Journal of the Academy of Nutrition and Dietetics最新文献

{"title":"Authors' Reponse","authors":"Sudha Raj PhD, RDN, Nanci S. Guest PhD, RD, CSCS, Matthew J. Landry PhD, RDN, A. Reed Mangels PhD, RDN, 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}

{"title":"Timing of Energy Intake and Ultra-Processed Food Consumption Are Associated With Obesity in Adults in the United Kingdom: A Pooled Cross-Sectional Analysis of the National Diet and Nutrition Survey (2008-2019)","authors":"Patrícia de Fragas Hinnig PhD ,&nbsp;Fernanda Rauber PhD ,&nbsp;Kiara Chang PhD ,&nbsp;Eszter P. Vamos PhD ,&nbsp;Renata Bertazzi Levy PhD","doi":"10.1016/j.jand.2025.156261","DOIUrl":"10.1016/j.jand.2025.156261","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The distribution of energy intake and types of food consumed throughout the day may influence health.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;This study investigated the association of energy intake and ultra-processed food (UPF) consumption in the morning, at midday, and in the evening with indicators of obesity.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;A pooled cross-sectional analysis of the National Diet and Nutrition Survey (2008-2019) of adults residing in England, Wales, Scotland, and Northern Ireland was conducted. Food consumption was assessed using 4-day food diaries. UPFs intake was assessed based on the Nova food classification. The 3 time periods were classified as morning (5:00 &lt;span&gt;am&lt;/span&gt; to 10:59 &lt;span&gt;am&lt;/span&gt;), midday (11:00 &lt;span&gt;am&lt;/span&gt; to 4:59 &lt;span&gt;pm&lt;/span&gt;), and evening (5:00 &lt;span&gt;pm&lt;/span&gt; to 4:59 am).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants/Setting&lt;/h3&gt;&lt;div&gt;This study included 5749 adults aged 19 to 64 years residing in private households in the United Kingdom.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome Measures&lt;/h3&gt;&lt;div&gt;The main outcome measures were overweight, obesity, and abdominal obesity. Body mass index (calculated as kg / m&lt;sup&gt;2&lt;/sup&gt;) values ≥25 and ≥30 were used to classify overweight (including obesity) and obesity, respectively. Abdominal obesity was defined as a waist circumference ≥102 cm for men and ≥88 cm for women.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Statistical Analyses Performed&lt;/h3&gt;&lt;div&gt;Multivariable logistic regression assessed the associations between the percentage of energy intake and the percentage of energy intake from UPFs in the morning, at midday, and in the evening, and indicators of obesity. Models were adjusted for sociodemographic variables (ie, sex, age, ethnicity, region, year of the survey, and social class occupation), behavioral variables (ie, physical activity, smoking status, frequency of alcohol consumption, sleep duration, and weight-loss diet), and variables related to food consumption.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The highest percentage of energy intake in the morning (third tertile) was associated with a 19% reduction in the odds of being overweight (95% CI, 0.68 to 0.96), and the highest percentage in the evening was associated with a 21% higher odds of being overweight (95% CI, 1.01 to 1.44). A 10% increase in the percentage of energy intake from UPFs at midday and in the evening was associated with an 11% (95% CI, 1.02 to 1.20) and 10% (95% CI, 1.02 to 1.18) higher odds of overweight, respectively. The highest percentage of energy intake from UPFs in the morning, at midday, and in the evening (third tertile) was associated with a 26%, 25%, and 45% higher odds of obesity, respectively. A 10% increase in the percentage of energy intake from UPFs in the evening was associated with a 12% (95% CI, 1.03 to 1.22) higher odds of abdominal obesity.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;The timing of energy intake was associated with overweight, and higher consumption of UP","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"126 3","pages":"Article 156261"},"PeriodicalIF":4.