Journal of the Academy of Nutrition and Dietetics最新文献

{"title":"Nutrition Support Interventions in Adults with Hematologic Malignancies: A Systematic Review and Meta-Analysis","authors":"Rachel Newman PhD, RDN ,&nbsp;Mary Rozga PhD, RDN ,&nbsp;Deepa Handu PhD, RDN ,&nbsp;Vanessa Fuchs-Tarlovsky MD, PhD, RD ,&nbsp;Lauren Fay MPH, RD-AP, CSO, CNSC ,&nbsp;Kim Robien PhD, RD, CSO, FAND ,&nbsp;Lisa Moloney PhD, RDN","doi":"10.1016/j.jand.2025.156221","DOIUrl":"10.1016/j.jand.2025.156221","url":null,"abstract":"<div><h3>Background</h3><div>Malnutrition is common in adults with hematologic malignancies and can negatively influence treatment outcomes.</div></div><div><h3>Objective</h3><div>This systematic review evaluated the association between nutrition support interventions compared with alternative or usual care, and primary outcomes (nutritional status, anthropometric measures, length of stay, readmissions, and quality of life) and secondary outcomes (survival, mucositis, graft-vs-host disease, delayed engraftment, inflammation, cost, and calorie or protein intake), in adults with hematologic malignancies.</div></div><div><h3>Methods</h3><div>MEDLINE, CINAHL, Cochrane CENTRAL, Food Science Source, and SPORTDiscus databases were searched for controlled trials and observational studies published in English in peer-reviewed journals from January 2000 to July 2024. Risk of bias (RoB) was assessed using the Cochrane RoB 2 tool for randomized controlled trials (RCTs), RoB in Non-randomized Studies of Interventions for non-RCTs, and RoB in Nonrandomized Studies of Exposures for observational studies. Meta-analyses used a maximum likelihood random-effects model, and heterogeneity was quantified using <em>I</em>². Certainty of evidence for primary outcomes was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation method.</div></div><div><h3>Results</h3><div>Twenty-one articles (11 RCTs, 9 cohorts, 1 non-RCT) representing 2122 participants were included. RoB was low (2 studies), some concerns/moderate (11 studies), and high (8 studies). Meta-analysis indicated a decrease in length of stay for enteral nutrition over parenteral nutrition, and no effect on length of stay for glutamine-enriched nutrition support; however, evidence was of very low certainty. Individualized nutrition support interventions, including the calculation of estimated needs, demonstrated benefit in decreasing weight loss. Overall, the association between nutrition support interventions and nutritional status, weight, readmissions, quality of life, and secondary outcomes was uncertain (very low certainty).</div></div><div><h3>Conclusions</h3><div>No single nutrition support intervention emerged as superior for all outcomes of interest, although current best practices were supported. Certainty of evidence was very low for primary outcomes, and heterogeneity limited conclusions for secondary outcomes. Further high-quality research is needed.</div></div>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"126 3","pages":"Article 156221"},"PeriodicalIF":4.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145923230","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":"The Role of Child Nutrition Programs in a Sustainable Food System","authors":"Melissa Pflugh Prescott PhD, RDN, FAND","doi":"10.1016/j.jand.2025.156230","DOIUrl":"10.1016/j.jand.2025.156230","url":null,"abstract":"","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"126 3","pages":"Article 156230"},"PeriodicalIF":4.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145511209","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":"Sex-Specific Associations Between Parenting Practices and Dietary Quality Within Male and Female Adolescents in the Western Region of Saudi Arabia","authors":"Hebah Alawi Kutbi PhD, RD ,&nbsp;Dana Firas AlShangiti MSc ,&nbsp;Hatoon Yousef Bawarith BSc ,&nbsp;Wala Abdulrahim Alamoodi BSc ,&nbsp;Lujain Ahmed Bahubaish BSc, RD ,&nbsp;Rana Hisham Mosli PhD, RD ,&nbsp;Walaa Abdullah Mumena PhD","doi":"10.1016/j.jand.2025.156248","DOIUrl":"10.1016/j.jand.2025.156248","url":null,"abstract":"<div><h3>Background</h3><div>Consistent evidence indicates existing associations between food parenting practices and children’s dietary quality, yet these associations are likely to be different in adolescents as they are exposed to a wider social network.</div></div><div><h3>Objective</h3><div>To expand the existing literature by examining sex-specific associations between maternal and paternal food parenting practices and the dietary quality of male and female adolescents using sex-stratified analyses.