Energy-Adjusted Dietary Intakes Are Associated with Perceived Barriers to Healthy Eating but Not Food Insecurity or Sports Nutrition Knowledge in a Pilot Study of ROTC Cadets
Abstract
:1. Introduction
2. Materials and Methods
2.1. Experimental Design and Participants
2.2. Procedures
2.3. Instruments
2.3.1. Perceived Barriers to Healthy Eating
2.3.2. Sports Nutrition Knowledge
2.3.3. Food Security
2.3.4. Dietary Intake
2.4. Data Analysis
3. Results
3.1. Participants
3.2. Perceived Barriers to Healthy Eating
3.2.1. Instrument Evaluation
3.2.2. Perceived Barriers Scales
3.3. Food Insecurity
3.4. Sports Nutrition Knowledge
3.5. Dietary Intake
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Scofield, D.E.; Kardouni, J.R. The Tactical Athlete: A Product of 21st Century Strength and Conditioning. Strength Cond. J. 2015, 37, 2–7. [Google Scholar] [CrossRef]
- Department of Army Headquarters Holistic Health and Fitness (FM 7-22). Available online: https://armypubs.army.mil/epubs/DR_pubs/DR_a/ARN30714-FM_7-22-000-WEB-1.pdf (accessed on 23 July 2021).
- Farina, E.K.; Thompson, L.A.; Knapik, J.J.; Pasiakos, S.M.; Lieberman, H.R.; Mcclung, J.P. Diet Quality Is Associated with Physical Performance and Special Forces Selection. Med. Sci. Sports Exerc. 2020, 52, 178–186. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Lutz, L.J.; Gaffney-Stomberg, E.; Williams, K.W.; McGraw, S.M.; Niro, P.J.; Karl, J.P.; Cable, S.J.; Cropper, T.L.; McClung, J.P. Adherence to the Dietary Guidelines for Americans Is Associated with Psychological Resilience in Young Adults: A Cross-Sectional Study. J. Acad. Nutr. Diet. 2017, 117, 396–403. [Google Scholar] [CrossRef] [PubMed]
- Smith, A.; Emerson, D.; Winkelmann, Z.; Potter, D.; Torres-McGehee, T. Prevalence of Eating Disorder Risk and Body Image Dissatisfaction among ROTC Cadets. Int. J. Environ. Res. Public. Health 2020, 17, 8137. [Google Scholar] [CrossRef]
- American College Health Association. National College Health Assessment III: Undergraduate Student Reference Group Executive Summary Spring 2021; American College Health Association: Silver Spring, MD, USA, 2021; Available online: https://www.acha.org/documents/ncha/NCHA-III_SPRING-2021_UNDERGRADUATE_REFERENCE_GROUP_EXECUTIVE_SUMMARY.pdf (accessed on 4 August 2021).
- Burrows, T.; Whatnall, M.; Patterson, A.; Hutchesson, M. Associations between Dietary Intake and Academic Achievement in College Students: A Systematic Review. Healthcare 2017, 5, 60. [Google Scholar] [CrossRef] [Green Version]
- U.S. Department of Agriculture; U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020–2025, 9th ed.; USDA: Washington, DC, USA, 2020. Available online: DietaryGuidelines.gov (accessed on 15 July 2021).
- Abbey, E.L.; Wright, C.J.; Kirkpatrick, C.M. Nutrition Practices and Knowledge among NCAA Division III Football Players. J. Int. Soc. Sports Nutr. 2017, 14, 13. [Google Scholar] [CrossRef] [Green Version]
- Rittenhouse, M.; Scott, J.; Deuster, P. Healthy Eating Index and Nutrition Biomarkers among Army Soldiers and Civilian Control Group Indicate an Intervention Is Necessary to Raise Omega-3 Index and Vitamin D and Improve Diet Quality. Nutrients 2020, 13, 122. [Google Scholar] [CrossRef] [PubMed]
- U.S. Army Public Health Center. Health of the Force. 2020. Available online: https://phc.amedd.army.mil/PHC%20Resource%20Library/2020-hof-web.pdf (accessed on 15 July 2021).
