Food insecure individuals do not always have access to adequate food for a healthy lifestyle and are at high risk of detrimental health outcomes. Researchers hypothesize that food insecurity leads to changes in dietary practices, including greater overall food purchase in times of adequate resources and purchase of low-cost, unhealthful foods when resources are constrained. Most measures of food insecurity do not measure changes in dietary practices and dietary quality. Research findings suggest education that provides alternative strategies to manage resources and improve dietary practices can improve food insecurity. We assessed the relationship between 1) food security and ability to afford foods and 2) the impact of Expanded Food and Nutrition Education Program (EFNEP) in a low-income, multi-cultural population in Massachusetts. We used a pre/post-education survey design, including the USDA six-item Food Security Module (FSM), food-affordability questions and EFNEP behavior checklist. EFNEP participants experienced high rates of food insecurity with over 40% of participants classified as food insecure (N=80). Pre-EFNEP, individuals in households with low food security were less likely to report being able to afford healthy foods (51.5%) and fruits and vegetables (57.6%) throughout the month compared to those in households with high (80.9%) and marginal (78.7%) food security (P=0.007, P=0.051). Individuals in households with marginal, low and very low food security were less likely to report being able to afford the same kinds of food throughout the month compared to individuals in high food secure households (56.4% vs. 84%) (P=0.022). Individuals in food insecure households reported running out of food before the end of the month more often than their food secure peers (P=0.013). Post-EFNEP, a greater proportion of participants fell into the high and marginal categories of food security (60.0% to 71.7%, P=0.065). Our results indicate that food insecure households have a harder time affording healthy foods throughout the month, leading to poor diet quality that possibly contributes to poor health outcomes. The food affordability questions may capture changes in dietary practices in food insecure populations throughout the month. EFNEP can provide skills and knowledge to at risk populations to improve abilities and combat food insecurity.

Background: A significant portion of lactating women in less developed countries have vitamin A (VA) deficiency. Lactation has substantial effects on a mother’s metabolism and VA is known to be needed in multiple biological processes, including growth, vision, immunity, and reproduction. Objective: The objective of this pilot study was to utilize metabolomics profiling to conduct a broad, exploratory assessment of differences in plasma metabolites associated with low VA status versus adequacy in lactating women. Methods: Plasma samples from lactating women who participated in a survey in Samar, Philippines, were selected from a cross-sectional study based on plasma retinol concentrations indicating low (VA-; n=5) or adequate (VA+; n=5) VA status (plasma retinol <0.7 or >1.05 µmol/L). The plasma results collected from six metabolomics assays (oxylipins, endocannabinoids, bile acids, primary metabolomics, aminomics, and lipidomics) were compared by group, using liquid chromatography mass spectrometry. Results: Twenty-eight metabolites were significantly different in the VA- versus VA+ status, with 24 being lipid mediators (p<0.05). The lipid mediators demonstrated lower concentrations of the arachidonic acid- and eicosapentaenoic acid-derived oxylipins, as well as lysophospholipids and sphingolipids, in the VA- group (p<0.05). Chemical similarity enrichment analysis identified HETEs, HEPEs, and DiHETEs as significantly different oxylipin clusters (p<0.0001, false discovery rate (FDR) p<0.0001), as well as sphingomyelins, saturated lysophosphatidylcholines, phosphatidylcholines, and phosphatidylethanolamines (p<0.001, FDR p<0.01). Conclusions: The multi-assay nutritional metabolomics profiling of low VA status compared with adequacy in lactating women demonstrated reduced lipid mediator concentrations. Future studies with stronger study designs and a large and more diverse population are needed to validate these preliminary results.

Vitamin D deficiency is considered to be a pandemic with implications for compromised bone health and other chronic diseases. Few studies have examined vitamin D status in college-aged individuals where prevention of future health consequences is still possible. Serum vitamin D 25(OH)D status and vitamin D intake were examined in 98 college students ages 18-29 years during winter. BMI was classified as < 25and 25 or greater. Race was categorized as Caucasian or other. Overall, 69.5% had suboptimal serum vitamin D levels, <30ng/mL. Only 8 students (8.2%) met the EAR (400 IU) per day for vitamin D intake. t tests were used to determine if there were significant differences in serum vitamin D level and dietary intake based on gender, race and BMI. Significant differences were found in serum vitamin D level when compared by gender and race. Females tended to have a higher serum vitamin D level than males. Those representing minorities had lower serum vitamin D levels than Caucasians; One hundred percent of the minority students had suboptimal serum vitamin D levels. Based on these findings, dietitians should increase efforts to target college-aged individuals in educational programming related to factors affecting vitamin D synthesis, vitamin D intake, and health consequences of suboptimal vitamin D status, particularly in winter. Consideration should be given to vitamin D fortification of foods that meet the preferences of today’s consumer.

