Nutrition Information Sources Vary with Education Level in a Population of Older Adults

Cross-cultural adaptation and validation of the short nutritional literacy scale for young adults (18-35years) and analysis of the influencing factors

OBJECTIVES

This study translated the short nutrition literacy scale for young adults (18-35 years) into Chinese, examined its reliability and validity, and analyzed its influencing factors.

METHODS

The scale was translated using a modified Brislin translation model. A convenience sample of 508 cases was selected for the survey. Content validity, structural validity, Cronbach's alpha coefficient, and test-retest reliability were used to evaluate the scale's reliability and validity. To screen the factors influencing nutrition literacy in young people.

RESULTS

The Chinese version of the Item-Level Content Validity Index (I-CVI) was 0.833 ~ 1, and the Scale-Level Content Validity Index/Average (S-CVI/Ave) was 0.908. The cumulative variance contribution of the scale was 51.029%, and the model was generally well-fitted. The Cronbach's alpha coefficient and retest reliability of the scale were 0.826 and 0.818. The results showed that the level of education, mother's education, nutrition-related courses, and frequency of attention to nutritional health information were the factors influencing the nutritional literacy of young people.

CONCLUSION

The Chinese version of the S-NutLit Scale can effectively assess the nutrients of young Chinese people. Low levels of education, low levels of education of mothers, lack of exposure to nutrition-related courses, and low frequency of attention to nutritional health information can lead to lower levels of nutritional literacy among young people.

Health Information Source Patterns and Dietary Variety among Older Adults Living in Rural Japan

Dietary variety is associated with some health outcomes among older adults. Rural areas, however, often have difficulty accessing health information that influences dietary variety. This study aimed to identify patterns of health information sources by using latent class analysis and assess their association with dietary variety among older adults aged ≥ 75 in rural Japan (n = 411). Three patterns of health information sources were identified: multi-sources (29.7%), television-only (53.5%), and non-sources (16.8%). In the multi-sources pattern, more people used television, radio, and newspapers. The television-only pattern had mostly television users, with fewer other sources. The non-sources pattern had many reporting "none." Logistic regression analysis revealed that the multi-sources pattern has a significant positive effect on dietary variety compared with the non-sources pattern (odds ratio: 5.434, 95% confidence interval: 1.792-16.472), even after adjusting for socioeconomic factors and physical health status. These findings underscore the positive impact of broad access to health information on the dietary habits of older individuals. The study highlights the importance of promoting access to diverse health information sources to enhance dietary variety and overall well-being among rural older adults.

The prevalence, risk factors and clinical implications of dehydration in older patients: a cross-sectional study

OBJECTIVES

Adequate hydration is essential for the maintenance of physiological functions. Older adults may not be able to maintain adequate hydration, which is often not recognized. Our aim was to investigate the prevalence, risk factors and clinical implications of dehydration in older adults.

METHODS

This cross-sectional study included 964 older adults in one geriatric outpatient clinic in Turkey. Dehydration was defined as a calculated [1,86 × (Na+K)+1,15×glucose+urea +14] plasma osmolarity of ≥ 295 mOsm/L. Clinical characteristics and measures of comprehensive geriatric assessments of patients with dehydration and normohydration were compared. Predictors of dehydration were assessed using logistic regression analysis.

RESULTS

Mean age was 79.9 ± 7.7 years, (71.7% female). The prevalence of dehydration was 31%. Female patients, diabetes mellitus (DM), chronic renal failure (CKD), a higher risk of falling (based on Timed Up and Go test), probable sarcopenia, dependence based on basic and instrumental daily living activities (BADL and IADL) were more common in the dehydrated group (p < 0.05). After adjusting for age and gender, dependency on BADL and IADL, the risk of falling were still higher in the dehydrated group (p < 0.05). There were significant relationships between dehydration and risk of falling (OR 1.38, 95% CI 1.00-1.90; p < 0.05), after adjustment for age, gender, DM, CKD.

CONCLUSION

Dehydration is common among older adults and is associated with a dependency, probable sarcopenia, and an increased risk of falling. Screening for dehydration and taking preventive measures may be beneficial in avoiding the negative consequences associated with dehydration.

Older adults' needs and preferences for a nutrition education digital health solution: A participatory design study

BACKGROUND

The global population is ageing rapidly and there is a need for strategies to promote health and wellbeing among older adults. Nutrition knowledge is a key predictor of dietary intake; therefore, effective educational programmes are urgently required to rectify poor dietary patterns. Digital health technologies provide a viable option for delivering nutrition education that is cost-effective and widely accessible. However, few technologies have been developed to meet the unique needs and preferences of older adults.

OBJECTIVE

The aim of this study was to explore technology use among older adults and qualitatively determine the content needs and design preferences for an online nutrition education resource tailored to older adult consumers in Australia.

