Sustainable Breastfeeding: A State-of-the Art Review.

BACKGROUND: Disparities in breastfeeding rates and exclusivity exist across regions and countries despite multifaceted breastfeeding promotion efforts in recent decades. Markets for artificial milk formula continue to grow as its substitution for breastfeeding is common. A new approach is needed for breastfeeding promotion strategies. RESEARCH AIM: This state-of-the-art review aimed to describe the implications of not-breastfeeding on the environment within the context of food system sustainability. METHOD: A total of 19 peer-reviewed articles within a 20-year timeframe were included in this review. Authors searched five databases for articles including Science Direct, GreenFILE, Springer Link, ProQuest, and PubMed. RESULTS: The demand for artificial milk formula production as a replacement for breastfeeding results in increased greenhouse gas emissions, water pollution, and waste, thereby aggravating problems with freshwater scarcity. A short duration of breastfeeding and limited exclusivity have been associated with close birth spacing and contributing to global population growth. Breastfeeding is a healthy, sustainable diet, and a culturally acceptable first food. It advances health equity and food security. Exclusive breastfeeding for the first 6 months of life can be promoted with emphasis on total carbon footprint reduction, prevention of waterway degradation, and natural birth spacing, thereby sustaining food systems at large. CONCLUSION: It is important to reform food, nutrition, and environmental policies to protect exclusive breastfeeding while decarbonizing artificial milk formula production. More research is needed to provide directions for new breastfeeding promotion strategies connecting breastfeeding with environmental stewardship.

Participants' Underlying Beliefs of Using WIC Electronic Benefit Transfer (EBT) Cards in Stores in New Jersey.

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is an essential nutrition assistance program that has led to successful health outcomes and healthcare access. To alleviate discomfort associated with WIC shopping at stores, the Congress mandated the transition to electronic benefit transfer (EBT) card system from paper vouchers. This study aimed to explore the experiences of WIC recipients in using EBT cards in stores. WIC recipients from one WIC clinic in northern New Jersey (N = 220) participated in this study. An online survey was framed under the theory of planned behavior to probe their underlying behavioral, normative, and control beliefs of using EBT cards. Using content analyses, dominating themes of each belief were extracted. Participants composed of Hispanic (91.2%) with mean age of 31.68 (SD = 7.69). Most frequently mentioned advantages of using EBT cards were convenience and ease (34.3%) followed by fast and efficient (28.5%). Participants noted that most people would approve of using EBT cards (70%), especially those who receive the benefits and approve of the public assistance (16.7%). They stated that having improved store inventory and an increase in WIC-authorized stores (17.2%) would make the EBT cards use easy. The transition to EBT cars allowed purchase flexibility, alleviated stigma and the purchase process burdens, but the challenges associated with WIC app usage and store specific issues remained. These challenges should be addressed in future intervention to enable WIC recipients more engaged in using the EBT cards.

Impact of Milk on the Move breastfeeding support campaign on students' and employees' attitudes, subjective norms, intention, knowledge, and awareness.

OBJECTIVE: To evaluate the impact of a campus-based breastfeeding support campaign grounded in the Theory of Reasoned Action. PARTICIPANTS: Seventy-eight students and employees. METHODS: An online survey was administered pre- and post-campaign to measure attitudes, subjective norm, normative and behavioral beliefs, intention, knowledge, and awareness. Regression analyses identified the most influential factors for intention to support breastfeeding on campus at both times. Paired sample t-tests compared changes over time. RESULTS: Attitudes, but not subject norm, had a significant impact on intention to support breastfeeding on campus at both times (p < .01). Subjective norm improved over time (p = .04), whereas changes to attitudes, normative and behavioral beliefs, intention, and knowledge were small and mostly not significant. Participants' gained awareness that a lactation space is available on campus (p = .034) and that students can be excused from class to pump (p = .005). CONCLUSIONS: Future campus-based efforts should target breastfeeding attitudes, knowledge, and awareness of breastfeeding supports.

An Investigation of Social Ecological Barriers to and Facilitators of WIC Farmers Market Nutrition Program Voucher Redemption.

