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1.
Foods ; 10(4)2021 Mar 25.
Article in English | MEDLINE | ID: mdl-33806134

ABSTRACT

Rate All That Apply (RATA) is a derivative of the popularly used Check-All-That-Apply (CATA) question format. For RATA, consumers select all terms or statements that apply from a given list and then continue to rate those selected based on how much they apply. With Rate All Statements (RATING), a widely used standard format for testing, consumers are asked to rate all terms or statements according to how much they apply. Little is known of how the RATA and RATING question formats compare in terms of aspects such as attribute discrimination and sample differentiation. An online survey using either a RATA or RATING question format was conducted in five countries (Brazil, China, India, Spain, and the USA). Each respondent was randomly assigned one of the two question formats (n = 200 per country per format). Motivations for eating items that belong to five food groups (starch-rich, protein-rich, dairy, fruits and vegetables, and desserts) were assessed. More "apply" responses were found for all eating motivation constructs within RATING data than RATA data. Additionally, the standard indices showed that RATING discriminated more among motivations than RATA. Further, the RATING question format showed better discrimination ability among samples for all motivation constructs than RATA within all five countries. Generally, mean scores for motivations were higher when RATA was used, suggesting that consumers who might choose low numbers in the RATING method decide not to check the term in RATA. More investigation into the validity of RATA and RATING data is needed before use of either question format over the other can be recommended.

2.
J Texture Stud ; 52(5-6): 679-683, 2021 12.
Article in English | MEDLINE | ID: mdl-33890326

ABSTRACT

This article is a "call to action" in the service delivery of thickened liquids. We discuss the importance of staff education and further development of educational resources in dysphagia management involving the use of thickened liquids, particularly as related to inadequacies in staff education and training. We discuss the use of contemporary instructional strategies to promote accuracy in preparation and knowledge about the thickening process.


Subject(s)
Deglutition Disorders , Deglutition Disorders/therapy , Humans , Viscosity
3.
Foods ; 10(2)2021 Feb 22.
Article in English | MEDLINE | ID: mdl-33671546

ABSTRACT

Food companies spend a large amount of money and time to explore markets and consumer trends for ideation. Finding new opportunities in food product development is a challenging assignment. The majority of new products launched in the market are either copies of existing concepts or line extensions. This study demonstrates how the global marketplace can be used for generating new texture concepts for snack foods. One hundred and twenty-three prepacked snack foods from South Korea (SK) and ninety-five from Japan (JP) were purchased for this study. Projective mapping (PM) was used to sort the snacks on a 2-dimensional map (texture and flavor). Sensory scientists grouped snacks on similarities and dissimilarities. PM results showed, 65% (JP) and 76% (SK) snacks were considered as hard textures, ranging from moderate to extremely hard. Sixty-five percent of JP snacks were savory, whereas 59% of SK snacks had a sweet flavor. The PM 2-dimensional map was used to find white spaces in the marketplace. Thirty-two diversified snacks from each country were screened and profiled using descriptive sensory analysis by trained panelists. Attributes such as sustained fracturability, sustained crispness, initial crispness, and fracturability were the main sensory texture characteristics of snacks. Results showed how descriptive analysis results can be used as initial sensory specifications to develop prototypes. Prototype refinement can be performed by doing multiple developmental iterations and consumer testing. The study showed how white spaces are potential opportunities where new products can be positioned to capture market space. Practical Application: The methodology produced in this study can be used by food product developers to explore new opportunities in the global marketplace.