METHODS

Twenty adult participants aged 55 years and older (95% female) participated in one of four 2-h participatory design workshops. In each workshop, prompted discussion questions were used to explore participants' technology use and preferences and to explore content needs and design preferences for an online nutrition education resource specific to older adults.

RESULTS

All participants were regularly using a range of different devices (e.g., smartphones, tablets and computers) and reported being comfortable doing so. Participants wanted a website that provided general nutrition information, practical advice and recipes. To enhance engagement, they sought a personalised resource that could be adjusted to suit their needs, included up-to-date information and allowed for easy sharing with others by exporting information as a PDF.

CONCLUSIONS

Participatory design methods generate new knowledge for designing and tailoring digital health technologies to be appropriate and useful for the target audience. Specifically, older adults seek an online resource that has large and simple fonts with clear categories, providing them with practical advice and general nutrition information that can be personalised to suit their own needs and health concerns, with the option to export and print information into a paper-based format.

PATIENT OR PUBLIC CONTRIBUTION

Older adults actively participated in the development and evaluation process to generate ideas about potential features, functionalities, uses and practicalities of an online nutrition education resource.

Exploring Rice Consumption Habits and Determinants of Choice, Aiming for the Development and Promotion of Rice Products with a Low Glycaemic Index

Current consumption drivers, particularly those related to health and wellbeing, have been influencing trends for the lower consumption of cereals, particularly rice, due to their typical high glycaemic index (GIs) and consequent impacts on obesity. To satisfy this consumer concern, more food innovations that promote healthy eating habits are required. Such innovations must be consumer-oriented to succeed, understanding the dynamics of consumer habits and responding to consumer expectations. This study explored these habits, from acquisition to consumption practices, and the expectations of the European market from the perspective of the major European consumer, Portugal, to obtain insights that support the development of low glycaemic index (GI) rice products. A mixed-methods approach was applied. For the first quantitative questionnaire, 256 Portuguese rice consumers aged 18-73 years were recruited. Twenty-four individuals were selected according to their gender and rice consumption profiles for in-depth interviews. The results confirmed that rice was the main side dish for the participants and was mainly consumed at home, cooked from raw milled rice. The drivers of consumption differ according to the provisioning process stage. In the acquisition stage, participants reported benefits from the rice's dynamic market by comparing products on price, brand, and rice types. In the preparation stage, participants reported the adequacy of the recipe and occasion, while in the consumption stage, participants enhanced their sensory preferences, depending on the rice dish. Although the GI concept was unknown to half of the participants, it was perceived as interesting and positive for healthy eating. Consumers showed concern about the taste and naturalness of the product, preferring it to be as close to a homemade dish as possible. The negative perceptions we verified were interpreted to be due to a lack of knowledge about the GI concept. Therefore, awareness actions and informative campaigns are recommended to promote low-GI rice products.

Perception of typical migraine images on the internet: Comparison between a metropolis and a smaller rural city in Germany

The medial portrayal of migraine is often stereotypical and inaccurate but reflects how society perceives migraine. The discrepancy between others' views and the reality of affected individuals may negatively affect access to treatment and the disease course of patients with migraine. This study aimed to investigate whether images presented in the media as typical migraine attacks are perceived as realistic and representative by migraine patients in Rostock, a smaller town in rural Germany, and compare the results to those from Berlin, a large metropolis. We performed an online survey in Rostock. Migraine patients were shown ten images of migraine attacks, which were among the most downloaded stock pictures on the internet under the search term "migraine". They rated on a scale of 0-100 to what extent the pictures were realistic for migraine attacks (realism score), representative of their own migraine (representation score), or the society's view of migraine (society score). In addition, we compared our results with a recently published study from the metropolitan region of Berlin. A total of 174 migraine patients completed our survey. Mean (SD) realism, representation, and society scores were 59.9 (17.5), 56.7 (18.3), and 58.4 (17.1) respectively. Images of older patients were perceived as significantly more realistic and representative than those of younger patients (P < .001). Patients in Rostock (rural region) rated the images as significantly more realistic and representative than survey participants in Berlin (metropolis). Migraine patients in a rural region found typical migraine images only moderately realistic and representative but to a higher degree than their counterparts from a metropolis.