In the United States, many communities lack sufficient access to fresh produce. To improve access to fresh fruits and vegetables, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides eligible participants vouchers through the Farmers Market Nutrition Program (FMNP) that can be redeemed directly from farmers at markets or farm stands. However, FMNP voucher redemption rates in New Jersey remain lower than those in neighboring states. This article used the social ecological model to examine differences between FMNP participants who redeem vouchers (Redeemers) and those who do not (non-Redeemers) in the areas of: produce procurement practices and consumption frequency, and barriers to and facilitators of FMNP voucher redemption. This cross-sectional study included WIC FMNP participants (N = 329) in northern New Jersey, USA. Analyses were conducted using descriptive statistics, independent sample t-tests, and one-way ANOVA. Compared to Redeemers, non-Redeemers consumed fewer average daily vegetable servings, were more likely to shop at small grocery/corner stores, and encountered significant barriers to FMNP redemption, e.g., difficulty finding time to redeem vouchers.

The Current State of Donor Human Milk Use and Practice.

Human milk contains nutrients and immune factors that promote health and growth of an infant. Donor human milk is recommended as the best alternative for infants whose mothers' breast milk is unavailable. This article describes the current status of donor human milk practice and suggests the areas of educational and research needs. Articles published in the last 10 years were reviewed, and findings were summarized under 4 themes: (1) women's knowledge and concerns about donor human milk use, (2) hospital practices, (3) cost-effectiveness, and (4) access and affordability of donor human milk. Women were concerned about donor human milk contamination, disease transmission, cost, and access to bank donor human milk, due to lack of knowledge and awareness of donor human milk benefits and its processing procedures. The absence of health care providers' support for donor human milk adds to the confusion. There is a rising trend of donor human milk use in hospitals for both healthy and vulnerable newborns and infants with varying policies on screening for donor human milk use, cost coverage, or consent procedure. However, a shortage of safe and affordable donor human milk is a barrier to its adoption. A standardized guideline is needed for hospitals regarding donor human milk implementation and cost coverage. Education programs for health care providers are needed to improve knowledge and understanding of donor human milk benefits and safety to provide guidance to parents. It is crucial to develop legislation expanding insurance coverage to achieve donor human milk equity and optimizing long-term human milk diet outcomes.

Critical Review of Theory Use in Breastfeeding Interventions.

BACKGROUND: Numerous efforts to promote breastfeeding resulted in a steady increase in the rates of breastfeeding initiation and duration. Increasing numbers of breastfeeding interventions are focused on breastfeeding maintenance and exclusivity and based on behavioral theories. Few studies critically analyzed the use of theories in breastfeeding intervention development and evaluation. RESEARCH AIM: The aim of this critical review was to examine the existing literature about breastfeeding intervention, and investigate the role of theory in its development, implementation, and evaluation to provide future directions and implications for breastfeeding interventions. METHODS: This critical review examined the existing breastfeeding intervention studies that used self-efficacy theories (SE), theory of planned behavior (TPB), and social cognitive theory (SCT) and were published during the past decade. Using five databases, studies in which researchers explicitly applied these three theories to frame the intervention were selected. Studies were critically reviewed for fidelity to theory in intervention design, delivery, and evaluation. RESULTS: Eighteen studies were reviewed: nine SE-, five TPB-, and four SCT-based. Most interventions were focused on building mothers' breastfeeding self-efficacy to improve breastfeeding exclusivity and duration. To achieve this goal, researchers who developed SE-based interventions used individual approaches, whereas other researchers who based studies on TPB incorporated social and environmental changes. SE-based studies were more likely to include theory-based instruments, but TPB- and SCT-based studies demonstrated less consistent choices of measurement. Researchers in most studies did not test the relationships between the proposed theoretical constructs and breastfeeding outcomes as guided by theories. Inconsistent outcomes resulted among the studies due to variations in study follow-ups. CONCLUSION: Sound applications of single or multiple theories demonstrate a great potential to help practitioners and researchers develop effective breastfeeding interventions and evaluate true impacts on positive breastfeeding outcomes.

Negotiating trans-ethno space: An inductive investigation of kimchi's ability to bound Korean-American transnational identity.

