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In the context of expanding public concern about the healthfulness of food, this thesis examines how health is understood and taken up in individuals’ everyday activities of eating. Sociological frameworks emphasize the complex relations shaping health practices in context; however, a greater focus on the structured nature of practice has weakened appreciation of the agent. Food scholars investigating choice and constructions of healthy food and eating categories, highlight processes involving meaning, experience, action, and identity, at work in contexts of healthy eating. To better locate the agent of health practices, and to connect a health practices approach to healthy eating scholarship, this study draws on theory and methods from the symbolic interactionist tradition in an analysis of lived experiences of healthy eating. Using ethnographic data, including qualitative interviews with 18 adopters of the Paleo Diet, and analysis techniques from grounded theory, this study aims to add nuance to current sociological understandings of health practices. Findings reveal that subjective understandings of the relationship between food and health evolve through interpretive processes involving meaning. By connecting cultural understandings of health to personal, embodied experiences, adopters achieve multilayered understandings of healthy eating that legitimate and catalyze their commitment to their diet. Facing challenges to achieving a Paleo diet, adopters, as agents, engage in material and symbolic work to create “doable” and “livable” versions of Paleo better aligned with resources, preferences, and understandings. Adopters also construct and work to maintain valued identities surrounding their practice; however, Paleo identities are spoiled identities, as adopters sought to manage conflicting expectations of what constitutes healthy eating, and impressions of who eats a Paleo diet. This thesis demonstrates how an interactionist perspective that appreciates the processual, subjective, and interactional elements of agents’ situated and contextual practices, can be usefully brought in to investigate and inform understandings of activities affecting health. / Thesis / Doctor of Philosophy (PhD)

Yes / The notion of educating the public through generic healthy eating messages has pervaded dietary health promotion efforts over the years and continues to do so through various media, despite little evidence for any enduring impact upon eating behaviour. There is growing evidence, however, that tailored interventions such as those that could be delivered online can be effective in bringing about healthy dietary behaviour change. The present paper brings together evidence from qualitative and quantitative studies that have considered the public perspective of genomics, nutrigenomics and personalised nutrition, including those conducted as part of the EU-funded Food4Me project. Such studies have consistently indicated that although the public hold positive views about nutrigenomics and personalised nutrition, they have reservations about the service providers’ ability to ensure the secure handling of health data. Technological innovation has driven the concept of personalised nutrition forward and now a further technological leap is required to ensure the privacy of online service delivery systems and to protect data gathered in the process of designing personalised nutrition therapies.

Yes / Background: National guidelines emphasize healthy eating to promote wellbeing and prevention of non-communicable diseases. The perceived healthiness of food is determined by many factors affecting food intake. A positive perception of healthy eating has been shown to be associated with greater diet quality. Internet-based methodologies allow contact with large populations. Our present study aims to design and a short nutritional perception questionnaire, to be used as a screening tool for assessing nutritional status, and to predict an optimal level of personalisation in nutritional advice delivered via the Internet. Methods: Data from all participants who were screened and then enrolled into the Food4Me proof-of-principle study (n=2369) were used to determine the optimal items for inclusion in a novel screening tool, the Nutritional Perception Screening Questionnaire-9 (NPSQ9). Exploratory and confirmatory factor analyses were performed on anthropometric and biochemical data and on dietary indices acquired from participants who had completed the Food4Me dietary intervention (n=1153). Baseline and intervention data were analysed using linear regression and linear mixed regression, respectively. Results: A final model with 9 NPSQ items was validated against the dietary intervention data. NPSQ9 scores were inversely associated with BMI (β=-0.181, p<0.001) and waist circumference (Β=-0.155, p<0.001), and positively associated with total carotenoids (β=0.198, p<0.001), omega-3 fatty acid index (β=0.155, p<0.001), Healthy Eating Index (HEI) (β=0.299, p<0.001) and Mediterranean Diet Score (MDS) (β=0. 279, p<0.001). Findings from the longitudinal intervention study showed a greater reduction in BMI and improved dietary indices among participants with lower NPSQ9 scores. Conclusions: Healthy eating perceptions and dietary habits captured by the NPSQ9 score, based on 9 questionnaire items, were associated with reduced body weight and improved diet quality. Likewise, participants with a lower score achieved greater health improvements than those with higher scores, in response to personalised advice, suggesting that NPSQ9 may be used for early evaluation of nutritional status and to tailor nutritional advice. / European Union’s Seventh Framework Programme for 23 research, technological development and demonstration (grant agreement no. 265494). "la Caixa" Banking Foundation through a grant.

