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

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

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

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*

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

The rapid rise in the incidence of obesity has emerged as one of the most pressing global public health issues in recent years. The underlying etiological causes of obesity, whether behavioral, environmental, genetic, or a combination of several of them, have not been completely elucidated. The obesity epidemic has been attributed to the ready availability, abundance, and overconsumption of high-energy content food. We determined here by Pearson's correlation the relationship between food type consumption and rising obesity using the loss-adjusted food availability data from the United States Department of Agriculture (USDA) Economic Research Services (ERS) as well as the obesity prevalence data from the Behavioral Risk Factor Surveillance System (BRFSS) and the National Health and Nutrition Examination Survey (NHANES) at the Centers for Disease Control and Prevention (CDC). Our analysis showed that total calorie intake and consumption of high fructose corn syrup (HFCS) did not correlate with rising obesity trends. Intake of other major food types, including chicken, dairy fats, salad and cooking oils, and cheese also did not correlate with obesity trends. However, our results surprisingly revealed that consumption of corn products correlated with rising obesity and was independent of gender and race/ethnicity among population dynamics in the U.S. Therefore, we were able to demonstrate a novel link between the consumption of corn products and rising obesity trends that has not been previously attributed to the obesity epidemic. This correlation coincides with the introduction of bioengineered corns into the human food chain, thus raising a new hypothesis that should be tested in molecular and animal models of obesity.
Aluminum Hydroxide ; Behavioral Risk Factor Surveillance System ; Callosities ; Carbonates ; Centers for Disease Control and Prevention (U.S.) ; Cheese ; Chickens ; Cooking ; Fats ; Food Chain ; Fructose ; Humans ; Incidence ; Models, Animal ; Nutrition Surveys ; Obesity ; Oils ; Population Dynamics ; Prevalence ; Public Health ; United States Department of Agriculture ; Zea mays

Onto the world-fastest ageing of society, the world-lowest fertility rate prompted a development of various policies and programs for a betterment of the population in Korea. Since the vulnerability of young children of low socio-economic class to malnutrition was clearly shown at the in-depth analysis of the 2001 Korea National Health and Nutrition Examination Survey data, an effort to devise supplemental nutrition care program for pregnant/breastfeeding women, infants and preschool children was initiated. The program was designed to offer nutrition education tailored to fit the needs of the participants and special supplementary foods, using USDA WIC program as a benchmark. Based on the dietary intake of those age groups, target nutrients were selected and their major food sources were searched through nutrient content of foods and dietary pattern analysis. As a result, we developed 6 kinds of food packages using combinations of 11 different food items. The amount of each item in a food package was determined to supplement the intake deficit in target nutrients. Nutrition education in NutriPlus + aims to improve the nutrition knowledge, attitude, and dietary behaviors of the participants, and is provided through group lessons, individual counseling sessions and home visits. Breastfeeding is promoted with top priority in education for the health of both mother and baby. The eligibility guidelines were set for residency, household income, age, pregnancy/breastfeeding and nutritional risk such as anemia, stunting, underweight, and/or inadequate nutrient intake. Income eligibility was defined as household income less than 200 percent of the Korean poverty guidelines. A pilot study to examine the feasibility of program implementation was run in 3 public health centers in 2005 and expanded to 15 and 20 in the following 2 years. The result of 3-year pilot study will be reported separately along with the ultimate nationwide implementation of the NutriPlus + in 2008.
Anemia ; Birth Rate ; Breast Feeding ; Child ; Child, Preschool ; Counseling ; Family Characteristics ; Female ; House Calls ; Humans ; Infant ; Internship and Residency ; Korea ; Malnutrition ; Mothers ; Nutrition Surveys ; Pilot Projects ; Poverty ; Public Health ; Thinness ; United States Department of Agriculture

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