</div></div><div><h3>Design</h3><div>A cross-sectional study was conducted between October 2021 and January 2022.</div></div><div><h3>Participants/setting</h3><div>A total of 2000 adolescents and their parents were recruited from 16 schools located in the western region of Saudi Arabia. A triadic dataset of 656 adolescents (aged 11 to 18 years) and their mothers and fathers was included in the analytic sample.</div></div><div><h3>Main outcome measures</h3><div>Food parenting practices questionnaires were completed for each adolescent by their mothers and fathers separately using the Comprehensive Feeding Practice Questionnaire-Arabic. Dietary quality of adolescents was assessed using a modified version of the Short Form Food Frequency Questionnaire.</div></div><div><h3>Statistical analyses performed</h3><div>Sex-stratified linear regression analyses were conducted to examine the association between each food parenting practice and dietary quality score of adolescents, adjusting for adolescents’ age, maternal education status, city of residence, and family income.</div></div><div><h3>Results</h3><div>In male adolescents, maternal modeling, teaching about nutrition, and monitoring (B = .37; 95% CI, 0.14 to 0.60; B = .26, 95% CI, 0.01 to 0.51; and B = .31; 95% CI, 0.08 to .54, respectively) and paternal restriction for weight (B = .22; 95% CI, 0.01 to 0.44) were associated with higher dietary quality scores. In female adolescents, maternal restriction for health was associated with a lower dietary quality score (B = –.24; 95% CI, –0.43 to –0.05), whereas paternal teaching about nutrition was positively associated (B = .21; 95% CI, 0.02 to 0.40).</div></div><div><h3>Conclusions</h3><div>Findings suggest distinct patterns of association between maternal and paternal food parenting practices and dietary quality within male and female adolescents. Future interventions aimed at enhancing adolescent dietary quality may benefit from considering sex-specific associations between parental practices and dietary quality.</div></div>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"126 3","pages":"Article 156248"},"PeriodicalIF":4.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145585751","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":"Associations Between the US Department of Agriculture COVID-19 Pandemic Waivers and Summer Meal Programs Access and Participation: A Systematic Review","authors":"Juliana F.W. Cohen ScD, ScM, RD ,&nbsp;Brooke L. Bennett PhD ,&nbsp;Hannah G. Calvert PhD ,&nbsp;Marlene B. Schwartz PhD ,&nbsp;Lindsey Turner PhD ,&nbsp;Saied Toossi PhD","doi":"10.1016/j.jand.2025.156249","DOIUrl":"10.1016/j.jand.2025.156249","url":null,"abstract":"<div><h3>Background</h3><div>The US Department of Agriculture (USDA) Summer Meal Programs (SMPs) are funded to ensure children from low-income households continue to have access to food over the summer months when most schools are closed for instruction. However, these programs are underutilized compared with school meal programs, in part due to barriers to accessing SMPs. During the COVID-19 pandemic, USDA waived several restrictions related to area eligibility and meal distribution.</div></div><div><h3>Objectives</h3><div>To systematically review the evidence of the association between USDA pandemic waivers and SMPs access (ie, scope and coverage) and participation.</div></div><div><h3>Methods</h3><div>Three electronic databases were searched (PubMed, Education Resources Information Center, and Thomson Reuters Web of Science) to identify peer-reviewed and government studies that examined associations between USDA pandemic waivers and changes in the number of SMP sponsors, sites, participants, and/or meals served. Inclusion criteria included studies conducted in the United States and published in English between August 2021 and June 2024. Qualitative studies, studies conducted only during the school year, or studies that did not examine the association between the waivers and relevant outcomes were excluded. Risk of bias was assessed using an adapted version of the Newcastle-Ottawa Scale. Articles were narratively synthesized.</div></div><div><h3>Results</h3><div>Twelve articles met the inclusion criteria. The majority found increases in the number of SMP sites that were sponsored by public schools after the pandemic waivers. However, some studies found decreases specifically among nonpublic school-sponsored sites. The majority also found increases in the number of children and/or meals served, even in the presence of fewer sites.