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Objective: To assess changes in the magnitude of food insecurity (FI) in Mexican households in poverty from 2012 to 2018 and to analyze the association of FI with the access, availability and consumption of food., Materials and Methods: Data on 4 464 households were drawn from the Encuesta Nacional de Salud y Nutrición in Mexican localities under 100 000 inhabitants (Ensanut 100k). We measured FI according to the Latin American and Caribbean Food Security Scale and analyzed food access and availability on the basis of food expenditures while consumption through dietary diversity among women. Using multiple logistic regression models, we estimated: the association between FI and expenditures for food groups, and the association between FI and dietary diversity., Results: Moderate and severe FI remained stable at 43% from 2012 to 2018. Larger expenditures on sugar, oil and on eating out as well as meat and dairy products consumption were associated with a lower possibility of FI., Conclusions: It is important to integrate different dimensions of FI in order to reinforce its measurement and monitoring., Competing Interests: Declaration of conflict of interests. The authors declare that they have no conflict of interests.

Objective: Examine dietary practices among Liberian refugees living in a protracted refugee situation and Ghanaians living among them., Design: Qualitative data were collected via audio-taped in-depth interviews as part of a larger mixed-methods cross-sectional study., Setting: Buduburam Refugee Settlement and neighboring villages, Ghana., Participants: Twenty-seven Liberian and Ghanaian women aged ≥16 years, who lived with ≥1 other female generation., Phenomenon of Interest: Similarities and differences in factors influencing dietary practices among Liberian refugees living in Buduburam Refugee Settlement and Ghanaians living in and around this settlement., Analysis: Domains, themes, and subthemes were confirmed through a highly iterative coding and consensus process. ATLAS.ti (version 7.5.10) was used to finalize coding and extract quotations., Results: Seven domains emerged forming direct and indirect pathways influencing dietary patterns among Liberian refugees and Ghanaians: social support, food availability, nutrition knowledge, cultural food beliefs, food access, food preparation, and national identity., Conclusions and Implications: Findings provide important insights into crucial factors driving dietary practices among refugees and local communities in and around a former protracted refugee settlement. Results strongly suggest that nutrition education, food availability, and access issues should be addressed with culturally sensitive programs targeting both the refugee and host communities., (Copyright © 2018 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Background: During the Pregnancy and Birth to 24 Months Project, the US Departments of Agriculture and Health and Human Services initiated a review of evidence on diet and health in these populations., Objectives: The aim of these systematic reviews was to examine the relation of 1) never versus ever feeding human milk, 2) shorter versus longer durations of any human milk feeding, 3) shorter versus longer durations of exclusive human milk feeding, and 4) feeding a lower versus higher intensity of human milk to mixed-fed infants with type 1 and type 2 diabetes in offspring., Methods: The Nutrition Evidence Systematic Review team conducted systematic reviews with external experts. We searched CINAHL, Cochrane, Embase, and PubMed for articles published January 1980-March 2016, dual-screened the results according to predetermined criteria, extracted data from and assessed the risk of bias for each included study, qualitatively synthesized the evidence, developed conclusion statements, and graded the strength of the evidence., Results: The 4 systematic reviews included 21, 37, 18, and 1 articles, respectively. Observational evidence suggests that never versus ever feeding human milk (limited evidence) and shorter versus longer durations of any (moderate evidence) and exclusive (limited evidence) human milk feeding are associated with higher type 1 diabetes risk. Insufficient evidence examined type 2 diabetes. Limited evidence suggests that the durations of any and exclusive human milk feeding are not associated with intermediate outcomes (e.g., fasting glucose, insulin resistance) during childhood., Conclusions: Limited to moderate evidence suggests that feeding less or no human milk is associated with higher risk of type 1 diabetes in offspring. Limited evidence suggests no associations between the durations of any and exclusive human milk feeding and intermediate diabetes outcomes in children. Additional research is needed on infant milk-feeding practices and type 2 diabetes and intermediate outcomes in US populations, which may have distinct metabolic risk., (© American Society for Nutrition 2019.)

