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The US Environmental Protection Agency Food Recovery Hierarchy suggests methods for diverting food waste from landfill. Knowledge of how hospital foodservices implement food waste management strategies could help modernize food waste practices. The aim of this study was to explore hospital staff members' experiences of implementing a food waste management strategy to divert food waste from landfill in their hospital foodservice, including the journey, challenges, and facilitators of this practice change. A qualitative study was conducted in 2022-2023 using semi-structured interviews. Eighteen participants were staff members with knowledge of the food waste management strategy from 14 exemplar hospitals in United States, Spain, Scotland, and Australia using strategies to divert food waste from landfill within the last 10 years. Mapping and thematic analysis were undertaken to code and identify themes from the interviews that described staff members' experiences of the journey to implement the strategy. Six hospitals donated food, 1 transferred food waste for animal feed, 4 used an industrial solution, and 3 sent food waste for composting. A common journey pathway for successful implementation was identified from participants' experiences. It features the following 6 phases: idea, preparation, roll out, maintenance, established practice, and evolution. Facilitators included legislation, enthusiastic staff members, executive support, and "luck." Challenges were smells, occasions when food waste was not collected, equipment breakage, and funding depletion. This study identified a common journey pathway for implementing a food waste management strategy in hospital foodservices that can be used to anticipate and prepare for the steps in the implementation process. [ABSTRACT FROM AUTHOR]

Background. Many diseases are linked to lifestyle in the United States, yet physicians receive little training in nutrition. Medical students' prior knowledge of nutrition and cooking is unknown. Objective. To determine incoming medical students' prior nutrition knowledge, culinary skills, and nutrition habits. Methods. A dual-methods study of first-year medical students. Cross-sectional survey assessing prior knowledge, self-efficacy, and previous education of cooking and nutrition. Interviews of second-year medical students explored cooking and nutrition in greater depth. Results. A total of 142 first-year medical students participated; 16% had taken a nutrition course, with majority (66%) learning outside classroom settings. Students had a mean score of 87% on the Nutritional Knowledge Questionnaire versus comparison group (64.9%). Mean cooking and food skills score were lower than comparison scores. Overall, students did not meet guidelines for fiber, fruit, vegetables, and whole grains. Interviews with second-year students revealed most learned to cook from their families; all believed it important for physicians to have this knowledge. Conclusions. Medical students were knowledgeable about nutrition, but typically self-taught. They were not as confident or skilled in cooking, and mostly learned from their family. They expressed interest in learning more about nutrition and cooking. [ABSTRACT FROM AUTHOR]

Examine how experiencing the coronavirus disease 2019 (COVID-19) pandemic influenced adolescent independent eating occasions (iEOs) and iEO-related parenting practices from the perspective of parents and adolescents Cross-sectional remote interviews were conducted for this basic qualitative research study. Participants were a purposive sample of multiracial/ethnic adolescents aged 11–14 years and their parents from households with low income (n = 12 dyads) representing 9 US states. The main outcome measures were iEOs and iEO-related parenting practices. Data were analyzed using directed content analysis. About half of the parents indicated that their adolescents had more iEOs during the COVID-19 pandemic and that there were changes in the types of foods consumed during iEOs. In contrast, most adolescents indicated their iEOs had not changed remarkably in frequency or foods consumed since the onset of the pandemic. Most parents reported no change in how they taught their adolescents about healthy food, the rules for foods/beverages permitted during iEOs, or how they monitored what their adolescents ate during iEOs; adolescent reports were in general agreement. Most parents indicated that family members were home together more often during the pandemic, which increased cooking frequency. The effect of the COVID-19 pandemic on adolescents' iEOs varied, and the parenting practices used to influence iEOs remained stable during the pandemic. Families experienced having more time together and cooking at home more often. [ABSTRACT FROM AUTHOR]

BACKGROUND: School meals have demonstrated positive effects on dietary habits of children and adolescents, yet opportunities to increase participation exist. Little is known about how participation differs by race/ethnicity or by acculturation levels, thus this study aims to identify acculturation and race/ethnicity on school meal participation of middle school students. METHODS: A national convenience sample of adolescents (n = 617) was recruited to participate in a survey about acculturation and obesogenic behaviors through a Qualtrics panel. Data were analyzed in SAS version 9.4 where 2 logistic regression models were built to examine associations between school meal participation and other salient variables. RESULTS: More than a quarter (26.2%) of participants indicated they eat school lunch daily and 17.4% eat school breakfast daily. In a multivariable model, race/ethnicity, preference for school meals, taste, convenience, cost, and parent influence were all significantly related to daily school lunch participation. Race/ethnicity, time lived outside of the United States, healthiness of school meals, preference of school meals, taste, and cost were significantly related to daily school breakfast participation. CONCLUSIONS: This study establishes differences in participation rates by race/ethnicities and other factors. Child nutrition professionals should consider students from minoritized populations to understand their lack of participation, particularly because these students likely have poorer diets compared to whites. Additional factors should be considered for increasing participation, including cost, taste, and perceived healthiness. [ABSTRACT FROM AUTHOR]

American Indian (AI) communities experience persistent diabetes-related disparities, yet few nutrition interventions are designed for AI with type 2 diabetes or address socio-contextual barriers to healthy eating. We describe our process of adapting the evidence-based Cooking Matters® program for use by AI adults with type 2 diabetes in a rural and resource-limited setting in the North-Central United States. We conducted three focus groups with AI adults with diabetes to (i) identify Cooking Matters® adaptations and (ii) gather feedback on appropriateness of the adapted intervention using Barrera and Castro's cultural adaptation framework. Transcripts were coded using an inductive, constant comparison approach. Queries of codes were reviewed to identify themes. Contextual considerations included limited access to grocery stores and transportation barriers, reliance on government food assistance and the intergenerational burden of diabetes. Adaptations to content and delivery included incorporating traditional and locally available foods; appealing to children or others in multigenerational households and prioritizing visual over written content. Our use of Barrera and Castro's framework adds rigor and structure to the cultural adaptation process and increases the likelihood of future intervention success. Other researchers may benefit from using this framework to guide the adaptation of evidence-based interventions in AI communities. [ABSTRACT FROM AUTHOR]