Socio-Demographic, Behavioral and Psychological Factors Associated with High BMI among Adults in a Southeast Asian Multi-Ethnic Society: A Structural Equation Model

While various influencing factors of overweight and obesity have been identified, the underlying mechanism remains unclear. We examined the relationships among sociodemographic, behavioral, and psychological factors on anthropometry in a multi-ethnic population with overweight and obesity. Participants (N = 251) were recruited from January to October 2022. Mean age and self-reported BMI were 31.7 ± 10.1 years and 29.2 ± 7.2 kg/m². Participants were mostly female (52.4%) and overweight (58.2%). Multivariate multiple regression was performed using maximum likelihood estimation. Body mass index was associated with waist circumference, age, sex, race, marital status, education level, residential region, overeating habit, immediate thinking, self-regulation, and physical activity, but not anxiety, depression, or the intention to change eating habits. Final model indicated good fit: χ² (30, N = 250) = 33.5, p = 0.32, CFI = 0.993, TLI = 0.988, RMSEA = 0.022, and SRMR = 0.041. Direct effects were found between BMI and overeating (β = 0.10, p = 0.004), race (β = -0.82, p < 0.001), marital status (β = -0.42, p = 0.001), and education level (β = -0.28, p = 0.019). Crisps (68.8%), cake (66.8%) and chocolate (65.6%) were identified as the most tempting foods. Immediate thinking indirectly increased overeating habits through poor self-regulation, although sociodemographic characteristics better predicted anthropometry than psycho-behavioral constructs.

Personalized dietary advices provided by a dietitian increase calcium intake in outpatients with multiple sclerosis-Results from a randomized, controlled, single-blind trial

Background and aims

Multiple sclerosis (MS) is associated with osteoporosis, possibly due to neurological disability and decreased calcium intake. The objective of this study was to evaluate the efficacy of a personalized nutritional advice program by a dietitian compared to the delivery of a standard advice form to optimize dietary calcium intake in outpatients with MS.

Methods

We performed a randomized, controlled, parallel trial comparing the efficacy of a personalized dietary advice (PDA) program to standard advice form (SAF) to increase daily calcium intake in MS patients. The study population was composed by patients with relapsing-remitting MS aged 18-69 years old. PDA program consisted in dietary advice delivered by a dietitian at baseline, 1 month, and 3 months. Calcium and nutrient intake in patients from both groups was evaluated at baseline and 6 months using a dietary survey.

Results

Of the 194 patients screened for inclusion, 182 patients were included (79% female, median age of 42 years, and median EDSS of 2.0), and randomized to SAF (n = 92) or PDA (n = 90). At 6 months, median calcium intake increased by 241 mg/day in the PDA group and decreased by 120 mg/day in the SAF group (p < 0.0001). However, the median calcium intake was 947 mg/day in the SAF group and 778 mg/day in the PDA group at baseline (p = 0.0077), potentially favoring the effect of dietary advice. Complementary analyses focusing on patients with insufficient calcium intakes at baseline revealed comparable values in both groups (p = 0.69). Of those, patients included in the PDA group obtained significantly higher calcium intakes at 6 months than patients from the SAF group (p = 0.0086) independently of EDSS, PASAT, HADS and EQ-5D scores.

Conclusion

This work shows the efficacy of dietary management based on personalized advice program over 3 months to durably increase calcium consumption in MS patients with insufficient calcium intake.

Clinical trial registration

clinicaltrials.gov, identifier NCT02664623.

Development and validation of a short nutrition literacy scale for young adults

Background

Due to their high media use, young adults are frequently exposed to contradictory or even erroneous nutrition information. To properly handle and critically assess nutrition information, young adults (both general population and patient populations) need adequate levels of nutrition literacy. Currently there is a lack of suitable instruments to measure nutrition literacy in young adults (18-25 years). Therefore the aim of this study was to develop and validate a Short Nutrition Literacy (S-NutLit) scale for use in this age group.

Methods

Development and validation of the S-NutLit consisted of six phases: (1) item generation based on literature, (2) expert assessments to evaluate content validity, (3) cognitive interviews with the target population to assess face validity and readability, (4) pre-test to reduce the number of items, (5) validation survey to assess dimensionality with exploratory factor analyses, internal reliability with Cronbach alpha, construct and criterion validity by examining associations with age, gender, education level, health literacy, general literacy, dietary behaviors and physical activity with correlations, ANOVAs, and t-tests, (6) two-week follow-up survey to assess test-retest reliability with intra-class correlations.

Results

Starting from an initial pool of 53 items, expert assessments and cognitive interviews led to the reformulation, removal, and construction of items. Young adults aged 18-25 years participated in cognitive interviews (n = 12), pre-test (n = 101), validation survey (n = 300), and reliability survey (n = 92). The final S-NutLit consisted of 11 items rated on a 5-point scale distributed across two subscales (i.e., information skills and expert skills). Cronbach alpha values ranged from 0.79 to 0.83 and intraclass correlations from 0.61-0.79 (p < 0.001). Significant associations were observed with health literacy (r = 0.27, p < 0.001), general literacy and numeracy (r_s = 0.12, p = 0.046), and education level (r_s = 0.13, p = 0.025).

