Childhood (ages 2-9 years) and adolescence (ages 10-19 years) make up important periods of human life. Food preferences and dietary behaviors are developing during this time, and health status can impact noncommunicable disease (NCD) risk in adulthood. Many of the behaviors associated with developing NCD are modifiable and include dietary behaviors. Globally, children and adolescents are impacted by NCD, and obesity prevalence is growing among this population. One of the recommendations for combating obesity is to promote the consumption of healthy foods and beverages and the reduction of sugar-sweetened beverage intake. In order to assess beverage patterns, the Healthy Beverage Index (HBI) was created for adults. This tool provides a score from 0-100, with higher scores indicating better adherence to evidence-based beverage recommendations. Because many beverage recommendations for children and adolescents differ from those for adults, the purpose of this thesis was to develop the HBI for U.S. Children and Adolescents (HBI-CA). National Health and Nutrition Examination Survey (NHANES) data was used to calculate HBI-CA scores among a sample of U.S. children and adolescents. The HBI-CA resulted in scores similar to the adult HBI and provides a reference of beverage pattern quality in this population. Significant differences in scores were found among males and females and certain races. Evaluation of the HBI-CA demonstrated its construct validity and reliability. The HBI-CA still needs to undergo predictive validity tests. Overall, the HBI-CA provides a method to assess beverage pattern quality in clinical, public health, and research settings for this important population. / Master of Science / Children (ages 2-9 years) and adolescents (ages 10-19 years) makeup an important population for the implementation of dietary interventions because they are still developing their food preferences and dietary behaviors. The rise of obesity among these age groups indicates that their dietary behaviors may not be aligned with recommendations. Beverages can easily be overlooked as a dietary component, but they currently constitute a large portion of daily energy intake. In order to assess beverage pattern quality in this population, the Healthy Beverage Index for U.S. Children and Adolescents (HBI-CA) was developed based on the HBI for adults. This tool provides a score from 0-100, with higher scores indicating better adherence to evidence-based beverage recommendations. The HBI-CA also provides a resource of comprehensive beverage recommendations for these age groups, which was previously limited in the literature. National Health and Nutrition Examination Survey (NHANES) data was used to calculate HBICA scores among a sample of U.S. children and adolescents. The HBI-CA resulted in scores similar to the adult HBI and provides a reference of beverage pattern quality in this population. Significant differences in scores were found among males and females and certain races. Evaluation of the HBI-CA demonstrated its ability to reliably and consistently measure beverage pattern quality. Future evaluation of the HBI-CA should include examination of the relationship between HBI-CA scores and dietary-related health outcomes. Overall, the HBI-CA provides a method to assess beverage pattern quality in clinical, public health, and research settings for this important population.

<p>The aim of the present thesis was to study elderly self-managing and disabled women’s dietary intake and meals in relation to age, household structure (single-living or cohabitant), disability and cooking ability. The women were aged 64-88 years and living at home, in the mid-eastern part of Sweden. The self-managing women were randomly selected. The disabled women – suffering from Parkinson's disease, rheumatoid arthritis or stroke – were selected from patient records. A total of 139 self-managing and 63 disabled women participated. Two dietary assessment methods were used: a repeated 24-h recall and a three-day estimated food diary, providing dietary intake for five non-consecutive days. The results indicate that elderly women still living in their homes seem to manage a sufficient dietary intake despite disability and high age. The reported energy intakes in all groups of women were low, which might be explained by an actual low intake and/or under-reporting. The portion sizes seemed to be smaller in the highest age group, leading to lower intakes of some nutrients. Thus also the nutrient density of the food should be given greater consideration. The meal pattern was shown to be regular and the distribution of main meals and snacks was found to be satisfactory. Meals and snacks that were defined as such by the women themselves thus seem to be more significant from an energy and nutritional perspective. Perceived cooking ability co-varied with energy and nutrient intake as well as with meal pattern.</p><p>Further, a qualitative dietary assessment method, FBCE, was analysed. It was concluded that it must be supplemented with a dietary assessment method providing energy intake figures to ensure a sufficient intake, especially when studying groups at risk for low energy intake. </p><p>Furthermore, the aim was to perform a dropout analysis. When studying older women and food, a low participation rate might be expected since the most active, the very ill as well as the disabled tend to decline participation, but also since food is a gender issue. Food could, especially for women, be a sensitive area of discussion, even though older women seem to choose "healthy foods" and eat "proper meals".</p>

The aim of the present thesis was to study elderly self-managing and disabled women’s dietary intake and meals in relation to age, household structure (single-living or cohabitant), disability and cooking ability. The women were aged 64-88 years and living at home, in the mid-eastern part of Sweden. The self-managing women were randomly selected. The disabled women – suffering from Parkinson's disease, rheumatoid arthritis or stroke – were selected from patient records. A total of 139 self-managing and 63 disabled women participated. Two dietary assessment methods were used: a repeated 24-h recall and a three-day estimated food diary, providing dietary intake for five non-consecutive days. The results indicate that elderly women still living in their homes seem to manage a sufficient dietary intake despite disability and high age. The reported energy intakes in all groups of women were low, which might be explained by an actual low intake and/or under-reporting. The portion sizes seemed to be smaller in the highest age group, leading to lower intakes of some nutrients. Thus also the nutrient density of the food should be given greater consideration. The meal pattern was shown to be regular and the distribution of main meals and snacks was found to be satisfactory. Meals and snacks that were defined as such by the women themselves thus seem to be more significant from an energy and nutritional perspective. Perceived cooking ability co-varied with energy and nutrient intake as well as with meal pattern. Further, a qualitative dietary assessment method, FBCE, was analysed. It was concluded that it must be supplemented with a dietary assessment method providing energy intake figures to ensure a sufficient intake, especially when studying groups at risk for low energy intake. Furthermore, the aim was to perform a dropout analysis. When studying older women and food, a low participation rate might be expected since the most active, the very ill as well as the disabled tend to decline participation, but also since food is a gender issue. Food could, especially for women, be a sensitive area of discussion, even though older women seem to choose "healthy foods" and eat "proper meals".