4.
Foods ; 9(11)2020 Nov 05.
Article in English | MEDLINE | ID: mdl-33167450

ABSTRACT

Currently, poverty, climate change, environmental pollution and the depletion of natural resources have generated a greater concern for sustainability. The objective is the survival of the human species and the persistence of all components of the biosphere. To achieve sustainability, human participation is essential; sustainable consumption depends on consumers' perceptions of sustainability and how they affect their behavior. The aim of this study was to understand consumers' perceptions and attitudes towards food sustainability based on country, age, gender, income and education level. An online survey was carried out in countries in Europe, America and Asia. Consumers were asked questions organized into food categories. The results showed that consumers' attitude towards sustainability is understood differently in each country, even within the same food category. Consumers with lower education level showed the lowest knowledge and concern about food sustainability. Older generations were less aware of sustainability and its related problems. While income level presented unclear results, gender did not affect attitude towards food sustainability. Therefore, to achieve a sustainable future, raising awareness among the population is increasingly necessary. Consequently, segmenting training campaigns according to the group they are aimed at will provide a greater impact and, therefore, greater awareness.

5.
Food Res Int ; 137: 109667, 2020 11.
Article in English | MEDLINE | ID: mdl-33233244

ABSTRACT

In today's market, there is a growing demand for high-quality coffee with distinctive sensory characteristics, such a cold brew (CB) coffee. The objectives of this study were to determine the impact of a) degree of roasting, b) coffee to water ratio (C2WR), and c) brewing method on the sensory characteristics of CB coffee from d) various Ugandan coffee beans, both Robusta and Arabica. Four distinct coffee samples, sourced from lowland and mountainous regions in Uganda, were roasted and tested using a factorial design. A highly trained sensory panel evaluated the samples using 42 attributes. Results showed that all factors studied had an impact on most of the attributes. Not surprisingly, Robusta coffees generally had more bitter taste than Arabica coffees and the dark roast samples generally were more bitter than the medium roast coffees. Also, coffee samples that were brewed using a higher C2WR generally were more bitter than the coffees using a lower C2WR. However, although most of the main effects had a significant impact, their effects were mitigated by their interaction with other factors. For example, Medium roast Robusta that was slow-dripped with a high C2WR had a more bitter taste than the corresponding Arabica samples. However, when the Medium roast Robusta was steeped with a high C2WR it had a similar bitter intensity with the corresponding Arabica samples. Thus, although major impacts are critical, individual sample combinations must be considered when evaluating coffee samples for their impact on the sensory characteristics.


Subject(s)
Coffea , Coffee , Cooking , Uganda , Water
6.
Foods ; 9(8)2020 Jul 23.
Article in English | MEDLINE | ID: mdl-32718026

ABSTRACT

Mushrooms are a nutritious versatile ingredient in many food products. They are low in calories and have various potential medicinal properties as well. Surprisingly, little research on their descriptive sensory properties has been conducted. The objectives of this study were to a) establish a descriptive sensory flavor lexicon for the evaluation of fresh, dried, and powdered mushrooms and 2) use that lexicon to compare a selection of different mushrooms of various species and in fresh dried and powdered forms. A lexicon for describing mushroom was developed using a consensus profile method. A highly trained, descriptive sensory panel identified, defined, and referenced 27 flavor attributes for commercially available mushroom samples prepared as "meat" and broth. Attributes could be grouped in categories such as musty (dusty/papery, earthy/humus, earthy/damp, earthy/potato, fermented, leather (new), leather (old), mold/cheesy, moldy/damp, mushroomy), and other attributes such as fishy, shell fish, woody, nutty, brown, green, cardboard, burnt/ashy, potato, umami, protein (vegetable), yeasty, bitter, salty, sweet aromatics, sour, and astringent. Samples were then tested in three replications and mean values were compared statistically. In addition, principal component analysis was used to understand the characteristics of mushrooms evaluated. Dried mushrooms showed bitter, burnt, musty/dusty, astringent, old leather, and fresh mushroom characteristics and fresh mushroom showed umami, sweet, earthy/potato, earthy/damp, yeasty, and fermented. Mushrooms were grouped and differentiated in similar ways regardless of whether they were tested as broth or "meat". Mushroom growers, product developers, chefs and other culinary professionals, sensory scientists, researchers, the food industry, and ultimately consumers will benefit from this lexicon describing a wide variety of mushroom flavor properties.

