Melissa N. Laska

Young adults and eating away from home: associations with dietary intake patterns and weight status differ by choice of restaurant.

BACKGROUND Young adults report frequent away-from-home eating; however, little is known regarding what types of restaurants are patronized or whether associations with dietary intake and weight status differ according to restaurant type. OBJECTIVE This cross-sectional study in a diverse sample of young adults examines sociodemographic differences in the frequency of eating at different types of fast-food and full-service (server brings food to table) restaurants. In addition, this study examines whether associations between away-from-home eating, dietary intake, and weight status differ according to restaurant type. DESIGN There were 1,030 men and 1,257 women (mean age=25.3 years) who participated in Project EAT-III (Eating and Activity in Teens and Young Adults). Participants were members of a longitudinal cohort who completed baseline surveys at schools in Minneapolis/St Paul, MN, and completed the EAT-III surveys online or by mail in 2008-2009. MAIN OUTCOME MEASURES Height, weight, and usual dietary intake were self-reported. STATISTICAL ANALYSES PERFORMED Regression models adjusted for sociodemographic characteristics were used to examine associations between frequency of restaurant use, dietary intake, and weight status. RESULTS More frequent use of fast-food restaurants that primarily served burgers and french fries was associated with higher risk for overweight/obesity; higher intake of total energy, sugar-sweetened beverages, and fat; and with lower intake of healthful foods and key nutrients. For example, those who reported burger-and-fries restaurant use on three or more occasions per week consumed nearly one additional sugar-sweetened beverage per day compared to those who reported burger-and-fries restaurant use on less than one occasion per week. More frequent use of fast-food restaurants that primarily served sandwiches/subs was related to a few markers of poorer diet quality, but unrelated to weight status. More frequent use of full-service restaurants was also unrelated to weight status and related to higher intake of vegetables. CONCLUSIONS There may be a need for interventions to promote healthier food choices among young adults who report frequent burger-and-fries restaurant use.

Healthy food availability in small urban food stores: a comparison of four US cities.

OBJECTIVE Given that small food stores may be important retail food sources in low-income urban communities, our objective was to examine cross-city comparative data documenting healthy food availability within such facilities, particularly those located in low-income areas and nearby schools. DESIGN Food stores in Baltimore, Maryland; Minneapolis/St. Paul, Minnesota; Oakland, California; and Philadelphia, Pennsylvania were selected for assessment based on proximity to low-income schools. Stores were defined as: (i) single-aisle (n 45); (ii) small (2-5 aisles; n 52); and (iii) large (> or = 6 aisles; n 8). Staff conducted in-store audits to assess the presence/absence of twenty-eight healthy items, organized within five categories: (i) fresh fruits/vegetables, (ii) processed fruits/vegetables, (iii) healthy beverages/low-fat dairy, (iv) healthy snacks and (v) other healthy staple foods. RESULTS The availability of healthy food items was low, particularly in single-aisle and small stores, and there was significant cross-site variability in the availability of healthy snacks (P < 0.0001) and other healthy staple foods (P < 0.0001). No cross-site differences existed for fruits/vegetables or healthy beverages/low-fat dairy availability. Healthy food availability scores increased significantly with store size for nearly all food/beverage categories (P < 0.01). CONCLUSIONS Overall, healthy food availability in these venues was limited. Region-specific factors may be important to consider in understanding factors influencing healthy food availability in small urban markets. Data suggest that efforts to promote healthy diets in low-income communities may be compromised by a lack of available healthy foods. Interventions targeting small stores need to be developed and tailored for use in urban areas across the USA.

Adolescent sleep, risk behaviors, and depressive symptoms: are they linked?

OBJECTIVE To explore how weekday and weekend sleep patterns are related to adolescent substance use, depressive symptoms, and school truancy. METHODS Selfreport surveys of 242 youth (93.4% white, mean age 16.4 years). RESULTS Longer weekday sleep duration was inversely associated with depressive symptoms, past month alcohol use, and drunkenness. Later weekend bedtime and wake-times, compared to those of weekdays, were associated with increased substance use and truancy. CONCLUSIONS Weekday sleep duration appears to be protective for substance use, depression and school truancy for teenagers. However, inconsistent sleep patterns between weekdays and weekends were associated with a range of markers for adolescent risk.