Background: During the Pregnancy and Birth to 24 Months Project, the USDA and US Department of Health and Human Services initiated an evidence review on diet and health in these populations., Objective: The aim of these systematic reviews was to examine the relationships of never versus ever feeding human milk, shorter versus longer durations of any and exclusive human milk feeding, and feeding a lower versus a higher intensity of human milk to mixed-fed infants with diagnosed celiac disease and inflammatory bowel disease (IBD)., Methods: The Nutrition Evidence Systematic Review team (formerly called the Nutrition Evidence Library) conducted systematic reviews with external experts. We searched CINAHL, Cochrane, Embase, and PubMed for articles published January, 1980 to March, 2016, dual-screened the results using predetermined criteria, extracted data from and assessed risk of bias for each included study, qualitatively synthesized the evidence, developed conclusion statements, and graded the strength of the evidence., Results: We included 9 celiac disease and 17 IBD articles. Limited case-control evidence suggests never versus ever being fed human milk is associated with higher risk of celiac disease, but concerns about reverse causality precluded a conclusion about the relationship of shorter versus longer durations of any human milk feeding with celiac disease. Evidence examining never versus ever feeding human milk and IBD was inconclusive, and limited, but consistent, case-control evidence suggests that, among infants fed human milk, shorter versus longer durations of any human milk feeding are associated with higher risk of IBD. For both outcomes, evidence examining the duration of exclusive human milk feeding was scant and no articles examined the intensity of human milk fed to mixed-fed infants., Conclusion: Limited case-control evidence suggests that feeding human milk for short durations or not at all associates with higher risk of diagnosed IBD and celiac disease, respectively. The small number of studies and concern about reverse causality and recall bias prevent stronger conclusions., (© American Society for Nutrition 2019.)

Background: During the Pregnancy and Birth to 24 Months Project, the US Departments of Agriculture and Health and Human Services initiated a review of evidence on diet and health in these populations., Objectives: The aim of these systematic reviews was to examine the relation of 1) never versus ever feeding human milk, 2) shorter versus longer durations of any human milk feeding, 3) shorter versus longer durations of exclusive human milk feeding, and 4) feeding a lower versus higher intensity of human milk to mixed-fed infants with acute childhood leukemia, generally, and acute lymphoblastic leukemia, specifically., Methods: The Nutrition Evidence Systematic Review team conducted systematic reviews with external experts. We searched CINAHL, Cochrane, Embase, and PubMed for articles published January 1980 to March 2016, dual-screened the results using predetermined criteria, extracted data from and assessed risk of bias for each included study, qualitatively synthesized the evidence, developed conclusion statements, and graded the strength of the evidence., Results: We included 24 articles from case-control or retrospective studies. Limited evidence suggests that never feeding human milk versus 1) ever feeding human milk and 2) feeding human milk for durations ≥6 mo are associated with a slightly higher risk of acute childhood leukemia, whereas evidence comparing never feeding human milk with feeding human milk for durations <6 mo is mixed. Limited evidence suggests that, among infants fed human milk, a shorter versus longer duration of human milk feeding is associated with a slightly higher risk of acute childhood leukemia. None of the included articles examined exclusive human milk feeding or the intensity of human milk fed to mixed-fed infants., Conclusions: Feeding human milk for short durations or not at all may be associated with slightly higher acute childhood leukemia risk. The evidence could be strengthened with access to broadly generalizable prospective samples; therefore, we recommend linking surveillance systems that collect infant feeding and childhood cancer data., (© American Society for Nutrition 2019.)

Background: During the Pregnancy and Birth to 24 Months Project, the US Departments of Agriculture and Health and Human Services initiated a review of evidence on diet and health in these populations., Objectives: The aim of these systematic reviews was to examine the relation of 1) never versus ever feeding human milk, 2) shorter versus longer durations of any human milk feeding, 3) shorter versus longer durations of exclusive human milk feeding, and 4) lower versus higher intensities of human milk fed to mixed-fed infants with intermediate and endpoint cardiovascular disease (CVD) outcomes in offspring., Methods: The Nutrition Evidence Systematic Review team conducted systematic reviews with external experts. We searched CINAHL, Cochrane, Embase, and PubMed for articles published January 1980-March 2016, dual-screened the results using predetermined criteria, extracted data from and assessed the risk of bias for each included study, qualitatively synthesized the evidence, developed conclusion statements, and graded the strength of the evidence., Results: The 4 systematic reviews included 13, 24, 6, and 0 articles, respectively. The evidence was insufficient to draw conclusions about endpoint CVD outcomes across all 4 systematic reviews. Limited evidence suggests that never versus ever being fed human milk is associated with higher blood pressure within a normal range at 6-7 y of age. Moderate evidence suggests there is no association between the duration of any human milk feeding and childhood blood pressure. Limited evidence suggests there is no association between the duration of exclusive human milk feeding and blood pressure or metabolic syndrome in childhood. Additional evidence about intermediate outcomes for the 4 systematic reviews was scant or inconclusive., Conclusions: There is insufficient evidence to draw conclusions about the relationships between infant milk-feeding practices and endpoint CVD outcomes; however, some evidence suggests that feeding less or no human milk is not associated with childhood hypertension., (© American Society for Nutrition 2019.)