7.
Foods ; 9(5)2020 May 10.
Article in English | MEDLINE | ID: mdl-32397670

ABSTRACT

Increasing consumer desire for functional food ingredients, including such products as shiitake mushroom (Lentinus edodes P.) powder (SM), demands that the sensory impact of such ingredients be tested in an appropriate food system. Pork patties are a common food in many Asian countries. Pork patties in this study were prepared with and without SM, an ingredient that is gaining popularity around the world. A lexicon for describing the texture and flavor of cooked pork patties, with and without 0.5% sodium tripolyphosphate (STP), a typical additive to meat, and with varying amounts of SM (0% to 6%) was developed by a highly trained panel to compare sensory properties for each type of patty. The attributes evaluated were juiciness, toughness, rubberiness, mealiness, pork identity (pork ID), meatiness, mushroom, onion, garlic, black pepper, heat/burn, soapy, chemical, animal hair, fatty, salty, sour, bitter, slick, and astringent. An addition of 0.5% STP produced more intense ratings for soapy, salty, sour, and astringent attributes. Without STP, patties containing shiitake mushroom powder had a more mealy consistency but more pork ID than they did with STP.

8.
J Food Sci ; 85(6): 1621-1628, 2020 Jun.
Article in English | MEDLINE | ID: mdl-32460354

ABSTRACT

In the last decade, consumer perception of protein as an important nutrient has increased exponentially and focused on alternative sources such as plant- or insect-based protein and microalgae. However, many consumers indicate that they do not consider insect ingredients, a potential source of high quality protein, to be a good choice in food products. But is it because of the sensory aspects? This consumer study was conducted in the United States of America, Mexico, and Spain to compare acceptability of a familiar product, chocolate chip cookies, in three "blind" variations: a control 100% wheat flour chocolate chip cookie, and two versions substituting 15% and 30% cricket flour for an equivalent amount of wheat flour. Two hundred consumers from each country were recruited and scored overall acceptability and acceptability of different sensory attributes for the three cookies. Acceptance was measured using a nine-point hedonic scale and a similar format was used for each attribute. US consumers did not find significant differences in liking between the control and 15% sample. The 30% cricket powder cookie showed a decrease in consumer acceptance. Mexican and Spanish consumers liked the 15% sample significantly more than the control and 30% sample. Spanish consumers also like the control more than the 30% sample. The substitution of 15% cricket powder does not negatively impact liking in this product and, in fact, may improve both liking and protein content. Further research is necessary to determine whether this finding can help to mitigate the impact of insect-containing ingredients. PRACTICAL APPLICATION: High protein and sustainability are two key aspects being used to promote products in many markets. The protein content and sustainability of insect-based ingredients could make more competitive baked products if certain negative aspects, such as sensory and emotional and psychological barriers, can be overcome. This study focused on three specific countries but products using insect powder as an ingredient have the potential to be used in other regions or countries as acceptable products. With the correct marketing, such products could become a competitive choice in the product category. The food industry should consider and explore different insect powders/flours as an alternative ingredient.


Subject(s)
Chocolate/analysis , Food Preferences , Insecta/chemistry , Taste , Animals , Cacao/chemistry , Flour/analysis , Food Analysis , Food Handling , Humans , Insecta/metabolism , Mexico , Powders/analysis , Spain , Triticum/chemistry , United States
9.
Foods ; 9(4)2020 Apr 17.
Article in English | MEDLINE | ID: mdl-32316672

ABSTRACT

This study investigated suitable approaches and effective applications for the evaluation of grain flavor differences among cultivars. A model system that helps to facilitate the characterization of flavors in grain varieties was developed using sorghum grain as a tool. Five different applications were initially used, including cooked grain, porridge, cookies, muffins, and extruded puffed snacks. Six highly trained sensory panelists participated in the project. The effectiveness of each application was determined based on the results of the attribute generation process and from panelist feedback. The results indicate that the combination of a cooked whole grain procedure and the use of flour made into cookies provides an effective and potent model for flavor characterization in both their grain form and as finished products. Both the recipes for the cooked grain and cookie applications effectively brought out the flavor characteristics of the grains as well as differentiated the flavor differences between grain cultivars. The developed model can be applied for the flavor evaluation of multiple grain types and can help researchers understand the flavor differences among grain cultivars. As a result, such knowledge will help to facilitate the selection of suitable products with favorable characteristics for specific applications as well as for selective breeding purposes.