As the market 'foodie' culture grows in the US, so does the demand for and popularity of ethnic foods. This study identifies the unique food attributes of a less-popular ethnic cuisine (i.e., Caribbean cuisine) and examines their impact on willingness to retry those foods. Specifically, we compared two consumer groups (i.e., regular vs frequent) of Caribbean cuisine in the United States. Overall, food quality had a positive impact on willingness to retry Caribbean food. However, cooking-style and cultural representativeness seemed to hinder the growth and popularity of Caribbean cuisine in the US. The results indicate that in order to attract and encourage more consumers to eat Caribbean foods, Caribbean cuisine should be positioned as appetizing as well as localized to the existing culture. This study concludes with a discussion and implications of our findings from both a practical and theoretical standpoint. [ABSTRACT FROM AUTHOR]

Introduction: The benefits of completing household chores appear to transfer beyond managing day‐to‐day living. It is possible that chore engagement may improve executive functions, as engagement in chores require individuals to plan, self‐regulate, switch between tasks, and remember instructions. To date, little research has been conducted on household chores and executive functions in children, for whom these skills are still developing. Methods: Parents and guardians (N = 207) of children aged 5–13 years (M = 9.38, SD = 2.15) were asked to complete parent‐report questionnaires on their child's engagement in household chores and their child's executive functioning. Results: Results of the regression model indicated that engagement in self‐care chores (e.g., making self a meal) and family‐care chores (e.g., making someone else a meal) significantly predicted working memory and inhibition, after controlling for the influence of age, gender, and presence or absence of a disability. For families with a pet, there was no significant relationship between engagement in pet‐care chores and executive function skills. Conclusion: We strongly recommend that further research explore the relationship between chores and executive functions. It is possible that parents may be able to facilitate their child's executive function development through encouraging participation in chores, whereas chore‐based interventions (e.g., cooking programmes) may also be used to target deficits in ability. [ABSTRACT FROM AUTHOR]

Health providers often focus on secondary conditions and spend less time prioritising overweight/obesity care. Informal caregivers are well positioned to facilitate health‐promoting behaviours of healthy eating and physical activity among community‐dwelling care recipients with spinal cord injury (SCI) for prevention and management of overweight/obesity. Literature has typically focused on caregiver adjustment post‐injury and burden related to their roles in secondary condition care. The novel objective of this study was to describe informal caregivers' perspectives of their roles in facilitating health‐promoting weight management behaviours, healthy eating and physical activity, for care recipients with SCI. This was a qualitative study that used semi‐structured interviews with informal caregivers for data collection in 2019. Braun & Clarke's established thematic phases were used for analysis. Participants included informal caregivers of individuals with SCI living in the community (n = 24). Caregivers identified eight themes to describe their role in facilitating weight management for care recipients. Themes included: (1) meal planning/shopping, (2) meal preparation/cooking, (3) using portion control, (4) serving/feeding, (5) helping the care recipient with physical activity and/or leisure activities, (6) mutually participating in weight management activities, (7) providing motivation and encouragement and (8) being an information liaison. In summary, informal caregivers have an intimate understanding of care recipients' needs and have insights on obstacles and enablers to health‐promoting behaviours, making their involvement in facilitating weight management in individuals with SCI vital. Caregivers self‐identified several significant roles for promoting weight management. This is especially valuable for conditions such as overweight/obesity for which prevention and treatment involve health‐promoting behaviours that need consistent attention in the community setting. It is important to ensure that informal caregivers and care recipients have the information required in order to facilitate healthy eating and physical activity in persons with SCI and have opportunities for mutual dyadic participation when both partners are interested. [ABSTRACT FROM AUTHOR]

This essay recounts the author's experience of growing up in a traditional Pakistani home, centered around a patriarchal culture in which men are the protectors and providers of the home and women are the caretakers. The reader is taken on a journey in which the writer moves to the United States, undergoes a drastic individuation process, and finds herself in a relationship with someone who embodies the shadow elements of the Dark Mother archetype. This relationship is crippling in many respects, and yet the writer triumphs by learning how to cook for herself—the alchemy of this act ultimately helps heal and nurture her soul as she finds her way back to Self. [ABSTRACT FROM AUTHOR]

Over 80% of chronic disease is caused by lifestyle practices, including an unhealthy diet. Despite this, most medical students in the United States graduate having received minimal nutrition education, guidance towards improving their nutrition, or skills needed to coach patients to adopt a healthier diet. This study aimed to educate fourth-year medical students in evidence-based knowledge regarding a delicious, whole-food plant-based diet while introducing practical culinary skills and patient coaching skills. We adapted an open-source culinary medicine curriculum designed for in-person teaching of pre-clinical medical students to provide a novel 1-month online elective to fourth-year medical students. We used a 26-item pre/post questionnaire to assess change in evidence-based knowledge regarding nutrition, culinary skills, patient coaching skills, and attitudes toward a whole-food plant-based diet. In addition, we reviewed narrative comments by the student participants, course directors, and medical-school administrators. Scores in all 4 domains were tested, and for all individual questions, they showed statistically significant improvement following the course. Most narrative responses were positive, and areas for improvement were also identified. We successfully adapted an open-source whole-food plant-based culinary medicine curriculum for advanced medical students into a 1-month elective taught on a virtual platform. This course filled a need for training in nutrition and counseling for these students as they start their professional careers. [ABSTRACT FROM AUTHOR]

Nutrient composition data that accurately represent available beef products are critical to understanding beef's role in healthy dietary patterns. The quality of beef products has changed over the past several decades, and updated nutrient data are warranted as USDA Prime beef cuts become more available. In an effort to provide a complete nutrient profile for frequently purchased USDA Prime beef cuts, five USDA Prime cuts; strip loin steak, tenderloin steak, ribeye steak, top sirloin steak, and rib roast were collected from retail stores in six geographical locations over three collections for macro- and micronutrient analysis in both the raw and cooked state. The separable lean portion of all analyzed USDA Prime cuts qualified as a good or excellent source, providing 10-19% or at least 20% of the daily value, respectively, for protein, niacin, vitamin B12, selenium, phosphorus, and zinc per FDA labeling claim standards. There was not a significant difference in cholesterol content between any of the cuts, raw or cooked ( p ≥ 0.44 and 0.34, respectively). The percent lipid in raw, separable lean portions of the rib roast and strip loin steak was significantly greater than the lipid portion in tenderloin and top sirloin steaks ( p ≤ 0.01). Per USDA standards, the separable lean portions of tenderloin steak and top sirloin steak qualify as lean beef, containing less than 10 g total fat, less than 4.5 g saturated fat, and less than or equal to 95 mg cholesterol. The current study provides the most up-to-date nutrient analysis for USDA Prime beef cuts, helping consumers and health professionals better identify the role of high-quality beef cuts in healthy dietary patterns.