Impact of Cooking and Home Food Preparation Interventions Among Adults: Outcomes and Implications for Future Programs

OBJECTIVE Cooking programs are growing in popularity; however, an extensive review has not examined their overall impact. Therefore, this study reviewed previous research on cooking/home food preparation interventions and diet and health-related outcomes among adults and identified implications for practice and research. DESIGN Literature review and descriptive summative method. MAIN OUTCOME MEASURES Dietary intake, knowledge/skills, cooking attitudes and self-efficacy/confidence, health outcomes. ANALYSIS Articles evaluating the effectiveness of interventions that included cooking/home food preparation as the primary aim (January, 1980 through December, 2011) were identified via Ovid MEDLINE, Agricola, and Web of Science databases. Studies grouped according to design and outcomes were reviewed for validity using an established coding system. Results were summarized for several outcome categories. RESULTS Of 28 studies identified, 12 included a control group with 6 as nonrandomized and 6 as randomized controlled trials. Evaluation was done postintervention for 5 studies, pre- and postintervention for 23, and beyond postintervention for 15. Qualitative and quantitative measures suggested a positive influence on main outcomes. However, nonrigorous study designs, varying study populations, and the use of nonvalidated assessment tools limited stronger conclusions. CONCLUSIONS AND IMPLICATIONS Well-designed studies are needed that rigorously evaluate long-term impact on cooking behavior, dietary intake, obesity and other health outcomes.

Interventions for weight gain prevention during the transition to young adulthood: a review of the literature.

PURPOSE To review studies examining weight gain prevention interventions among young adults. METHODS A snowball strategy was used to identify relevant studies, beginning with systematic PubMed, MEDLINE, PsychINFO, Education Resources Information Center (ERIC), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) searches. INCLUDED STUDIES (a) were published from 1985 to 2011; (b) were completed in the United States or Canada; (c) focused on weight gain prevention among young adults aged 18-35 years, assessing weight, body mass index, body composition, diet, or physical activity as an outcome; and (d) comprised pre- and postintervention assessments. RESULTS Thirty-seven interventions were identified. Ten interventions assessed weight, body mass index, or body composition; 27 addressed other relevant outcomes (e.g., diet, physical activity). Of the studies examining weight or body composition, six evaluated university courses or seminar-based interventions. Overall, many studies focused on individual-level intervention delivery and changes in weight-related knowledge and/or skills, although some incorporated relatively unique aspects (e.g., focusing on eating disorders and obesity simultaneously, using online technology, providing personalized feedback on weight change). Most showed promising results as small-scale pilot studies but lacked data from fully powered randomized trials. CONCLUSIONS There is an urgent need to develop effective young adult-focused weight gain prevention strategies. This review identified promising areas for future work, although much additional research is needed.

Longitudinal associations between key dietary behaviors and weight gain over time: Transitions through the adolescent years

Previous studies have yielded inconsistent results when documenting the association between key dietary factors and adolescent weight change over time. The purpose of this study was to examine the extent to which changes in adolescent sugar‐sweetened beverage (SSB), diet soda, breakfast, and fast‐food consumption were associated with changes in BMI and percent body fat (PBF). This study analyzed data from a sample of 693 Minnesota adolescents followed over 2 years. Random coefficient models were used to examine the relationship between dietary intake and BMI and PBF and to separate cross‐sectional and longitudinal associations. Adjusting for total physical activity, total energy intake, puberty, race, socioeconomic status, and age, cross‐sectional findings indicated that for both males and females, breakfast consumption was significantly and inversely associated with BMI and PBF, and diet soda intake was significantly and positively associated with BMI and PBF among females. In longitudinal analyses, however, there were fewer significant associations. Among males there was evidence of a significant longitudinal association between SSB consumption and PBF; after adjustment for energy intake, an increase of one serving of SSB per day was associated with an increase of 0.7 units of PBF among males. This study adds to previous research through its methodological strengths, including adjustment for physical activity and energy intake assessed using state‐of‐the‐art methods (i.e., accelerometers and 24‐h dietary recalls), as well as its evaluation of both BMI and PBF. Additional research is needed to better understand the complex constellation of factors that contribute to adolescent weight gain over time.

Predictors of Fruit and Vegetable Intake in Young Adulthood

Few young adults meet national recommendations to consume at least 2 c fruit and 2 to 3 c vegetables daily. Effective strategies and messaging are needed to address this disparity, but research examining influences on fruit and vegetable (F/V) intake during young adulthood has been limited and primarily cross-sectional. This study was conducted to identify 5-year and 10-year longitudinal predictors of F/V intake in young adulthood. The sample included 476 male and 654 female participants enrolled in a population-based cohort study (Projects EAT-I, II, and III [Eating and Activity in Teens and Young Adults]). Participants completed surveys and food frequency questionnaires in Minneapolis/St Paul, MN, high school classrooms in 1998-1999 (mean age=15.8 years, adolescence) and follow-up measures in 2003-2004 (mean age=20.4 years, emerging adulthood) and 2008-2009 (mean age=26.2 years, young adulthood). In young adulthood, average daily intake was 0.9 servings of fruit (excluding juice) and 1.8 servings of vegetables (excluding potatoes). Factors examined in adolescence and in emerging adulthood that were predictive of F/V intake in young adulthood included favorable taste preferences, fewer perceived time barriers to healthy eating, higher home availability of F/V, and limited home availability of unhealthy foods. Analyses also identified additional factors that were specifically relevant to fruit (eg, breakfast patterns) or vegetable intake (eg, home food preparation) and of particular relevance during emerging adulthood (eg, significant others healthy eating attitudes). Findings suggest individual and socioenvironmental factors, particularly food preferences and home food availability, during adolescence and emerging adulthood may influence F/V intake in young adulthood.