Conclusion

Findings indicate that the S-NutLit is a valid and reliable tool to assess nutrition literacy among young adults. The S-NutLit fills a gap in the field by offering a short measure of nutrition literacy and may be incorporated in digital technology to support the nutrition care process.

Patients' and Health Care Workers' Perception of Migraine Images on the Internet: Cross-sectional Survey Study

BACKGROUND

The representation of migraine in the media is stereotypical. Standard images of migraine attacks display stylish young women holding their head in a pain pose. This representation may contribute to the social stigmatization of patients with migraine.

OBJECTIVE

We aimed to analyze how patients with migraine and health care workers perceive online images of migraine.

METHODS

The study consisted of an anonymous web-based survey of patients with migraine at the Headache Center of Charité - Universitätsmedizin Berlin (migraine group) and employees and students at our university (health care group). A total of 10 frequently used Adobe Stock photos of migraine attacks were presented to the participants. Each photo was rated on a scale of 0% to 100% based on how closely it resembled a realistic migraine attack (realism score). Patients with migraine also indicated how much each photo corresponded to their own experience of migraine as a percentage (representation score). We calculated the mean realism and representation scores for all photos and conducted further analyses using the categories male or female models, younger or older models, and unilateral or bilateral pain pose.

RESULTS

A total of 367 patients with migraine and 331 health care employees and students completed the survey. In both groups, the mean realism score was <50% (migraine group: 47.8%, SD 18.3%; health care group: 46.0%, SD 16.2%). Patients with migraine identified their own migraine experience in these photos to a lesser degree (mean representation score 44.4%, SD 19.8%; P<.001 when compared to the realism score). Patients and health care workers considered photos with male models to be more realistic than photos with females (P<.001) and photos with older models to be more realistic than those with younger people (P<.001). In the health care group only, a bilateral pain posture was deemed more realistic than a unilateral pose (P<.001).

CONCLUSIONS

Standard images of migraine attacks are considered only slightly or moderately realistic by patients and health care workers. Some characteristics perceived as more realistic such as male sex or older age are in contrast with migraine epidemiology. A more accurate representation of migraine in the media could help to raise awareness for migraine and reduce the associated stigma.

Aged Persons Living with HIV and Nutritional Wellness: Analysis of 2013 South Africa-SAGE Well-Being of Older People Study (WOPS) Wave 2

INTRODUCTION

This study sought to examine the nutritional wellness among aged persons living with HIV in Somkhele, South Africa.

METHODS

Data were extracted from the 2013 South Africa-SAGE Well-Being of Older People Study (WOPS) Wave 2. The study sampled 440 aged persons (50 years and above). The proportion of the aged persons with high nutritional wellness by key covariates was reported with chi-square and p-values (p < 0.05). Two-level binary logistic regression models were fitted.

RESULTS

Results show that there were more aged women (79.8%) than men (20.2%) and the younger old (50-64) dominated (65.7%) in the ages, among the respondents. A higher percent of the aged persons were widows (39.5%) and had no formal education (46.1%). Six in 10 aged persons were HIV infected (59.5%). Percentage distribution of men with high nutrition was higher (78.7%). Regression results show that having nutritional wellness was low for aged persons who were infected by HIV (OR = 0.74, 95% CI = 0.69, 1.26) when compared to those who were not infected. Regarding ages of respondents, having high nutritional wellness was higher for young old (65-74 years) (OR = 1.21, 95% CI = 0.65, 2.25) compared to younger old (50-64 years).

CONCLUSION

This study suggests that age, education, source of drinking water, household source of income, and financial situation are important for nutritional wellness of aged persons who are HIV infected in South Africa. Moreover, having HIV infection is associated with low nutritional wellness. Being a young old (65-74 years) and receiving government grants and with better financial situation is associated with high nutritional wellness. Stakeholders and agencies who have interest in aged persons affected by HIV must understand the socioeconomic status in relation to their nutritional wellness. The results are of great importance to ageing policies, specifically in health and nutrition.

Visceral adiposity index and its association with Dietary Approaches to Stop Hypertension (DASH) diet scores among older adults: National Health and Nutrition Examination Surveys 2011-2014

BACKGROUND & AIMS

The visceral adiposity index (VAI) has been shown to be a reliable estimate of visceral adiposity, but little is known about its association with specific dietary patterns such as the Dietary Approaches to Stop Hypertension (DASH) diet, particularly in older adults. Many studies have shown the DASH diet to be beneficial for cardiometabolic health. The purpose of this study was to investigate the relationship between DASH diet scores and the VAI in older adults using a nationally representative dataset.

METHODS

Using the National Health and Nutrition Examination Surveys (NHANES) from 2011 to 2014, data from 508 community-dwelling older adults were examined, and dietary intake was evaluated using the Dixon's DASH diet index. Using multiple linear regression analysis, the relationship between VAI and DASH diet score was assessed while controlling for demographic variables.