</div></div><div><h3>Conclusions</h3><div>Evidence suggests that the pandemic waivers were associated with improvements in scope, coverage, and participation in SMPs. Continued support of state agencies to administer SMPs using flexible and innovative strategies should be considered.</div></div>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"126 3","pages":"Article 156249"},"PeriodicalIF":4.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145686639","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":"Food Substitution and Waste Reduction Can Reduce the Environmental Impacts and Food Costs of School Meal Programs in the United States: An 2011-2018 NHANES Analysis","authors":"David C. Love PhD, MSPH ,&nbsp;Zach Conrad PhD, MPH ,&nbsp;Daphene Altema-Johnson MPH, MBA, RDN, LD ,&nbsp;Rebecca Ramsing MPH, RDN ,&nbsp;Karen Bassarab MPAff, MSCRP ,&nbsp;Andrew L. Thorne-Lyman ScD, MHS ,&nbsp;D’Ann L. Williams DrPH ,&nbsp;E.R.H. Moore PhD, MPH ,&nbsp;Elizabeth M. Nussbaumer MPP ,&nbsp;Patti Truant Anderson PhD, MPH","doi":"10.1016/j.jand.2025.04.006","DOIUrl":"10.1016/j.jand.2025.04.006","url":null,"abstract":"<div><h3>Background</h3><div>US school meal programs serve billions of meals annually; however, little is known about their environmental impacts.</div></div><div><h3>Objective</h3><div>This study estimated the daily greenhouse gas emissions (GHGE), water scarcity footprint (WSF), and food cost associated with food consumed in the National School Lunch Program and School Breakfast Program, and modeled the association of food substitutions and food waste reduction.</div></div><div><h3>Design</h3><div>A cross-sectional analysis of Day-1 dietary intake in the National Health and Nutrition Examination Survey, 2011-2018. A diet model was constructed to estimate the effects of food substitutions and food waste reduction on GHGE, WSF, food cost, and nutrient intake.</div></div><div><h3>Participants/setting</h3><div>Participants included 796 children and adolescents from prekindergarten to grade 12 who consumed breakfast or lunch on a weekday from a school cafeteria that met the minimum standard for an eligible meal (ie, offered or served minimum amounts of milk, protein foods, whole grains, fruits, and/or vegetables), and that is reimbursed for food costs.</div></div><div><h3>Main outcome measures</h3><div>The main outcomes were per capita nutrient intake, GHGE, WSF, and food cost.</div></div><div><h3>Statistical analyses performed</h3><div>Differences in mean influences and between actual consumption and 2 modeled scenarios (food substitutions and food waste reductions) were evaluated using paired Wald tests. The modeled food substitutions were soy milk for cow’s milk, plant-based meat alternatives for beef, poultry for beef, and seafood for beef. All values in the figures were adjusted for energy and survey cycle using linear regression models.</div></div><div><h3>Results</h3><div>Daily per capita GHGE and WSF for food consumed in school food programs were 1.69 kg carbon dioxide equivalents (95% CI 1.55-1.84) and 1023 L equivalents (95% CI 920-1127), respectively. Dairy (mainly cow’s milk) and protein foods (mainly beef) were the largest contributors to GHGE. Fruit was the largest contributor to the WSF. Modeled food substitutions significantly reduced GHGE by 14% to 25% and WSF by 11% to 14% for the school meal programs; however, there were mixed effects on food cost (–2% to 6% change) and nutrient intake. Modeled food waste reductions of 5% were associated with a 1% decrease in GHGE, WSF, and food costs.</div></div><div><h3>Conclusions</h3><div>The National School Lunch Program and School Breakfast Program are critical to child nutrition, and food substitution and food waste reduction strategies may lower their environmental footprint with manageable influences on nutrient density, although implementing these programs effectively can be challenging.</div></div>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"126 3","pages":"Article 156118"},"PeriodicalIF":4.