Millennials have been shown to have distinctly different behaviors; however, factors affecting their liking of beef, pork and chicken has not been fully elucidated. As millennials are current and future animal protein consumers, the question of if they have different drivers of liking for beef, pork, and chicken has not been answered. Top loin steaks cooked to 58.3 or 80 °C; and pork loin chops and chicken breasts cooked to 62.7 or 80 °C were cooked on a flat grill. Beef bottom round roasts cooked to 58.3 or 80°; and pork inside ham roasts and chicken thighs were cooked to 62.7 or 80 °C in a Crock-pot®. A descriptive flavor and texture attribute panel and a consumer central location test in four cities were used to evaluated flavor and texture attributes. Consumers were either millennials or non-millennials, and light or heavy beef-eaters. Meat descriptive flavor and texture attributes differed by cooking method, cut, and internal temperature (P < 0.05). Consumers preferred grilled meat more than meat cooked in the Crock-pot® (P > 0.05). Consumers rated grill flavor, juiciness, and tenderness (P ≥ 0.05) higher in grilled meat. Light beef-eaters, those who ate beef 2 to 4 times per month, rated overall, flavor, and species flavor lower (P < 0.05) than heavy beef-eaters, but consumers liked beef regardless of generational segment or their consumption of beef; however, millennials rated overall, overall flavor, and tenderness liking slightly lower than non-millennials. These results indicate that millennials have similar drivers of liking as non-millennials across beef, pork, and chicken protein sources., Competing Interests: Declaration of competing interest We declare no conflict of interest associated with this publication and no financial support for this work that could have influenced the outcome. As Corresponding Author, I confirm that the manuscript has been read and approved for submission by all the named authors., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

To examine changes in cooking and dietary behaviors and health outcomes following participation in A Taste of African Heritage , a culinary heritage cooking course. One group, pre-post program design, surveys, and physical assessments. Community centers, churches, health care settings, homes, and housing complexes. Participants (n = 586, 84% women) were recruited by partner organizations from 2013–2018 across 21 states and the District of Columbia. A 6-week cooking curriculum that teaches history, nutrition, and cooking techniques to reconnect participants with the vibrant, healthy traditions of the African Diaspora. Weekly frequency of cooking, food group intake, and exercise assessed by surveys, measured weight, waist circumference, and blood pressure. Linear and logistic mixed-effects models with random intercepts for participant and teacher, sex and site type as covariates comparing pre-post physical measurements and binary behavioral outcomes, P < 0.0033 for statistical significance after Bonferroni correction. Intake frequencies of fruit, vegetable, and greens and exercise frequency were improved from preprogram to postprogram (all P < 0.0021). Weight, waist circumference, and systolic blood pressure were also improved from preprogram to postprogram (all P <0.0001). Participation in A Taste of African Heritage was associated with positive behavior changes and health outcomes. Integrating cultural heritage and behaviors are positive components to connect participants to healthy old ways or traditions. [ABSTRACT FROM AUTHOR]

Macroeconomic changes are associated with population health outcomes, such as mortality, accidents, and alcohol use. Diet quality is a risk or protective factor that could be influenced by economic conditions. This study examined the trajectory of diet quality measured by the Healthy Eating Index 2015 before, during, and after the 2008-2009 Great Recession. Repeated cross-sectional survey data from the National Health and Nutrition Examination Survey were analyzed. The analytic sample included 48,679 adults who completed at least one dietary recall from National Health and Nutrition Examination Survey 1999-2018. Diet quality was assessed with a 24-hour dietary recall to calculate the Healthy Eating Index 2015 total scores, a measure of the conformance with the 2015-2020 Dietary Guidelines for Americans. Least squares regression was used to adjust for demographic changes across waves. Diet quality improved noticeably during the Great Recession and deteriorated as economic conditions improved. Deteriorating economic circumstances may constrain choices, but that does not necessarily imply a worsening of dietary quality. During the Great Recession, American diets became more consistent with Dietary Guidelines for Americans recommendations, possibly because of a shift toward food prepared at home instead of prepared food bought away from home. [ABSTRACT FROM AUTHOR]

Introduction: Our Whole Lives-Hypertension (OWL-H) is an eHealth toolkit for hypertension and cardiac risks factors. It is a hybrid online self-management platform that teaches blood pressure (BP) self-monitoring and evidence-based lifestyle modifications combined with in-person teaching kitchen medical group visit. Qualitative feedback from participants regarding the facilitators and barriers of using OWL-H has been discussed in this article. Methods: The OWL-H platform was pilot tested in a pre–post trial with two cohorts of participants with hypertension (N = 24). The online intervention utilized OWL-H for teaching mindfulness meditation, the Dietary Approaches to Stop Hypertension nutrition plan, and evidence-based strategies for lifestyle modifications. Three in-person teaching kitchen medical group visits were held to demonstrate cooking skills to reinforce the online platform. Semi-structured focus group discussions (FGDs) were held after the intervention. Results: Fourteen of the 24 participants in the trial participated in the FGDs, and 1 participant provided feedback in a solo interview. Major themes that emerged included: (1) participants' request to tailor OWL-H's recipes and meal planning to suit their own dietary needs or preferences, to personalize the Home Practices (e.g., meditation) according to individual preferences (e.g., addition of nature sounds or guided visual imagery); (2) the strengths and weaknesses of OWL-H as a BP self-monitoring tool; (3) the need for community support in managing BP; and (4) participants noted lack of time, work and commute, Internet connectivity, stress, and sickness as obstacles in using OWL-H. Participants described feeling outpaced by the growth of technology and raised concerns of poor Internet connectivity hampering their use of OWL-H. Conclusion: OWL-H and the accompanying teaching kitchen medical group visit are potential tools to help reduce hypertension and cardiac risk factors. The intervention was found to have acceptability among people with lower income. Clinical Trials Registration#: NCT03974334. [ABSTRACT FROM AUTHOR]

