OBJECTIVES: Snacks contribute to the diet quality in youth, which is often poor. Although the US Department of Agriculture (USDA) has guidelines for healthy snacks, this is lost in translation when youth are choosing snacks. To develop a userfriendly app to help identify healthy snacks based on the US Department of Agriculture guidelines and evaluate the app's feasibility, usability, satisfaction, and acceptability. METHODS: The ‘Snackability’ app was developed following the ADDIE (analysis, design, development, implementation, and evaluation) model. The app was pilot tested for 2 weeks among college-age students (18–24 years) using questionnaires and focus groups. Based on the feedback received, the app was improved, and pilot-tested again. RESULTS: The app had a simple score (−1 to 11) and feedback (the higher the score, the healthier the snack is). The 1st pilot test among 12 students showed that the app's feasibility and usability were >50% (p < 0.05). Participants reported that the app was a good way to help individuals select and consume healthy snacks and suggested improving the search process and including average score reports, a ‘consumed history’ tab, gamification, notifications, and the option to add snacks not found. These were incorporated into the 2nd version of the app, which was pilot tested among 8 students. Feasibility, usability, and acceptability of the 2nd version were >50% (p < 0.05). Additional suggestions were to include images for serving size, snack alternatives, and barcode scanning, which were incorporated into the 3rd version. CONCLUSIONS: Snackability app was feasible, usable, satisfactory, and acceptable, and several features were improved as suggested by participants.
Adolescent ; Agriculture ; Diet ; Focus Groups ; Humans ; Serving Size ; Smartphone ; Snacks ; United States Department of Agriculture

BACKGROUND/OBJECTIVES: Fruit and vegetable consumption of children in the United States falls below recommendations. The U.S. Department of Agriculture Fresh Fruit and Vegetable Program (FFVP) is a national free-fruit and vegetable school distribution program designed to address this problem. This permanent, legislated program provides funding to qualified elementary schools for provision of additional fruit and vegetables outside of school meals. The objective of this study was to understand children's perceptions of FFVP after the intervention and formulate recommendations that may improve success of the intervention. SUBJECTS/METHODS: Secondary data were obtained from 5,265 4th-6th graders at 51 randomly-selected FFVP intervention schools in Indiana. Anonymous questionnaires were completed late in the 2011-2012 academic year. Multilevel logistic regressions were used to determine associations between students' perceptions of program effects (4 close-ended items) and their preference toward the program. Content analysis was applied to a single open-ended item for program comments. RESULTS: Over 47% of students reported greater intake of fruit and vegetables due to FFVP, and over 66% reported liking the program. Student-reported program effects were positively associated with preference for the program (P < 0.01). Themes that emerged during analysis of 3,811 comments, included, students liked: the opportunity to try different kinds of fruit and vegetables, types and flavors of fruits served, and benefits of eating fruit. Fewer students liked the types of vegetables and their benefits. A small group disliked the program citing poor flavor of vegetables and quality of fruits. Important suggestions for the program include serving more dipping sauces for vegetables, cooking vegetables, and providing a greater variety of produce. CONCLUSIONS: The degree that students liked FFVP may predict the program's effects on fruit and vegetable intake. FFVP may become more acceptable to students by incorporating their suggestions. Program planners should consider these options for achieving program goals.
Accidental Falls ; Agriculture ; Anonyms and Pseudonyms ; Child ; Cooking ; Eating ; Financial Management ; Fruit* ; Humans ; Indiana ; Logistic Models ; Meals ; Program Evaluation ; United States Department of Agriculture* ; United States* ; Vegetables*

