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We conducted a natural field experiment to estimate the impact of including recipes and nutrition tips in a monthly food-box pre-ordering program on produce orders. Customers were randomized at order pickup to receive recipes and nutrition tips (n = 125), or not (n = 120), and received reminder calls to place next month's order. We observed type(s) and number of boxes ordered. Customers receiving recipes and nutrition tips allocated significantly more (15.7%) of their next month's purchase to fruit (P = 0.04). Customers (33.3%) in this intervention group also increased the amount of produce in their next month's order (P = 0.01) compared to the control group (15.8%). [ABSTRACT FROM AUTHOR]

Compared the level of nutrition knowledge of low- and higher-income American consumers with children, and their nutrition attitudes and practices. Found that both groups had Body Mass Indexes above the range of a healthy weight, but that low-income participants were less likely to know nutrition specifics such as diet/disease relationships or serving recommendations from the USDA "Food Pyramid." (HTH)

Food Stamp Nutrition Education (FSNE) is an optional component of the Food Stamp Program aimed at improving food choices of program participants. The last decade has seen a dramatic expansion in FSNE, accompanied by increased interest in FSNE evaluation. The Society for Nutrition Education, as a leader in nutrition education research, has worked collaboratively with federal partners to improve FSNE evaluation. This is the first in a 3-part series of papers presented in this issue of the Journal of Nutrition Education and Behavior. The series reviews the issues, priority needs, and opportunities identified through this process; explains our current focus on the development of a brief measure assessing FSNE-relevant dietary behaviors; and describes plans for measurement development. Key Words: food stamp nutrition education, evaluation

The Dietary Guidelines for Americans is the official nutrition policy statement for the United States. Government involvement in providing information on private behavior, such as food choice, is justified by the high cost of poor diets, as measured in medical expenses and lost productivity. The Guidelines are intended to provide an up-to-date, consistent information base for federal nutrition education and information efforts and food assistance program regulations. Through these policy mechanisms, the Guidelines are assumed to improve dietary behavior, and, ultimately, health. By law, the Dietary Guidelines for Americans must be updated every five years; however, there is no mandate for evaluation. Evaluation could provide useful information to assess the extent to which the Guidelines positively influence health and provide insights into reasons for their successes and limitations. However, evaluation would also present considerable challenges. This paper discusses the critical data and methodological needs for improving evaluation of the Dietary Guidelines for Americans. J Am Diet Assoc. 2003; 103:S42-S49.

The objectives of this study were to determine changes in fat and energy intakes in the United States between 1989-199 1 and 1994-1996, and to examine the implications of expressing fat intake in grams vs as a percent of total energy intake. The source of data was the Continuing Survey of Food Intake by Individuals. The results suggest that intake of energy rose between the 2 time periods, primarily due to higher carbohydrate intake. There was also a modest increase in fat intake. However fat intake, as a percent of total energy, declined. The higher energy intakes were primarily from beverages, especially soft drinks, food mixtures, grain snacks, and pastries. The primary sources of higher fat intakes were meat mixtures, vegetables, and some categories of the grain group. Similar trends in the Food Supply Series suggested that the changes observed were not entirely due to changes in survey methodology. Because the increase in fat intake was masked by the increase in energy intake, we conclude that assessing trends in fat intake as a percent of energy consumption can be misleading, unless information on total energy and fat intake, in grams, is also provided. These preliminary findings should be interpreted cautiously until they are confirmed by formal secular trend analyses. JAm Diet Assoc. 2003;103:867-872., In 1990 the Dietary Guidelines for Americans, the Federal government's statement of policy that provide Americans with advice on the most important aspects of healthful eating, specifically recommended an intake [...]