Background: Childhood obesity is a pressing public health concern; the prevalence of childhood obesity is 15.5% in Virginia. About 15% of Virginia's K-12 population participates in after-school programs (ASPs), identified as appropriate venues in which to promote healthy eating. In 2011, the National Afterschool Association (NAA) adopted the evidence-based Healthy Eating and Physical Activity Quality Standards (HEPAQS) to address snack quality and physical activity in ASPs. Although research has indicated promise in implementation of such policies in after-school programs, a need for assessment of effectiveness still exists. Are the quality standards being implemented effective in increasing positive nutritional habits among children in ASPs? In 2014, Danville Parks and Recreation (PandR), a key partner in the Dan River Partnership for a Healthy Community (DRPHC), adopted the HEPAQS policies to improve the nutrition and physical activity of attending students. Objective: The primary purpose of this study was to determine the effectiveness of the adopted HEPAQS Healthy Eating standards by comparing the quality of snacks served at the ASP sites before and after the HEPAQS policies were implemented. A secondary purpose of this study was to describe the quality of snacks among both policy-adoption and comparison sites. The tertiary purpose of this study was to compare the quality of program versus non-program snacks in the ASPs. Methods: To meet the objective, a natural experiment followed a pre-post evaluation design to determine the impact of adoption of the Healthy Eating standards at three policy-adoption ASPs. Applying an interrupted time series design, a total of 531 children's snack observations were performed across all sites during a five-week pre-policy adoption data collection period and 412 total snack observations were performed during a six-week post-policy data collection period. Direct observation methods including a modified quarter-waste method for dietary observations and the HAAND tool were conducted by trained research staff to collect snack quantity, type, brand, and amount consumed. Observational data was entered into statistical software for hypothesis testing. Data were also analyzed using Nutrition Data System for Research (NDSR) software to determine the mean servings, fluid ounces, or grams of each nutrient specified in the adopted Healthy Eating standards. Results: Adoption of the Healthy Eating standards among the three policy-adoption sites did not result in better snack quality based on adherence to the Healthy Eating standards. Policy-adoption sites were only meeting four of the nine adopted Healthy Eating standards post-policy, almost all of which were also being met pre-policy: serving foods without trans-fats, serving no sugar-sweetened beverages (SSBs), limiting fruit juice to one 8 oz. serving, and avoiding artificially sweetened beverages. By post-policy data collection, policy-adoption sites were not meeting five of the nine adopted standards: weekly serving a fruit or vegetable, offering water at all times, serving no candy or sugar-based snacks, emphasizing whole grains, and serving no snack chips. Although no significant changes were expected among comparison sites, they saw a significant increase in 100% fruit juice consumption and a decrease in grams of trans-fat from pre- to post-policy data collection. Across all five sites, program snacks were generally healthier than non-program snacks, as program snacks contained less SSBs, sweets, and snack chips. Conclusion: Adoption of the Healthy Eating standards among the three policy-adoption sites did not result in better snack quality. Pursuing additional HEPAQS regarding implementation, staff training, and social and program support may be necessary to impact snack quality. ASPs may improve non-program snack quality by addressing HEPAQS for vending machines and guidelines provided to parents regarding non-program snacks. The PandR partners of the Dan River Partnership for a Healthy Community should continue to seek support as they implement the Healthy Eating standards in their ASPs. / Master of Science

Yes / The You Are What You Ate project is a collaboration between historians, archaeologists, museum officers, medieval re-enactors and food scientists. We aim to encourage public debate and personal reflection on modern eating habits through exploration of the dietary choices of the medieval and early modern period. This paper will discuss our osteology workshops, aimed at adults or at school children. We use archaeological examples of diet-related conditions, including dental disease, scurvy, rickets and gout, plus those associated with obesity such as osteoarthritis and DISH, to help the public visualise how dietary choices can affect the body. This information is delivered via an introductory talk and carefully monitored bone handling sessions – and, for the children, includes the analysis of a plastic skeleton modified to display pathological conditions. Evaluation data shows that the majority of adults and all children feel they have learnt something new during the sessions, and that this has led them to think about healthy eating. The inclusion of examples of dental pathology has promoted dental hygiene to school children, although it was not one of our primary aims. It is difficult to assess if these short-term experiences translate to long-term knowledge gain or to changes in behaviour.

This study examines the influence of teaching digital resources of MyPlate on the nutrition knowledge, attitudes, and practices (KAP) related to healthy eating habits among first and second-grade students. A pre-and post-assessment of this quasi-experimental research study measured the baseline KAP levels of 45 participants regarding healthy eating habits. Students were divided into three groups: digital MyPlate (n =16), pencil-and-paper (n =15), and control (n =14). Following the pre-assessment, an intervention was conducted involving teaching MyPlate and the five food groups. A post-assessment was then implemented to measure the change in KAP levels resulting from the intervention. In addition to the surveys, digital photography observation was used to assess the practice component of the intervention. Participants' lunch meals at the cafeteria were photographed before and after consumption to observe food variety and meal composition. An ANOVA was used to analyze the differences in post-assessment scores between the three groups: 2 intervention groups (the digital MyPlate group and the pencil-and-paper group) and the control group for knowledge, attitudes, and practice. For knowledge, F(2, 42) = 15.55, p < .001 indicating significant differences between groups for knowledge post-assessment. For attitudes, ANOVA revealed no significant differences, F(2, 42) = 1.619, p < .21. For practice, ANOVA revealed differences that approached but were not quite significant, F(2, 42) = 3.025, p < .0593. Tukey’s post-hoc tests showed a significant difference in the outcome between the digital MyPlate group and the control group (diff = 4.41, p-value of 0.00), and the pencil-and-paper group and the control group (diff = 3.68, p-value of 0.00) for knowledge. Both the digital MyPlate and pencil-and-paper group scored significantly higher than the control group on knowledge post-assessment. However, when pre-test and post-test measures of knowledge, attitudes, and practice were analyzed, there were no significant changes between pre- and post-test data for any of the groups (digital, pencil-and-paper, control). This study had several limitations such as a small sample size and intervention duration. This research can be used as a basis for future studies on MyPlate by expanding the intervention or investigating if this knowledge can lead to behavioral changes.