BACKGROUND/OBJECTIVES: Fruit and vegetable consumption of children in the United States falls below recommendations. The U.S. Department of Agriculture Fresh Fruit and Vegetable Program (FFVP) is a national free-fruit and vegetable school distribution program designed to address this problem. This permanent, legislated program provides funding to qualified elementary schools for provision of additional fruit and vegetables outside of school meals. The objective of this study was to understand children's perceptions of FFVP after the intervention and formulate recommendations that may improve success of the intervention. SUBJECTS/METHODS: Secondary data were obtained from 5,265 4th-6th graders at 51 randomly-selected FFVP intervention schools in Indiana. Anonymous questionnaires were completed late in the 2011-2012 academic year. Multilevel logistic regressions were used to determine associations between students' perceptions of program effects (4 close-ended items) and their preference toward the program. Content analysis was applied to a single open-ended item for program comments. RESULTS: Over 47% of students reported greater intake of fruit and vegetables due to FFVP, and over 66% reported liking the program. Student-reported program effects were positively associated with preference for the program (P < 0.01). Themes that emerged during analysis of 3,811 comments, included, students liked: the opportunity to try different kinds of fruit and vegetables, types and flavors of fruits served, and benefits of eating fruit. Fewer students liked the types of vegetables and their benefits. A small group disliked the program citing poor flavor of vegetables and quality of fruits. Important suggestions for the program include serving more dipping sauces for vegetables, cooking vegetables, and providing a greater variety of produce. CONCLUSIONS: The degree that students liked FFVP may predict the program's effects on fruit and vegetable intake. FFVP may become more acceptable to students by incorporating their suggestions. Program planners should consider these options for achieving program goals.
Accidental Falls ; Agriculture ; Anonyms and Pseudonyms ; Child ; Cooking ; Eating ; Financial Management ; Fruit* ; Humans ; Indiana ; Logistic Models ; Meals ; Program Evaluation ; United States Department of Agriculture* ; United States* ; Vegetables*

Preeclampsia (PE) is one of the major disorders in pregnancy leading to many adverse maternal outcomes. Although the etiology of PE is not fully understood, resent studies suggest that an imbalance between free radicals production and the antioxidant defense system might have key role. Our aim of the current study was to evaluate the association between dietary total antioxidant capacity (TAC), serum TAC and risk of PE in women with preeclampsia and normal pregnancy. This case-control study conducted on 55 women with preeclampsia and 93 with normal pregnancy. Dietary intakes were obtained by a semi-quantitative food frequency questionnaire (FFQ) with 168 itmes. Dietary TAC was assessed according to United States Department of Agriculture (USDA) Database for oxygen radical absorbance capacity (ORAC), Release 2. Serum TAC was measured by a double-antibody sandwich enzyme-linked immunesorbent assay (ELISA). After adjusting for energy, pre-pregnant body mass index (BMI) and history of PE, no relationship was found between intake of hydrophilic-ORAC (H-ORAC), lipophilic-ORAC (L-ORAC), total phenolics (TP), total-ORAC (T-ORAC), and PE risk. However, serum TAC had a significant positive relationship with the risk of PE after adjusting for energy (odds ratio [OR], 0.07; 95% confidence interval [CI], 0.16–0.35), BMI and history of PE (OR, 0.04; 95% CI, 0.01–0.32). Findings of this study indicate that serum TAC is positively associated with the risk of PE but no association was found between intake of antioxidant indices and PE risk.
Body Mass Index ; Case-Control Studies ; Female ; Free Radicals ; Humans ; Oxygen ; Phenol ; Pre-Eclampsia* ; Pregnancy ; United States Department of Agriculture

The Purposes of this article were to review school meal programs and school food safety practices in USA and to draw up improvement plan of school foodservice in Korea. American school meal programs are composed of national school lunch program(NSLP), school breakfast program(SBP), special milk program(SMP) and summer food service program(SFSP). More than 29 million children receive meals daily. School districts and independent schools that choose to take part in the NSLP get cash subsidies and donated commodities from the USDA for each meal they serve. In case of NSLP, around 59% of the participant students are benefited from free or reduced price. According to the U.S. Government Accounting Office, outbreaks of foodborne disease in schools are rare, but appear to be increasing in incidence proportional to overall increases. School outbreaks tends to comprise a greater number of large outbreaks and this shows a similarity with the foodborne disease trend in Korea. School districts, federal agencies, and state and local agencies in USA use or suggest useful food safety practices for school meal programs. They told that four of these practices had the potential to enhance the safety of school meal programs. The four practices are (1) employing key foodservice personnel who are trained and certified in food safety practices, (2) implementing a risk-based approach for safely preparing, storing, and serving foods, (3) purchasing precooked or irradiated meal and poultry products, and (4) applying the more stringent purchasing specifications that USDA uses when purchasing some of the food commodities it donates to schools.
Breakfast ; Child ; Disease Outbreaks ; Food Safety* ; Food Services ; Foodborne Diseases ; Humans ; Incidence ; Korea ; Lunch ; Meals ; Milk ; Poultry Products ; United States Department of Agriculture