Gas and propane stoves emit nitrogen dioxide (NO 2 ) pollution indoors, but the exposures of different U.S. demographic groups are unknown. We estimate NO 2 exposure and health consequences using emissions and concentration measurements from >100 homes, a room-specific indoor air quality model, epidemiological risk parameters, and statistical sampling of housing characteristics and occupant behavior. Gas and propane stoves increase long-term NO 2 exposure 4.0 parts per billion volume on average across the United States, 75% of the World Health Organization's exposure guideline. This increased exposure likely causes ~50,000 cases of current pediatric asthma from long-term NO 2 exposure alone. Short-term NO 2 exposure from typical gas stove use frequently exceeds both World Health Organization and U.S. Environmental Protection Agency benchmarks. People living in residences <800 ft 2 in size incur four times more long-term NO 2 exposure than people in residences >3000 ft 2 in size; American Indian/Alaska Native and Black and Hispanic/Latino households incur 60 and 20% more NO 2 exposure, respectively, than the national average.

Background: Household air pollution might lead to fetal growth restriction during pregnancy. We aimed to investigate whether a liquefied petroleum gas (LPG) intervention to reduce personal exposures to household air pollution during pregnancy would alter fetal growth., Methods: The Household Air Pollution Intervention Network (HAPIN) trial was an open-label randomised controlled trial conducted in ten resource-limited settings across Guatemala, India, Peru, and Rwanda. Pregnant women aged 18-34 years (9-19 weeks of gestation) were randomly assigned in a 1:1 ratio to receive an LPG stove, continuous fuel delivery, and behavioural messaging or to continue usual cooking with biomass for 18 months. We conducted ultrasound assessments at baseline, 24-28 weeks of gestation (the first pregnancy visit), and 32-36 weeks of gestation (the second pregnancy visit), to measure fetal size; we monitored 24 h personal exposures to household air pollutants during these visits; and we weighed children at birth. We conducted intention-to-treat analyses to estimate differences in fetal size between the intervention and control group, and exposure-response analyses to identify associations between household air pollutants and fetal size. This trial is registered with ClinicalTrials.gov (NCT02944682)., Findings: Between May 7, 2018, and Feb 29, 2020, we randomly assigned 3200 pregnant women (1593 to the intervention group and 1607 to the control group). The mean gestational age was 14·5 (SD 3·0) weeks and mean maternal age was 25·6 (4·5) years. We obtained ultrasound assessments in 3147 (98·3%) women at baseline, 3052 (95·4%) women at the first pregnancy visit, and 2962 (92·6%) at the second pregnancy visit, through to Aug 25, 2020. Intervention adherence was high (the median proportion of days with biomass stove use was 0·0%, IQR 0·0-1·6) and pregnant women in the intervention group had lower mean exposures to particulate matter with a diameter less than 2·5 μm (PM 2·5 ; 35·0 [SD 37·2] μg/m 3 vs 103·3 [97·9] μg/m 3 ) than did women in the control group. We did not find differences in averaged post-randomisation Z scores for head circumference (0·30 vs 0·39; p=0·04), abdominal circumference (0·38 vs 0·39; p=0·99), femur length (0·44 vs 0·45; p=0·73), and estimated fetal weight or birthweight (-0·13 vs -0·12; p=0·70) between the intervention and control groups. Personal exposures to household air pollutants were not associated with fetal size., Interpretation: Although an LPG cooking intervention successfully reduced personal exposure to air pollution during pregnancy, it did not affect fetal size. Our findings do not support the use of unvented liquefied petroleum gas stoves as a strategy to increase fetal growth in settings were biomass fuels are used predominantly for cooking., Funding: US National Institutes of Health and Bill & Melinda Gates Foundation., Translations: For the Kinyarwanda, Spanish and Tamil translations of the abstract see Supplementary Materials section., Competing Interests: Declaration of interests LW reports a grant from the US National Institute of Environmental Health Sciences. All other authors declare no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Background Seafood has a nutritional profile that can be beneficial to human health, which gives it a role to play in healthy diets. In addition, because its production and harvesting can have fewer environmental impacts than some forms of animal protein, it can contribute to sustainable diets. However, the positive health and environmental outcomes are not guaranteed—they depend on how seafood is prepared and served and whether it is sourced from sustainable fisheries and aquaculture industries. Objectives We examined the availability and nutritional attributes of seafood meals at chain restaurants in the United States. We assessed nutritional attributes by store type and geography. We also assessed menu labeling for species, production methods, and origin. Methods The study population was 159 chain restaurants with 100,948 branch locations in the United States. Data were harvested from online restaurant menus, and the nutritional profile of seafood meals was calculated. Results The average seafood menu item provides up to 49–61% of the total daily limit of saturated fat, 65% of the total daily limit of sodium, and 58–71% of total daily protein requirement for adult men and women. Restaurant chains located in the Deep South and Ohio River Valley, and casual dining chains nationally, carry seafood meals with more total calories and saturated fat per 100 g than other regions or chain types. Most menu items did not list origin or production methods, which is information that would help consumers make informed decisions. Conclusions The added ingredients and cooking methods used at chain restaurants can attenuate the health benefits of seafood. We recommend reformulating menus to reduce portion sizes, total calories, added fat, and sodium content per meal and to improve consumer-facing information about origin and production methods. [ABSTRACT FROM AUTHOR]