Objectives: To assess the consumption of ultra-processed foods among inmates in a women's prison in the State of São Paulo, Brazil., Methods: We conducted a cross-sectional study in 2012/2013 with 1,013 female inmates. A structured interview questionnaire was used to collect socio-demographic, self-reported morbidity and healthy lifestyles and health-related behaviors data. The inmates' usual diet was assessed with a food frequency questionnaire. Foods were classified as either natural or minimally processed, processed or ultra-processed., Results: Inmates age ranged from 18 to 65 years, 51.7% were black, 80.3% had children, 69.5% smoked, 47% were overweight/obese and half of them had high blood triglycerides. The prevalence of daily consumption of natural or minimally processed foods (rice, beans and cassava flour) was 87.7%. The prevalence of daily consumption of green leafy and other vegetables was 63.7%. Almost two-thirds reported consuming milk and fried chicken frequently. A high prevalence of daily consumption of ultra-processed foods was observed in this study. Hot dog bread and sweet bread with margarine were consumed by 86.5% of the interviewees on a daily basis; sugar sweetened beverages by 68.4%, and biscuits as well as candies by 77.1%., Conclusions: The women's diet in the prison is of low quality, and may lead to metabolic alterations, obesity and other comorbidities. It is recommended that the prison's Food Evaluation Committee considers improvements to the quality of the prisoners' diets.

Previous research suggests that acculturation (i.e., exposure and assimilation to local culture) is associated with changes in dietary patterns among immigrants. This study investigates this association in a refugee population using time in refugee settlement as a proxy for acculturation. A cross-sectional survey was conducted among a systematic sample to (a) identify dietary patterns in Liberian refugees and Ghanaians living in or near a refugee settlement, (b) compare adherence to these dietary patterns between groups, and (c) investigate the association between acculturation and dietary patterns in Liberian refugees. Participants were Liberian and Ghanaian women with young children living in the Buduburam refugee settlement or Awutu in Ghana (n = 480; 50% Liberian; mean age 28, SD 6.3, range 16-48 years). Time in settlement was assessed by self-report; food consumption was assessed by food frequency questionnaire. Principal component analysis was used to identify dietary patterns; a generalized linear model was used to test the association of interest. Three distinct dietary patterns emerged: Healthy, Sweets, and Fats. Ghanaians were more adherent to the Healthy pattern than Liberians (p < 0.05). Liberians were more adherent to the Sweets and Fats patterns than Ghanaians (p < 0.05). There were no significant differences in dietary pattern adherence among the Liberians based on time in settlement. Ghanaians living in Awutu were more adherent to the Healthy pattern than Ghanaians who lived in settlement (p < 0.05). Differences in dietary patterns were observed between Liberian refugees and Ghanaians. These differences were not associated with acculturation and may be related to the food environment in the settlement., (© 2016 John Wiley & Sons Ltd.)