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145754678","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 Effectiveness of Medical Nutrition Therapy in Prevention and Treatment of Chronic Disease: A Position Paper of the Academy of Nutrition and Dietetics","authors":"Lisa Moloney PhD, RDN ,&nbsp;Mary Rozga PhD, RDN ,&nbsp;Alison Steiber PhD, RDN ,&nbsp;Deepa Handu PhD, RDN","doi":"10.1016/j.jand.2025.10.010","DOIUrl":"10.1016/j.jand.2025.10.010","url":null,"abstract":"<div><div>It is the position of the Academy of Nutrition and Dietetics that all individuals with nutrition-related health conditions or risk factors should have access to medical nutrition therapy (MNT) provided by a registered dietitian nutritionist (RDN). MNT provided by RDNs is effective in improving health outcomes for many chronic conditions that are leading drivers of morbidity, mortality, and health care costs in the United States. Widespread access to MNT using an individualized, client-centered, and evidence-based approach has the potential to improve population health, reduce health disparities, and reduce health care costs associated with nutrition-related health conditions. This Academy of Nutrition and Dietetics position paper summarizes recent evidence from systematic reviews on the effectiveness of MNT provided by an RDN for the prevention and treatment of nutrition-related health conditions. A total of 25 systematic reviews published between 2017 and 2024 were summarized and assessed for certainty of evidence. Systematic reviews with high or moderate certainty of evidence demonstrate that MNT is likely effective in improving a range of health outcomes in adults with pre-diabetes, type 1 diabetes, type 2 diabetes, obesity, pre-hypertension, hypertension, dyslipidemia, chronic kidney disease, head and neck cancer, and chronic obstructive pulmonary disease compared with no MNT or standard care. Barriers exist to accessing MNT, including inadequate staffing of RDNs in some areas, a lack of provider referrals to an RDN for MNT, and a lack of payer coverage and reimbursement. This position was approved in September 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 2","pages":"Article 156219"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285338","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":"Greenhouse Gas Emission Menu Icons Decrease Service of All Menu Items in Residential Dining Halls at a Large, Midwestern Public US University","authors":"Andrew D. Jones PhD ,&nbsp;Lesli Hoey PhD ,&nbsp;Cindy W. Leung ScD ,&nbsp;Melissa J. Slotnick PhD ,&nbsp;Wei Hao PhD ,&nbsp;Kitty Oppliger MPH ,&nbsp;Alex Bryan ,&nbsp;Steve Giardini MBA ,&nbsp;Ha Young Kim ,&nbsp;Steve Mangan ,&nbsp;Hailey McQuaid MS ,&nbsp;Melanie Reid ,&nbsp;Keith Soster","doi":"10.1016/j.jand.2025.09.008","DOIUrl":"10.1016/j.jand.2025.09.008","url":null,"abstract":"<div><h3>Background</h3><div>Reducing food-related greenhouse gas (GHG) emissions is essential for meeting global climate goals. Consumer information food labels are often associated with healthier diet choices, although less is known about the influence of environment-focused food labels.</div></div><div><h3>Objective</h3><div>Determine the effect of GHG emission menu icons on the service and intake of high-emission menu items in residential dining halls of a large, midwestern public US university.</div></div><div><h3>Design</h3><div>A cluster-randomized mixed-methods study design was employed. Three matched pairs of dining halls were randomized to intervention or control status. Data were collected on the amount of menu items served at dining halls; recent diet intake among a survey of frequent diners; and changes in food choices in response to menu icons among focus group participants.</div></div><div><h3>Participants and Setting</h3><div>The study was conducted in 6 residential dining halls. Foodservice data were based on 1 017 447 entries into dining halls; data were analyzed from 799 frequent diners who submitted survey responses at baseline (January 2022) and follow-up (March to April 2022). Five focus groups were conducted with 23 frequent diners in total across all groups.</div></div><div><h3>Intervention</h3><div>Traffic light-style GHG emission menu icons, representing the life cycle emissions of recipes, were displayed on all menu items in intervention dining halls for 10 weeks following a 4-week baseline period, alongside informational materials explaining the icons.</div></div><div><h3>Main Outcome Measures</h3><div>The difference between treatment groups in the change in per-person service (in grams) of high-emission menu items from baseline to follow-up.</div></div><div><h3>Statistical Analyses</h3><div>Generalized estimating equations using a gamma distribution and log link function were used to model treatment effects.