This study was reviewed databases and outcomes of national/international off-line and on-line(Internet) nutrition softwares to identify the present conditions of nutrition softwares, and investigated user's needs and determine which component should be included in nutrition software. The most frequently used databases for the national programs were the food composition table provided from the National Rural Living Science Institution in Rural Development Administration and the food composition table and the nutrient contents of foods provided from the Korean Nutrition Society. For international programs, the food composition table from the USDA was commonly used. The analysed outcomes included the degree of obesity, nutrient analysis and nutrient intake compared with RDA, food intake from each by food group, food habits and the frequency of food consumption. As to the result of needs assessment for the Internet nutrition softwares, it was suggested that the needs of the Internet nutrition softwares were high because most of the respondents replied that 3-point('it is needed') or 4-point('it is necessary') on 4-points likert scale. As to the databases, the needs of 'food composition analysis' and 'the suggestion of the Korean RDA' were high. For the basic information for foods, the respondents replied that 'the classification of foods', 'foods codes', 'the amount of ingredients' and 'nutrient analysis' should be included. The needs of 'nutrient analysis of meal', 'diet therapy' and 'meal plan by caloric requirements' were high. As for utilizing the Internet meal planning programs, the respondents replied that 'it should be easy to use' most and demand for 'data saving and the saved data should be usable later' and 'meal planning education tools' were high. In conclusion, the Internet nutrition software that satisfies various needs of users should be developed for policy making that promote public health, nutritional care and self-supporting of foods.
Classification ; Surveys and Questionnaires ; Eating ; Education ; Food Habits ; Internet* ; Meals ; Needs Assessment ; Obesity ; Policy Making ; Public Health ; Social Planning ; United States Department of Agriculture

There is little information on dietary vitamin K intake and nutritional status of daily requirements of vitamin K in Korea. The objective of this study was to investigate the vitamin K intake and major food sources of Vitamin K in Koreans. The survey data from the 2010-2011 Korean National Health and Nutrition Examination Survey of 7,792 subjects (aged 19-64 years) were examined. Total vitamin K intake was calculated from 24-hour dietary recall using a vitamin K food database, Computer Aided Nutritional analysis Program and the United States Department of Agriculture database. The geometric mean of vitamin K was estimated as 322.40 +/- 6.33 ug/day for men and 271.20 +/- 4.92 ug/day for women. Daily vitamin K intake increased significantly with age (p for trend < 0.001). The main food source of vitamin K was vegetables (72.84%), including cabbage kimchi (19.26%), spinach (17.38%), sesame leaves (7.11%), radish leaves (6.65%), spring onions (6.28%), and laver (4.82%), followed by seaweed, seasonings, and fat and oils. We observed that the vitamin K intake of Koreans was relatively higher than that reported by other studies in Western countries and differed depending on age.
Brassica ; Female ; Humans ; Korea ; Male ; Nutrition Surveys* ; Nutritional Status ; Oils ; Onions ; Raphanus ; Seasons ; Seaweed ; Sesamum ; Spinacia oleracea ; United States Department of Agriculture ; Vegetables ; Vitamin K 1 ; Vitamin K* ; Vitamins*