Seventy percent of Mexican households experience some level of food insecurity (FI). Studies have shown positive associations between FI and poor dietary quality. As far as it is known, this is the first time the Healthy Eating Index (HEI-2010) has been used to assess dietary quality of children and adolescents in Mexico, and to examine if FI is related to it. The objective of this research is to assess dietary quality and its association with FI among Mexican children and adolescents from a nationally representative cross-sectional sample. We analyzed data from 4635 2-19-year-old Mexican children and adolescents participating in the Mexican National Health and Nutrition Survey (Ensanut 2012). FI was measured using the Latin American and Caribbean Household Food Security Scale (ELCSA) and dietary quality with the HEI-2010. We examined the association between FI and dietary quality using multivariate linear regressions. Dietary quality was worst as FI became more severe among children and adolescents compared with their counterparts living in households with food security. Specifically, FI had a negative association with fruits, vegetables, and protein foods, and a positive association with refined grains consumption. Dairy intake was negatively associated with FI among older children and adolescents. Added sugars were not associated with FI, but intake was excessive across the population at 15% of total daily energy intake. Decreasing FI may help improve dietary quality of Mexican children and adolescents., (© 2016 John Wiley & Sons Ltd.)

Background: Regular nutrition label use may have important long-term health implications. To our knowledge, the role of nutrition label use in protecting against the development of chronic diseases was unexplored prospectively before this study. Objective: We tested the association between nutrition label use and risk of a future diabetes diagnosis in a multiethnic US cohort. Design: Data from the ongoing National Longitudinal Survey of Youth-1979 (NLSY79) were analyzed. From 2002 (baseline) to 5 follow-up time points (2004-2012), 7150 diabetes-free, multiethnic young adults were prospectively followed for a diagnosis of incident diabetes. Nutrition label use, diabetes diagnosis, time to diabetes diagnosis, and all covariates were self-reported. Results: Between January 2002 and September 2013, 430 participants (6.0%) were diagnosed with diabetes. A weighted, multivariable, extended Cox regression was conducted, which suggested that in nutrition label users, the HR of diabetes diagnosis risk decreased significantly with time ( P -nutrition label use × time interaction < 0.05) compared with risk in nutrition label nonusers. Conclusions: There is an association between nutrition label use and diabetes risk in the longer term. However, additional longitudinal research with a robust dietary intake assessment is needed to test this hypothesis., (© 2017 American Society for Nutrition.)

Introduction: The objective of this exploratory study was to determine whether fruit and vegetable consumption differed by race/ethnicity, by origin and nativity among Hispanics, and by language preference (as an indicator of acculturation) among foreign-born Hispanics., Methods: We recruited 723 women enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) and orally administered a questionnaire containing demographic items, validated measures of food security status and social desirability trait, and the Behavioral Risk Factor Surveillance System fruit and vegetable module. Differences in intakes of 100% fruit juice, fruit, cooked or canned beans, and dark green, orange-colored, and other vegetables were assessed by using analysis of covariance with Bonferroni post hoc tests. Analyses were controlled for age, pregnancy status, breastfeeding status, food security status, educational attainment, and social desirability trait., Results: The frequency of vegetable intake differed by race/ethnicity (cooked or canned beans were consumed more often among Hispanic than non-Hispanic black and non-Hispanic white or other participants, orange-colored vegetables were consumed more often among Hispanics than non-Hispanic black participants, and other vegetables were consumed more often among non-Hispanic white or other than among non-Hispanic black and Hispanic participants), origin (other vegetables were consumed more often among Columbian and other Hispanics than Dominican participants) and nativity (orange-colored vegetables were consumed more often among foreign-born than US-born Hispanics). Fruit and vegetable intake did not differ by language preference among foreign-born Hispanics., Conclusion: Differences in fruit and vegetable consumption among WIC participants by race/ethnicity and by Hispanic origin and nativity may have implications for WIC nutrition policies and nutrition education efforts.