It has been suggested that the linkages among the sensory, memorial and social aspects of culinary symbolism for transnationals are pronounced by particular food preparations. By using direct evidence, the present investigation tests this postulate by seeking to understand the connectivity of kimchi to Korean-American identity and if so, how this functions above and below the surface. Five focus groups were conducted comprised of 35 Korean-American adults. The research was designed around a grounded theory approach with an open-ended grand tour question: How does kimchi affect your sense of identity? Seven themes were uncovered: Recreating Memories - Collectivity, Connectivity and Family; Affirmation of Family Structure; Kimchi Is Love; Territorial Space; Acquired Taste; Cheating Memories - Shame and Sadness; and Female Kitchen Agency and Power Relations. Kimchi has held on through space and time to provide a shared sense of connectivity to the Korean-American informants, perhaps more intensely and more democratically than in Korea, their ethic homeland. Reported kimchi taste acquisition followed a trajectory from aversion to familiarity to longing. The re-negotiation of kimchi's ethno-space in America has led to feelings of shame, guilt and sadness to some. Concessions have been made. Manufactured kimchi provided a common generic bridge to the trans-Korean-American community. However, the move away from home-prepared kimchi has taken a toll on family's historic and structural connectivity, emotions, the deliverance of cultural capital and has affected the distribution of household agency.

Impact of a school-based culinary nutrition education program on vegetable consumption behavior, intention, and personal factors among Korean second-graders.

BACKGROUND/OBJECTIVES: Veggiecation was developed to improve children's vegetable consumption through classroom lecture and cooking activities. In this study, we explored potential determinants of vegetable consumption behavior and intention, and examined the impact of Veggiecation on vegetable consumption behavior, intention and personal factors among Korean children. MATERIALS/METHODS: The 4-week Veggiecation program was implemented for second-graders in South Korea (35 children in the intervention group, 36 in the control group). We identified personal and environmental factors influencing vegetable consumption behavior and intention using multiple regression analyses. Consumption behavior, intention and, personal factors such as preference, attitude, and self-efficacy were compared between the groups before and after the intervention. RESULTS: Children's vegetable consumption behavior was significantly correlated with personal, social-, and physical-environmental factors as well as intention. Among the variables, preference was the most influential factor on intention, and attitude and intention had great influence on the behavior. After the program, children in the intervention group demonstrated significant improvements in vegetable consumption, intention, attitude, preference, and self-efficacy compared with children in the control group. CONCLUSION: Veggiecation, a school-based culinary nutrition education program, improved vegetable consumption and intention, as well as preference, attitude, and self-efficacy, in second-graders. Veggiecation has great potential, as a global program, to increase children's vegetable consumption. This program can be expanded through various channels, such as after-school programs or camps, to provide a positive impact for children.

Using a Model to Design Activity-Based Educational Experiences to Improve Cultural Competency among Graduate Students.

To improve the cultural competency of 34 students participating in graduate nutrition counseling classes, the Campinha-Bacote Model of Cultural Competence in the Delivery of Health Care Services was used to design, implement, and evaluate counseling classes. Each assignment and activity addressed one or more of the five constructs of the model, i.e., knowledge, skill, desire, encounters, and awareness. A repeated measure ANOVA evaluated pre- and post-test cultural competence scores (Inventory for Assessing the Process of Cultural Competence among Healthcare Professionals). The overall cultural competence score significantly improved (p < 0.001) from "culturally aware" (68.7 at pre-test) to "culturally competent" (78.7 at post-test). Students significantly improved (p < 0.001) in four constructs of the model including awareness, knowledge, skill, and encounter. Factor analysis indicated that course activities accounted for 83.2% and course assignments accounted for 74.6% of the total variance of cultural competence. An activity-based counseling course encouraging self-evaluation and reflection and addressing Model constructs significantly improved the cultural competence of students. As class activities and assignments aligned well with the Campinha-Bacote Model constructs, the findings of this study can help guide health educators to design effective cultural competence training and education programs.

Validation of a Theory of Planned Behavior-Based Questionnaire to Examine Factors Associated With Milk Expression.

BACKGROUND: A proper assessment of multidimensional needs for breastfeeding mothers in various settings is crucial to facilitate and support breastfeeding and its exclusivity. The theory of planned behavior (TPB) has been used frequently to measure factors associated with breastfeeding. Full utility of the TPB requires accurate measurement of theory constructs. Research aim: This study aimed to develop and confirm the psychometric properties of an instrument, Milk Expression on Campus, based on the TPB and to establish the reliability and validity of the instrument. METHODS: In spring 2015, 218 breastfeeding (current or in the recent past) employees and students at one university campus in northern New Jersey completed the online questionnaire containing demography and theory-based items. Internal consistency (α) and split-half reliability ( r) tests and factor analyses established and confirmed the reliability and construct validity of this instrument. RESULTS: Milk Expression on Campus showed strong and significant reliabilities as a full scale (α = .78, r = .74, p < .001) and theory construct subscales. Validity was confirmed as psychometric properties corresponded to the factors extracted from the scale. Four factors extracted from the direct construct subscales accounted for 79.49% of the total variability. Four distinct factors from the indirect construct subscales accounted for 73.68% of the total variability. CONCLUSION: Milk Expression on Campus can serve as a model TPB-based instrument to examine factors associated with women's milk expression behavior. The utility of this instrument extends to designing effective promotion programs to foster breastfeeding and milk expression behaviors in diverse settings.