Yes / Purpose - Randomised controlled trials identify causal links between variables but not why an outcome has occurred. This analysis sought to determine how psychological factors assessed at baseline influenced response to personalised nutrition. Design/methodology/approach – Web-based, randomised, controlled trial (RCT) was conducted across seven European countries. Volunteers, both male and female, aged over 18 years were randomised to either a non-personalised (control) or a personalised (treatment) dietary advice condition. Linear mixed model analysis with fixed effects was used to compare associations between internal and external health locus of control (HLoC), nutrition self-efficacy (NS-E) and self-report habit index (S-RHI) at baseline (N 5 1444), with healthy eating index (HEI) and Mediterranean diet index (MDI) scores between conditions post-intervention (N 5 763). Findings – An increase in MDI scores was observed between baseline and six months in the treatment group which was associated with higher NS-E (p / EU FP7 Project “Personalised nutrition: an integrated analysis of opportunities and challenges” (Contract No. KBBE. 2010.2.3–02, Project No. 265494)

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Pakankamas vaisių ir daržovių vartojimas – tai neabejotinas gerų sveikos mitybos įpročių pagrindas. Vaisiai ir daržovės ypač svarbūs jaunam organizmui, nes jų pakankamas vartojimas vaikystėje susijęs su sumažejusia rizika sirgti širdies bei kraujagyslių ligomis, tam tikromis vėžio formomis ir kitomis lėtinėmis neinfekcinėmis ligomis tiek jaunystėje, tiek vyresniame amžoiuje. Moksliniais tyrimais įrodyta, kad vaikai, vartojantys mažiau vaisių ir daržovių, yra linkę turėti viršsvorį ar net būti nutukę, o vaikystėje susiformavę tinkami šių produktų vartojimo įpročiai dažniausiai išlieka ir suaugus. Darbo tikslas – nustatyti ir įvertinti Lietuvos bendrojo lavinimo mokyklų pradinių klasių mokinių daržovių ir vaisių vartojimo ypatumus. Darbo uždaviniai: 1. įvertinti pradinių klasių mokinių daržovių ir vaisių vartojimą ir jo atitikimą sveikos mitybos rekomendacijoms; 2. nustatyti veiksnius, galinčius daryti įtaką mokinių vaisių ir daržovių vartojimui; 3. įvertinti mokinių nuomonę ir žinias apie daržovių ir vaisių vartojimą bei sveiką mitybą. Atsitiktinės atrankos būdu tyrimui buvo atrinktos 72 Lietuvos Respublikos bendrojo lavinimo mokyklos. Buvo išdalinta 3750 apklausos anktetų, gauta 2402 teisingai užpildytos anketos. Atsako dažnis – 64,1% . Statistinė duomenų analizė atlikta naudojant SPSS (Statistical Package for Social Sciences) statistinę programinę įrangą (13.0 for Windows versija) ir Epi Info (Version 5.1) kompiuterinę programą. Išanalizavus atlikto tyrimo duomenis... [toliau žr. visą tekstą] / Adequate consumption of fruits and vegetables is the undisputed evidence of healthy nutrition skills. These foods are extremely important for the children because of their ability to protect against cancers and cardiovascular diseases and the consumption of these foods during childhood is associated with decreased risk of stroke and cancer. It is scientificly proven that higher fruit and vegetable intake was associated with a lower risk of overweight or even obese and healthy eating habits formed by consumption of fruits and vegetables tend to persist into adulthood. The objective of this research – to evaluate and assess the pecularities of the fruits and vegetables consumption among primary classes of Lithuanian schools. The tasks of the paper – assessment of the fruits and vegetables consumption and concordance with healthy nutrition recommendations among primary school pupils, evaluation the circumstances affecting fruits and vegetables consumption among primary school pupils, assessment of the knowledge and opinion of primary school children about fruits and vegetables consumption healthy eating. In this randomized study 72 general education schools of the Republic of Lithuania were selected. 3750 questionnaires were distributed, 2402 correctly filled questionnaires received. The response rate – 64,1%. The statistical data was processed with the help of SPSS 13.0 (Statistical Package for Social Sciences) and Epi Info (Version 5.1). As the reserch data shows, it is... [to full text]