Background: Poor-quality diet is associated with one in five deaths globally. In the United States, it is the leading cause of death, representing a bigger risk factor than even smoking. For many, education on a healthy diet comes from their physician. However, as few as 25% of medical schools currently offer a dedicated nutrition course. We hypothesized that an active learning, culinary nutrition experience for medical students would improve the quality of their diets and better equip them to counsel future patients on food and nutrition. Methods: This was a prospective, interventional, uncontrolled, non-randomized, pilot study. Ten first-year medical students at the Wayne State University School of Medicine completed a 4-part, 8-h course in culinary-nutritional instruction and hands-on cooking. Online assessment surveys were completed immediately prior to, immediately following, and 2 months after the intervention. There was a 100% retention rate and 98.8% item-completion rate on the questionnaires. The primary outcome was changes in attitudes regarding counselling patients on a healthy diet. Secondary outcomes included changes in dietary habits and acquisition of culinary knowledge. Average within-person change between timepoints was determined using ordinary least squares fixed-effect models. Statistical significance was defined as P ≤.05. Results: Participants felt better prepared to counsel patients on a healthy diet immediately post-intervention (coefficient = 2.8; 95% confidence interval: 1.6 to 4.0 points; P <.001) and 2 months later (2.2 [1.0, 3.4]; P =.002). Scores on the objective test of culinary knowledge increased immediately after (3.6 [2.4, 4.9]; P <.001) and 2 months after (1.6 [0.4, 2.9]; P =.01) the intervention. Two months post-intervention, participants reported that a higher percentage of their meals were homemade compared to pre-intervention (13.7 [2.1, 25.3]; P =.02). Conclusions: An experiential culinary nutrition course may improve medical students' readiness to provide dietary counselling. Further research will be necessary to determine what effects such interventions may have on the quality of participants' own diets. [ABSTRACT FROM AUTHOR]

The prevalence of psychosocial distress is increasing in the United States. At the same time, the American default lifestyle has steadily displaced household food production with industrial food production, despite increased cultural interest in cooking. An important focus of cooking research to date has been on cooking's association with nutrition and dietary quality. Less focus has been placed on how cooking might foster the qualities that allow for mitigation of psychosocial distress and promote well-being. Rooted in its evolutionary role in the human experience, cooking requires skills and knowledge that have the capacity to encourage aspects of well-being as described by Seligman as flourishing. Evidence for a beneficial role of cooking in psychosocial health exists, but the exploration is limited, potentially due to lack of a theoretical context to explain these benefits. From this perspective, we review the current literature showing the application of Seligman's prominent well-being model, Positive emotion, Engagement, Relationships, Meaning, and Accomplishment (PERMA), to cooking, defined as the activity related to the preparation of food or a meal. We propose that the PERMA model as applied to cooking may function as a theoretical framework to explore psychosocial outcomes associated with cooking. Broader application of this approach may also help to further the application of positive psychology in the developing literature around psychosocial health and nutrition-related chronic diseases. [ABSTRACT FROM AUTHOR]

This mixed-methods community-based participatory pilot study examined the feasibility and preliminary efficacy of group obesity management visits offered through school-based health centers. The study was implemented through an academic–community partnership in three school health centers serving primarily Latinx and African American youth. Participants (n = 71) completed pre- and post-surveys about intention to change diet and exercise habits, knowledge and self-efficacy related to healthy eating, and social support. Focus groups were conducted after the intervention and 18 months later. Group visits were feasible and highly valued by study participants. Quantitative results showed a significant decrease in soda consumption, increased support from classmates, and an increased number of exercise days. In focus groups, youth endorsed cooking, tasting, and shopping activities, noted the importance of family involvement in behavior change, and stated that stress reduction mindfulness exercises helped to change eating habits. Implications for school-based health care and school nursing are discussed. [ABSTRACT FROM AUTHOR]

Background and Objective. Scald burns are a major cause of pediatric burn injuries. Instant soups have been identified as one source of these injuries. This study aims to quantify and characterize these injuries in pediatric patients. Methods. Ten-year query of National Electronic Injury Surveillance System (NEISS) database identified instant soup- and noodle-related scald burns in children aged 4 to 12 years. Data included patient demographics, injured body part, case narratives, and emergency department disposition. Results. A total of 4518 cases were identified, yielding an estimate of 9521 cases/year in the United States. Younger children were affected more than the older. Trunk was the most commonly burned body area. Approximately 10% of injuries required admission or transfer for further care. Conclusion. Instant soup and noodle products are a common cause of pediatric scald burns, potentially injuring 25 children per day in the United States and leading to high rates of health care utilization. [ABSTRACT FROM AUTHOR]

Indoor sources of air pollution worsen indoor and outdoor air quality. Thus, identifying and reducing indoor pollutant sources would decrease both indoor and outdoor air pollution, benefit public health, and help address the climate crisis. As outdoor sources come under regulatory control, unregulated indoor sources become a rising percentage of the problem. This American Thoracic Society workshop was convened in 2022 to evaluate this increasing proportion of indoor contributions to outdoor air quality. The workshop was conducted by physicians and scientists, including atmospheric and aerosol scientists, environmental engineers, toxicologists, epidemiologists, regulatory policy experts, and pediatric and adult pulmonologists. Presentations and discussion sessions were centered on 1 ) the generation and migration of pollutants from indoors to outdoors, 2 ) the sources and circumstances representing the greatest threat, and 3 ) effective remedies to reduce the health burden of indoor sources of air pollution. The scope of the workshop was residential and commercial sources of indoor air pollution in the United States. Topics included wood burning, natural gas, cooking, evaporative volatile organic compounds, source apportionment, and regulatory policy. The workshop concluded that indoor sources of air pollution are significant contributors to outdoor air quality and that source control and filtration are the most effective measures to reduce indoor contributions to outdoor air. Interventions should prioritize environmental justice: Households of lower socioeconomic status have higher concentrations of indoor air pollutants from both indoor and outdoor sources. We identify research priorities, potential health benefits, and mitigation actions to consider (e.g., switching from natural gas to electric stoves and transitioning to scent-free consumer products). The workshop committee emphasizes the benefits of combustion-free homes and businesses and recommends economic, legislative, and education strategies aimed at achieving this goal.