RESULTS

Participants' average DASH diet score was 2.41 (SE = 0.07), and the average VAI was 1.55 (SE = 0.08). The results suggest a significant inverse relationship between the DASH diet and VAI (β = -0.19, t = -2.73, p = 0.009).

CONCLUSIONS

Results of this study suggest that protective properties of the DASH diet pattern may be due in part to its inverse relationship with visceral adiposity. This information supports practitioners' use of the VAI with older adults in addition to providing nutrition counseling with the DASH diet to reduce patients' cardiometabolic risk.

Unhealthy aging? Featuring older people in television food commercials in China

Objectives

Advertising messages can affect the public as a risk or protective factor for socially disadvantaged groups, and they may reflect how characters reflect perceptions are perceived in a society. This study aimed to investigate how older people are portrayed in televised food commercials from the approach of a healthy aging perspective in contemporary Chinese society.

Methods

All televised advertising in the Ad Topic archive were screened against inclusion and exclusion criteria, and a total of 164 commercials from the years of 2016–2019 that portrayed Chinese older people were sampled. The association between the main older characters with the product categories, healthy vs. unhealthy foods, use of health claims, sex, type of spokesperson, companions, and tones and manners were included in the analysis.

Results

Older people more frequently appeared in unhealthy food products than in healthy food products. Health claims involving older adults were portrayed adequately, whereas nursing professions as companions of older adults were overlooked. Positive advertising that delivered happy, caring, or warm tones was overwhelmingly represented. Thus, the advertising messages circulated in China represent a binary stereotype model of images of older adults’ characteristics that reflect ageist and the so-called agelessism, referring to the new application of the look from the approach of social psychology and marketing field.

Conclusions

This study examined aging discrimination reflected in advertisements. Studies exploring the impact of a crisis remain limited. Research is needed to improve the accuracy of advertised healthy older adults and normal aging.

Health claims and information sources in relation to bean consumption in older adults

Bean consumption can reduce chronic disease risk and improve diet quality; however, bean consumption among North Americans is low. Since health claims and other information sources could increase bean consumption, their exploration is warranted, particularly among older adults, a population well positioned to benefit. The purpose of this study was to explore bean consumption among older adults (≥65 years old) in relation to health claims and other information sources. A mixed-methods explanatory sequential study design utilizing a between strategy data collection approach was used. Community-dwelling older adults (n = 250; 76.0% female) completed a validated researcher-administered questionnaire to explore bean consumption, awareness and reading of health claims, the likelihood of health claims influencing bean consumption, and current and preferred sources of nutrition and/or health information regarding beans. The questionnaire was followed up with 10 semi-structured focus groups (n = 46; 76.1% female). Awareness of nutrient content, nutrient function, therapeutic and disease risk reduction claims was reported by 94.4%, 64.0%, 79.6% and 77.2% of participants, respectively. Among those aware, these health claims were read by 91.5%, 85.6%, 87.9% and 88.6% of participants, respectively. The prevalence of bean consumption was 51.2% and participants (46.8%) most frequently indicated that all health claims would equally increase their likelihood of bean consumption. Participants (72.0%) reported that they would like more information about the nutrition and/or health properties of beans, with their most common preferred sources including food labels (54.8%), brochures (51.2%) and the internet (47.2%). This research advances the literature on how health claims relate to eating behaviour and can inform regulatory and food industry scientists about consumer perception to bean health claims, and healthcare professionals about preferred information sources for their clients.

Improving rural newspaper coverage of nutrition stories: an educational assessment of editors' attitudes and learning needs

Local newspapers are an important source of information for rural residents but often lack accurate or helpful nutrition-related information. To improve the quantity and quality of nutrition stories in rural, local newspapers, it is important to understand the perspective of editors. An online survey of 51 rural Midwest editors was conducted to assess attitudes toward writing nutrition stories, sources of information, perceived challenges, and interest in learning more about writing such stories. Of respondents, 49% were female, and 63% had at least a 4-year college degree. Through a mix of closed- and open-ended questions, the majority indicated positive attitudes toward nutrition stories, were confident in their abilities to write them, and expressed interest in learning more. Challenges cited include lack of print space, small staff, lack of specific requests from readers for nutrition stories, and the need to avoid offending local agricultural businesses. Results should be useful in planning an educational intervention for editors. Meanwhile, public health practitioners should provide concise press releases to their local newspapers about their activities. Also, greater expressions of appreciation from public health professionals and other readers may lead to higher prioritization of nutrition-related stories, and ultimately to an environment more supportive of healthy eating.