- Healthy Base Initiative. Available online: https://bipartisanpolicy.org/download/?file=/wp-content/uploads/2019/03/Healthy-Base-Initiative-Report.pdf (accessed on 3 August 2021).
- Chukwura, C.L.; Santo, T.J.; Waters, C.N.; Andrews, A. ‘Nutrition Is out of Our Control’: Soldiers’ Perceptions of Their Local Food Environment. Public Health Nutr. 2019, 22, 2766–2776. [Google Scholar] [CrossRef] [Green Version]
- Jagim, A.R.; Fields, J.B.; Magee, M.; Kerksick, C.; Luedke, J.; Erickson, J.; Jones, M.T. The Influence of Sport Nutrition Knowledge on Body Composition and Perceptions of Dietary Requirements in Collegiate Athletes. Nutrients 2021, 13, 2239. [Google Scholar] [CrossRef]
- Posthumus, L.; Fairbairn, K.; Darry, K.; Driller, M.; Winwood, P.; Gill, N. Competition Nutrition Practices of Elite Male Professional Rugby Union Players. Int. J. Environ. Res. Public. Health 2021, 18, 5398. [Google Scholar] [CrossRef]
- Hanson, J.; Dole, A. Potential Nutrition Contributions to Exercise-Associated Muscle Cramping in Four Recreational Half-Marathoners: A Case Series. Int. J. Strength Cond. 2021, 1. [Google Scholar] [CrossRef]
- Condo, D.; Lohman, R.; Kelly, M.; Carr, A. Nutritional Intake, Sports Nutrition Knowledge and Energy Availability in Female Australian Rules Football Players. Nutrients 2019, 11, 971. [Google Scholar] [CrossRef] [Green Version]
- Andajani-Sutjahjo, S.; Ball, K.; Warren, N.; Inglis, V.; Crawford, D. Perceived Personal, Social and Environmental Barriers to Weight Maintenance among Young Women: A Community Survey. Int. J. Behav. Nutr. Phys. Act. 2004, 1, 15. [Google Scholar] [CrossRef] [Green Version]
- Vázquez-Espino, K.; Fernández-Tena, C.; Lizarraga-Dallo, M.A.; Farran-Codina, A. Development and Validation of a Short Sport Nutrition Knowledge Questionnaire for Athletes. Nutrients 2020, 12, 3561. [Google Scholar] [CrossRef] [PubMed]
- USDA ERS-Survey Tools. Available online: https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/survey-tools/#six (accessed on 24 July 2021).
- Blumberg, S.J.; Bialostosky, K.; Hamilton, W.L.; Briefel, R.R. The Effectiveness of a Short Form of the Household Food Security Scale. Am. J. Public Health 1999, 89, 1231–1234. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Schakel, S.F.; Buzzard, I.M.; Gebhardt, S.E. Procedures for Estimating Nutrient Values for Food Composition Databases. J. Food Compos. Anal. 1997, 10, 102–114. [Google Scholar] [CrossRef] [Green Version]
- Munt, A.E.; Partridge, S.R.; Allman-Farinelli, M. The Barriers and Enablers of Healthy Eating among Young Adults: A Missing Piece of the Obesity Puzzle: A Scoping Review: Barriers and Enablers of Healthy Eating. Obes. Rev. 2017, 18, 1–17. [Google Scholar] [CrossRef]
- Poti, J.M.; Mendez, M.A.; Ng, S.W.; Popkin, B.M. Is the Degree of Food Processing and Convenience Linked with the Nutritional Quality of Foods Purchased by US Households? Am. J. Clin. Nutr. 2015, 101, 1251–1262. [Google Scholar] [CrossRef] [Green Version]