The purpose of this study was to estimate the daily intake of vitamin A in Korean female university students. Vitamin A intake was estimated using an inconsecutive 3-day dietary intake survey from 481 young women. Vitamin A intake values were calculated based on the data in USDA database. Average age, height, and weight of the subjects were 20.05 years, 162.13 cm and 54.38 kg, respectively. The subject's average intake of energy was 1645.67 kcal. The mean vitamin A, retinol and beta carotene intakes were 908.35 +/- 863.18 ug retinol equivalent/day, 199.19 +/- 166.00 ug/day and 3872.59 +/- 4972.17 ug/day, respectively. The 21.83% of the subjects consumed less than the Estimated Average Requirement (EAR) for vitamin A. And subjects consumed 141.69% of the Recommended Nutrient Intake (RNI) for vitamin A. Food groups consumed with high vitamin A content in our subjects included vegetables (423.96 ug RE/day), potato and starches (213.64 ug RE/day), cereals (62.60 ug RE/day), eggs (55.17 ug RE/day) and milks (53.45 ug RE/day). The major food sources of vitamin A were sweet potato, carrot, spinach, egg, and cereal, and the top 30 foods provided 89.57% of total vitamin A. Also animal-derived food provided 9.65% of the vitamin A intake from the top 30 foods. In conclusion, judging from RNI, the vitamin A intake of the Korean female university students in this study was generally adequate. The result of our study may be used as a basis for follow-up studies of vitamin A intake like assessment of vitamin A nutritional status or evaluation of carotenoid food sources in Korean young women.
beta Carotene ; Carotenoids ; Edible Grain ; Daucus carota ; Eggs ; Female ; Humans ; Ipomoea batatas ; Milk ; Nutritional Status ; Ovum ; Solanum tuberosum ; Spinacia oleracea ; Starch ; United States Department of Agriculture ; Vegetables ; Vitamin A ; Vitamins

This study examined household food insecurity and the associations of food insecurity with socioeconomic conditions, food behaviors, and nutrient intakes among 458 older adults (mean age = 73.2 +/- 4.5) from 5 clusters of low-income areas in Seoul, Korea. Using an adapted version of the USDA short form household food insecurity scale, 63.4% of the households were food insecure (40.7% for food insecure without hunger and 22.7% for food insecure with hunger). The proportion of household was lower on the items measured more severe level of food insecurity. Food insecurity was linearly and negatively associated with food expenditure, food secured period and the degree of nutrition management skills, health status and depression. Food secure older adults had more of energy and other nutrients from animal resources (riboflavin and animal protein, fat and calcium), but less of carbohydrates than those from the food insecure households. These results suggest household food insecurity measures used in this study was valid as well as food insecurity was prevalent and an important indicator of nutrition well-being among low income elderly persons.
Adult ; Aged* ; Animals ; Carbohydrates ; Depression ; Family Characteristics* ; Food Supply* ; Health Expenditures ; Humans ; Hunger ; Korea ; Seoul ; Social Class ; United States Department of Agriculture

PURPOSE: The purpose of this study was to evaluate the food insecurity status and dietary behavior and examine the association between the food insecurity status and consumption of processed beverage for secondary school students in Vientiane, capital city of Lao PDR. METHODS: The study subjects are 714 students (boys = 307 and girls = 407) in four secondary schools (Chao_Anouvong, Phiavat, Saysetha, and Chansavang) of Vientiane, Lao PDR. Data on study subject's demographic characteristics, dietary behavior, food insecurity, and Mini Dietary Assessment (MDA) index were collected. A “Self-Administered Food Security Survey Module for Children Aged 12 Years and Older” developed by the United States Department of Agriculture (USDA) was used for the food insecurity assessment. RESULTS: As a result, 72.7% of the subjects were in a state of food insecurity, and food security was associated with higher socioeconomic status (higher life satisfaction, higher parent's education attainment, higher item ownership, fewer number of siblings, and having more lunches at the school restaurant than at home). Compared to the food insecurity group, the frequency of breakfast, self-rated diet, and the total score of MDA index were higher in the food security group. On the other hand, multiple logistic regression analysis showed that ‘food security’ was also associated with a higher consumption of processed beverages (OR 1.544; 95% CI 1.078–2.213; p = 0.018). CONCLUSION: Improving the quality of the diet is essential for adolescents in both the food insecurity and food security groups in Lao PDR. Therefore, it is necessary to provide well organized nutrition education and establish adequate nutrition policy for adolescents in Lao PDR.
Adolescent* ; Beverages* ; Breakfast ; Child ; Diet ; Education ; Female ; Food Supply* ; Hand ; Humans ; Logistic Models ; Lunch ; Nutrition Policy ; Ownership ; Restaurants ; Siblings ; Social Class ; United States Department of Agriculture