10.
Eur J Investig Health Psychol Educ ; 10(3): 859-875, 2020 Sep 01.
Article in English | MEDLINE | ID: mdl-34542516

ABSTRACT

This study developed and evaluated risk communication messages for ready to eat (RTE) foods targeted towards consumer storage practices in a food safety health campaign. Concepts were determined from a fractional factorial design of five categories of attributes potentially present in health promotion: title, message, graphic, slogan, and icon. Consumers viewed a subset of concepts and scored how useful the concept was in remembering to throw away RTE foods that were stored too long. Regression analysis determined which combinations of message attributes were most likely to result in using the information to throw out foods, which could help prevent foodborne illness. Findings showed that for this type of information, a graphic is a critical element for the printed schematic. The slogan (i.e., a short statement similar to a jingle or tag-line in a commercial) may be important to consumers, but the icon was not important.

11.
J Texture Stud ; 51(2): 308-313, 2020 04.
Article in English | MEDLINE | ID: mdl-31609465

ABSTRACT

Simple measurement tools that provide objective information about the consistency of thickened liquids have received increasing attention given possible application to clinical practice for dysphagia. The International Dysphagia Diet Standardization Initiative (IDDSI) advocates the use of the IDDSI Flow Test for measuring thickness and verifying a prescribed level of consistency. This study compares gravity flow test measurements taken with two 10-ml syringes of starch and gum-thickened samples prepared to a mildly thick consistency using product label information. One of the 10-ml syringes met IDDSI specification and the other 10-ml syringe did not. Thickened samples also were measured using the line spread apparatus. The results showed that two syringes yielded significantly different gravity flow test measurements, often resulting in changes to the classification level of thickness. There was no effect of thickening agent. Line spread measurements did not vary from one another. Study findings indicate the importance of continued testing with the IDDSI Flow Test and education/awareness about the use of the IDDSI reference syringe. An essential aspect about the use of thickened liquids in dysphagia management is that beverage preparations represent their prescribed level of modification. The findings of this study indicate the importance of following syringe specifications when conducting gravity flow testing using the IDDSI methodology. The implication is that the wrong 10-ml syringe could result in errant clinical decisions in determining the accuracy of texture modifications, resulting in care providers who are more likely to over or under thicken modifications to achieve a targeted level of thickness.


Subject(s)
Beverages/analysis , Deglutition Disorders/diet therapy , Food Technology , Humans , Rheology , Viscosity
12.
Foods ; 8(10)2019 Oct 12.
Article in English | MEDLINE | ID: mdl-31614755

ABSTRACT

The choice of food products is affected by the combination of food properties, consumer motives, emotions, and context, especially in cross-cultural studies. The designs of cross-cultural studies involve several limitations such as conceptual perception and linguistic and cultural differences in response style. These factors confine the validity and generalizability of such study models. In this study, we have combined linguistic and contextual perception together to generate consumer texture terminologies. Four focus groups discussions were conducted with consumers from nine different countries in English, Hindi, Mandarin, and Spanish. Vocabularies for sixteen texture terms were generated. Consumers provided a single consensus term that they typically use to describe contextual sensory perception. The results show that consumers use several terms to describe texture, and terms are very specific to product and related perception. The English translation of words like "snack", "texture", and other sensory texture terms are meaningless for non-English speaking cultures. Researchers are encouraged to validate (test) the structure of cross-cultural study models before application. Practical application: The findings of this study present a model which can be utilized to conduct cross-cultural research studies. The results can contribute to generate accurate consumer responses, acceptance, preference, and addressing consumers concerns. Food industries could leverage these by using our methodology in product development, finding consumer insights, effective communication, and products testing in international settings.

