Location: Office of The Area Director
2020 Annual Report
Objectives
1. Determine if the association between self-assessed and measured diet quality (based on the Healthy Eating Index) in adolescents is moderated by gender, body mass index, and food related behaviors using the most recent National Health and Nutrition Examination Survey and associated Flexible Consumer Behavior Survey datasets.
2. Determine if health behavior relationships in families are moderated or mediated by psychosocial constructs related to diet and physical activity, parenting style, and community/neighborhood environments using the Family Life, Activity, Sun, Health and Eating Study datasets.
3. Measure the different food environments to which children living in the Lower Mississippi Delta region are exposed.
Approach
1. Associations between self-assessed and measured diet quality will be determined for adolescents 16-19 years of age using the 2 most recent cycles of the National Health and Nutrition Examination Survey (NHANES). NHANES is a program of studies designed to assess the health and nutritional status of adults and children in the United States. Self-assessed diet quality will be based upon the Flexible Consumer Behavior Survey item “In general, how healthy is your overall diet?”. Measured diet quality will be computed using dietary intake data collected in the dietary interview component of NHANES, and the Healthy Eating Index, a diet quality scoring system. Moderation analysis will be used to determine if the association between self-assessed and measured diet quality is differentially influenced by gender, body mass index, and food related behaviors.
2. Relationships between adolescent and parent/caregiver dietary and physical activity behavior will be determined using the Family Life, Activity, Sun, Health and Eating Study (FLASHE) datasets. FLASHE is a cross-sectional, Internet based survey that was administered to dyads of parents and their adolescent child (aged 12-17 years) in 2014. It was designed to examine lifestyle behaviors, including diet and physical activity, that relate to cancer risk. Dietary behavior, related psychosocial constructs, and community/neighborhood food environment characteristics will be based upon data from the Teen Diet and Parent Diet Surveys which contained a 27-item dietary screener. Physical activity, measured as minutes of moderate-to-vigorous physical activity, and related psychosocial constructs will be based upon data from the Teen Physical Activity and Parent Physical Activity Surveys. Measures of parenting style will be obtained from the Teen Demographic and Parent Demographic Surveys using the 6 items that pertain to the adolescent/parent(s) relationship. The Actor-Partner Interdependence Model will be used to measure the influence that parents have on their adolescent's dietary and physical activity behaviors.
3. Food outlets will be measured using tools designed to assess community nutrition environments. Childcare facilities will be measured using tools designed to assess child nutrition environments specific to such facilities. Geographical analyses will be conducted to determine if patterns of food outlets are clustered, dispersed, or random in the geographic areas of interest. Census tract data will be mapped to explore spatial relationships among food outlets, child care facilities, and population demographic characteristics such as age, race/ethnicity, and poverty status.
Progress Report
Progress was made on Objectives 2 and 3, both of which fall under National Program 107, Prevention of Obesity and Obesity-Related Diseases. No milestones were set for Objective 1 this year. In support of Objective 2, analyses concerning relationships between parent and child dietary behaviors and intake were completed. Interpretation of these analyses and subsequent reporting of the results were conducted in collaboration with researchers at the University of Central Arkansas and Tufts University. The Family Life, Activity, Sun, Health and Eating Study (FLASHE) is a cross-sectional, internet-based survey that was conducted by the National Cancer Institute and administered to dyads of parents and their adolescent children (12-17 years of age). Latent class analysis was used to identify patterns of parent- and child-reported fruit and vegetable parenting practices as well as junk food and sugary drinks parenting practices. Additionally, moderation analysis was used to determine if presence of neighborhood food outlets differentially affects relationships between dietary intake and food outlet shopping or meal sources. These efforts have resulted in 1 paper published in a peer-reviewed journal, 2 manuscripts submitted for publication to peer-reviewed journals, and 2 abstracts accepted for presentation at international conferences. Both abstracts were presented virtually due to COVID-19 constraints.
In support of Objective 3, measurement of community food environments and analysis of the resulting data were completed. Interpretation of these analyses and subsequent reporting of results were conducted in collaboration with the University of Central Arkansas. The Delta Food Outlets Study involved measurement of food outlets – grocery stores, convenience stores, and restaurants – in 5 rural Lower Mississippi Delta towns using the Nutrition Environment Measures Survey (NEMS) tools. The Delta Produce Sources Study involved the measurement of farmers markets and grocery stores – including availability, source, and price of produce (fresh fruits and vegetables) – in 5 rural Lower Mississippi Delta towns. Data collection began in June 2019 but was halted in March 2020 due to COVID-19 constraints. Additionally, a third study – Farm to School (F2S) Procurement and Simulation Study – was designed and implemented in October 2019. This study aims to determine the amounts of produce purchased by 3 Lower Mississippi Delta school districts during the 2018-2019 school year and conduct a simulation analysis to estimate the impact of implementing a locally grown F2S menu at various replacement levels based on the data from the 2018-2019 school year. Data collection began in December 2019 but was interrupted in March 2020 due to COVID-19 constraints. These efforts have resulted in 2 published papers in peer-reviewed journals, 1 manuscript submitted for publication to a peer-reviewed journal, and 1 abstract accepted for presentation at an international conference. The abstract was presented virtually due to COVID-19 constraints.