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957666","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":"Vegetarian Dietary Patterns for Adults: A Position Paper of the Academy of Nutrition and Dietetics","authors":"Sudha Raj PhD, RDN, FAND ,&nbsp;Nanci S. Guest PhD, RD ,&nbsp;Matthew J. Landry PhD, RDN, FAND, FAHA ,&nbsp;A. Reed Mangels PhD, RDN ,&nbsp;Roman Pawlak PhD, RDN ,&nbsp;Mary Rozga PhD, RDN","doi":"10.1016/j.jand.2025.156227","DOIUrl":"10.1016/j.jand.2025.156227","url":null,"abstract":"<div><div>It is the position of the Academy of Nutrition and Dietetics that, in adults, appropriately planned vegetarian and vegan dietary patterns can be nutritionally adequate and can offer long-term health benefits such as improving several health outcomes associated with cardiometabolic diseases. Vegetarian dietary patterns exclude meat, poultry, and seafood, and vegan dietary patterns exclude all foods of animal origin. Registered dietitian nutritionists (RDNs) and nutrition and dietetics technicians, registered (NDTRs) play a pivotal role in providing meal-planning strategies and evidence-based nutrition information to clients currently following vegetarian or vegan dietary patterns or who may benefit from and express interest in following vegetarian or vegan dietary patterns. RDNs and NDTRs can work with their clients to create tailored, lifestyle-oriented, nutritionally balanced, and culturally suitable vegetarian and vegan dietary patterns that optimize health benefits while reducing concerns about nutrient inadequacies. Adults follow vegetarian and vegan dietary patterns for various reasons. The aim of this position paper is to inform health care practitioners, including RDNs and NDTRs, about the evidence-based benefits and potential concerns of following vegetarian and vegan dietary patterns for different populations of nonpregnant, nonlactating adults. This position paper is supported by current evidence, including several systematic reviews. As leaders in evidence-based nutrition care, RDNs and NDTRs should aim to support the development and facilitation of vegetarian and vegan dietary patterns and access to nutrient-dense plant-based meals. Promoting a nutrient-balanced vegetarian dietary pattern on both individual and community scales may be an effective tool for preventing and managing many diet-related conditions. This position was approved in January 2025 and will remain in effect until December 31, 2032.</div></div>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"126 3","pages":"Article 156227"},"PeriodicalIF":4.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145861584","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":"Academy of Nutrition and Dietetics’ Vegetarian Position Paper Mistakenly Links Vegetarian and Vegan Diets with Vitamin D Deficiency","authors":"Noah Praamsma MS, RDN,&nbsp;Anna Herby DHSc, RD, CDCES","doi":"10.1016/j.jand.2025.156224","DOIUrl":"10.1016/j.jand.2025.156224","url":null,"abstract":"","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"126 3","pages":"Article 156224"},"PeriodicalIF":4.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145861662","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":"Authors' Reponse","authors":"Sudha Raj PhD, RDN,&nbsp;Nanci S. Guest PhD, RD, CSCS,&nbsp;Matthew J. Landry PhD, RDN,&nbsp;A. Reed Mangels PhD, RDN,&nbsp;Roman Pawlak PhD, RDN","doi":"10.1016/j.jand.2025.156225","DOIUrl":"10.1016/j.jand.2025.156225","url":null,"abstract":"","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"126 3","pages":"Article 156225"},"PeriodicalIF":4.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145861635","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":"Potential Prevalence of Front-of-Package Labels on Packaged Foods in a Supermarket Chain in the Northeast United States Under Two Proposed Labeling Systems","authors":"Joshua Petimar ScD ,&nbsp;C. Ross Hatton PhD, MPA ,&nbsp;Yutong Zhang MS ,&nbsp;Alyssa J. Moran ScD, RD ,&nbsp;Anna H. Grummon PhD, MSPH ,&nbsp;Lauren P. Cleveland MS, MPH ,&nbsp;Jason P. Block MD, MPH ,&nbsp;Aviva A. Musicus ScD","doi":"10.1016/j.jand.2025.156271","DOIUrl":"10.1016/j.jand.2025.156271","url":null,"abstract":"<div><h3>Background</h3><div>The US Food and Drug Administration has proposed a mandatory “Nutrition Info” label be placed on the front of packaged foods, showing whether products have low, medium, or high amounts of saturated fat, sodium, and added sugar. The agency also has considered a “High-In” labeling system, which would require labels on products with high levels of these nutrients.</div></div><div><h3>Objective</h3><div>The aim of this study was to analyze the proportion of purchased packaged foods that would display specific front-of-package labels under the Nutrition Info and High-In front-of-package labeling systems overall and across 15 food groups.