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Background: Non-Hispanic blacks in the United States are less likely to not meet national dietary recommendations than non-Hispanic whites; however, most studies do not consider nativity of US blacks. Objectives: With the use of the Alternative Healthy Eating Index-2010 (AHEI-2010) and the Dietary Approach to Stop Hypertension (DASH) scores, this cross-sectional study compared diet quality between US-born (n = 3,911) and foreign-born (n = 408) non-Hispanic black adults aged 22-79 y, based on pooled nationally representative data (NHANES 2003-2012) as well as by length of US residency. Design: The association between nativity and diet quality was determined by using multivariable-adjusted linear regression for the continuous total diet quality scores and their components or multinomial (polytomous) logistic regression for categorical tertiles (low, medium, or high) of the total scores and their components. Results: Foreign-born blacks had significantly higher AHEI-2010 β: 9.3; 95% CI: 7.5, 11.0) and DASH (β: 3.1; 95% CI: 2.5, 3.8) scores compared with US-born blacks and more favorable intakes for many of the score components. Among foreign-born blacks, diet quality did not significantly differ by length of residency. Foreign-born blacks were more likely to be in the high than in the low tertile for vegetables [excluding starchy vegetables; relative risk ratio (RRR): 1.68; 95% CI: 1.24, 2.29], fruit [excluding and including fruit juice--RRR: 2.42 (95% CI: 1.69, 3.47) and RRR: 2.95 (95% CI: 1.90, 4.59), respectively], percentage of whole grains (RRR: 2.39; 95% CI: 1.64,3.49), and omega-3 (ω-3) fatty acids (RRR: 2.03; 95% CI: 1.38, 2.97). Conclusions: Foreign-born blacks have better diet quality than their US-born counterparts. In nutrition research and public health efforts, considering the place of birth among US blacks may improve the accuracy of characterizing dietary intakes and facilitate the development of targeted nutrition interventions to reduce diet-related diseases in the diverse black population in the United States. [ABSTRACT FROM AUTHOR]

This study used the US Department of Agriculture’s (USDA) Farm to School Census to examine whether school districts in states with formal farm-to-school (FTS)-related laws had higher participation rates and a greater frequency of serving local foods in school meals than districts in states without such laws. The presence of FTS-related laws was associated with an increased likelihood of having FTS programs and with serving local foods at higher frequencies in school meal programs. Further research is required to assess the impact of specific types of laws in order to determine the most effective policies to support FTS programs. [ABSTRACT FROM PUBLISHER]

Data from the 2007–2008 National Health and Nutrition Examination Survey (NHANES) suggested that nearly half of U.S. adults aged 20 to 69 reported taking at least one dietary supplement in the past month. Logistic regression showed that the following factors were independently associated with a greater likelihood of supplement use: being female, older, white, having higher level of education, non-SNAP participation, and living in a food-secure household. To compare nutrient intakes between supplement users and non-supplement users, daily intakes of eight nutrients were examined. When considering nutrients from food, supplement users tended to consume greater amounts of vitamin A, vitamin C, vitamin E, folic acid, calcium, and iron; meanwhile there was no association between supplement use and daily intakes of vitamin B12 and zinc from food sources only. Including nutrients from daily supplement use, supplement users consumed greater amounts of all eight nutrients. [ABSTRACT FROM PUBLISHER]