Determinants of the Intention to Pump Breast Milk on a University Campus.

INTRODUCTION: The number of young mothers in the workforce and in schools of higher education has steadily increased. In order to maintain a breastfeeding relationship with their children, these mothers need to pump or express breast milk multiple times a day while at work or school. This study examines the factors associated with the intention to pump breast milk at one university campus. METHODS: Between January and February 2015, an online survey invitation was sent out to all female employees and students at one university. The survey, based on the Theory of Planned Behavior, assessed intentions to pump breast milk on campus. The intention to pump breast milk was examined between employees and students separately. Within these 2 groups, behavioral performers (women who pump or have pumped breast milk while on campus) were compared to nonperformers. Using multiple regression analysis, the most influential predictors of the intention to pump (ie, attitudes, subjective norm, perceived behavioral control, and underlying beliefs) were identified. RESULTS: A total of 218 women participated in the study (62 employees and 156 students, a 71.7% survey completion rate). Among university employees, the most influential factor that predicted pumping intention among performers was attitude toward pumping (ß = 0.36, P = .03). Among student performers, the most influential factor to predict pumping intention was the subjective norm (ß = 0.31, P = .02). For student nonperformers, perceived behavioral control (ß = 0.54, P < .001) was the most influential factor. Important determinants of the intention to pump on campus included relieving discomfort from engorgement, availability of milk storage, experiencing other people's approval of pumping breast milk, and the inconvenience of carrying pump equipment. DISCUSSION: Continued efforts are needed to create a supportive culture for breastfeeding in the campus community as well as to provide pump loan and milk storage options for both employee and student mothers.

Breastfeeding: The Illusion of Choice.

BACKGROUND: Breastfeeding is frequently described as a woman's decision, yet this choice is often illusionary owing to suboptimal social and structural supports. Despite passage of the Patient Protection and Affordable Care Act (2010) that requires all qualifying employers to provide mothers "reasonable" break time and a private, non-bathroom space to express breast milk, the majority of women in the United States still do not have access to both accommodations. THE PROBLEM: At least three issues may be influencing this suboptimal implementation at workplaces: 1) federal law does not address lactation space functionality and accessibility, 2) federal law only protects a subset of employees, and 3) enforcement of the federal law requires women to file a complaint with the United States Department of Labor. RECOMMENDATIONS: To address each of these issues, we recommend the following modifications to current law: 1) additional requirements surrounding lactation space and functionality, 2) mandated coverage of exempt employees, and 3) requirement that employers develop company-specific lactation policies. CONCLUSIONS: If the goal is to give women a real choice of whether to continue breastfeeding after returning to work, we must provide the proper social and structural supports that will allow for a truly personal decision. No mother should have to choose between breastfeeding her child and earning a paycheck.

Breastfeeding Initiation and Continuation by Employment Status among Korean Women.

PURPOSE: The objective of this study was to examine the factors associated with initiation and continuation of breastfeeding among Korean women in relation to their employment status. METHODS: Data were collected using a web-based self-administered questionnaire from 1,031 Korean mothers living in Seoul with babies younger than 24 months. Demographic characteristics, education on breastfeeding, rooming in, breastfeeding during hospital stay, and breastfeeding knowledge were examined. Multivariate logistic regression analyses were performed to identify factors associated with initiation and continuation at 1, 6 and 12 months according to mothers' employment status. RESULTS: Breastfeeding initiation rates were similar regardless of mothers' employment status. Continuation rates decreased for both groups of mothers, but were significantly lower among employed mothers at all duration points. Unemployed mothers who were able to keep their babies in the same room during the hospital stay were more likely to initiate breastfeeding. The factor that was consistently associated with breastfeeding continuation for all duration points among unemployed mothers was whether the mother breastfed during the hospital stay. Higher knowledge scores and having an infant with atopic dermatitis were also associated with breastfeeding continuation at 6 months and 12 months, respectively for unemployed mothers, and receiving education on breastfeeding was associated with 12-month continuation for employed mothers. CONCLUSION: These results emphasize the significant roles of hospitals for breastfeeding initiation and continuation, with rooming-in, initial breastfeeding practice and education during hospital stay as important practices. In addition, for working mothers to continue their breastfeeding, significant support from the workplace is crucial.