Objective: To examine changes, between 1977-78 and 1994-96, in the quantity and quality of food Americans consumed that was prepared at home versus away from home. Design: Data were obtained from nationwide surveys of food consumption conducted by the US Department of Agriculture (USDA) in 1977-78 and 1994-96. To maximize comparability, we used 'day 1' dietary data, which both surveys collected via 24-hour recall. Subjects/Settings: Individuals 2 years of age and over were selected. USDA sampling weights were used to generate nationally representative estimates. Variables Measured: We categorized foods by preparation at home or at restaurants, fast-food establishments, schools/day care, and other non-home locations. We assessed percent calories from total fat and saturated fat, and the cholesterol, sodium, fiber, calcium, and iron densities of foods prepared at home versus those prepared away from home. Statistical Analyses: T tests were calculated using accepted procedures to adjust for survey design effects. Results: Between 1977-78 and 1994-96, consumption of food prepared away from home increased from 18% to 32% of total calories. Meals and snacks based on food prepared away from home contained more calories per eating occasion, and 'away' food was higher in total fat and saturated fat on a per-calorie basis than at-home food. 'Away' food contained less dietary fiber, calcium, and iron on a per-calorie basis. Among adults but not children, food prepared away from home was more sodium and cholesterol dense. Implications: When developing intervention messages and strategies, nutrition educators need to be aware of the increasing role of 'away' food in Americans' diets. Key Words: diet assessment, eating behavior, food consumption trends (J Nutr Educ Behav. 2002;34:140-150.)

With the elderly becoming an ever-larger proportion of the American population, their dietary well-being is of increasing concern. In particular, lower-income elderly may face special challenges in maintaining a healthful diet. This group makes up a sizeable proportion of the elderly population; we estimate that almost 1 in 5 (19%) of the elderly have household incomes at or below 130% of the federal poverty level, the income level that generally qualifies a household to participate in the federal Food Stamp Program. Here we examine the dietary intakes and related behaviors, as well as the food security status, of lower- and higher-income elderly and review major US government food and nutrition assistance programs that can be of benefit to the elderly, particularly those of low income. Our subjects are individuals 60 years of age and over, living in community (noninstitutionalized) settings. Data on dietary intakes and behaviors were obtained from the US Department of Agriculture's Continuing Survey of Food Intakes by Individuals (CSFII), 1994-96. Food security data were obtained from the 1999 Current Population Survey (CPS), conducted by the US Census Bureau. For both the CSFII and the CPS, sampling weights were used to generate nationally representative estimates. We found that lower-income elderly consume significantly fewer calories than higher-income elderly, fewer servings of major Food Guide Pyramid food groups, and most nutrients. Approximately 6% of elderly households report some degree of food insecurity. Although food and nutrition assistance programs can benefit elderly individuals, many do not participate. Many lower-income elderly also face physiological and social obstacles to obtaining a healthful diet. How best to meet these varied needs is a challenge for nutrition educators, researchers, and policy makers. KEY WORDS: elderly, low income, dietary intakes, food security, food and nutrition assistance (J Nutr Educ Behav. 34:S31-S41.)

EF Myers is Director, Scientific Affairs and Research at ADA headquarters in Chicago, IL; JF Guthrie, PhD, MPH, RD, is assistant deputy director for child nutrition research, Food Assistance & Nutrition Research Program, Economic Research Service, US Department of Agriculture in Washington, DC., ********** Because nutrition is a basic human need, most nutritionists think of actions to improve the diet status of individuals as being simply and obviously the 'right thing to do.' [...]

Despite progress towards implementing the Dietary Guidelines for Americans, many consumers are still not eating enough fruits, vegetables, or grains. In addition, many people continue to eat high-fat diets. Developing a better understanding of consumers' food and nutrition-related knowledge, attitudes, and practices is an important preliminary step in changing dietary behavior. This study compares the nutrition-related knowledge, attitudes, and practices of low- and higher income American consumers with children in the household using data from the 1994 Continuing Survey of Food Intakes by Individuals and Diet and Health Knowledge Survey. Compared with higher income respondents, low-income respondents with children in the household were found to be less aware of diet-disease relationships, less likely to use the nutrition panel on the food label when buying foods, and significantly less likely to have lowfat and low cholesterol eating practices. Low-income respondents with children were more concerned with price, convenience, and how well food keeps than were higher income respondents. Results have implications for focusing nutrition education and promotion efforts for the low-income population with children. Nutrition educators and promotion messages must be realistic about the limited means and competing concerns of low-income consumers when attempting to improve their eating practices., Knowledge regarding nutrition and its influence on health and longevity has greatly increased over the last decade. National efforts such as the promotion of the Dietary Guidelines for Americana (4) [...]