This paper compares a qualitative and a quantitative (Rasch) method of item assessment for developing the content of a food insecurity scale for Bangladesh. Data are derived from the Bangladesh Food Insecurity Measurement and Validation Study, in which researchers collected 2 rounds of ethnographic information and 3 rounds of conventional household survey data between 2001 and 2003. The qualitative method of scale development relied on content experts and respondents themselves to evaluate household food insecurity items generated through ethnographic research. The quantitative method applied the Rasch model to assess the fit of the same items using representative survey data. The Rasch model was then used to test for differential item functioning (DIF) across diverse demographic and geographic subgroups. The qualitative assessment flagged and discarded 10 items, leaving 13. The Rasch assessment of infit and outfit flagged 3 items, and the Rasch DIF test discarded another 10 items, leaving a total of 10 items in the Rasch-derived scale. The 2 scales contained 8 of the same items. The qualitatively and quantitatively derived scales were highly correlated (r = 0.96, P < 0.01), and the 2 methods located 90% of households in the same food insecurity tercile. This convergence lends added confidence to the use of either scale for identifying food-insecure households in different regions of Bangladesh. Multiple methods should continue to be applied in a systematic and transparent way to lend additional credence to the results when they converge and to pinpoint directions for further clarification where they do not. [ABSTRACT FROM AUTHOR]

In 2004, almost 12% of all U.S. households, and about one in three low-income households (36.8%) were food insecure While the Food Stamp Program (FSP) is intended to provide a safety net for low-income households to purchase food, recent data indicate it reaches only about 55% of those eligible. The purpose of this study was to examine one specific group of underserved, the working poor, in order to assess the reasons why income-eligible households do or do not participate in the FSP. Participants were selected based on their income-between 100 and 130% of the federal poverty level (FPL), and FSP participation (divided proportionately) from a larger pool of working families receiving state subsidized child care assistance in Rhode Island. Individuals from 418 low-income households were surveyed regarding household demographics, participation in food assistance programs (Food Stamps, Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), National School Lunch (NSL), and School Breakfast), food security and hunger, and child well-being. Results indicate that more than half (56%) of the low-income working families were food insecure over the past year and close to 20% of households had members who experienced hunger. Further, households participating in the FSP were more disadvantaged than those not participating. Households receiving FSP benefits had lower incomes, higher rates of food insecurity, and more reported difficulties with their children, despite greater use of other food assistance programs. Finally, participation in all of the nutritional assistance programs was low relative to estimated eligibility. The findings highlight the difficulties of working families, who despite employment, and in many cases, nutritional assistance, were still experiencing hunger and food insecurity in unacceptably high percentages. [ABSTRACT FROM AUTHOR]

This review examines the relationship among malabsorption, diarrhea, dietary intake, and body composition in an outpatient cohort of individuals with HIV infection. Twenty-three percent of the participants had malabsorption, which was not associated with the presence of current or chronic diarrhea. In this ‘outpatient’ HIV cohort with a mean body-mass Index (BMI) of 25 kg/m², the presence of malabsorption did not have adverse nutritional outcomes in terms of body weight, lean body mass, hemoglobin, or albumin. The diets of those with or without malabsorption did not meet the goals of the Dietary Guidelines for Americans. Median dietary intake was high in percentage of total fat and saturated fat and low in total fiber intake and some key micronutrients. [ABSTRACT FROM AUTHOR]

Objectives: Non-Hispanic Blacks in the United States have the highest reported prevalence of hypertension (44%) worldwide. However, this does not consider the heterogeneity of Blacks within the United States, particularly comparing US-born to long-standing or recent (foreign-born) immigrants. The objective of this study is to compare odds of hypertension between US-born and foreign-born Blacks in the United States., Methods: We assessed the prevalence of hypertension among US-born (n = 4511) vs. foreign-born (n = 522) non-Hispanic Black adults aged 22-79 years, based on pooled nationally representative data (2003-2014); as well by length of US residency among immigrants. Multivariable-adjusted logistic regression was used to investigate the association between nativity and hypertension odds., Results: Nearly half (42.8%) of US-born Blacks but only 27.4% of foreign-born Blacks had hypertension. After adjusting for major covariates, foreign-born Blacks were 39.0% less likely (odds ratio 0.61 95% confidence interval 0.49, 0.77) to have hypertension than their US-born counterparts. Among foreign-born Blacks, length of US residency was not significantly associated with odds of hypertension., Conclusion: Foreign-born vs. US-born non-Hispanic Blacks have substantially lower prevalence of hypertension. Considering nativity among US Blacks in clinical research and public health efforts may improve accuracy of characterizing health disparities and facilitate development of targeted interventions to reduce hypertension in this diverse population.