- Remnant, J.; Adams, J. The Nutritional Content and Cost of Supermarket Ready-Meals. Cross-Sectional Analysis. Appetite 2015, 92, 36–42. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Peltner, J.; Thiele, S. Convenience-Based Food Purchase Patterns: Identification and Associations with Dietary Quality, Sociodemographic Factors and Attitudes. Public Health Nutr. 2018, 21, 558–570. [Google Scholar] [CrossRef] [Green Version]
- Purvis, D.L.; Lentino, C.V.; Jackson, T.K.; Murphy, K.J.; Deuster, P.A. Nutrition as a component of the performance triad: How healthy eating behaviors contribute to soldier performance and military readiness. U.S. Army Med. Dep. J. 2013, 66–78. [Google Scholar]
- Hanson, A.J.; Kattelmann, K.K.; McCormack, L.A.; Zhou, W.; Brown, O.N.; Horacek, T.M.; Shelnutt, K.P.; Kidd, T.; Opoku-Acheampong, A.; Franzen-Castle, L.D.; et al. Cooking and Meal Planning as Predictors of Fruit and Vegetable Intake and BMI in First-Year College Students. Int. J. Environ. Res. Public. Health 2019, 16, 2462. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- El Zein, A.; Shelnutt, K.P.; Colby, S.; Vilaro, M.J.; Zhou, W.; Greene, G.; Olfert, M.D.; Riggsbee, K.; Morrell, J.S.; Mathews, A.E. Prevalence and Correlates of Food Insecurity among U.S. College Students: A Multi-Institutional Study. BMC Public Health 2019, 19, 660. [Google Scholar] [CrossRef] [PubMed]
- Bovill, M.E.; Tharion, W.J.; Lieberman, H.R. Nutrition Knowledge and Supplement Use among Elite U.S. Army Soldiers. Mil. Med. 2003, 168, 997–1000. [Google Scholar] [CrossRef] [Green Version]
- Niebuhr, D.W.; Page, W.F.; Cowan, D.N.; Urban, N.; Gubata, M.E.; Richard, P. Cost-Effectiveness Analysis of the U.S. Army Assessment of Recruit Motivation and Strength (ARMS) Program. Mil. Med. 2013, 178, 1102–1110. [Google Scholar] [CrossRef] [Green Version]
- Naghii, M.R. The Importance of Body Weight and Weight Management for Military Personnel. Mil. Med. 2006, 171, 550–555. [Google Scholar] [CrossRef] [Green Version]
- Cowan, D.N.; Bedno, S.A.; Urban, N.; Yi, B.; Niebuhr, D.W. Musculoskeletal Injuries among Overweight Army Trainees: Incidence and Health Care Utilization. Occup. Med. Oxf. Engl. 2011, 61, 247–252. [Google Scholar] [CrossRef] [Green Version]
- What We Eat in America, NHANES 2017–2018. Nutrient Intakes from Food and Beverages. Available online: https://www.ars.usda.gov/ARSUserFiles/80400530/pdf/1718/Table_1_NIN_GEN_17.pdf (accessed on 26 August 2021).
- Department of Defense, Office of the Deputy Assistant Secretary of Defense for Military Community and Family Policy. Demographics: Profile of the Military Community. 2019. Available online: https://download.militaryonesource.mil/12038/MOS/Reports/2019-demographics-report.pdf (accessed on 7 July 2021).
Characteristic | Category | n (%) |
---|---|---|
Gender | Male | 26 (70.3) |
Female | 11 (29.7) | |
Race/Ethnicity | Asian/Pacific Islander | 1 (2.7) |
Black/African American | 2 (5.4) | |
Hispanic/Latino | 1 (2.7) | |
White/Caucasian | 32 (86.5) | |
Multi/Biracial | 1 (2.7) | |