The relationship of household meal planners' diet-health attitudes and nutrition knowledge to their fat and fiber intakes and to the intakes of 2- to 5-year-old children in the households was examined using data from the 1989-91 Continuing Survey of Food Intake by Individuals and Diet Health Knowledge Survey (CSFII/DHKS). Selected households (n = 478) provided 24-hour diet recalls and the households' main meal planners responded to the DHKS. Meal planner attitude variables were defined according to the Health Belief Model and selected CSFII/DHKS questions served as proxy measures. The relationship of meal planners' attitudes and knowledge to meal planners' and children's fat and fiber consumption at home and in the total diet was analyzed using multiple regression. Several diet-health attitude variables were significantly related to meal planners' fat and fiber intakes and relationships were similar for foods eaten at home and for foods eaten in the total diet. Knowledge was significantly related to meal planners' and children's home fat intake (p < .05) but the relationships failed to reach statistical significance for the total diets. Meal planners' taste concerns differed significantly in their relationship to meal planners' and children's fiber consumption (p < .05). Results indicate that parents' diet-health attitudes are more influential in their diets than in the diets of preschoolers. Findings also suggest that taste and practical food concerns are significant barriers to healthy eating among younger adults and that general nutrition knowledge may not be as helpful in making healthy food choices outside the home as it may be in the home setting.

This paper provides an overview of the current iron status of the U.S. population. The most prevalent nutrient deficiency in the United States is iron deficiency. Factors potentially associated with iron deficiency are discussed, such as low income, homelessness, pregnancy, vegetarianism, and participation in endurance sports. Females in their childbearing years are not attaining their Recommended Dietary Allowance for iron. A number of factors contribute to the iron intakes of Americans, such as the iron content of the U.S. food supply, individual dietary patterns, and the use of supplements. About 1 in 5 Americans take either a multivitamin and mineral supplement or supplemental iron. There are health risks associated with low iron status, as well as with iron overload. Numerous recent studies are cited, and implications for nutrition education and policy are discussed.

The USDA Food Guide provides recommended numbers of servings of five major food groups: (1) bread, cereal, rice, and pasta; (2) vegetables; (3) fruit; (4) milk, yogurt, and cheese; and (5) meat, poultry, fish, dry beans, eggs, and nuts. The objective of this study was to examine the relationship of knowledge of recommended servings of the five major food groups to reported food group consumption among female adult meal planners using data from the 1990 and 1991 Continuing Survey of Food Intakes by Individuals and Diet and Health Knowledge Survey conducted by the U.S. Department of Agriculture. Because about 99 percent of Diet and Health Knowledge Survey respondents gave incorrect responses for grain products, the effects of correct information on consumption of this group could not be analyzed. For the remaining four food groups studied, knowledge of serving recommendations was significantly associated with food group consumption after controlling for the effects of a number of other factors that may influence food consumption behavior. Results provide support for the use of a food guide-based approach to dietary guidance.

Information on the characteristics of individuals using nutrition labeling and the effects of label use on diet quality can be used to guide the development of more effective consumer education programs. For this study, data from the U.S. Department of Agriculture's (USDA) 1989 Continuing Survey of Food Intakes by Individuals (CSFII) and Diet and Health Knowledge Survey (DHKS) were used to identify socioeconomic, demographic, and health-related characteristics and the nutrition-related knowledge and attitudes that were associated with label use. This analysis employed a theoretical model of determinants of label use that was based on an economic model of information search. Characteristics found to be positively associated with the likelihood of using nutrition labeling were having at least some college education, being female, living with others rather than living alone, being more knowledgeable about nutrition, believing that following the principles of the Dietary Guidelines for Americans is important, and being more concerned about nutrition and product safety and less about taste when shopping for food. Having identified the characteristics of label users, this information was used in a model of nutrient consumption that was based on consumer demand theory. A selectivity analysis was employed to correct for potential self-selection bias on label use. Label use appeared to be associated with the consumption of diets that were higher in vitamin C and lower in cholesterol. However, label use in 1989 did not significantly influence the intake of 24 other food components investigated.