</div></div><div><h3>Results</h3><div>Analyses of all menu items served indicated that per-person service (in grams) of high-, moderate-, and low-GHG emission menu items was lower at follow-up compared with baseline in intervention dining halls. This observed decline in service was statistically significantly greater than the change in service in control dining halls, wherein service declined more modestly or increased. Examining menu items that were exactly matched within dining hall pairs, only the service of low-emission menu items within intervention halls declined to a greater extent compared with control halls. Data from self-reports of recent diet by frequent diners showed no statistically significant treatment effects for the frequency of intake of any food category or overall diet quality.</div></div><div><h3>Conclusions</h3><div>GHG emission menu icons may not be sufficient to shift consumer food choices at scale in university dining settings.</div></div>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"126 2","pages":"Article 156206"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079181","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":"Self-Efficacy: The Key to Nutrition Facts Label Use: Theory-Based Findings from the 2019 Food and Drug Administration Food Safety and Nutrition Survey","authors":"Fanfan Wu PhD,&nbsp;Martine Ferguson MS,&nbsp;Amy Lando MPP,&nbsp;Linda Verrill PhD","doi":"10.1016/j.jand.2025.09.007","DOIUrl":"10.1016/j.jand.2025.09.007","url":null,"abstract":"<div><h3>Background</h3><div>The Nutrition Facts label is a useful tool for consumers to achieve a healthy diet.</div></div><div><h3>Objective</h3><div>This study aimed to develop and test a theoretical framework examining factors that may influence consumers’ use of the Nutrition Facts label, using a nationally representative sample.</div></div><div><h3>Design</h3><div>Analyses of cross-sectional, nationally representative 2019 Food and Drug Administration Food Safety and Nutrition Survey data included developing a theoretical framework adopting key constructs from 2 health behavior theories—the Integrated Behavior Model and the Theory of Planned Behavior—to test research hypotheses.</div></div><div><h3>Participants and Setting</h3><div>Participants were 2041 US adults who participated in the 2019 Food and Drug Administration Food Safety and Nutrition Survey, Nutrition Version.</div></div><div><h3>Main Outcome Measures</h3><div>Consumers’ use of the Nutrition Facts label, health habits, self-efficacy, attitude, knowledge and skills, economic conditions, health status, potential exposure to the Nutrition Facts label, age, sex, education, race/ethnicity, and urbanicity were measured.</div></div><div><h3>Statistical Analyses Performed</h3><div>A structural equation model was used.</div></div><div><h3>Results</h3><div>Eighty-seven percent of respondents reported having used the Nutrition Facts labels on food packages. Among all factors tested, self-efficacy has the strongest positive relationship with consumers’ use of the label (standardized regression estimate = .67; <em>P</em> &lt; .001). Findings also suggest that people living in urban areas are more likely to report using the Nutrition Facts label (standardized regression estimate = .11; <em>P</em> = .02). Results suggest that although knowledge and skills and attitude are not directly associated with consumers’ label use, the relationship between these 3 constructs is strongly mediated by self-efficacy (standardized regression estimates = .38; <em>P</em> &lt; .001 and .10; <em>P</em> = .01, respectively). Furthermore, individuals with better health status and more exposure to the Nutrition Facts label are more likely to have higher levels of self-efficacy (standardized regression estimates = .34; <em>P</em> &lt; .001 and .28; <em>P</em> &lt; .001, respectively).</div></div><div><h3>Conclusions</h3><div>This study highlights the vital role self-efficacy plays in the theoretical model determining consumers’ use of the Nutrition Facts label. The results also shed light on the factors that are important to consider when developing strategies to increase self-efficacy for Nutrition Facts label use and target populations for education and intervention.</div></div>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"126 2","pages":"Article 156205"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068838","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":"A 2-Group Path Analysis of a Food Environment Conceptual Model by Food Security Status: Home Food Environment Variables Were Associated With Healthy Eating Index 2015 Component Scores for Total Vegetables Among Those With Food Security","authors":"Cerra C. Antonacci PhD, MBE, MHS ,&nbsp;Regine Haardörfer PhD, MEd, MS ,&nbsp;Megan R. Winkler PhD, RN ,&nbsp;Terry J. Hartman PhD, MPH, RD ,&nbsp;Alexandra B. Morshed PhD, MS ,&nbsp;Candace Muncy ,&nbsp;Michelle C. Kegler DrPH, MPH","doi":"10.1016/j.jand.2025.156222","DOIUrl":"10.1016/j.jand.2025.156222","url":null,"abstract":"<div><h3>Background</h3><div>The Model of Community Nutrition Environments is a well-known conceptual model in public health nutrition, although few studies have tested the model as a valid representation of food environment-diet pathways. Further, no study has explored whether the model differs by food security status, despite documented disparities in food environments and diet for those experiencing food insecurity.