The opinions of both national aging and health experts and practicing registered dietitians (RDs) were surveyed on which key quality indicators from the Food And Nutrition Care Indicators checklist should be regulated in assisted-living facilities (ALFs) for older adults. The extent to which the practices on which the indicators were based should be regulated, and which were in fact included in the current regulations of the 50 states was also studied. One hundred fifty-three national aging and health experts were surveyed in 2005 and 882 practicing RDs who were members of two American Dietetic Association dietetic practice groups employed in ALFs were surveyed in 2006. Both the experts and the RDs believed that the need for regulations in ALF food and nutrition services was vital for about a third of the indicators, (eg, 18 items on the 57 item checklist), particularly those involving facilities and staffing. For seven out of the 18 indicators, there was substantial consensus between experts and RDs. Only three of the seven indicators were addressed by regulations in more than half of the states. Consensus exists among experts and RDs that a small but significant number of food and nutrition service indicators need to be regulated.

Objectives: There has been no consensus on best practices in food and nutrition services in assisted living facilities for older adults. We documented experts' views on optimal food and nutrition services emphases in assisted living facilities, and factors affecting their views., Methods: One hundred thirty-five national experts specializing in health, aging, nutrition and assisted living facilities completed a survey consisting four scenarios (ie, home-style, restaurant/hotel, and health/medical, and a combination of these three) in six food and nutrition services areas: dining room environment, meal services, meal quality, nutrition services, employees' qualifications, and therapeutic nutrition services., Results: Sixty-three percent of experts favored the combination scenario. Dietetics education and experts' beliefs that assisted living facilities should be health promotion and maintenance facilities were significant predictors of emphases, including wellness considerations. Experts' personal views exerted a powerful influence., Conclusions: Experts chose food and nutrition service quality indicators that emphasized a focus on both wellness and amenities as their ideal scenarios for optimal food and nutrition services in assisted living facilities.

This study assessed the utility of the 57-indicator Food and Nutrition Care Indicators Checklist for assessing food and nutrition services in assisted-living facilities for older adults among registered dietitians (RDs). They were members of two American Dietetic Association practice groups focusing on aging and long-term care and were also employed in assisted-living facilities. The 1,281 respondents rated the importance of each checklist item and provided their views on the role of assisted-living facilities and their level of agreement with statements regarding the importance of residents' autonomy for making food choices and their ability to make wise dietary choices. Registered dietitians practicing in assisted-living facilities considered all of the domains on food and nutrition quality indicators on the Food and Nutrition Care Indicators Checklist to be highly important (92% of dining room environment items, 83% of foodservice operations, 92% of general nutrition, and 89% of therapeutic nutrition items). They preferred a service style that included both health and amenities, as did national health and aging experts. Registered dietitians should work with other professionals to further validate the checklist, promote its use, and establish optimal service models for food and nutrition services in assisted-living facilities for older adults.

This study assessed the views of 153 national experts in nutrition, health, and aging services in assisted-living facilities; including gerontological nutrition (39%), foodservice (14%), aging and disability (22%), geriatric medicine (9%), and assisted living (16%); on the practices that serve as indicators of the quality of food and nutrition services provided in assisted-living facilities and ascertained the most favored style of service delivery: health, amenities, or both. An 88-item Food and Nutrition Care Indicators survey was developed from assisted-living facility regulations in 50 states and other quality indicators of nutrition services. Respondents rated each item on a scale from 1 (not important) to 5 (extremely important). Results show that at least 80% of experts rated the majority of indicators in each domain as highly important (57% of dining room, 67% of foodservice indicators, 65% of general nutrition, and 70% of therapeutic nutrition indicators). Most experts (89%) rated a combination of indicators that included both health (general and therapeutic) and amenities service styles as being highly important. The 57 items rated most important were consolidated into a checklist. A service model that incorporates all of these elements appears to be most appropriate.