Introduction: Dietary quality is poor and intake of ultraprocessed foods (UPFs) is high among children and adolescents in the United States. Low dietary quality and high UPF intake are associated with obesity and higher risk of diet-related chronic diseases. It is unknown whether household cooking behavior is related to improved dietary quality and lower consumption of UPFs among US children and adolescents. Methods: Nationally representative data from the 2007-2010 National Health and Nutrition Examination Survey ( n  = 6032 children and adolescents ≤19 years of age) were used to examine the relationships between household cooking frequency of evening meals and children's dietary quality and UPF intake using multivariate linear regression models adjusted for sociodemographics. Two 24-hour diet recalls were used to assess UPF intake and dietary quality [Healthy Eating Index-2015 (HEI-2015)]. Food items were categorized according to Nova classification to obtain the UPF percent of total energy intake. Results: A higher household frequency of cooking dinner was associated with lower UPF intake and higher overall dietary quality. Compared to children in households cooking dinner 0-2 times per week, children in households cooking dinner 7 times/week had lower intake of UPFs [β = -6.30, 95% confidence interval (CI) -8.81 to -3.78, p  < 0.001] and marginally higher HEI-2015 scores (β = 1.92, 95% CI -0.04 to 3.87, p  = 0.054). The trends toward lower UPF intake ( p -trend <0.001) and higher HEI-2015 scores ( p -trend = 0.001) with increasing cooking frequency were significant. Conclusions: In this nationally representative sample of children and adolescents, more frequent cooking at home was associated with lower intake of UPFs and higher HEI-2015 scores.

Evidence of the benefits of culinary nutrition education is growing in the literature. Culinary nutrition education programs are naturally experiential, social, skills-based, and effective in improving nutrition-related beliefs, knowledge, and behaviors. In this article, we explore a set of motivational experiences in culinary nutrition education that have been identified as "drivers" of behavior change. These drivers emerged from 20 years of implementation and evaluation of hands-on cooking programs across the life span in more than 30 states within the United States. From these drivers, we developed a framework to guide both new and existing programs that can be best designed to motivate behavior change. These frameworks add value to the work of culinary nutrition educators and will inform and support future culinary nutrition education programs. In future research, health educators implementing skills-based health promotion programs in diverse settings can test the application of this framework to determine its relevance in broader areas. [ABSTRACT FROM AUTHOR]

Purpose: Atrial fibrillation (AF) is a frequently encountered cardiac arrhythmia in clinical practice. While fried food consumption is common in United States, little is known about the association between fried food consumption and incident AF. Methods: We prospectively examined the association of fried food consumption with incident AF in 18,941 US male physicians. Fried food consumption was assessed via a self-administered food frequency questionnaire. Incident AF was ascertained through yearly follow-up questionnaires. Cox regression was used to estimate relative risks of AF. Results: The average age at baseline was 66 ± 9 years. During a mean follow up of 9.0 ± 3.0 years, 2099 new cases of AF occurred. Using < 1/week of fried food consumption as the reference group, multivariable adjusted hazard ratios (95% confidence interval) for AF were 1.07 (0.97, 1.18) and 1.03 (0.91, 1.17), for people reporting an average fried food consumption of 1–3/week and ≥ 4/week, respectively, p linear trend 0.4. In a secondary analysis, the results did not change after exclusion of participants with prevalent coronary heart disease or congestive heart failure. Lastly, the source of fried food (away from home or at home) did not influence the relation of fried food with AF risk. Conclusions: In conclusion, our study does not provide evidence for an association between fried food consumption and incident AF among US male physicians. [ABSTRACT FROM AUTHOR]

BACKGROUND: Approximately 2.2 million people are incarcerated in the United States, a disproportionate number of whom are African American, experience behavioral health conditions and are poor. Various federal and regional policies, compounded by stigma, keep the formerly incarcerated disenfranchised by restricting access to housing, employment and community engagement. OBJECTIVE: This case study highlights how public health crises of one large county led to the piloting of a multidisciplinary team to improve quality of life outcomes for those frequently arrested. METHODS: Occupational therapy was integrated into an interdisciplinary team developed to promote community integration among participants. RESULTS: Occupational therapy aided the client in overcoming barriers of community engagement while increasing skills for independent living. CONCLUSION: By highlighting evidence-based interventions and multidisciplinary approaches, the case study illustrates the complexity of need among this population and how occupational therapy contributes to housing stability, behavioral health management, occupational engagement and quality of life. [ABSTRACT FROM AUTHOR]

Over the past several decades, important advances have been made in the United States to ensure that our residents breathe clean air. Still, nearly 12 million homes in this country burn wood for heating. Globally, 3 billion people, or close to half of the world's population, depend on polluting solid fuels such as wood for daily cooking and heating. Unlike in the United States where stoves used for heating are vented, many homes in low-income countries use simple stoves that often lack chimneys, leading to toxic amounts of smoke inside and outside the home. Household air pollution from these fires is the 16th leading risk factor for death and disability worldwide. Childhood pneumonia, chronic obstructive pulmonary disease, and cardiovascular disease have all been associated with household air pollution globally, yet many nurses are not aware of this burden when caring for immigrants and refugees residing in the United States. Global organizations are working to provide access to clean cookstoves (those that run on electricity, solar power, or liquid fuel), and nurses can get involved. This is one step toward improving the lives of vulnerable populations in the United States and worldwide. This series is in collaboration with the Alliance of Nurses for Healthy Environments (https://envirn.org). [ABSTRACT FROM AUTHOR]

This brief history of U.S. rice consumption from 1680 to 1960 traces the influences of race and region in shaping the prevalence of rice in certain communities over others. It examines the earliest cuisines that significantly integrated rice into the diet, in the Carolina Lowcountry and Cajun Louisiana during the colonial era and in the annexed Mexican territories of the Southwest and Asian communities of the West Coast in the nineteenth century. Outside those areas, rice was not generally consumed as a regular staple. As rice production expanded westward in the late nineteenth century, consumers in the newer areas did not embrace rice as the industry had expected. The turning point came after World War II when cooperative rice associations put forth national publicity campaigns to re-brand rice into a more cosmopolitan food commodity. This essay explores the factors that shaped when and how rice became a dietary staple for Americans across race and region. [ABSTRACT FROM AUTHOR]