Media coverage and awareness of the 2010 Dietary Guidelines for Americans and MyPlate

PURPOSE

To examine the extent and content of coverage of the 2010 Dietary Guidelines for Americans (DGA) and MyPlate in selected mass media outlets and to determine the prevalence of awareness of this recent guidance among adults.

DESIGN

Qualitative content analysis of media coverage, from January 2011 to October 2011, and a cross-sectional survey of the 2010 DGA and MyPlate.

SETTING

Large metropolitan area.

PARTICIPANTS

Four major newspapers (New York Times, Wall Street Journal, New York Daily News, and New York Post), three network television channels (ABC, CBS, and NBC), and six print magazines (Cooking Light, Ebony, Essence, Jet, O! The Oprah Magazine, and Shape). Adults aged ≥50 years (n = 200), college students (n = 219), and African-American women (n = 167); response rates >70%.

METHODS

Number and content of news stories and self-administered survey of prevalence of awareness of DGA and MyPlate.

RESULTS

Twelve newspaper, 14 television, and two magazine stories covered the 2010 DGA and MyPlate. The DGA coverage emphasized population-group-specific sodium recommendations, and MyPlate coverage emphasized the plate icon. Awareness of the DGA and MyPlate varied from approximately 6% in college students to 22% among ≥50-year-olds.

CONCLUSION

The newspapers and television (but not magazines) covered both the 2010 DGA and MyPlate; the content was accurate but brief. However, the awareness of this guidance in study samples was low.

The association of geographical location and neighbourhood deprivation with older people's use of NHS Direct: a population-based study

BACKGROUND

no research has investigated how older people's use of NHS Direct, the 24-h telephone health advice and information service in England and Wales, varies according to geographical location and deprivation.

OBJECTIVES

to describe the geographic pattern of older people's use of NHS Direct and examine the relationship between service use and deprivation.

DESIGN

descriptive, exploratory, cross-sectional, population-based study.

SETTING

calls to all 32-NHS Direct contact centres in England/Wales.

PARTICIPANTS

people aged 65 years and above who used NHS Direct between 1 December 2007 and 30 November 2008.

RESULTS

differences in older people's use of NHS Direct were observed in England and Wales. In England, the call rate was highest in Yorkshire and the Humber and was lowest in the West Midlands. At the postcode level, the rate of calls ranged from 0.167 (Blackburn) to 0.011 (Carlisle) per person per annum. In England, but not in Wales, the level of deprivation was associated with the rate of calls, older people living in the most deprived areas had the highest rate of calls to NHS Direct.

CONCLUSIONS

the results are useful for future planning to meet the needs of older people, and in informing national policies for the development of NHS Direct.

Use of nutritional information in Canada: national trends between 2004 and 2008

OBJECTIVE

To examine longitudinal trends in use of nutrition information among Canadians.

DESIGN

Population-based telephone and Internet surveys.

SETTING AND PARTICIPANTS

Representative samples of Canadian adults recruited with random-digit dialing sampling in 2004 (n = 2,405) and 2006 (n = 2,014) and an online commercial panel in 2008 (n = 2,001).

MAIN OUTCOME MEASURES

Sociodemographic predictors of label use, use of nutrition information sources, and nutrient content information.

ANALYSIS

Linear and logistic regression models to examine predictors and changes over time.

RESULTS

Food product labels were the most common source of nutritional information in 2008 (67%), followed by the Internet (51%) and magazines/newspapers (43%). The Internet was the only source to significantly increase during the study period (odds ratio = 1.39; P < .001); however, the frequency of reading food product labels increased since 2004. Food selection based on trans fat increased significantly in 2006 (odds ratio = 1.43; P < .001) after mandatory labeling of trans fat on packaged foods. Taste and nutrition were consistently the primary factors guiding food choice.

CONCLUSIONS AND IMPLICATIONS

Food product labels and the Internet are nutrition information sources with broad reach. More comprehensive labeling regulations were associated with increased use of labels and nutrient information over time.

Physical activity information seeking and advertising recall

The purposes of this research were to examine the characteristics of those who look for physical activity-related information, where they find it, and to examine what types of physical activity-related advertisements are recalled (i.e., publicly funded or commercial). These purposes were tested using secondary data analyses from two population health surveys. Results from the first survey (n=1211) showed gender, age, education, and activity-level differences in who is more likely to search for physical activity-related information. Adding the goal of being active into the model made age and activity level no longer significant but gender and education remained significant factors. The Internet was the most often cited source of physical activity information. The second survey (n=1600) showed that adults 55 years of age or older and participants with the least amount of education were more than twice as likely to name commercial advertisements than were participants aged 18-54 years or those with more education. These results help further our understanding of how publicly funded promotional campaigns fare against commercial advertising and also highlight the need to understand physical activity information-seeking behavior on the Internet and its implications for health promotion.

