (SSBs), this behavior is influenced and reinforced by a complex network of structures and systems.</p><p><strong>Objective: </strong>The objectives of this study were to develop a shared understanding among multiple stakeholders about the structural and underlying, interconnected drivers of SSB and water consumption in the Washington D.C. metro area and to have them identify feasible and impactful policy levers.</p><p><strong>Design: </strong>A community-based system dynamics approach was used during a 2-day group model building workshop where stakeholders engaged to develop a shared visual representation of the underlying, interconnected drivers of SSB and water intake and to identify what they thought were impactful and feasible policy levers.</p><p><strong>Participants/setting: </strong>Stakeholders were purposively recruited from diverse sectors (early childhood education (n=6), nutrition assistance programs (n=2), food policy council and advocacy groups (n=4), city government officials including municipal water (n=4), and food and beverage retail (n=1)) to participate in a group model building workshop in July of 2022 in Washington, D.C.</p><p><strong>Analysis: </strong>Using member checking and iterative feedback, the research team synthesized the outputs from the workshop into one causal loop diagram and ranked policy levers.</p><p><strong>Results: </strong>Stakeholders visualized 7 subsystems that drive water and SSB consumption, then identified and ranked 5 policy levers by potential impact and ease of implementation, including 1) increase public health spending (high impact/hard to do); 2) invest in new and updated infrastructure for public water (high impact/hard to do); 3) implement coordinated public health campaigns to promote drinking safe, palatable water as an alternative to SSB (low impact/easy to do); 4) provision of tap water filters (low impact/easy to do); and 5) limits on SSB marketing (high impact/debated easy-or-hard to do).</p><p><strong>Conclusions: </strong>This participatory approach allowed stakeholders to envision multiple places to intervene in the system simultaneously to both decrease SSB and increase water consumption in the specific context of their community.</p>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142941867","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":"Association Between the Nutritional Quality of Food Purchases and Household Food at Home Expenditures in Mexico.","authors":"Néstor A Sánchez-Ortiz, Carolina Batis, Analí Castellanos-Gutiérrez, M Arantxa Colchero","doi":"10.1016/j.jand.2024.07.002","DOIUrl":"10.1016/j.jand.2024.07.002","url":null,"abstract":"<p><strong>Background: </strong>Poor-quality diets are a major risk factor for noncommunicable diseases. Few studies in Mexico have tested whether higher expenditures are needed to purchase high-quality food.</p><p><strong>Objective: </strong>The objective of the study was to assess how dietary quality of food purchases was associated with household food at home expenditures.</p><p><strong>Design: </strong>This study was a secondary analysis of cross-sectional data from the National Household Income and Expenditure Survey (EncuestaNacional de Ingresos y Gastos de los Hogares [ENIGH] 2018).</p><p><strong>Participants/setting: </strong>The study included 74 469 households with information on food and beverage purchases in Mexico in 2018.</p><p><strong>Main outcome measures: </strong>Quarterly household food at home expenditures by adult equivalent (AE) for all food groups that were scored with the Global Dietary Quality Score (GDQS) for food purchases expressed in dollars/quarterly/AE.</p><p><strong>Statistical analyses performed: </strong>Adjusted generalized linear models were used to evaluate the association between GDQS for food purchases (expressed in tertiles: low, mid, and high) and quarterly food expenditures. The analyses were performed at the national level by place of residence and income quintile.</p><p><strong>Results: </strong>At the national level, the difference in food expenditures between the high- and the low-GDQS groups was +$13.85/AE. By place of residence, the difference between the high- and the low-GDQS groups was +$17.31/AE in urban and +$5.12/AE in rural areas. For income quintile 1 (lowest), there was a statistical difference of -$4.79/AE and +$43.25 for quintile 5 (highest).</p><p><strong>Conclusions: </strong>Quality of food purchases can be associated with higher or lower expenditures depending on the specific food purchased. High GDQS is associated with lower expenditures among the lowest-income households as they purchase less expensive options compared with high-income households.</p>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":" ","pages":"99-108.e12"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141544353","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":"Systems Thinking and Sustainable Food Systems in Dietetics Education: A Survey of Directors.","authors":"Erin E Bergquist, Lyndi Buckingham-Schutt, Christina Gayer Campbell, Awoke Dollisso, Shuyang Qu, Angela M Tagtow, Scott Smalley","doi":"10.1016/j.jand.2024.06.233","DOIUrl":"10.1016/j.jand.2024.06.233","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Systems thinking is recommended, but not required, for teaching food and water system sustainability in nutrition and dietetics education.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study investigated systems thinking and sustainable, resilient, and healthy food and water systems (SRHFWS) in nutrition and dietetics programs. It examined program directors' practices, values, attitudes, confidence levels, and the relationships between systems thinking, teaching SRHFWS topics, confidence levels, and years of experience as a dietitian and program director.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Conducted in September 2022, the study used a descriptive design with a validated 20-item Systems Thinking Scale and a researcher-designed survey with 1-5 Likert-type scales.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants and setting: &lt;/strong&gt;The online survey was distributed to 611 Accreditation Council for Education in Nutrition and Dietetics program directors, with a 27% (N = 163) response.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Statistical analysis: &lt;/strong&gt;Descriptive statistics (frequency or mean ± SD) were calculated using Excel. Inferential statistics were examined using R. Analysis of variance was used to compare experience as a registered dietitian nutritionist and experience as a program director to confidence levels in teaching each SRHFWS topic. Linear regression was used determine the relationship between total Systems Thinking Scale score and demographic and programmatic variables.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Seventy-seven percent of program directors scored high on the Systems Thinking Scale (mean score = 65.2 ± 8.4 on a 0 to 80 scale), and more than 85% of directors agreed that including systems thinking in dietetics was important. However, only 32.1% reported teaching systems thinking. Less than half of program directors agreed that systems thinking was adequately addressed in Accreditation Council for Education in Nutrition and Dietetics standards, and nearly 80% of program directors agreed there was room to strengthen systems thinking content. Directors neither agreed nor disagreed there are adequate Accreditation Council for Education in Nutrition and Dietetics standards addressing SRHFWS and reported SRHFWS topics were inconsistently taught. Confidence levels were lowest for teaching economic and environmental topics. Awareness and use of resources developed by the Academy of Nutrition and Dietetics Foundation was low.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Integration of systems thinking in nutrition and dietetics education presents promising opportunities to address complexity in the field. Applying systems thinking to teach SRHFWS may narrow the disparity between educators' perceived importance and program coverage. Enhancing program directors' awareness and utilization of Academy of Nutrition and Dietetics Foundation resources and improved alignment between practice standards and accreditation standards may empower program directors to use systems thinking","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":" ","pages":"42-53"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141533184","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}