Teresa M. Smith

Snack Food, Satiety, and Weight

In todays society, snacking contributes close to one-third of daily energy intake, with many snacks consisting of energy-dense and nutrient-poor foods. Choices made with regard to snacking are affected by a multitude of factors on individual, social, and environmental levels. Social norms, for example, that emphasize healthful eating are likely to increase the intake of nutrient-rich snacks. In addition, satiety, the feeling of fullness that persists after eating, is an important factor in suppressing overconsumption, which can lead to overweight and obesity. Thus, eating snacks between meals has the potential to promote satiety and suppress overconsumption at the subsequent meal. Numerous studies have explored the relation between snack foods and satiety. These studies concluded that whole foods high in protein, fiber, and whole grains (e.g., nuts, yogurt, prunes, and popcorn) enhance satiety when consumed as snacks. Other foods that are processed to include protein, fiber, or complex carbohydrates might also facilitate satiety when consumed as snacks. However, studies that examined the effects of snack foods on obesity did not always account for satiety and the dietary quality and portion size of the snacks consumed. Thus, the evidence concerning the effects of snack foods on obesity has been mixed, with a number of interventional and observational studies not finding a link between snack foods and increased weight status. Although further prospective studies are warranted to conclusively determine the effects of snack foods on obesity risk, the consumption of healthful snacks likely affects satiety and promotes appetite control, which could reduce obesity.

Availability, Price, and Quality of Fruits and Vegetables in 12 Rural Montana Counties, 2014

We assessed the consumer food environment in rural areas by using the Nutrition Environment Measures Survey for Stores (NEMS–S) to measure the availability, price, and quality of fruits and vegetables. We randomly selected 20 grocery stores (17 rural, 3 urban) in 12 Montana counties using the 2013 US Department of Agriculture’s rural–urban continuum codes. We found significant differences in NEMS–S scores for quality of fruits and vegetables; of 6 possible points, the mean quality score was 4.5; of rural stores, the least rural stores had the highest mean quality scores (6.0). Intervention strategies should aim to increase fruit and vegetable quality in rural areas.

Development and testing of a revised cooking matters for adults survey

OBJECTIVES The purpose of this study was to: (1) develop and psychometrically test a survey designed to assess Cooking Matters for Adults (CMA); and (2) assess changes in outcomes from pre- to post-pilot testing in English-speaking CMA classes to support the construct validity of the survey. METHODS Cognitive interviewing participants were drawn from a low-income convenience sample in Omaha, Nebraska (N = 21). The survey included items to assess dietary patterns and choices, sociodemographics, and psychosocial correlates. Analyses were conducted with SPSS and included descriptive statistics, exploratory factor analysis, Cronbachs alpha, and paired sample t-tests. RESULTS Cognitive interviewing resulted in changes to survey layout and wording. Factor analysis revealed 4 actors with Cronbach alphas supporting internal consistency. Between pretest and posttest, fruit intake increased (p < .05) and non-fried potatoes decreased (p < .05). Selection of healthy dietary options (low-fat dairy and milk, sodium, lean meats; ps < .05), healthy food preparation (p < .001), and cooking confidence (p < .001) increased and perceived barriers to cooking (p < .01) decreased. CONCLUSIONS The CMA Survey includes psychometrically sound items and positive self-reported changes. This survey can be a valuable resource for other similar programs.

Using Secondary 24-Hour Dietary Recall Data to Estimate Daily Dietary Factor Intake From the FLASHE Study Dietary Screener