</div></div><div><h3>Objective</h3><div>To test the Model of Community Nutrition Environments by food security status using multigroup path analysis.</div></div><div><h3>Design</h3><div>This secondary analysis of baseline data from a hybrid-effectiveness implementation trial, Healthy Homes/Healthy Families, which included a home environment survey and 2 unscheduled 24-hour dietary recalls, was merged with the US Department of Agriculture 2019 Food Access Research Atlas.</div></div><div><h3>Participants/setting</h3><div>Participants recruited through 4 United Way 2-1-1 agencies in Georgia were eligible if they were aged 18 to 70 years, spoke English, and self-reported a body mass index ≥20. Baseline data collection occurred from October 2020 to December 2022 (N = 510 participants).</div></div><div><h3>Main outcome measures</h3><div>Main outcomes included Healthy Eating Index 2015 component scores for total fruits and total vegetables.</div></div><div><h3>Analyses</h3><div>Multigroup path analysis compared the unstandardized effects of pathways in the Model of Community Nutrition Environments for those who were food secure and food insecure.</div></div><div><h3>Results</h3><div>The 2-group model had good global model fit (root mean square error of approximation = 0.000, comparative fit index = 1.000, Tucker-Lewis index = 1.000, standardized root mean square residual = 0.047). Home availability (<em>b</em> = .08 ± .04; <em>P</em> = .029) and accessibility (<em>b</em> = .68 ± .27; <em>P</em> = .012) of fruits and vegetables were positively associated with Healthy Eating Index 2015 scores for total vegetables among those with food security. No significant associations were found with either outcome among those with food insecurity. The food secure model explained more variance in the outcomes than the food insecure model (food secure: <em>R</em>²_total _fruits = 0.20, <em>R</em>²_{total vegetables} = 0.36; food insecure: <em>R</em>²_{total fruits} = 0.10, <em>R</em>²_total _vegetables = 0.06).</div></div><div><h3>Conclusions</h3><div>Additional mechanisms need to be added to the Model of Community Nutrition Environments to better explain food environment-diet pathways for those experiencing food insecurity.</div></div>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"126 2","pages":"Article 156222"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022959","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":"Intersections of Educational Attainment, Indigenous Identity, and Race/Ethnicity Best Predicted Diet Quality Among Adults in Canada: A Conditional Random Forests Analysis","authors":"Natalie Doan MSc ,&nbsp;Martin J. Cooke PhD ,&nbsp;Michael P. Wallace PhD ,&nbsp;Elena Neiterman PhD ,&nbsp;Dana Lee Olstad PhD, RD","doi":"10.1016/j.jand.2025.09.009","DOIUrl":"10.1016/j.jand.2025.09.009","url":null,"abstract":"<div><h3>Background</h3><div>Although it is well-known that diet quality varies according to multiple dimensions of socioeconomic position (SEP), much remains unknown about how these dimensions together shape diet quality. Given that diet quality associated with 1 SEP dimension (eg, income) can systematically differ across another dimension (eg, race and ethnicity), it is necessary to investigate diet quality across SEP intersections.</div></div><div><h3>Objectives</h3><div>The aim of this study was to identify SEP intersections that best predicted lower and higher diet quality among adults in Canada.</div></div><div><h3>Design</h3><div>Population-based data were from the cross-sectional 2015 Canadian Community Health Survey–Nutrition. Data were collected by interviewers who visited selected dwellings to collect household information and administer a general health questionnaire and a 24-hour dietary recall.</div></div><div><h3>Participants/Setting</h3><div>Data from 13 617 adults aged 18 years and older living in Canada’s 10 provinces.</div></div><div><h3>Main Outcome Measures</h3><div>Twenty-four–hour dietary recall data were used to assess diet quality based on the Healthy Eating Index-2015 (HEI-2015) score (range, 0 to 100).