BACKGROUND: Per- and polyfluoroalkyl substances (PFASs) are common industrial and consumer product chemicals with widespread human exposures that have been linked to adverse health effects. PFASs are commonly detected in foods and food-contact materials (FCMs), including fast food packaging and microwave popcorn bags. OBJECTIVES: Our goal was to investigate associations between serum PFASs and consumption of restaurant food and popcorn in a representative sample of Americans. METHODS: We analyzed 2003–2014 serum PFAS and dietary recall data from the National Health and Nutrition Examination Survey (NHANES). We used multivariable linear regressions to investigate relationships between consumption of fast food, restaurant food, food eaten at home, and microwave popcorn and serum levels of perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), perfluorohexanesulfonic acid (PFHxS), and perfluorooctanesulfonic acid (PFOS). RESULTS: Calories of food eaten at home in the past 24 h had significant inverse associations with serum levels of all five PFASs; these associations were stronger in women. Consumption of meals from fast food/pizza restaurants and other restaurants was generally associated with higher serum PFAS concentrations, based on 24-h and 7-d recall, with limited statistical significance. Consumption of popcorn was associated with significantly higher serum levels of PFOA, PFNA, PFDA, and PFOS, based on 24-h and 12-month recall, up to a 63% (95% CI: 34, 99) increase in PFDA among those who ate popcorn daily over the last 12 months. CONCLUSIONS: Associations between serum PFAS and popcorn consumption may be a consequence of PFAS migration from microwave popcorn bags. Inverse associations between serum PFAS and food eaten at home—primarily from grocery stores—is consistent with less contact between home-prepared food and FCMs, some of which contain PFASs. The potential for FCMs to contribute to PFAS exposure, coupled with concerns about toxicity and persistence, support the use of alternatives to PFASs in FCMs. [ABSTRACT FROM AUTHOR]

Nutrition-associated chronic disease is an epidemic in the United States (US), yet most medical schools lack adequate nutrition education. We developed a six-session culinary medicine (CM) seminar entitled "Eat to Treat: A Nutrition Course for Future Clinicians" that teaches culinary skills, nutrition science, and counseling techniques to improve clinical nutrition management. The seminar was offered in-person to first-year medical students in a medical school-based teaching kitchen from 2017 to 2019. A virtual three-session course was also offered to practicing clinicians in 2020. Voluntary self-efficacy questionnaires were collected at the beginning of the first and last sessions of the student seminar, and paired t -tests determined the course's effect on survey items. A total of 53 first-year medical students attended the program over five semesters, and 39 students (73.6%) completed both surveys. All except one measure of self-efficacy were significantly higher at session 6 than session 1 ( p < 0.05). A post-course survey was utilized for the clinician seminar and of the 31 participants, 14 completed the surveys; 93% and 86% of respondents agreed the course was clinically relevant and improved their confidence, respectively. We developed a CM curriculum that improved nutrition knowledge and confidence among a professionally diverse cohort and may represent a scalable education model to improve nutrition education in US medical schools.

Rice accumulates arsenic, an established lung toxicant. Little is known about the association of rice consumption with arsenic-related health effects, particularly interstitial lung disease. Between 2000 and 2002, 6,814 white, black, Hispanic, and Chinese adults from 6 US cities were enrolled in the Multi-Ethnic Study of Atherosclerosis. We included 2,250 participants who had spirometry data, 2,557 with full-lung computed tomography (CT) scans, and 5,710 with cardiac CT scans. Rice consumption and 310 participants with urinary arsenic were assessed at baseline. Spirometry and full-lung CT-derived measures of total lung capacity and high attenuation area (HAA), and interstitial lung abnormalities were measured at examination 5. Cardiac CT-derived HAA was measured at 1–3 visits. Twelve percent of participants reported eating at least 1 serving of rice daily. Comparing data between that group with those who ate less than 1 serving weekly, the mean difference for forced vital capacity was −102 (95% confidence interval (CI): −198, −7) mL, and for forced expiratory volume in 1 second was −90 (95% CI: −170, −11) mL after adjustment for demographics, anthropometrics, dietary factors, and smoking. The cross-sectional adjusted percent difference for total lung capacity was −1.33% (95% CI: −4.29, 1.72) and for cardiac-based HAA was 3.66% (95% CI: 1.22, 6.15). Sensitivity analyses for urinary arsenic were consistent with rice findings. Daily rice consumption was associated with reduced lung function and greater cardiac-based HAA. [ABSTRACT FROM AUTHOR]

Almost one-third of the entire U.S. is buying organic produce. It is believed that organic foods taste better and are more nutritious than conventional foods. To develop successful market positioning, the characteristics desirable to consumers, for sweetpotato must be identified. Different processing methods particularly thermal treatments would impact sweetpotato textures differently and as such affect the consumer liking and eventually product acceptability. Clear understanding of the influence of different thermal treatments on the textural characteristics of sweetpotato is therefore needed. The major objective of this research work was to evaluate the impact of different thermal processing techniques such as baking, pressure cooking, and open cooking on the textural characteristics of sweetpotato cultivars. Six cultivars of sweetpotato grown on a certified organic farm were subjected into different thermal treatments. Baking was done using an air oven for 60 min. Pressure cooking was done using a pressure cooking for 15 min and open cooking was done using a vessel filled with water (500 ml) for 1 hour. In all thermal treatments, the inside product temperature was kept constant (60±2°C). The texture parameters were recorded with a texture analyzer using a 100 mm dia probe. The samples were also penetrated 5 mm from the surface using a needle probe of 2 mm dia. Maximum peak force was set in Newtons. Across the treatments, open cooked Japanese Purple was found to be the hardest although not significantly different from Hernandez open cooked cultivar. Baked Old Yellow sweetpotato was the most gummy and chewy while the softest cultivar was the pressure cooked Old Yellow; however it did not differ significantly from the other five cultivars tested. [ABSTRACT FROM AUTHOR]

To investigate parent and child food preparation cognitions and behaviors qualitatively to create recommendations for nutrition programs targeting these audiences. Focus groups were conducted in community settings with school-age children (n = 37) and parents (n = 38) in Florida, West Virginia, and New Jersey. Community settings in Florida, West Virginia, and New Jersey. School-age children (n = 37) and parents (n = 38). Factors influencing food preparation of school-aged children and their parents to inform Social Cognitive Theory-based recommendations. Content analysis. Parents believed that child involvement in meal preparation was important for developing cooking skills, responsibility, and self-esteem, but noted that involvement was limited by time scarcity and concern regarding child safety in the kitchen. Parents recommended having children engage in age-appropriate food preparation activities, such as packing their own snacks. Children echoed parents' beliefs, stating they would need to know how to cook later in life. Many children acknowledged being a part of meal preparation by setting the table and helping grocery shop. Food preparation's link to improving diet quality was not mentioned by parents or children. To increase involvement, children suggested that parents demonstrate skills, select age-appropriate tasks for them, and reward them for helping. This research provides insight into parents' and children's food preparation cognitions (eg, beliefs, attitudes) and behaviors and assembles results into recommendations that may guide decisions during nutrition intervention development and potentially improve nutrition intervention. [ABSTRACT FROM AUTHOR]