Objective: Identify barriers and facilitators to improve prenatal fruit and vegetable (F&V) intake among Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)-eligible Latinas using the Health Action Process Approach framework., Design: Qualitative data were collected via audiotaped in-depth interviews as part of a larger study to design an intervention to increase prenatal F&V intake., Setting: Hartford, Connecticut., Participants: Forty-five WIC-eligible Latinas completed the study. Included women were: ≥ 18 years old; in 2nd or 3rd trimester; having a singleton pregnancy; overweight or obese (ie, pregravid body mass index ≥ 25); not on a restricted diet; nonsmokers., Phenomenon of Interest: Prenatal factors that promote and hinder F&V intake., Analysis: Transcripts were independently read and coded, and a consensus was reached about emerging themes., Results: Ten factors influenced prenatal F&V intake: social support, family structure, F&V access, F&V preferences, F&V knowledge, F&V health outcome expectations, self-efficacy, intentions, F&V action/coping planning strategies, and maternal health status., Conclusions and Implications: Social support from family/friends emerged as the primary distal factor driving prenatal F&V intake. Interventions designed to empower pregnant Latinas to gain the access, confidence, knowledge, and strategies necessary to consume more F&Vs must consider strengthening support to achieve the desired outcome., (Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Objectives: To determine the impact of an intervention led by community health workers (CHWs) on food label use and to assess whether food label use and diet quality mediate the intervention's impact on glycemic control., Methods: From 2006 to 2010, 203 Latinos (intervention group, n = 100; control group, n = 103) in Hartford County, Connecticut, with type 2 diabetes were randomized to an intervention that included 17 CHW-led home-based sessions over a 12-month period in addition to the standard of care available in both study arms. Data on food label use, diet quality, covariates, and glycated hemoglobin (HbA1c) were collected at baseline and at 3, 6, 12, and 18 months. Data were analyzed via mixed effects and multilevel structural equation modeling., Results: Food label use in the intervention (vs control) group was significantly higher at 3, 12, and 18 months (odds ratio = 2.99; 95% confidence interval = 1.69, 5.29). Food label use and diet quality were positive mediators of improved HbA1c levels., Conclusions: Culturally tailored interventions led by CHWs could increase food label use. Also, CHW-delivered food label education may lead to better diet quality and improve glycemic control among Latinos with type 2 diabetes.

Energy density is a relatively new concept that has been identified as an important factor in body weight control in adults and in children and adolescents. The Dietary Guidelines for Americans 2010 encourages consumption of an eating pattern low in energy density to manage body weight. This article describes the systematic evidence-based review conducted by the 2010 Dietary Guidelines Advisory Committee (DGAC), with support from the US Department of Agriculture's Nutrition Evidence Library, which resulted in this recommendation. An update to the committee's review was prepared for this article. PubMed was searched for English-language publications from January 1980 to May 2011. The literature review included 17 studies (seven randomized controlled trials, one nonrandomized controlled trial, and nine cohort studies) in adults and six cohort studies in children and adolescents. Based on this evidence, the 2010 Dietary Guidelines Advisory Committee concluded that strong and consistent evidence in adults indicates that dietary patterns relatively low in energy density improve weight loss and weight maintenance. In addition, the committee concluded that there was moderately strong evidence from methodologically rigorous longitudinal cohort studies in children and adolescents to suggest that there is a positive association between dietary energy density and increased adiposity. This review supports a relationship between energy density and body weight in adults and in children and adolescents such that consuming diets lower in energy density may be an effective strategy for managing body weight., (Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Objective: To document nutrient and food group serving intakes from food sources among Latina subgroups living in the same geographical area., Design: A cross-sectional study. Nutrient and food group serving intakes were assessed by means of a 24 h recall administered immediately after a prenatal survey., Setting: Hartford, CT, USA., Subjects: A total of 233 low-income pregnant Latinas. For analyses, Latinas were classified into two groups on the basis of self-reported ethnic identity: Puerto Ricans and non-Puerto Rican Latinas., Results: Puerto Rican Latinas were more likely than non-Puerto Rican Latinas to be more acculturated and to consume foods (i.e. processed meat, cheese, soft drinks) and higher levels of nutrients (i.e. fat, SFA, MUFA, trans fatty acids) that have been implicated in the development of chronic diseases. By contrast, non-Puerto Rican Latinas were more likely to consume foods (i.e. fruits, dark green/yellow vegetables, tomatoes, non-starchy vegetables) and higher levels of nutrients (i.e. fibre, vegetable protein, folate, β-carotene) that promote health when compared with Puerto Rican Latinas., Conclusions: Findings suggest that acculturation may play a role in dietary intake. Clinicians and dietitians need to be aware of these differences to encourage healthy eating patterns among more acculturated pregnant Latina clients.