Age | ≤23 years | 27 (83.8) |
≥24 years | 10 (73.0) | |
BMI | ≤24.9 | 18 (48.6) |
25.0–29.9 | 15 (40.5) | |
≥29.9 | 4 (10.8) | |
Student Classification | Freshman | 3 (8.1) |
Sophomore | 6 (18.9) | |
Junior | 13 (32.4) | |
Senior | 15 (40.5) | |
Credits Enrolled | >12 | 27 (73) |
8–12 | 9 (24.3) | |
<8 | 1 (2.7) | |
Work Status | Full time > 35 h/week | 7 (18.9) |
Part time < 35 h/week | 18 (48.6) | |
Not working | 12 (32.4) |
Barriers to Healthy Eating | Median (IQR) * | Strongly Disagree (%) | Disagree (%) | Neither Agree/Disagree (%) | Agree (%) | Strongly Agree (%) |
---|---|---|---|---|---|---|
Social barriers (α = 0.86) | ||||||
I do not have family support to eat a healthy diet | 2.0 (1.5–3.0) | 16 (43.3) | 9 (24.3) | 7 (18.9) | 4 (10.8) | 1 (2.7) |
I do not have the support from friends to eat a healthy diet | 2.0 (1.0–2.5) | 15 (40.5) | 13 (35.1) | 5 (13.5) | 4 (10.8) | - |
I do not have time to prepare or eat healthy foods because of my job | 2.0 (1.5–3.0) | 10 (27.0) | 9 (24.3) | 10 (27.0) | 5 (13.5) | 3 (8.1) |
I do not have time to prepare or eat healthy foods because of family commitments | 2.0 (1.0–2.0) | 14 (37.8) | 18 (48.6) | 3 (8.1) | 2 (5.4) | - |
I do not have enough time to prepare or eat healthy foods because of school | 3.0 (2.0–4.0) | 6 (16.2) | 9 (24.3) | 6 (16.2) | 12 (32.4) | 4 (10.8) |
I do not have time to prepare or eat healthy foods because of my commitment to ROTC ** | 3.0 (2.0–4.0) | 8 (21.6) | 9 (24.3) | 6 (16.2) | 13 (35.1) | 1 (2.7) |
Access barriers (α = 0.95) | ||||||
I do not have access to healthy foods | 2.0 (1.0–2.0) | 18 (48.6) | 13 (35.1) | 3 (8.1) | 3 (8.1) | - |
I am unable to buy healthy foods | 1.0 (1.0–2.0) | 19 (51.4) | 14 (37.8) | 2 (5.4) | 2 (5.4) | - |
Personal barriers (α = 0.77) | ||||||
I do not have enough information about a healthy diet | 2.0 (1.5–3.0) | 9 (25.3) | 18 (48.6) | 2 (5.4) | 6 (16.2) | 2 (5.4) |
I do not have the motivation to eat healthy | 2.0 (2.5–3.0) | 5 (13.5) | 16 (43.2) | 8 (21.6) | 7 (18.9) | 1 (2.7) |
Not retained | ||||||
I do not enjoy eating healthy foods | 2.0 (1.0–3.0) | 12 (32.4) | 19 (51.4) | 2 (5.4) | 3 (8.1) | 1 (2.7) |
I do not have the skill to plan, shop for, or cook healthy foods | 2.0 (1.0–3.0) | 13 (35.1) | 13 (35.1) | 3 (8.1) | 4 (10.8) | 4 (10.8) |
Characteristics | n | Social Barriers | Access Barriers | Personal Barriers | ||||
---|---|---|---|---|---|---|---|---|
U | p * | U | p * | U | p * | |||
Gender | Male | 26 | 134.0 | 0.78 | 125.5 | 0.57 | 105.5 | 0.22 |
Female | 11 | |||||||
Race/ethnicity | White/Caucasian | 32 | 69.0 | 0.65 | 72.5 | 0.75 | 56.0 | 0.31 |
All others | 5 | |||||||
Employment | Working | 25 | 150.0 | 1.0 | 135.0 | 0.64 | 135.5 | 0.64 |
Not Working | 12 | |||||||
Body weight status | Non-Obese | 33 | 62.0 | 0.87 | 30.0 | 0.08 | 45.0 | 0.33 |
Obese | 4 |
Nutrient/Food Group | Mean | Median (IQR) |
---|---|---|
Energy (kcal) | 2393 | 2174 (1664–2786) |
Added sugar (g) | 59.4 | 45.5 (29.7–70.5) |
Calcium (mg) | 1063.6 | 1019.6 (700.7–1251.0) |
Fiber (g) | 20.3 | 17.4 (14.1–24.1) |