INTRODUCTION The National Cancer Institutes 2014 Family Life, Activity, Sun, Health, and Eating Study utilized a 27-item Dietary Screener tailored to adolescent eating patterns that assessed the frequency of intake of several foods and beverages in parent-adolescent dyads. This study estimated intake of fruits and vegetables (FVs), dairy, added sugars, and whole grains for screener respondents using existing, nationally representative, 24-hour dietary recall data. METHODS Dietary Screener items were converted from frequency responses to daily intake. Intake (dependent variable) was estimated using regression coefficients and portion sizes of foods and beverages (independent variables) generated from the 2003-2006 National Health and Nutrition Examination Survey 2-day 24-hour recall data set. Means (SDs) were used to examine daily dietary factor intake among parent and adolescents. Analysis was conducted in 2015-2016. The analytic sample consisted of 1,732 parents (aged ≥18 years) and their adolescent aged 12-17 years (n=1,632). RESULTS Male parents consumed 3.6 cups of FVs, 1.8 cups of dairy, 22.6 teaspoons of added sugars, and 2.1 ounces of whole grains daily; female parents consumed 2.8 cups of FVs, 1.3 cups of dairy, 14.8 teaspoons of added sugars, and 1.4 ounces of whole grains daily. Male adolescents consumed 2.2 cups of FVs, 1.9 cups of dairy, 17.9 teaspoons of added sugars, and 1.0 ounces of whole grains daily; female adolescents consumed 2.2 cups FVs, 1.6 cups of dairy, 14.2 teaspoons of added sugars, and 0.8 ounces of whole grains daily. CONCLUSIONS Utilizing a dietary screener tailored to adolescent eating patterns in parent-adolescent dyads provided estimated dietary factor intake, underscoring existing 24-hour dietary recall data can be used to calibrate dietary habits.

Food assistance programs for children afford mixed dietary quality based on HEI-2010.

Backpack programs across the United States distribute easy-to-prepare foods in a backpack to potentially food-insecure students on Fridays to help reduce weekend hunger. This study used Healthy Eating Index 2010 (HEI-2010) to assess foods provided in Montana backpack programs. Healthy Eating Index 2010 measures compliance with the 2010 Dietary Guidelines and is a tool to assess the diet quality of foods provided in supplemental food assistance programs. We hypothesized that HEI-2010 scores would be of average dietary quality. One randomly selected menu was collected from each Montana backpack program (n = 5) from the 2011-2012 academic year. Each food provided was analyzed for diet quality using HEI-2010 to obtain component and total scores. Descriptive statistics and t tests were calculated to assess whether mean HEI-2010 component scores and total scores differed significantly (P < .05) from the maximum scores. The mean total score for HEI-2010 was significantly lower than the maximum score of 100 (58.65; SD, 15.59; P = .004). Analysis resulted in significantly lower mean scores for total vegetables (2.26; SD, 1.37; P = .011), greens and beans (0; SD, 0; P < .001), fatty acids (0; SD, 0; P < .001), and sodium (3.90; SD, 2.52; P = .006). Dietary quality of backpack programs may further improve with information sharing between programs about the availability of specific food group items. To better suit childrens nutritional needs and increase HEI-2010 scores, researchers, practitioners, and the food industry should identify food options for the backpack program that are easy to prepare, appealing, and affordable.

Auxiliary measures to assess factors related to food insecurity: Preliminary testing and baseline characteristics of newly designed hunger-coping scales.

The objective of this paper is to describe the development and preliminary testing of new scales to assess hunger-coping behaviors in a very low-income population. Very low-income adults (≥ 19 years), caregivers to at least one child (n = 306) completed a survey in a community setting (e.g., libraries). The survey included novel items assessing hunger-coping behaviors (e.g., trade-offs to purchase food, strategies to stretch and obtain food), food insecurity status, and physiological hunger. Internal consistency of hunger-coping scales, one-way ANOVAs, post-hoc analyses, Spearmans correlations among variables. Respondents were 75% female, 51% African American, 34% White, and 15% Hispanic, and 73% earned <

An Examination of Organizational and Statewide Needs to Increase Supplemental Nutrition Assistance Program (SNAP) Participation

20,000/year. Four scales emerged: hunger-coping trade-offs, financial coping strategies, rationing coping strategies, and physiological adult hunger symptoms. All scales demonstrated acceptable internal consistency (α/KR-20 = 0.70–0.90). Predictive, construct, and content validity were demonstrated by correlations between hunger-coping scales and food insecurity (FI), measured with the USDA 6-item HFSSM (rs = 0.42–0.68, ps < 0.001). Higher levels of hunger-coping trade-offs (F(2,297) = 42.54, p < 0.001), financial coping strategies (F(2,287) = 70.77, p < 0.001), and rationing coping strategies (F(2,284) = 69.19, p < 0.001), corresponded with increasing levels of FI. These preliminary results support use of newly developed hunger-coping scales in a very low-income population and can compliment traditional food security measures to inform hunger prevention policy and programming.