This cross-sectional study assessed: (a) awareness and knowledge of federal dietary tools (MyPyramid, Food Guide Pyramid (FGP), and food labels (FL)), and (b) the influence of acculturation and state of residence on FGP knowledge (FGPK) indicators among low-income Latina WIC participants (N = 479) living in Connecticut, Ohio, Texas, and California. Participants were familiar with FGP but only 37% recognized MyPyramid. FGPK was highest for fruits (71%) and lowest for the 'breads and cereals' group (12%). Less than half (47%) used FL's when grocery shopping. Living in OH, was associated with the lowest FGPK. Multivariate analyses showed that more acculturated individuals living in CT/CA had better FGPK than participants living in TX and their less acculturated counterparts in CT/CA. The forthcoming revised federal dietary tools need to be adequately disseminated among Latinos, with special emphasis on those with lower acculturation levels, living in rapid emerging Latino communities or in the US-Mexico border.

Human immunodeficiency virus (HIV) seropositive women living in low-income communities may have difficulty meeting the increased energy requirements that are associated with both lactation and HIV infection. Data on household food security and maternal socio-demographic characteristics, perceived stress, anthropometry, reported illness, dietary intakes and preferences, and exposure to nutrition education were collected from 70 lactating women [16 seropositive (HP), 27 seronegative (HN), and 27 who refused to be tested and had unknown HIV status (HU)]. Diet was assessed with three 24-h recalls (one market day, one weekend day, and one non-market weekday). Data were collected at 8.4 (SD = 4.7) months postpartum. Most women (74.3%) reported being in good health at the time of study. Three-day mean energy intakes did not differ by HIV status [HP: 12,000 kJ (SD = 3600), HN: 12,600 kJ (SD = 5100), and HU: 12,300 kJ (SD = 4800); P = 0.94]. Protein, fat, vitamin A, thiamin, riboflavin, niacin, vitamin C, calcium, iron, and zinc intakes also did not differ by group (P > 0.10). There was a higher proportion of women with high stress levels in food insecure households compared with food secure households (55.6% vs. 26.5%; P = 0.01). Energy intake was independently negatively associated with food insecurity [high: 11,300 kJ (SD = 3500) vs. low: 13,400 kJ (SD = 5400), respectively; P = 0.050] and stress [high: 10,800 kJ (SD = 2800) vs. low: 13,400 kJ (SD = 5300), P = 0.021]. These results suggest the need to integrate multi-dimensional interventions that address economic and mental health constraints which may limit some women's ability to meet their dietary needs., (© 2010 Blackwell Publishing Ltd.)

Proper nutrition during gestation is important to prevent adverse pregnancy outcomes. Eggs contain many important nutrients necessary for fetal development and human survival. Three focus groups were conducted with Latina women living in Connecticut to identify cultural beliefs toward egg consumption during pregnancy, traditional egg dishes, and methods of preparation. A cross-sectional study was then carried out with a sample of predominately Puerto Rican pregnant Latinas (N = 241) to identify the frequency of consumption of eggs and egg-containing dishes as well as methods of preparation using a tailored food frequency questionnaire modified for this population. Paired sample t-tests were used to examine if there were differences in weekly mean egg intake patterns between the year prior to the pregnancy and during pregnancy based on a Food Frequency Questionnaire. Women were categorized into eggs consumers and non-consumers if they consumed or did not consume eggs during the previous day based on 24-hour recall data. Independent-sample t-test and chi-square cross-tabulation analyses were conducted to examine the association between egg consumption and nutrient intake categories. Results showed that eggs and egg-containing traditional dishes are consumed by Latinas before and during pregnancy. Egg consumers had higher intakes of protein, fat, vitamin K, vitamin E, selenium, beta carotene, lutein and zeaxanthin, cholesterol, total polyunsaturated fatty acids, and docosahexaenoic acid. Eggs contribute significantly to the diet of pregnant Latinas.

Objective: To examine the associations of nutrition knowledge, food label use, and food intake patterns among Latinas with and without diagnosed diabetes., Design: This was a case-control study., Subjects/setting: A convenience sample of 201 (100 cases with diagnosed type 2 diabetes, 101 controls without diagnosed diabetes) nonpregnant, nonbreastfeeding Latinas without severe health conditions, aged 35 to 60 years were interviewed by bicultural interviewers. Diverse community-based recruitment methods were used., Statistical Analyses Performed: Independent samples t test, Mann-Whitney U, and chi(2) tests, and multivariate logistic regression were performed., Results: Food labels self-efficacy and stage of change, and average nutrition knowledge scores were similar between cases and controls (P>0.05). Within the diabetes group, nutrition knowledge was greater among those who had seen a registered dietitian or a diabetes educator (P=0.020). Cases reported consuming artificially sweetened desserts and beverages more frequently than controls (P<0.001). Pooled sample cross-sectional analyses showed that nutrition knowledge was positively related to food label use, which in turn was related to a more healthful food intake pattern (P<0.05). After adjusting for likely confounders, socioeconomic status (SES) was positively related to nutrition knowledge (P=0.001) and intakes of fruits, vegetables, and meats (P