This study was conducted to determine the impact of nutrition edu cation on participants of the Supplemental Food Program for Women, Infants and Children (WIC) and the Expanded Food and Nutrition Education Program (EFNEP). The specific objectives were to: 1) determine the impact of participation in EFNEP on iron status as assessed by hematocrit (hct) and ferritin levels; 2) determine the effect of nutrition knowledge on hct and ferritin values; and 3) determine the effect dietary behavior has on hct and ferritin levels for both WIC and EFNEP participants. Each study participant completed a 24-hour dietary recall record plus food frequency record, medical history, validated nutrition knowledge test, and finger stick blood sample prior to program enrollment or nutrition education, and again six months later. There were 42 WIC, 26 EFNEP, 23 WIC-control, and 23 EFNEP-control participants. Paired t-tests were used to find differences between preprogram and postprogram evaluation scores for the variables of nutrition knowledge score, hematocrit level, ferritin level, and levels of several nutrients. Nutrition knowledge test scores increased significantly from preprogram to postprogram for both WIC and EFNEP participants (14.2 ± 3.27 to 15.5 ± 2.89 for WIC, 14.2 ± 3.77 to 15.6 ± 2.79 for EFNEP). EFNEP participants also increased significantly in hct levels (38.5% ± 3.78 to 40.7% ± 2.13). Hematocrit levels did not change significantly for the WIC or control groups and nutrition knowledge did not increase for the control group between preprogram and postprogram evaluations. Mean intakes of vitamin A, vitamin c, calcium, and protein were above the RDA at preprogram and postprogram evaluations, yet the percentage of individual participants who consumed less than 67% of the RDA in this study was higher than in the continuing survey of Food Intake of Individuals - 1985. Improvement in nutrient intake at postprogram evaluations was encouraging. Regression analysis indicated that nutrition education classes in college, income level, and level of formal education each had a positive effect on nutrient intake and nutrition knowledge.

Background: Hispanics are the largest minority group in the U.S. and by the year 2060 the number of Hispanics is projected to double. They are disproportionately affected by obesity and chronic diseases which translate into decreased quality of life, loss of work opportunities and perceptions of injustice for the Hispanic population. The Dietary Guidelines (DG) provide information to help Americans make healthy food and physical activity choices and if followed can be a means of reducing the health disparity gap. However, culturally relevant recommendations specific to Hispanics’ health and nutritional habits are often lacking. The purpose of this study was to examine Hispanics’ knowledge, perceptions, benefits and barriers to the recommendations in the DG for Americans, Choose MyPlate, and the Department of Health and Human Services physical activity guidelines. Methods: A qualitative research design was used. Focus groups were conducted in Spanish and audiotapes were transcribed and then, translated into English. Thematic analysis was used to identify different key concepts subgrouping these topics according to common emergent themes. Results: A total of 24 participants took part in the study. Participants viewed healthy eating in terms of portion sizes. They viewed the DG as helpful but felt they needed more information to follow the guidelines. Several barriers were identified in following the MyPlate: lack of availability of healthy, fresh, inexpensive grocery options in Hispanic neighborhoods. Participants described the benefits of physical activity as related to improved mental health and quality of life such as looking and feeling better. Conclusion and Implications: Promoting nutrition education that is culturally and linguistically appropriate for Hispanics might help facilitate the adoption of the DG and MyPlate recommendations. Also, improving the design of existing low-income neighborhoods is still a challenge to improve participation in physical activity among Hispanics’.

This thesis examines the trajectory of food politics and its relationship with modernizing food landscapes. Today’s food politics discussions in the US and other high-income countries lean towards concerns with social issues, while in the recent past it was more focused on producing enough food to feed the growing population – two different situations with important concerns. The question this thesis explores is whether the modernization of society has given us a higher level of wellbeing and a better world through food landscapes and food policy, and how we came up with the current food situations we face today. It looks into the food landscape and policies of the US and its implications on wellbeing, and the dietary transition of Japan, comparing it to other modernized countries. It is important to look at these factors of food politics to see how other countries may handle a food transition, and whether or not there is a direction all countries can go in that will better benefit its food landscapes. Concerns not only lie in producing sufficient yields but also in wellbeing, cultural values, and true consumer demands. Only when true consumer demands are acknowledged individually can the trajectory of food politics be better harnessed and guided to a more desirable outcome than it has been going in so far.

Household-level characteristics have been shown to be associated with food insecurity but studies among vulnerable populations are sparse. A food security assessment was developed to determine food security and collect sociodemographic and household level data across San Luis Obispo County. The assessments were administered to vulnerable groups through interviews at multiple sites across the County. Three household characteristics (marital status, number of children in the household and number of workers in the household) were examined in this analysis. A total of 808 surveys were collected, 69% in English and 31% in Spanish. Through ethnicity-stratified sequentially adjusted logistic regression models, the association between food insecurity and household characteristics were tested, controlling for sociodemographic, economic and other potentially mediating variables. In the fully adjusted model for Hispanic/Latino households, associations were observed with number of children in the household and workers in the household, but confidence intervals were wide. In the fully adjusted model for White households, marital status was weakly associated with food insecurity. In both groups, per capita monthly income was strongly associated with food insecurity. Several interrelated household and individual level variables determined a households food security status. Because of this complexity, comprehensive social and economic changes are needed to improve food security in California and the rest of the United States. Also, different processes associated with race/ethnicity and coping strategies with regard to food insecurity should be considered when designing studies, planning policies, and conducting interventions.