Barriers and catalysts of nutrition literacy among elderly Japanese people

Improving skills for accessing and utilizing diet/nutrition information is important for preventing non-communicable diseases and frailty among elderly people. With the rapidly increasing number of elderly people in the world, promoting nutrition literacy among them is a pivotal health policy for maintaining and promoting health. This article describes the barriers and catalysts of nutrition literacy among elderly Japanese people (aged ≥75 years). A cross-sectional analysis of the responses to a questionnaire administered to 678 study participants (men = 347, women = 331) was conducted. Logistic regression analysis revealed that more men had limited nutrition literacy than did women. After stratification by gender, the limited nutrition literacy group was associated with cognitive difficulty in men and women, visual impairment in men and hearing impairment in women. Lower education level and economic status were associated with limited nutrition literacy among women. Adjusted odds ratios (ORs) controlling for age, education level and economic status, as well as cognitive, visual and hearing function, indicated that informational support [OR = 5.59, 95% confidence interval (95% CI) = 1.28-24.49] and diet/nutrition information obtained from friends of the participants (OR = 2.16, 95% CI = 1.11-4.20) were both associated with adequate nutrition literacy among men, whereas diet/nutrition information from health professionals (OR = 3.96, 95% CI = 1.97-7.95) had a significant relation with adequate nutrition literacy among women. Moreover, in the adequate nutrition literacy group, men were more likely to be overweight (OR = 2.17, 95% CI = 1.20-3.91). These findings suggested that cognitive and sensory functions should be taken into account when diet information is provided to older adults. Enhancement of social networks is also a key point in improving nutrition literacy. An effective intervention to improve nutrition literacy in elderly people, particular old men, warrants further investigation.

Physical activity related information sources predict physical activity behaviors in adults with type 2 diabetes

Physical activity (PA) is a key management strategy for type 2 diabetes. Despite the known benefits, PA levels are low. Whether the low level of PA is related to lack of knowledge or support is not fully understood. This study was conducted to describe where and how often adults with type 2 diabetes receive and seek information related to PA and examine the relationships between the source and quality of PA information with PA behaviors. A series of questions related to the source and quality of PA information were added to a baseline survey distributed to the participants (N = 244) of the Canadian Aerobic and Resistance Training in Diabetes (CARED) study. Physicians and television were found to be the main sources of PA-related information. In our cross-sectional model, sources of PA-related information other than that from health care professionals explained 14% (p = .05) and 16% (p < .05) of the variance for aerobic-based and resistance training behaviors and 22% (p < .01) and 15% (p < .05) for these behaviors in our longitudinal model. Physical activity (PA)-related information is widely available to adults with type 2 diabetes. Neither the quantity nor the quality of the PA information provided by health care professionals predicted PA behavior. These data provide further insight into the modes with which PA can be promoted to adults with type 2 diabetes.

Determinants of food expenditure patterns among older consumers. The Spanish case

The continuously evolving lifestyles of European consumers are most noticeable in the elderly age segment, which, as a result, is drawing increasing attention from agrifood companies. The aim of this study is to perform an empirical analysis of the main determinants of food expenditure among elderly Spanish consumers, by comparing key variables reported in the literature, based on data from different years. The performed estimations yield a linear model with three statistically significant variables; type of household, level of education--a proxy measure for family income--and consumer's age. The results enable us to conclude that agrifood companies will need to deal with a changing demographic environment, and increase the flexibility of their supply to adjust to the new situation.

Mass media nutrition information sources and associations with fruit and vegetable consumption among adolescents

Objective

The objective of the present study was to examine associations between exposure to nutrition information as covered in mass media and daily fruit and vegetable (FV) consumption among adolescents.

Design

Cross-sectional nutrition survey.

Setting

Vocational schools in Vienna, Austria.

Subjects

A sample of 2949 ethnically diverse adolescents with mean age 17·3 (sd 1·7) years. An FFQ was used to assess usual FV consumption. Data on mass media exposure and sociodemographic characteristics were collected by means of a self-administered questionnaire. Multiple logistic regression analyses were used to control for potentially confounding variables.

Results

Adolescents who reported exposure to nutrition information provided by booklets, the Internet or newspaper articles were more likely to eat FV daily. For example, the OR for daily fruit consumption (ORfru) was 1·6 (P < 0·001) when exposure to the Internet was reported after adjustment for age, gender, ethnicity, BMI and salary. No such associations were found for radio, television and magazines as sources of nutrition information. A negative impact on daily FV consumption was found for exposure to radio commercials (ORfru = 0·74, P = 0·04 and ORveg = 0·67, P = 0·03). Exposure to TV commercials had a negative impact on vegetable consumption (ORveg = 0·81, P = 0·05).