Background: Food insecurity (FI) impacted 15.7% (5.9 million) of US households with children in 2017. These households often experience issues within one or more of the food security pillars: access, availability, utilisation or stability. An underexplored area within the pillar of utilisation that may impact FI risk is the availability of kitchen equipment in households. This exploratory project aimed to quantify household food preparation equipment ownership and use by household FI status. Methods: An online platform (Qualtrics, Provo, UT, USA) was used to administer a questionnaire to a sample of 135 parents of children aged 11–14 years. The instrument queried sociodemographic characteristics, food preparation items owned and frequency of use of 44 items within a 6‐month interval. Household FI was measured using the 18‐item US Department of Agriculture, Household Food Security Survey Module with a 12‐month reference period. Results: Households experiencing FI (n = 39; 28.9%) owned an average of five fewer items than their food secure counterparts (n = 96, 71.1%, P < 0.001), reporting lower item ownership within each equipment category subgroup (i.e. large appliances, small appliances, food preparation utensils and cooking utensils; all P < 0.01). There were no differences between FI and food secure households in frequency of use (all P > 0.01). Conclusions: Compared to food secure households, the number of food preparation items owned was lower, although frequency of use was the same, in US households that were FI. Future projects should investigate how food equipment ownership impacts cooking behaviours, and whether households experiencing FI display behaviours to compensate for a differing set of equipment. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Describe fruit and vegetable (FV) preferences and other factors that may influence participation in community-supported agriculture (CSA). Design In-depth, semi-structured interviews. Setting Eight rural/micropolitan communities in 4 US states. Participants There were 41 caregivers and 20 children (8–12 years of age) from low-income, English-speaking households. Phenomena of Interest Knowledge, attitudes, and behaviors regarding FVs; perceived barriers to CSA participation. Analysis Transcribed verbatim and iteratively coded. Results Caregivers and children believed FVs were important to health, yet FVs were not featured in dinners or snacks and consumption was challenged by limited preferences and neophobia. Few caregivers and children knew about the seasonality of FV. Most caregivers were unfamiliar with CSA and had concerns about CSA cost, accessibility, produce quality, and selection. Conclusions and Implications These qualitative data support improvements in: 1) CSA distribution practices to offer flexible payment and pick-up options, more fruits, and self-selection of FV; 2) public awareness of produce seasonality and the CSA distribution model as necessary precursors to participation, and lower cost for low-income families who highlighted this barrier; and 3) capacity to prepare FV by enhancing skills and providing time-saving kitchen tools. Approaches to aligning CSA practices with the needs and preferences of low-income families warrant further research. [ABSTRACT FROM AUTHOR]

Women's current high levels of participation in the labor force have focused attention on changing life-styles and consumption patterns. This study uses life-style variables as predictors of food shopping behavior. A set of intervening variables reflecting women's attitudes toward food preparation explains their food shopping behavior better than either a working/nonworking classification or general role orientations. [ABSTRACT FROM AUTHOR]

A value-added approach for valuing household production is presented with application to household processing of foods into meals. Data are from the 1977-1978 USDA Household Food Consumption Survey. The cost of input (food) is subtracted from estimates of the value of output (meals) to yield value added within households. This amounts to an estimated 7 percent of the U.S. GNP that is unaccounted for. Value added was negatively associated with female employment. Household size, household income, and age of householder had small but statistically significant positive associations with value added. The mean net value added through meal preparation was $33.82 per week when fuel and capital charges were subtracted. [ABSTRACT FROM AUTHOR]

School meals play a critical role in promoting child nutrition and advancing equity. An understanding of which evidence-based strategies can increase meal participation is needed to improve student school meal consumption and foodservice finances. Our aim was to systematically review the evidence on interventions, initiatives, and policies to increase school meal participation in the United States. Four electronic databases were searched (PubMed, Academic Search Ultimate, Education Resources Information Center, and Thomson Reuters' Web of Science) to identify peer-reviewed and government studies conducted in the United States and published in English through January 2022. Qualitative studies; studies focused on snacks, afterschool meals, or universal free meals as the sole exposure; and studies conducted in schools not participating in the federal school meal programs or outside of the school year were excluded. Risk of bias was assessed using an adapted version of the Newcastle-Ottawa Scale. Articles were grouped according to type of intervention or policy and were narratively synthesized. Thirty-four articles met inclusion criteria. All studies examining alternative breakfast models (eg, breakfast in the classroom or grab-and-go breakfast) and restrictions on competitive foods found increases in meal participation. There is also some evidence that stronger nutrition standards do not negatively impact meal participation and, in some cases, may promote meal participation. There is limited evidence on other strategies, including taste tests, modified menu options, changes to the meal period length, changes to the cafeteria environment, and wellness policies. There is evidence that alternative breakfast models and restrictions on competitive foods promote meal participation. There is a need for additional rigorous evaluation of other strategies to promote meal participation. [ABSTRACT FROM AUTHOR]

Fast food is omnipresent in the United States (U.S.) and contributes to poor dietary quality and poor health among youth and adults alike. Children need adults to teach them good eating habits to attain and maintain good health by introducing them to healthful foods and being good role models. The fast food industry, through vast funds and advertising, contribute to challenges parents face to provide healthful foods for their families and thwart our best efforts to meet health goals. Research shows fast food consumption is influenced by lack of cooking confidence, time pressures, and perceptions of ease and convenience. We need practical strategies to help parents and children make healthier food choices. As a product of conference proceedings, this paper provides a non-exhaustive narrative summary of the fast food marketplace and marketing, the contributions of fast food to diet and health, struggles with healthful eating among families, and possible solutions of how we can help children and parents empower themselves to have healthier lives. [ABSTRACT FROM AUTHOR]