Anna Claire Tucker

Objective: To examine how food agency is associated with frequency of cooking dinner at home, frequency of consuming fast food and diet quality among adults in the USA. Design: Analysis of cross-sectional survey and dietary intake data. The survey measured food agency, dinner cooking frequency, fast-food frequency, dietary intake (Prime Diet Quality Score-30 Day (PDQS-30D)) and sociodemographic characteristics. Multivariable Poisson and linear regression models adjusted for sociodemographic characteristics were used to estimate the association between food agency and dinner cooking frequency, fast-food frequency and diet quality. Setting: A national, web-based survey in the USA fielded in November 2023. Participants: Adults aged >18 years living in the USA ( n 4453). Results: Compared with the lowest quartile of food agency, the highest quartile was associated with greater dinner cooking frequency (incidence rate ratio (IRR) = 1·27, P < 0·001), lower fast-food frequency (IRR = 0·74, P < 0·001) and higher diet quality ( β = 6·28, P < 0·001). Higher self-efficacy, more positive attitudes and fewer structural barriers to cooking were associated with greater dinner cooking frequency, lower fast-food frequency and higher diet quality ( P < 0·001 for all). Overall, comparing the highest to lowest quartile of food agency, predicted values were significantly higher for diet quality (Q4: 57·2, Q1: 50·8, P < 0·001) and dinner cooking frequency (Q4: 5·37, Q1: 4·09, P < 0·001) and lower for fast-food frequency (Q4: 4·74, Q1: 6·83, P < 0·001). Conclusions: Food agency is associated with higher dinner cooking frequency, lower fast-food consumption and higher diet quality. Utilising a food agency framework in policies and interventions may be useful to promote greater home cooking and healthier dietary behaviours.

Objective: There is growing public health interest in ultra-processed foods (UPF), but limited research exploring consumers’ perceptions of these foods in the United States. We aimed to characterise consumers’ beliefs about UPF, the association between perceived food processing and perceived food healthfulness and alignment between consumers’ perceptions and objective measures of food processing and healthfulness. Design: In a cross-sectional survey, participants answered questions regarding their beliefs about UPF. They rated the healthfulness and processing levels of a random selection of ten out of forty possible foods. We used descriptive statistics to examine participant beliefs about UPF. We used linear regression models to test associations between perceived processing and perceived healthfulness and between objective and perceived measures of food healthfulness and processing. Setting: We fielded an online survey in the USA in November 2023. Participants: This study included US adults aged ≥ 18 years ( n 4455). Results: Fifty-four percent of participants correctly identified UPF as ‘Food products submitted to a series of industrial processing’ and 52 % correctly identified UPF as, ‘Food products that contain artificial ingredients’. However, one-third of participants believed UPF were genetically modified products. While foods with higher perceived processing tended to have lower perceived healthfulness and individuals perceived UPF as more processed and less healthful than minimally processed foods, healthfulness perceptions better aligned with Food Compass 2.0, a measure that integrates food processing and nutrient-profile. Conclusions: Educational and policy efforts (e.g. food labeling) are needed to help consumers distinguish UPF and holistically assess the healthfulness of foods and beverages.

Purpose: Diet is crucial for improving outcomes among pregnant people with diabetes. We present lessons learned from developing and piloting a program, Diabetes Prevention Program Cooks in Pregnancy (DPP Cooks in Pregnancy), tailored to address unique barriers to healthy eating among this population. Methods: Participants ( n = 23) attended at least one cooking class and completed a post-survey. We used descriptive statistics to summarize findings. Results: DPP Cooks in Pregnancy was well received by participants, with higher enrollment and attendance for virtual classes compared with in-person classes. Conclusion: Lessons learned from DPP Cooks in Pregnancy can inform the development and implementation of future cooking skills interventions.

(1) Background: Independently owned restaurants (IORs) are prevalent in under-resourced racial and ethnic minority communities in the US and present a unique setting for public health nutrition interventions. (2) Methods: We conducted 14 in-depth interviews with IOR owners in Baltimore about their perceptions of healthy food, and customers’ acceptance of healthier menus and cooking methods and concurrent observations of the availability of healthy options on their menus. Qualitative data were coded and analyzed using ATLAS.ti. Observations were analyzed with statistical analysis performed in R. (3) Results: Owners perceived non-fried options, lean proteins, and plant-based meals as healthy. While open to using healthier cooking fats, they had mixed feelings about reducing salt, adopting non-frying methods for cooking, and adding vegetables and whole grains to the menu, and were reluctant to reduce sugar in recipes and beverages. Only 17.5% of 1019 foods and 27.6% of 174 beverages in these IORs were healthy, with no significant differences in the healthfulness of restaurant offerings within low-healthy-food-access/low-income neighborhoods and those outside. (4) Conclusion: Healthy options are generally scarce in Baltimore’s IORs. Insights from owners inform future interventions to tailor healthy menu offerings that are well-received by customers and feasible for implementation.