1. Nutrition Knowledge, Food Label Use, and Food Intake Patterns among Latinas with and without Type 2 Diabetes
Nurgül Fitzgerald, PhD, RD: Rutgers Grace Damio, MS, CD/N:Hispanic Health Council (HHC)
Sofia Segura-Pérez, MS, RD: HHC Rafael Pérez-Escamilla, PhD: University of Connecticut
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION
Fitzgerald, et al.
J Am Diet Assoc . 108(6), Jun. 2008

2. Nutrition Knowledge, Food Label Use, and Food Intake Patterns among Latinas with and without Type 2 Diabetes Study Design
Case-control study among 201 Latinas, age 35 to 60 yr
100 with diagnosed type 2 diabetes (diabetes group) 101 without diagnosed diabetes (control group)
Bilingual interviewers conducted the face-to-face interviews
Collected data
25-item nutrition knowledge scale (=0.813), food label use and food intake frequencies
Self-efficacy and stages of change about food label use
6-item acculturation scale (=0.726), demographic and socioeconomic status, food insecurity
Body mass index
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION
Fitzgerald, et al.
J Am Diet Assoc . 108(6) ,Jun. 2008

3. Nutrition Knowledge, Food Label Use, and Food Intake Patterns among Latinas with and without Type 2 Diabetes Participant Characteristics
Control
(n=101)
Diabetes
(n=100)
Age, mean ± standard deviation
47.3 ± 5.9
50.6 ± 6.9*
Ethnicity: Puerto Rican, %
Other Latina, %
84.1
15.9
85.0
15.0
Education: < High school diploma, %
 High school diploma, %
61.4
38.6
66.0
34.0
Employed, %
Unemployed, %
30.7
69.3
26.0
74.0
Marital status: Have partner, %
No partner, %
40.6
59.4
40.0
60.0
Acculturation score:  median, %
> median, %
45.5
54.5
40.0*
BMI, mean ± standard deviation
31.2 ± 8.2
34.7 ± 8.6*
Our sample was predominantly Puerto Rican, and the diabetes and control groups were similar in characteristics such as education, employment, marital status, and food security.
Statistically significant differences are shown in red color. As you can see, the diabetes group was about 4 years older than the control group. Women with diabetes were less acculturated and 70% of them were obese versus 54% of the controls.
* p<0.05
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION
Fitzgerald, et al.
J Am Diet Assoc . 108(6), Jun. 2008

4. Nutrition Knowledge, Food Label Use, and Food Intake Patterns among Latinas with and without Type 2 Diabetes
Associations of nutrition knowledge and food label use with food intake frequency (>median) among Latinasa * * * * *
Nutrition knowledge level, food label self-efficacy and stages of change, and food label use were similar between the diabetes and control groups.
Among Latinas with diabetes, those who had seen a dietitian or a diabetes educator (n=64) were more likely to have a higher nutrition knowledge score compared to Latinas who had not seen one (11.1±4.3 vs. 9.0±4.3, respectively, p=0.020).
a Diabetes and control groups were pooled for these analyses. F&V: fruits and vegetables; soft drinks and sweets exclude the ones made with artificial sweeteners; snacks: salty snacks; high nutrition knowledge: score >10 (median), score range 0-25; *: p0.05 determined by Chi-square test.
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION
Fitzgerald, et al.
J Am Diet Assoc . 108(6), Jun. 2008

5. Nutrition Knowledge, Food Label Use, and Food Intake Patterns among Latinas with and without Type 2 Diabetes
Determinants of consuming fruits and vegetables, regular soft drinks, sweets, and salty snacks frequently (>median) among Latinas * * * * * * * *
First of all, to orient you to the slides, the odds ratio of 1 represents the reference category. If the OR is less than 1, that indicates a lower likelihood of the outcome, in this case, smoking cigarettes. If it is more than 1, it shows a higher likelihood of the outcome. Stars next to the bars indicate the statistical significance, bars without stars mean that the effect was not statistically significant, but the variable remained in the final model during the stepwise analyses.
When we looked at the determinants of smoking: Not consuming alcohol, having a partner and being less acculturated were related to lower likelihood of smoking, and the effect of acculturation was quite strong as suggested by an interaction between acculturation and marital status: highly acculturated individuals were more likely to smoke regardless of their marital status.
Participants with lower economic level indicated by not owning a car were about 2.5 times more likely to smoke.
***************
[The negative influence of low SES was further supported by a significant interaction between employment and car ownership: There was a substantial drop in the smoking rates only among those with higher SE level determined by both of these variables, not by one or the other alone].
Adjusted for age and body mass index. FL: food label; F&V: fruits and vegetables; less acculturation: scale score 1 (median), score range 0-6; high nutrition knowledge: score >10 (median), score range 0-25; high education: high school diploma/GED or higher; *: p0.05 determined by logistic regression analyses.
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION
Fitzgerald, et al.
J Am Diet Assoc. 108(6), Jun. 2008

6. Nutrition Knowledge, Food Label Use, and Food Intake Patterns among Latinas with and without Type 2 Diabetes Summary and Implications
Similar levels of nutrition knowledge, food label self-efficacy and stages of change, food label use, and intake patterns between Latinas with and without diagnosed diabetes suggest a need to improve nutrition knowledge, skills, and food intake behaviors in this population.
Among Latinas with diabetes, receiving services from registered dietitians or certified diabetes educators was related to a better nutrition knowledge score, which points out the need for the provision of such services.
The results suggest a multifaceted relationship between education level and nutrition-related skills and behaviors: a direct association between education and food intake independent of nutrition knowledge and skills, and also, a likely association through increased nutrition knowledge resulting in greater food label use, which in turn was related to a healthier food intake pattern. Hence, populations with a low socioeconomic status may still benefit from interventions aiming to increase instrumental nutrition knowledge and food label education that strengthen the necessary skills needed to improve dietary intake.
As suggested by the positive associations of acculturation with soft drink and salty snack intakes, emphasizing the retention of healthful lifestyle behaviors within the Latino culture can be a valuable strategy when targeting health disparities.
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION
Fitzgerald, et al.
J Am Diet Assoc . 108(6), Jun. 2008