13.
J Food Sci ; 84(9): 2638-2645, 2019 Sep.
Article in English | MEDLINE | ID: mdl-31429489

ABSTRACT

Fortified blended foods (FBFs), a staple of food aid around the world, must maintain desirable characteristics for long periods of storage. This study estimated the shelf life of FBFs, including a traditional FBF (nonextruded corn soy blend plus [CSB+]) and 13 novel extrusion cooked FBFs. All products were stored under accelerated and real-time environments (real time = 30 °C and 65% relative humidity [RH], accelerated = 50 °C and 70% RH based on a Q10 factor of 2). Products were made into porridges and evaluated by a descriptive sensory panel for five times in each shelf life condition. Rancid and painty sensory characteristics were key determining factors for shelf life. Real-time (RT) and accelerated shelf life (ASL) testing agreed that most novel extrusion cooked FBFs had shelf lives of at least 2 years, which is comparable to current CSB+. However, ASL testing failed to predict RT shelf life of two novel FBFs, which were estimated by RT testing to have a 2+ year shelf life. The results indicated that novel extrusion cooked FBFs have high potential for use as alternative complementary food and maintain quality for long storage periods. It is essential to conduct RT testing parallel with ASLT testing, especially for new products, to obtain a more precise estimation of products' shelf life. PRACTICAL APPLICATION: These findings show that extrusion cooked novel fortified blended foods made with extrusion generally can last up to or exceeding 24 months at ambient conditions as measured either real-time or under accelerated conditions. This is plenty of time for storage, shipping, distribution, and home storage of such products by recipients. Thus, there should be no concerns about shelf life of these products for international distribution.


Subject(s)
Food Storage , Food, Fortified/analysis , Temperature
14.
Foods ; 8(8)2019 Aug 17.
Article in English | MEDLINE | ID: mdl-31426524

ABSTRACT

Why do many human beings find bugs repulsive? Disgust, a psychological factor, is believed to be the main reason why consumers would not consider eating foods containing insect ingredients. This study aimed to understand specific consumers' behaviors toward insect based products. A global survey was launched in 13 different countries. The participants (n = 630 from each country) completed the survey that included demographic questions and questions about why they would or would not eat insect-based products. The results show, particularly for some of the Asian countries, that it is necessary to start exposing and familiarizing the populations about insects in order to diminish the disgust factor associated with insects. It is strongly recommended that an insect-based product should not contain visible insect pieces, which trigger negative associations. The exceptions were consumers in countries such as Mexico and Thailand, evaluated in this study, which did not show significant negative beliefs associated with including insects in their diets. Additional research to promote insect-based product consumption with popular product types might be the first strategy to break the disgust barriers and build acquaintance about insect-based products. The need to educate consumers that not all insects are unhygienic is crucial to eliminating the potentially erroneous concepts from consumer mindsets.

15.
Foods ; 8(8)2019 Aug 04.
Article in English | MEDLINE | ID: mdl-31382670

ABSTRACT

Natural foods are important to consumers, yet frustrating to producers due to the lack of a formal definition of "natural". Previous work has studied how consumers define naturalness and how they rate the naturalness of various products, but there is a gap in knowledge relating to how color and flavor additives impact perceptions. The objective of this study was to understand how colorants and flavorants on ingredient statements affect perceptions of naturalness. An online survey was launched in the United States, United Kingdom, and Australia to determine how consumers perceive products with ingredient statements containing different combinations of artificial and natural colors and flavors when shown with and without the product identity. Results showed that consumers look at the whole product primarily to make decisions about naturalness, but also consider other factors. Products derived from plants and products with natural colors and flavors were perceived to be the most natural. Artificial flavors may be more acceptable than artificial colors due to negative health perceptions and labeling rules associated with colors. Additionally, factors like ingredient familiarity and processing likely influence consumers when making decisions about product naturalness. Males, Millennials, and educated participants have higher naturalness scores than other participants in their respective demographics.