Because nearly 25% of American adults live in single-person households, it is important to examine the quality of their diets. Using data from the U.S. Department of Agriculture's 1987-88 Nationwide Food Consumption Survey, we compared the diets of adults living in single-person households to those living in multiperson households by selected sex-age groups. Dietary quality was examined in terms of intake as a percent of the recommended dietary allowance (RDA) for 15 essential nutrients, a measure of dietary adequacy, and of intake of fat, saturated fat, cholesterol, and sodium, a measure of dietary moderation. To facilitate comparisons, indices reflecting dietary adequacy and dietary moderation were constructed. Overall, single women and men reported fewer intakes meeting the RDA and consequently had lower dietary adequacy scores than their counterparts in multiperson households. However, these individuals had significantly better dietary moderation scores than their counterparts in multiperson households. Based on these results, the dietary moderation and dietary adequacy indices may be useful for identification of factors influencing overall diets and for prediction of dietary status of groups of individuals sharing common characteristics. These indices may also be valuable to nutrition educators because they provide measures of dietary compliance with specific aspects of current dietary recommendations.

Quantitative nutrition education research assists nutrition educators first, by helping them understand the factors that influence dietary behavior, and second, by providing a systematic method of investigating the most effective methods for influencing dietary behavior to promote health. This paper discusses four broad categories of factors influencing dietary behavior: physiological factors, sociodemographic factors, behavioral and lifestyle factors, and knowledge and attitude factors. Research findings illustrating what can be learned from examination of each of these categories of factors are presented. The need for more unified, theory-based research on factors influencing dietary behavior is discussed and the U.S. Department of Agriculture's Diet and Health Knowledge Survey is presented as a data set that can be used to carry out this type of research. Finally, the advantages of using both qualitative and quantitative research methodologies to investigate methods of influencing dietary behavior are argued. J. Nutr. 124: 1813S-1819S, 1994. INDEXING KEY WORDS: * nutrition education research * dietary behavior * nutrition-related knowledge and attitudes

This study investigated the effects of a parent education program on the nutrition-related behavior of Head Start parents and the dietary intake of their preschool children. Six New York City and five Maryland Head Start centers were assigned to either the treatment (nutrition education) or control group. Treatment group mothers received 13 weekly nutrition newsletters and were encouraged to attend four nutrition workshops addressing child nutrition, meal planning, food preparation, and food shopping. A total of 89 mothers in the treatment group and 82 mothers in the control group completed pre- and post-program interviews examining their children's food consumption and their nutrition-related behaviors. One to two months after the nutrition education program, Maryland treatment group parents reported that their children were consuming a significantly more diverse and high quality diet, and were consuming significantly more servings of selected nutritious foods than were children in the control group. There were no significant differences in the food consumption of New York treatment and control group children following the program. Treatment group parents from both Maryland and New York reported making more positive changes in their meal planning, food shopping, food preparation, and cooking practices than did their control group counterparts. Findings indicate that nutrition education programs can have a positive effect on Head Start parents' nutrition-related behaviors and can lead to improvements in the diets of children who have been eating fewer than the recommended number of servings of nutritious foods.

Editor's Note: This month the Journal contains four articles on food insecurity. The article below outlines federal activities to fight food insecurity; Hampl and Hall's Commentary (pp 919-922) discusses what [...]

ABSTRACT Objective To identify food sources of added sweeteners in the US diet. Design A descriptive study using data from the US Department of Agriculture (USDA) 1994-1996 Continuing Survey of [...]

Food guides are nutrition education tools that are used to translate scientifically based dietary standards, such as the Recommended Dietary Allowances (6) and the Dietary Guidelines for Americans (15), into [...]