We analyzed the 1994-1996 Continuing Survey of Food Intake by Individuals and the Diet and Health Knowledge Survey (DHKS) to examine whether the relationship between income and dietary quality is modified by food label (FL) use among 20- to 60-y old DHKS respondents who were either household meal preparers, meal planners or food shoppers (n = 2952). Multivariate logistic regression results indicated that the influence of income on dietary quality is mediated by FL use. Those who were wealthier and used FL were significantly less likely to have a lower Healthy Eating Index (HEI) compared with the reference group formed by those in the lower income category who did not use FL [OR = 0.42; 95% confidence interval (CI): 0.31, 0.56]. By contrast, those who were wealthier but did not use FL were as likely as the reference group to have a low HEI (OR = 1.08; 95% CI: 0.74, 1.54). Those who were poorer but used FL were significantly less likely to have a low HEI compared with the reference group (OR = 0.62; 95% CI: 0.48, 0.80). Thus, FL use is associated with improved dietary quality among all income groups with a greater benefit of use among higher income individuals. Income is not associated with improved dietary quality in the absence of FL use.

The goal of the present study was to examine the association of the Food Stamp Program with the food security and dietary intake of low-income children from Hartford, CT, who were enrolled in the Supplemental Food Program for Women, Infants, and Children (WIC). We compared the food and nutrition situation of low-income preschoolers who received food stamps (FS, n = 59) with that of those who did not receive food stamps (NFS, n = 40). Children were an average age of 2.7 +/- 0.6 y, and 95% were receiving WIC benefits at the time of the study. Groups were comparable in demographic characteristics, but the socioeconomic status of the FS group was lower than that of the NFS group (P < 0.05). Food security was assessed with the Radimer/Cornell hunger scale, and dietary intake was assessed with a single 24-h recall and a 14-item food frequency questionnaire. Multivariate analyses within the FS group indicated that a monthly duration of food stamps of <4 wk was a predictor of household food security (odds ratio 0.10, 95% confidence interval 0.02-0.56). Food stamp use was associated with above-median energy-adjusted intakes of vitamin B-6 (3.13, 1.16-8.45), folate (2.92, 1.09-7.81) and iron (3.72, 1.31-10.54). The NFS children were more likely to consume <8 mg iron/d (3.73, 1.09-12.80). These results suggest that the Food Stamp Program is associated with food security and preschoolers' micronutrient intake.

This study compared food insecurity, nutritional status (as measured through anthropometry and dietary intake), and food preparation patterns of low-income Puerto Rican female out-of-treatment drug users with that of low-income Puerto Rican women who reported no drug use. A convenience sample of 41 drug users was compared with 41 age-matched non-drug-users from inner-city Hartford, Connecticut. A culturally appropriate food frequency questionnaire was administered and anthropometric measurements were taken. The findings suggest a high degree of poverty among all study participants, but in particular among drug users. Drug users were more likely than the controls to be food insecure (P < 0.05) and to be exposed to increasingly severe food sufficiency problems. The daily frequency of consumption of vegetables was lower (P = 0.03) for drug users than non-drug-users. Conversely, the frequency of consumption for sweets/desserts was significantly higher for drug users than the controls (P = 0.0001). Drug users, who were classified as food insecure were less likely to consume vegetables (P = 0.004) and fish (P = 0.03) than were controls who were food insecure. When comparing drug users with controls, the former group reported consuming fewer meals during a usual week than the latter group (P < 0.0001). Drug users were more likely to fry foods (P = 0.02) while the controls were more likely to bake (P = 0.005), boil (P = 0.02), and steam (P = 0.002) foods. All anthropometric measurements, except for height, were significantly lower for drug users. The results show that drug users generally maintain poorer nutritional status than non-drug-users. Nutrition interventions as part of drug treatment are needed.