</div></div><div><h3>Statistical Analyses Performed</h3><div>Conditional random forests, a supervised machine-learning technique, were used to identify 4 of 12 SEP indicators that best individually predicted HEI-2015 scores. The resulting 4 most important predictors were used to predict diet quality using all possible 2-way intersections.</div></div><div><h3>Results</h3><div>The 4 most important intersectional predictors of HEI-2015 scores based on conditional random forest variable importance measures were (1) educational attainment and Indigenous identity and race/ethnicity, (2) educational attainment and household food insecurity, (3) educational attainment and sex/gender, and (4) household food insecurity and sex/gender. Among these 4 SEP intersections, individuals without a high school diploma living in a severely food-insecure household had the lowest (55.7), and individuals without a high school diploma identifying as Middle Eastern had the highest (64.5) predicted HEI-2015 scores.</div></div><div><h3>Conclusions</h3><div>The SEP intersection defined by educational attainment and Indigenous identity and race/ethnicity was the most important predictor of diet quality among adults in Canada.</div></div>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"126 2","pages":"Article 156207"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124102","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":"Perspectives on Messaging Strategies to Increase Participation in Universal Free School Meal Programs: A Qualitative Study With Parents of Elementary School-Aged Children","authors":"Amanda B. Zeitlin MPH ,&nbsp;Alix Zuceth Durán Gómez MD ,&nbsp;Cristina J.Y. Lee MPH ,&nbsp;Andrea Pedroza-Tobias PhD, MSc ,&nbsp;Christina A. Hecht PhD ,&nbsp;Anisha I. Patel MD, MSPH, MSHS ,&nbsp;Kenneth Hecht LLB ,&nbsp;Anna H. Grummon PhD, MSPH","doi":"10.1016/j.jand.2025.09.011","DOIUrl":"10.1016/j.jand.2025.09.011","url":null,"abstract":"<div><h3>Background</h3><div>At least 8 states currently have universal free school meal programs that offer school meals at no charge to all students regardless of their household income. Marketing campaigns offer a scalable strategy for motivating parents to encourage their children to participate in these programs, but little is known about what topics campaigns should address.</div></div><div><h3>Objective</h3><div>To explore perceptions of the content and design of messages encouraging school meal participation among parents of elementary school-aged children.</div></div><div><h3>Design</h3><div>Qualitative online semistructured interviews conducted during February and March 2024. Interviews explored parents’ reactions to messages encouraging school meal participation with a variety of topics (eg, saving time, improving nutrition) and design elements (eg, cartoons, photographs).</div></div><div><h3>Participants</h3><div>Parents of children in grades 1 through 5 not frequently consuming school meals and living in states with universal free school meal programs (N = 18; 14 women; 6 Spanish-speaking).</div></div><div><h3>Analysis</h3><div>Discussions were transcribed verbatim. Investigators developed codes in vivo and analyzed transcripts using a thematic approach.</div></div><div><h3>Results</h3><div>Parents perceived messages that focused on how school meals are convenient and save money to be most likely to motivate them to encourage their children to eat school meals. Parents also believed that school meals can foster social and developmental benefits. Parents perceived messages describing the nutritional quality of school meals as likely to be motivating, but only if they perceived school meals to be nutritious. Some parents reported they did not know school meals were free, despite living in states with universal free school meals. In terms of design, parents preferred succinct messages with bold colors, modern layouts, and references or statistics.</div></div><div><h3>Conclusions</h3><div>Campaigns seeking to motivate parents to encourage their children to participate in universal free school meal programs may wish to discuss convenience, saving money, and social and developmental benefits, and to communicate that school meals are free for all students. Future studies will be needed to evaluate whether campaigns discussing these topics successfully promote school meal participation.</div></div>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"126 2","pages":"Article 156209"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145256991","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}