Folate (mcg) | 495.7 | 442.7 (323.7–613.3) |
Iron (mg) | 15.6 | 14.6 (10.0–18.6) |
Saturated Fat (g) | 33.1 | 18.8 (20.3–39.6) |
Sodium (mg) | 4205.4 | 3887.6 (2984.2–4673.3) |
Vitamin A (mcg) | 996.2 | 693.8 (573.1–1020.2) |
Vitamin B12 (mcg) | 7.0 | 6.0 (3.8–8.1) |
Vitamin C (mg) | 109.2 | 86.7 (55.1–147.4) |
Vitamin E (IU) | 20.3 | 16.4 (12.8–24.8) |
Whole Grains (oz eq) | 1.9 | 1.4 (1.0–2.7) |
Fruit | 1.0 | 0.9 (0.5–1.1) |
Vegetable | 1.8 | 1.2 (0.9–2.80) |
Energy-Adjusted Dietary Intake | Personal Barriers | Social Barriers | Access Barriers | Sports Nutrition Knowledge |
---|---|---|---|---|
Added Sugar | 0.06 | 0.08 | 0.07 | −0.13 |
Calcium | −0.47 ** | −0.27 | −0.07 | 0.22 |
Fiber | −0.35 * | −0.36 * | −0.32 | 0.06 |
Folate | −0.32 | −0.25 | −0.27 | 0.03 |
Iron | −0.06 | −0.19 | −0.10 | 0.03 |
Saturated Fat | 0.07 | 0.15 | 0.12 | 0.12 |
Sodium | −0.08 | −0.26 | −0.30 | 0.22 |
Vitamin A | −0.46 ** | −0.18 | −0.29 | 0.06 |
Vitamin B12 | −0.04 | −0.13 | −0.01 | 0.29 |
Vitamin C | −0.43 ** | −0.37 * | −0.40 * | 0.17 |
Vitamin E | −0.30 | −0.45 ** | −0.29 | 0.01 |
Whole Grains | −0.06 | −0.90 | −0.08 | 0.12 |
Fruit | −0.34 * | −0.11 | −0.13 | 0.14 |
Vegetable | −0.50 ** | −0.27 | −0.25 | 0.21 |
Energy-Adjusted Dietary Intake | Food Security Status | n | U | p |
---|---|---|---|---|
Added Sugar | Secure | 26 | 119.0 | 0.72 |
Insecure | 10 | |||
Calcium | Secure Insecure | 26 | 96.0 | 0.24 |
10 | ||||
Fiber | Secure Insecure | 26 | 126.0 | 0.90 |
10 | ||||
Folate | Secure Insecure | 26 | 124.0 | 0.85 |
10 | ||||
Iron | Secure Insecure | 26 | 95.0 | 0.23 |
10 | ||||
Saturated Fat | Secure Insecure | 26 | 93.0 | 0.20 |
10 | ||||
Sodium | Secure Insecure | 26 | 111.0 | 0.52 |
10 | ||||
Vitamin A | Secure Insecure | 26 | 78.0 | 0.07 |
10 | ||||
Vitamin B12 | Secure Insecure | 26 | 104.0 | 0.37 |
10 | ||||
Vitamin C | Secure Insecure | 26 | 114.0 | 0.59 |
10 | ||||
Vitamin E | Secure Insecure | 26 | 128.0 | 0.96 |
10 | ||||
Whole Grains | Secure Insecure | 26 | 109.0 | 0.48 |
10 | ||||
Fruit | Secure Insecure | 26 | 109.0 | 0.48 |
10 | ||||
Vegetable | Secure Insecure | 26 | 84.0 | 0.11 |
10 |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Daniels, E.; Hanson, J. Energy-Adjusted Dietary Intakes Are Associated with Perceived Barriers to Healthy Eating but Not Food Insecurity or Sports Nutrition Knowledge in a Pilot Study of ROTC Cadets. Nutrients 2021, 13, 3053. https://doi.org/10.3390/nu13093053
Daniels E, Hanson J. Energy-Adjusted Dietary Intakes Are Associated with Perceived Barriers to Healthy Eating but Not Food Insecurity or Sports Nutrition Knowledge in a Pilot Study of ROTC Cadets. Nutrients. 2021; 13(9):3053. https://doi.org/10.3390/nu13093053
Chicago/Turabian StyleDaniels, Elizabeth, and Jennifer Hanson. 2021. "Energy-Adjusted Dietary Intakes Are Associated with Perceived Barriers to Healthy Eating but Not Food Insecurity or Sports Nutrition Knowledge in a Pilot Study of ROTC Cadets" Nutrients 13, no. 9: 3053. https://doi.org/10.3390/nu13093053