Assessment of nutrition and physical activity practices using self-report and observation in early care and education across multiple US states

This study examined Supplemental Nutrition Assistance Program (SNAP) outreach efforts among representatives of community organizations, as well as local and statewide needs for increasing SNAP participation. We conducted qualitative interviews with 34 SNAP outreach workers across 27 states; participants reported working at food banks, social services agencies, antihunger nonprofits, legal aid agencies, faith-based nonprofits, and health clinics. Four major needs emerged as themes for community-level organizations: increased personnel, increased funding, improved application process, and increased community awareness. For broader, statewide needs, 3 themes emerged: increased staffing of state caseworkers, decreased stigma and negative perceptions, and improved application processing capacity and infrastructure. The findings of this qualitative study suggest that community organizations and state SNAP-administering offices should work together more closely to share best practices, improve SNAP application-related technology, and develop tailored outreach plans.

Factors Associated With Supplemental Nutrition Assistance Program Participation Among the Working Poor: Findings From 2012 American Community Survey

OBJECTIVE The National Early Care and Education Learning Collaboratives (ECELC) Project aims to promote healthy physical activity and nutrition environments, policies and practices in early care and education (ECE) programmes across multiple states. The present pilot study sought to assess changes to the physical activity and nutrition practices in a sub-sample of ECE programmes participating in the ECELC using the Environment and Policy Assessment and Observation (EPAO). Additionally, it sought to compare results with the Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC). DESIGN Quasi-experimental pre-post pilot study where paired-sample t tests examined changes to physical activity and nutrition practices from pre-assessment to post-assessment (P<0·05). Pearson correlation coefficients examined change scores from EPAO compared with NAP SACC with statistical significance set at a two-sided α level of P<0·10 to account for sample size. SETTING The study occurred among ECE programmes. SUBJECTS Pre-school classrooms in nineteen ECE programmes across four US states were observed. RESULTS EPAO data demonstrated an increase in total score from pre-assessment to post-assessment (150 (sd 30) to 176 (sd 35)). NAP SACC change scores demonstrated little relationship with EPAO domain change scores, with exceptions in Nutrition Policy and Physical Activity Policy (r=-0·4 and -0·6, respectively). CONCLUSIONS The overall improvements reported through the EPAO suggest participation in the ECELC resulted in changes in critical nutrition- and physical activity-related practices. However, considerable differences in data reported using the NAP SACC compared with the EPAO suggest subjective data should be interpreted with caution and objective measurement should be used when feasible.

What Factors Influence SNAP Participation? Literature Reflecting Enrollment in Food Assistance Programs From a Social and Behavioral Science Perspective

ABSTRACT The goal of the U.S. Department of Agriculture’s Supplemental Nutrition Assistance Program (SNAP) is to assist food insecure households by providing federally allocated funds to increase purchasing power and ultimately achieve a more nutritious diet; however, working poor households tend to be underserved by SNAP. This study identified factors associated with SNAP participation in a nationally representative sample of the working poor (adults with household incomes ≤ 130% of the poverty level who worked 27 or more weeks during the year). Data were from the 2012 American Community Survey. Multivariable logistic regression was used to examine independent factors associated with SNAP participation. Adjusting for all other factors and state of residence, those more likely to participate in SNAP included those who were women; younger; non-Hispanic black or Hispanic; separated/divorced; less educated; U.S. citizens; English-speaking; disabled; with no health insurance; on government health plan; moved within the past year; lived in household with no access to a vehicle; paid more for electricity; multigenerational; and those who had at least one child member or one or more elderly members (P < .05, for each). SNAP outreach and policy may be more effective by targeting the working poor, specifically segments of the population who are less likely to participate in SNAP.