Workplace lactation support by New Jersey employers following US Reasonable Break Time for Nursing Mothers law.

BACKGROUND: Returning to an unsupportive work environment has been identified as a major reason for avoidance or early abandonment of breastfeeding among working mothers. OBJECTIVE: This study aimed to examine the nature and extent of accommodations offered to breastfeeding employees among New Jersey employers since the US federal Reasonable Break Time for Nursing Mothers law enactment. METHODS: A cross-sectional survey was conducted to measure current lactation support in the workplace in New Jersey. Using convenience sampling, the survey was sent to managerial personnel in hospitals and nonhospitals. The level of support was assessed on company policy, lactation room, and room amenity. A composite lactation amenity score was calculated based on responses about lactation room amenities. RESULTS: Respondents (N = 51) completed a 22-item online questionnaire during fall 2011. The support level was compared by type of organization: hospital (n = 37) versus nonhospital (n = 14). The amenity score of hospitals was significantly higher than nonhospitals (1.44 vs 0.45, P = .002). The mean amenity score (score = 0.95) for all employers was far below comprehensive (score = 3.0). Compared to nonhospitals, hospitals were more likely to offer lactation rooms (81% vs 36%, P = .003), have their own breastfeeding policy (35.1% vs 7.1%, P = .01), and provide additional breastfeeding support (eg, education classes, resources; P < .05). CONCLUSION: Employers, regardless of the type of organization, need to improve their current practices and create equity of lactation support in the workplace.

Breast milk pumping beliefs, supports, and barriers on a university campus.

BACKGROUND: Compared to nonemployed mothers, employed mothers are more likely to terminate breastfeeding sooner than recommended, due in part to a lack of workplace support. OBJECTIVE: The purpose of this study is to compare the beliefs of employees and students affiliated with a university regarding pumping breast milk on campus. METHODS: This qualitative study used semistructured interviews grounded in the theory of planned behavior, focused on behavioral, normative, and control beliefs regarding pumping on campus. Responses were independently coded and categorized based on common themes. Response frequencies were calculated and compared between students, staff, and faculty. RESULTS: Thirty-two women (11 students, 8 staff, 13 faculty) participated in the interview. Overall, participants most frequently reported that maintaining milk supply/extending breastfeeding duration was an advantage to pumping on campus, and time/scheduling issues a disadvantage. The most commonly perceived supporters were peers, whereas those unaware, uninformed, and/or disapproving of breastfeeding were most commonly perceived as opponents to pumping on campus. Reporting within each category differed between students, staff, and faculty. It is notable that students most frequently identified the lack of available pumping space as a barrier, whereas faculty often reported that space availability made pumping on campus easier for them. In addition, both staff and faculty frequently stated that scheduling and time constraints were a pumping barrier. CONCLUSION: An inequality of current lactation support practice may exist at colleges and universities. It is necessary to extend this protection to all members of a workplace, regardless of their role.

Investigating obesity risk-reduction behaviours and psychosocial factors in Chinese Americans.

AIM: The purpose of this research was to examine the attitudes, beliefs and behaviours related to obesity risk reduction in Chinese Americans. METHODS: A questionnaire was administered to a convenience sample of 300 US-born and foreign-born Chinese Americans residing in the New York metropolitan area, ranging from 18 to 40 years of age. Obesity risk reduction behaviours and psychosocial variables derived from the Theory of Planned Behaviour and Health Belief Model were measured. Acculturation was assessed using a modified Suinn-Lew Asian Self-Identity Acculturation Scale. Frequency distributions were delineated and stepwise regression analyses were analysed for different acculturation groups. RESULTS: 65% of the respondents were female and the mean age of the sample was 26 years. Respondents indicated the most commonly practised behaviour to be eating home-cooked meals instead of restaurant-prepared foods. Perceived barriers to adopting obesity risk-reduction behaviours included convenience of consuming fast foods, cost, lack of time to prepare home-cooked meals, and the physical environment of unhealthy foods. In predicting intention to perform obesity risk-reduction behaviours, attitude was significant for 'western-identified' individuals. In 'Asian-identified' individuals, perceived behavioural control, self-efficacy and perceived benefits were salient. CONCLUSIONS: Nutrition educators working with Chinese Americans need to address self-efficacy in preparing plant-based, home-cooked meals and making healthy choices at fast-food restaurants with portion control. Concrete and perceived barriers such as lack of time and convenience need to be addressed in nutrition education interventions. Educators need to identify new channels and media outlets to disseminate practical, easy-to-implement behaviours for obesity risk reduction that are socially acceptable.