Accomplishments
1. Nutrition environments of rural, Lower Mississippi Delta communities are poor. Approximately half of adults in the US have one or more preventable, diet-related chronic disease with higher rates in rural, socioeconomically disadvantaged areas such as the Lower Mississippi Delta. Assessing nutrition environments of rural communities prior to intervention may lead to more successful and lasting intervention effects on diet. ARS researchers in Stoneville, Mississippi, with University of Central Arkansas faculty in Conway, Arkansas, measured the nutrition environments of 5 Lower Mississippi Delta towns and found that all 4 food outlet types – grocery stores, convenience stores, full-service restaurants, and fast food restaurants – scored low achieving only 8% to 54% of maximum points possible. Additionally, all 5 towns contained both food deserts (low access to healthful foods) and food swamps (high access to high-calorie, nutrient-poor foods), often in overlapping patterns. Behavioral interventions designed to improve the diet quality of rural residents living in poor nutrition environments should consider teaching adults and children how to navigate less healthful food environments to select nutritious foods for optimal health.
2. Distinct patterns of food parenting practices exist among parent-adolescent dyads. Parental child feeding practices (e.g., pressure to eat, monitoring, encouragement) affect children’s food preferences, intake patterns, self-regulation of food intake, and weight status. Effects of food parenting practices are important because U.S. adolescents typically do not meet recommendations for fruit and vegetable consumption and exceed recommendations for consumption of added sugars (e.g., junk food and sugary drinks). ARS researchers in Stoneville, Mississippi, with faculty at Tufts University in Boston, Massachusetts, and the University of Central Arkansas in Conway, Arkansas, analyzed data from over 1,500 parent-adolescent dyads who participated in the Family Life, Activity, Sun, Health and Eating Study and identified 5 patterns of parenting practices regarding fruits and vegetables and 5 patterns regarding junk food and sugary drinks. Patterns ranged from use of all 6 parenting practices to use of few practices and parent- and child-reports were generally in agreement for all but one of the classes in each food group. Additionally, patterns were associated with parent (sex) and adolescent (age, sex) demographic characteristics, dietary intake, and legitimacy of parental authority (belief that parents have the right to set rules about their children’s food intake). Counseling or intervening with parents to use a mix of structure and autonomy support practices, such as modeling, availability, and child involvement, to positively influence their children’s and possibly their own dietary intake may prove more efficacious than use of coercive control practices, such as pressure to eat and restriction.
3. Parent and adolescent diets are affected by neighborhood presence of food outlets, shopping at food outlets, and meals sources. Exposure to nutrition environments can affect an individual’s dietary choices both positively and negatively. However, research assessing relationships between diet and food outlet presence in neighborhoods and between diet and shopping at food outlets is inconsistent. ARS researchers in Stoneville, Mississippi, with faculty at the University of Central Arkansas in Conway, Arkansas, analyzed data from over 1,500 parent-adolescent dyads who participated in the Family Life, Activity, Sun, Health and Eating Study and determined that presence of neighborhood farmers markets as well as shopping at farmers markets positively affected parent diets (increased intakes of fruits, vegetables, and whole grains). Conversely, shopping at convenience stores and eating meals away from home at restaurants adversely affected both parent and adolescent diets (increased intakes of added sugars). Eating scratch cooked meals at home positively affected both parent and adolescent diets (increased intakes of fruits, vegetables, and whole grains). Thus, regardless of neighborhood nutrition environments, interventions and policies designed to bring about positive changes in familial diets should consider teaching adults and children how to shop for healthful foods at numerous types of food outlets, avoid or reduce frequency of eating away from home, and cook and consume meals at home, particularly those that are scratch cooked.
Review Publications
Thomson, J.L., Goodman, M.H., Landry, A.S. 2020. Measurement of nutrition environments in grocery stores, convenience stores, and restaurants in the Lower Mississippi Delta. Preventing Chronic Disease. 17/190293. https://doi.org/10.5888/pcd17.190293.
Tussing-Humphreys, L.M., Thomson, J.L., Goodman, M.H., Landry, A.S. 2019. Enhanced vs standard Parents as Teacher curriculum on factors related to infant feeding among African American women. Southern Medical Journal. 112(10):512-519. https://doi.org/10.14423/SMJ.0000000000001024.
Porter, K., Thomson, J.L., Zoellner, J. 2020. Predictors of engagement and outcome achievement in a behavioural intervention targeting sugar-sweetened beverage intake among rural adults. Public Health Nutrition. 23(3):554-563. https://10.1017/S1368980019003392.
Thomson, J.L., Landry, A.S., Tussing-Humphreys, L.M., Goodman, M.H. 2020. Diet quality of children in the United States by body mass index and sociodemographic characteristics. Obesity Science & Practice. 6(1):84-98. https://doi.org/10.1002/osp4.388.
Goodman, M.H., Thomson, J.L., Landry, A.S. 2020. Food environment in the Lower Mississippi Delta: food deserts, food swamps, and hot spots. International Journal of Environmental Research and Public Health. 17/(10):3354. https://doi.org/10.3390/ijerph17103354.
Thomson, J.L., Hennessy, E., Landry, A.S., Goodman, M.H. 2020. Patterns of food parenting practices regarding fruit and vegetables among parent-adolescent dyads. Childhood Obesity. 16(5):340-349. https://doi.org/10.1089/chi.2020.0087.