Conclusions

Newspaper articles, the Internet and booklets as a source of nutrition information are positively associated with daily FV consumption among adolescents, whereas radio commercials have a negative impact. Dissemination of ‘healthy eating’ slogans should make use of print media and the Internet.

A mixed methods evaluation of televised health promotion advertisements targeted at older adults

The purpose of this research was to evaluate television advertisements targeted at 55-70-year olds that promoted physical activity and fruit and vegetable consumption. Awareness of the campaign, perceived credibility of the source, intentions to visit a promoted website, and intentions to perform the healthy behaviors were evaluated using mixed methods research. Results from a population level survey (n=1600) showed low unprompted and prompted awareness of the campaign and no differences in intentions or behaviors among those who were aware of the campaign. Unprompted recall resulted in a very wide range of responses including the citation of many commercial advertisers. Qualitative themes that emerged from the focus groups included neutral, positive, and negative comments about the advertisements, source credibility, website considerations specific to seniors, and suggestions about appropriate advertising for older adults. This research showed that the increased attention paid to the advertisements was due in a large part to negative reactions to the character used in the advertisements. Another important finding was the government was not considered to be a credible source of health information. Finally, health promoters should be cautious about websites as the primary source of information, particularly for older adults.

Home and child safety on reality television

Injuries, many of which occur at home, are the leading cause of death for children. With such an extensive problem, it is natural to look for outlets such as mass media to reach large numbers of families with educational messages about safety and injury prevention. Mass media has been widely used to educate people about health issues. While studies have examined the portrayal of topics such as substance use and sexual behavior, no study has looked at media content about home and child safety practices. A pilot study with a sample of 10 television shows about home renovation, children or families was examined using content analysis for the presence or absence of home and child safety practices and products and discussion of injury topics. Most practices, like checking the water temperature when bathing a child or having smoke alarms, were never discussed or shown. Results suggest these shows provide information about home or family life, but few role models are shown offering information or examples of safe practices. Promoting safety information in these television programs may be a potentially important way to educate a large number of people, and feasibility of adding safety information to such shows should be explored.

Health and nutrient content claims in food advertisements on Hispanic and mainstream prime-time television

OBJECTIVE

Characterize frequency and type of health and nutrient content claims in prime-time weeknight Spanish- and English-language television advertisements from programs shown in 2003 with a high viewership by women aged 18 to 35 years.

DESIGN

Comparative content analysis design was used to analyze 95 hours of Spanish-language and 72 hours of English-language television programs (netting 269 and 543 food ads, respectively).

MAIN OUTCOME MEASURES

A content analysis instrument was used to gather information on explicit health and nutrient content claims: nutrition information only; diet-disease; structure-function; processed food health outcome; good for one's health; health care provider endorsement.

ANALYSIS

Chi-square statistics detected statistically significant differences between the groups.

RESULTS

Compared to English-language television, Spanish-language television aired significantly more food advertisements containing nutrition information and health, processed food/health, and good for one's health claims. Samples did not differ in the rate of diet/disease, structure/function, or health care provider endorsement claims.

CONCLUSIONS AND IMPLICATIONS

Findings indicate that Spanish-language television advertisements provide viewers with significantly more nutrition information than English-language network advertisements. Potential links between the deteriorating health status of Hispanics acculturating into US mainstream culture and their exposure to the less nutrition-based messaging found in English-language television should be explored.

Assessment of nutrition and life quality scores of individuals aged 65 and over from different socio-economic levels in Turkey

Determination and assessment of nutritional status of elderly people is important to improve healthy living. The aim of the study was to determine the quality of life (QoL) and nutrition inadequacies of elderly people. For the nutrition risk scanning (NRS) including food consumption frequency with nutrition status of individuals above 65 years of age from different socio-economic status (SES), we selected 1060 elderly subjects. Of them, 400 (200 women, 200 men) are from low SES, 360 (180 women, 180 women) are from medium SES, and 300 (150 women, 150 women) are from upper SES. Their QoL scores were assessed according to the index of competence developed by Tokyo Metropolitan Institute of Gerontology (TMIG-IC). Parallel with the increase in SES, it has been found that scores of nutrition risk and capability index are increased and it is thought that this result is based on increased education status and pecuniary capabilities (p<0.05). Body mass index (BMI) (kg/m(2)) averages have been found as 29.3+/-4.9 kg/m(2) for women, and 26.9+/-4.0 kg/m(2) for men. It has been found that elderly individuals, at each of these three levels, consume milk and milk products at the recommended level (p>0.05), meat and meat products below the recommended level (p<0.05), fruit and vegetables at the recommended level (p<0.05). Lower SES consumes the cereals and cereal products the most. It has been found that daily liquid consumption (water, tea, fruit juice, and buttermilk) does not differ according to SES and is close to the recommended level (2300 ml/day).