Lactation accommodation in the workplace and duration of exclusive breastfeeding.

INTRODUCTION: The purpose of this study was to assess current lactation accommodations in a workplace environment and to examine the association between the different dimensions of support and the duration of exclusive breastfeeding. METHODS: A survey was conducted with employees of a higher-education institution and clients of an obstetric hospital in New Jersey. Factor analysis identified dimensions of workplace support. The dimensions were correlated with the duration of exclusive breastfeeding using Pearson's r correlation analysis. RESULTS: One hundred and thirteen working mothers participated in the study. The mean (SD) number of working hours of the participants was 34.3 (2.8) hours per week. Participants were primarily white (89.4%), older (mean age, 33.8 [6.0] years), highly educated (>82% above college graduate), and married (92%). Participants indicated that in their workplaces, breastfeeding was not common, breast pumps were not available, and on-site day care was not always an option. The analysis identified 4 dimensions of breastfeeding accommodation: break time, workplace environment, technical support, and workplace policy. Technical support (r = 0.71, P = .01) and workplace environment (r = 0.26, P = .01) were significantly associated with the duration of exclusive breastfeeding. DISCUSSION: Employers can strengthen technical support and workplace environment to encourage breastfeeding continuation in working mothers. New federal laws should consider specific guidelines for minimum requirements for functional lactation support to achieve comprehensive breastfeeding benefits.

Alternative hospital gift bags and breastfeeding exclusivity.

The type of gift bags given to new mothers at the time of discharge from the hospital can influence their confidence in breastfeeding. Most hospitals in the US continue to distribute commercial gift bags containing formula samples despite the reported negative influence of commercial bags on the duration of breastfeeding. This study compared breastfeeding outcomes in women receiving three different kinds of gift bags at discharge. A prospective intervention study was conducted during 2009-2010 in New Jersey. Three breastfeeding cohorts were recruited and assigned to three groups: COMMERCIAL received discharge bags containing formula samples, BF-INFO received breastfeeding information and supplies, and PUMP received breastfeeding information/supplies plus a manual breast pump. Follow-up contacts were at 2, 4, and 12 postpartum weeks to determine breastfeeding outcome. The mean durations of exclusive (EBF) and partial breastfeeding were compared between groups using ANOVA. A total of 386 participants completed the study. The mean EBF duration (weeks) in the PUMP (n = 138, 8.28 ± 4.86) and BF-INFO (n = 121, 7.87 ± 4.63) were significantly longer (P < 0.01) than COMMERCIAL (n = 127, 6.12 ± 4.49). The rate of EBF through 12 weeks in PUMP was most consistent. The mean duration of partial breastfeeding showed similar results: significantly longer in PUMP and BF-INFO than COMMERCIAL (P < 0.01).

Eating behaviors of older adults participating in government-sponsored programs with different demographic backgrounds.

The purpose of this study was to determine the food behaviors of nutritionally high-risk seniors as a function of their racial background, gender, marital status, and education level. A total of 69 seniors were identified to be at high nutritional risk using the Nutrition Screening Initiative (NSI) checklist. A supplemental questionnaire (SQ) was created to examine the risk factors in relation to the participant's demographic background. Key results indicated that Asians practiced healthy food behaviors and women were more likely to eat alone (p?0.05). Married participants (90.9%) were most likely to consume 2 meals or more each day. College educated individuals practiced healthier eating, eating 5 servings or more of fruits and vegetables (p?0.01) and 2 or more servings of milk and milk products (p?0.01). These preliminary findings indicate that more studies should be conducted to focus on the demographic characteristics and food behaviors among older populations.