The rapidly growing rate of the older adult population has created a need to better understand younger adults’ self-perceptions of aging and current trends of ageism. The purpose of this secondary data analysis research project was to determine changes, if any, in participants’ self-perception of aging after the Socially Nutritious facilitator or nutrition ambassador volunteer training, which aims to develop knowledge and skills related to aging trends, older adult nutrition, preventing ageism, and communication and educational considerations when working with older adults. Findings indicate that participants with more frequent interactions with older adults had a more positive perception of their aging at pre-test than those with less frequent interactions. However, these differences diminished at post-test. Training that includes information about healthy aging, as well as addressing ageism, may lead to a more positive self-perception of aging.

The rate of overweight and obesity among adolescents aged 12-19 years has more than tripled since 1980, and disproportionately impacts low-income and marginalized populations. Reduction in adolescent obesity rates may result in decreased health risks, decrease healthcare costs, and increased quality of life. Effective intervention methods for adolescent participants have incorporated nutrition knowledge and culinary skill building into afterschool programs. This study examines whether building knowledge, skills, and confidence through a culinary intervention can improve adolescent participants’ choices of healthful foods through increased fruit and vegetable intake. Pink and Dude Chefs (PDC) is an afterschool nutrition education and culinary skills program for middle-school adolescents aged 11-14 years. This project aimed to improve eating behavior in participants by increasing culinary and nutrition self-efficacy. PDC was implemented in Shandon, California from Spring 2014 to Fall 2014, and in Santa Maria, Guadalupe, and New Cuyama, California from Fall 2015 to Summer 2016. Eighty-three middle school students participated and completed surveys in the 12-lesson program that covered food safety, micro- and macronutrients, meal planning, and USDA MyPlate guidelines. Participant fruit and vegetable consumption improved following participation. Girls’ frequency of overall fruit consumption increased from a mean of 1.8 (SD 0.9) to 2.0 (SD 1.0). Girls’ vegetable consumption increased from 1.2 (SD 0.8) to 1.5 (SD 0.9). Boys’ fruit consumption increased from 1.9 (SD 1.0) to 2.2 (SD 1.0), and boys’ vegetable consumption increased from 1.1 (SD 0.9) to 1.3 (SD 0.8). More research is needed to evaluate the long-term effect of participation in nutrition education and culinary skills programs. If obesity prevention programs that incorporate a skill-based culinary approach continue to show promising outcomes for adolescents, larger scale efforts may contribute to decreasing the public health and economic burdens associated with obesity.

Food borne illnesses continues to be a public health challenge in the United States (U.S.); an estimated 9.4 million incident cases occurred in 2011. In view of this challenge we conducted two food safety studies; 1) related to product formulation (hummus spoilage challenge study) and 2) evaluating the microbial safety of domestic kitchen surfaces in Residential Child Care Institutions (RCCI pilot study). Hummus is of Mediterranean origin but is currently eaten globally. This challenge study evaluates a variety of industrial hummus formulations (four in total, differing in pH and/or addition of a preservative (natamycin). Two batches were setup: batch 1; aseptically inoculated hummus with 100 CFU/g fungal isolates and batch 2; uninoculated hummus. Samples of both hummus batches were stored at both 20oC (10 days accelerated testing) and 4oC (84 days recommended temperature testing). Inoculated samples were analyzed for fungus, whiles both fungi and bacteria (standard plate count (SPC) and Lactococci) counts were done for uninoculated samples. Results indicate that accelerated testing inaccurately predicts fungal growth at 4oC in hummus, also fungal growth inhibition requires a pH ≤ 4.0 ± 0.2 and refrigeration. Limited studies have specifically evaluated the prevalence of pathogenic bacteria in domestic kitchens in the U.S, for this reason we assessed the microbial safety of 6 RCCI locations in MA. Fifteen key food contact surfaces and dish washing sponges, if available at each RCCI facility were assessed for SPC, yeast and molds, total coliform and E. coli, Listeria sp and Salmonella sp. Microbiological assessments were conducted preceding and after a hazard analysis and critical control point (HACCP) food safety training and implementation at each location. Microbial growth varied by surface for each type of microorganism, wet surfaces had higher most probable number (MPN) counts. Compared to dry surfaces, wet surfaces had significantly higher mean total coliform counts. For both E. coli and total coliform, microbial load differed significantly by surfaces sampled (P = 0.0323 and 0.014) respectively. The surface and training interaction effect was highly significant for only E. coli (P = 0.0089). Training overall had no significant effect on reducing the microbial load on kitchen surfaces.