Carotenoids are a category of health-promoting phytonutrients that are found in a variety of fruits and vegetables and have been used as a biomarker to approximate dietary fruit and vegetable (F/V) intake. Carotenoids are consumed, metabolized, and deposited in blood, skin, and other tissues. Emerging evidence suggests spectroscopy-based skin carotenoid measurement is a noninvasive method to approximate F/V intake. Spectroscopy-based skin carotenoid measurement overcomes bias and error inherent in self-reported dietary recall methods, and the challenges in obtaining, storing, and processing invasive blood samples. The objective of this systematic review was to examine criterion-related validity of spectroscopy-based skin carotenoid measurement as a proxy for F/V intake. The 3 methods examined were resonance Raman spectroscopy (RRS), pressure-mediated reflection spectroscopy (RS), and spectrophotometers. A comprehensive literature search of PubMed, Excerpta Medica Database (Embase), Cumulative Index of Nursing and Allied Health Literature (CINAHL), ProQuest, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials (CENTRAL) was performed in December 2018, yielding 7931 citations. Studies that examined associations between spectroscopy, blood carotenoids, and/or dietary intake were identified and reviewed independently by ≥2 reviewers to determine eligibility for inclusion. Twenty-nine articles met the inclusion criteria and all 29 studies found significant correlations or associations between spectroscopy-based skin carotenoids and plasma or serum carotenoids and/or dietary F/V intake. A majority of the studies evaluated carotenoid concentration in adults; however, 4 studies were conducted in infants and 6 studies evaluated children. Twenty studies specified the racial/ethnic groups from which the samples were drawn, with 6 including ≥20% of the sample from a minority, nonwhite population. The findings of this systematic review support the use of spectroscopy for estimating F/V intake in diverse human populations, although additional validation is needed, particularly among racially/ethnically diverse populations and populations of varying ages.
Food insecurity is a global phenomenon which impacts a variety of social, economic, and life-stage groups. One such group affected by food insecurity is college students, who tend to experience food insecurity at a prevalence which exceeds the average of their local communities. The impacts of food insecurity in this population are multifaceted and have implications for their college experience and beyond. Food insecurity has been observed to have negative effects on college student academic performance, physical health, and mental health. This review explores the impacts of and solutions for food insecurity in this population globally, with particular emphasis on the United States, and specifically California.
Objective: (1) Identify demographic and academic differences among university students who are food secure or food insecure and (2) explore CalFresh knowledge, attitudes, and practices (KAPs) among university students. Design: A questionnaire, including the 10-item USDA Adult Food Security Survey Module, CalFresh KAPs, and student factors was distributed in Winter 2020 to 10,000 university students. Chi-square test of independence, logistic and linear regressions were used to assess associations between food-secure status and student factors. Exploratory factor analysis determined factors relating to CalFresh KAPs. Kendall’s tau assessed association between CalFresh KAPs factors. Setting: A public research university in California. Participants: Enrolled undergraduate and graduate/professional students (n = 10,000). 1535 responses with 1408 included in analysis for having complete data. Results: Food insecurity was associated with: race/ethnicity (Latino/a, OR = 1.97; p < 0.001); first-generation status (OR = 2.01; p < 0.001); and transfer status (OR = 1.58; p = 0.01). Exploratory factor analysis identified five factors related to CalFresh knowledge and attitudes: (1) CalFresh knowledge, (2) Positive attitudes around participating in CalFresh, (3) Negative attitudes around participating in CalFresh, (4) Negative attitudes around others participating in CalFresh, and (5) Fortunate attitudes for not participating in CalFresh. CalFresh knowledge was correlated with positive attitudes towards CalFresh participation (τb = 0.15, p = 0.025); negative attitudes towards other individuals’ CalFresh participation (τb = −0.28, p < 0.001); feeling fortunate for not needing CalFresh (τb = 0.12, p = 0.004); and CalFresh participation OR = 1.40; p = 0.02). Conclusions: CalFresh knowledge may influence program participation. Populations who are most impacted by food insecurity should be a focus for improving CalFresh knowledge to promote CalFresh participation.
Objectives To develop a comprehensive questionnaire which assesses food security and knowledge, attitudes, and practices (KAPs) regarding food access resources at a large public university. Methods A comprehensive food security and food resource questionnaire was developed by a panel of nutrition and survey design experts for use with university students. The questionnaire underwent two rounds of cognitive interviews with a diverse group of university students to ensure questions were understood as intended. Feedback from the first round of cognitive interviews was used to inform changes and improve clarity. The second round of cognitive interviews was used to clarify changes made to the questionnaire during the first round of interviews. Following the cognitive interviews, the questionnaire was reviewed by the panel of nutrition and survey design experts and finalized. Results Following a systematic approach, a comprehensive questionnaire was developed and finalized for use with university students. The initial questionnaire contained 40 questions. Following the first round of cognitive interviews (n = 15 students) 34 questions were revised, 7 questions were added and 1 question was removed. Following the second round of cognitive interviews (n = 10 students), Likert-scale questions were edited for simplicity, and question formatting was edited to emphasize differences in questions that were otherwise identical. Before distribution, 7 questions about food choice were added, food security screening questions were added, and skip-logic was incorporated into the questionnaire and tested. Conclusions The final questionnaire evaluates food resource KAPs and contains 68 items, including questions from the 10-item USDA Food Security Module, and newly developed questions regarding student food choice motivations, sugar-sweetened beverage consumption habits, knowledge/awareness of food access resources, perceptions of food access resources, current student concerns/stressors, and financial considerations. This newly developed questionnaire has been distributed to 10,000 University of California, Davis students. Future applications for this questionnaire include distribution at other universities and colleges within California. Funding Sources This project was funded by an internal University of California, Davis research grant.
Food insecurity (FI) is associated with many adverse outcomes in college students. The Supplemental Nutrition Assistance Program (SNAP, known as CalFresh in California) has been observed to alleviate FI; however, on college campuses, the benefits of food assistance programs are not well understood. This study investigated whether college students benefit from CalFresh participation. It was hypothesized that students would experience increased FI over time and that CalFresh participation would moderate the effect of FI on grade point average (GPA). A comprehensive FI and CalFresh questionnaires were distributed during the 2020–2021 academic year to 849 students. The chi-square test of independence assessed differences between FI and student factors. A Friedman test assessed differences in FI during the three quarters. Moderation analysis assessed whether CalFresh participation moderated FI’s effect on GPA. Differences were observed among food security scores in Winter 2021 (median = 1.69) and Fall 2020 (median = 2.14; p = 0.013) and Spring 2020 (median = 2.17; p = 0.009). In the moderation model, the interaction of FI score and CalFresh participation was positively correlated with GPA (B = 0.11; p = 0.002). These results indicate that SNAP/CalFresh participation was particularly beneficial for mitigating the negative effects of FI on GPA. Given these benefits, encouraging SNAP/CalFresh enrollment should be a priority for university administrators.
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