</div></div><div><h3>Design</h3><div>This was a cross-sectional study of 1 year of sales data.</div></div><div><h3>Setting</h3><div>This study used sales and nutrition data from 2022 from a supermarket chain with 184 stores in the Northeast United States.</div></div><div><h3>Main outcome measures</h3><div>The sales-weighted percentage of products that would display different Nutrition Info labels (“non-mixed”: all nutrients have the same level; “slightly mixed”: mix of low/medium or medium/high; “severely mixed”: a mix of low/high) and High-In labels (eg, percentage with ≥1 High-In label) was determined overall and by food group.</div></div><div><h3>Statistical analyses performed</h3><div>Descriptive statistics and χ² tests were calculated.</div></div><div><h3>Results</h3><div>Under Nutrition Info labeling, 12% of products would display non-mixed labels, and 40% would display severely mixed labels. In 7 food groups (eg, pizza, candy), &gt;50% of products would display severely mixed labels. Under High-In labeling, 49% of products would display ≥1 High-In label.</div></div><div><h3>Conclusions</h3><div>The Nutrition Info front-of-package label would place severely mixed labels on a large proportion of products in unhealthy food groups, which may confuse consumers. High-In front-of-package labeling would place labels on a large proportion of these products without mixed messaging.</div></div>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"126 3","pages":"Article 156271"},"PeriodicalIF":4.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145779787","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":"Navigating Infant Feeding in the Context of Household Food Insecurity: A Qualitative Study of New Zealand Mothers","authors":"Ioanna Katiforis PhD ,&nbsp;Claire Smith PhD ,&nbsp;Anne-Louise M. Heath PhD ,&nbsp;Lisa A. Te Morenga PhD ,&nbsp;Sara E. Styles PhD","doi":"10.1016/j.jand.2025.156229","DOIUrl":"10.1016/j.jand.2025.156229","url":null,"abstract":"<div><h3>Background</h3><div>Household food insecurity is a major public health concern that disproportionately burdens mothers. Infants may be especially vulnerable to its negative impacts, given the central role mothers play in their feeding. Mothers’ insights on infant complementary feeding while experiencing household food insecurity are needed to expand on previous research focused on breastfeeding.</div></div><div><h3>Objective</h3><div>The aim of the study was to explore the experiences of New Zealand mothers introducing complementary foods to their infants in the context of household food insecurity.</div></div><div><h3>Design</h3><div>This qualitative study involved in-person, semi-structured interviews (conducted in 2022) with participants from the First Foods New Zealand study (conducted in 2020-2022), focusing on mothers’ infant feeding experiences and particularly complementary feeding.</div></div><div><h3>Participants/setting</h3><div>Participants were mothers (n = 15) living in Dunedin (New Zealand) who had been identified as experiencing moderate or severe household food insecurity when their infant was aged 7 to 10 months.</div></div><div><h3>Analysis</h3><div>Thematic analysis of transcripts was performed using a reflexive thematic analysis approach.</div></div><div><h3>Results</h3><div>Three main themes and 1 subtheme were generated: (1) Food purchasing strategies were used to stretch money; (2) the infant’s nutrition was prioritized (subtheme: breast milk was perceived to support the infant’s nutrition); and (3) support was appreciated, but seeking money or food often brought a sense of shame and disempowerment.</div></div><div><h3>Conclusions</h3><div>Mothers prioritized feeding their infants by stretching limited resources, compromising their own diets, and seeking support despite considerable challenges. Their determination and skill in feeding their infants nutritiously highlight the extensive labor involved in infant feeding and food provision in the context of household food insecurity. However, these efforts also contributed to ongoing cognitive and emotional strain for the mothers themselves.</div></div>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"126 3","pages":"Article 156229"},"PeriodicalIF":4.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145480221","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}