Understanding young adult physical activity, alcohol and tobacco use in community colleges and 4-year post-secondary institutions: A cross-sectional analysis of epidemiological surveillance data

BackgroundYoung adults experience many adverse health behavior changes as they transition from adolescence into adulthood. A better understanding of the relationships between health promoting and risky health behaviors may aid in the development of health promotion interventions for various types of young adult post-secondary students. Therefore, the purpose of this study was to examine associations between alcohol and tobacco use and physical activity among 2-year and 4-year college students.MethodsCross-sectional analyses were conducted using 2007 survey data, collected as part of an on-going post-secondary health surveillance system in Minnesota. Students were randomly selected to participant from 14 Minnesota colleges and universities (six 2-year community and/or technical colleges, eight 4-year post-secondary institutions). The 2007 surveillance data included 9,931 respondents.ResultsThe prevalence of demographic characteristics and health behaviors (e.g., physical activity, tobacco use) differed between young adults attending 2-year and 4-year post-secondary institutions; in general, those attending 2-year institutions are representative of more at-risk populations. Overall, higher levels of moderate, vigorous and strengthening physical activity were associated with higher levels of alcohol consumption and lower levels of smoking. In general, despite the disparities in the prevalence of these risk behaviors, the associations between the behaviors did not differ substantially between 2-year and 4-year post-secondary populations.ConclusionsThese findings illustrate links between leading risk behaviors. Interventions targeting multiple risk behaviors among young adults may warrant further consideration. Overall, future research is needed to support and inform young adult health promotion efforts that may be implemented in a wide array of post-secondary institutions.

Positive Attitudes toward Organic, Local, and Sustainable Foods Are Associated with Higher Dietary Quality among Young Adults

Scant evidence is available on the relationship between preferences for organic, local, sustainable, and nonprocessed foods (ie, alternative food production practices) and dietary quality. This cross-sectional study examined the characteristics and dietary behaviors (eg, consumption of fruits, vegetables, fast food) of young adults who reported placing low, moderate, or high importance on alternative food production practices. A diverse sample of 1,201 students at a 2-year community college and a 4-year public university in the Twin Cities, MN, completed the Student Health and Wellness Study survey in spring 2010. χ(2) tests examined differences in attitudes across demographic characteristics. Linear regression adjusted dietary intake across attitudes. About half (49%) of young adults placed moderate to high importance on alternative production practices, and few demographic differences across attitudes were found. Young adults who placed high importance on alternative production practices consumed 1.3 more servings of fruits and vegetables (P<0.001), more dietary fiber (P<0.001), fewer added sugars (P<0.001), fewer sugar-sweetened beverages (P=0.001), and less fat (P=0.025) than those who placed low importance on these practices. Young adults who placed high importance on alternative food production practices also consumed breakfast approximately 1 more day per week and fast food half as often as those who placed low importance on these practices (P<0.001). Study findings suggest that nutrition messaging around social and environmental implications of food production practices may be well received by this age group. Experimental studies are needed to investigate whether attitudes toward alternative production practices can be manipulated to improve dietary quality.

Does involvement in food preparation track from adolescence to young adulthood and is it associated with better dietary quality? Findings from a 10-year longitudinal study

OBJECTIVES To examine whether involvement in food preparation tracks over time, between adolescence (15-18 years), emerging adulthood (19-23 years) and the mid-to-late twenties (24-28 years), as well as 10-year longitudinal associations between home food preparation, dietary quality and meal patterning. DESIGN Population-based, longitudinal cohort study. SETTING Participants were originally sampled from Minnesota public secondary schools (USA). SUBJECTS Participants enrolled in Project EAT (Eating Among Teens and Young Adults)-I, EAT-II and EAT-III (n 1321). RESULTS Most participants in their mid-to-late twenties reported an enjoyment of cooking (73 % of males, 80 % of females); however, few prepared meals including vegetables most days of the week (24 % of males, 41 % of females). Participants in their mid-to-late twenties who enjoyed cooking were more likely to have engaged in food preparation as adolescents and emerging adults (P < 0·01); those who frequently prepared meals including vegetables were more likely to have engaged in food preparation as emerging adults (P < 0·001), but not as adolescents. Emerging adult food preparation predicted better dietary quality five years later in the mid-to-late twenties, including higher intakes of fruit, vegetables and dark green/orange vegetables, and less sugar-sweetened beverage and fast-food consumption. Associations between adolescent food preparation and later dietary quality yielded few significant results. CONCLUSIONS Food preparation behaviours appeared to track over time and engagement in food preparation during emerging adulthood, but not adolescence, was associated with healthier dietary intake during the mid-to-late twenties. Intervention studies are needed to understand whether promoting healthy food preparation results in improvements in eating patterns during the transition to adulthood.