Date of Completion

8-24-2017

Embargo Period

8-24-2018

Keywords

Dietary Guidelines, low-income, fruit, vegetable, whole grains, Trials of Improved Practices

Major Advisor

Amy R. Mobley, PhD, RD

Associate Advisor

Ock K. Chun, PhD

Associate Advisor

Nancy R. Rodriguez, PhD, RD

Associate Advisor

Kim M. Gans, PhD

Associate Advisor

Amy A. Gorin, PhD

Field of Study

Nutritional Science

Degree

Doctor of Philosophy

Open Access

Campus Access

Abstract

The Dietary Guidelines for Americans (DGA) provide recommendations to improve dietary behaviors including intake of fruits, vegetables, and whole grains. Low-income populations’ diets’ are particularly lacking in these foods which may increase the risk of chronic diseases. Therefore, the overall purpose of this three phase study is to identify the factors that may prevent low-income families from meeting the DGA recommendations for fruits, vegetables, and whole grains, and determine communication strategies that are effective in increasing intake of these foods.

Phase 1 include interviews with low-income adults (n = 98) and nutrition educators (n = 9) to evaluate the DGA messages. While the majority of low-income adults reported that they understood the messages and that the messages were easy to implement, the results revealed that participants often misinterpreted the messages consistent with the perception of nutrition educators. Phase 2 utilized the Trials of Improved Practices (TIPs) to test strategies in increasing consumption of fruits, vegetables, or whole grains among low-income adults (n = 35). Participants selected a fruit, vegetable, or whole grain strategy to implement for a week. A pre- and post- test interview with a 24-hour recall was conducted with each participant and Healthy Eating Index (HEI) scores were calculated. The whole fruit significantly increased after the intervention (P = 0.05). Overall total HEI score increased from a “poor diet” to a “diet that needs improvement” but this increase was not statistically significant (P = 0.11). Phase 3 sought to examine factors that influence whole grain consumption in low-income adults (n = 169). Participants (n = 169) viewed 11 grain foods (6 refined and 5 whole grain) and were asked to identify the foods as whole or refined grains. Some participants (n = 60) also completed an interview to describe how they identified the foods. Less than half of low-income adults (46%) identified four or more whole grain foods correctly. Overall, DGA messages need to be clear and feasible for low-income adults. Furthermore, the barriers (e.g. cost) to consuming fruits, vegetables, and whole grains by low-income adults should be addressed with interventions at various levels of influence including nutrition education and policy (whole grain labeling).

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