16.
Foods ; 8(8)2019 Jul 26.
Article in English | MEDLINE | ID: mdl-31357542

ABSTRACT

The sensory properties of foods are the most important reason people eat the foods they eat. What those properties are and how we best measure those properties are critical to understanding food and eating behavior. Appearance, flavor, texture, and even the sounds of food can impart a desire to eat or cause us to dismiss the food as unappetizing, stale, or even inappropriate from a cultural standpoint. This special issue focuses on how sensory properties, including consumer perceptions, are measured, the specific sensory properties of various foods, which properties might be most important in certain situations, and how consumers use sensory attributes and consumer information to make decisions about what they believe about food and what they will eat.

17.
Foods ; 8(2)2019 Feb 14.
Article in English | MEDLINE | ID: mdl-30769896

ABSTRACT

This study examined the changes in viscosity in response to small alterations in the amount of a thickening agent mixed with three commonly thickened beverages. A total of 11 incremental adjustments in the amount of a starch-based thickening agent (5.0 g to 7.0 g) were made. The results showed that the incremental increases resulted in systematic changes to the liquid thickness, reflecting modifications that ranged from a nectar (mildly thick) to a honey-like (moderately thick) level of consistency. The findings emphasize the importance of the proper preparation of thickened beverages, highlighting the need for standards in training practices and the use of simple measurement tools for assuring the prescribed levels of consistency.

18.
Food Res Int ; 116: 645-651, 2019 02.
Article in English | MEDLINE | ID: mdl-30716991

ABSTRACT

Coffee sensory properties can depend on several factors such as the species/varieties cultivated, the processing after the harvesting phase, geographical origin, and climatic factors. The impact of microclimates has been suggested to be critical to coffee sensory properties. Thirteen Arabica coffee samples from different farms in different sub areas of the same municipality (Pitalito region of Huila, Colombia), were evaluated using descriptive sensory analysis. The coffee samples differed in growing altitude, shading level, and fermentation practices. Overall, samples differed for attributes such as burnt, acrid, ashy, metallic, sour and sweet aromatics. However, differences generally were small, <1-point on a 0-15 scale for most attributes. Differences could not be directly attributed to geographical area, different farming practice, or storage methods. This study suggests that the impact of specific microclimates within the same small region does not have a large impact on sensory properties of coffee.


Subject(s)
Coffea/metabolism , Coffee/metabolism , Odorants/analysis , Olfactory Perception , Smell , Taste Perception , Taste , Coffea/growth & development , Colombia , Humans , Microclimate
19.
J Food Prot ; 82(3): 528-534, 2019 Mar.
Article in English | MEDLINE | ID: mdl-30810378

ABSTRACT

Undercooked poultry is a potential source of foodborne pathogens, such as Salmonella and Campylobacter. The best way to avoid eating undercooked poultry is to use a food thermometer during cooking. However, consumers who cook poultry often use visual appearance for determining doneness, which relies on extrinsic factors, including lighting conditions. Because the United States recently mandated changes in lighting to promote energy conservation, this study evaluated the effect of lighting sources on consumer perceptions of doneness and willingness to eat cooked poultry patties. Consumers ( n = 104) evaluated validated photographs of turkey patties cooked to different end point temperatures (57 to 79°C) and rated the level of perceived doneness and willingness to eat each sample. Evaluations were conducted under different lighting sources: incandescent (60 W, soft white), halogen (43 W, soft white), compact fluorescent lamp (13 W, soft white), light-emitting diode (LED; 10.5 W, soft white), and daylight LED (14 W). Lighting changed perception of doneness and willingness to eat the patties, with some of the energy-efficient options, such as LED and halogen making samples appear more done than they actually were, increasing the willingness to eat undercooked samples. This poses a risk of consuming meat that could contain bacteria not killed by heat treatment. Recent changes in lighting regulations can affect lighting in homes that affects perceptions of poultry doneness, requiring that educators place extra emphasis on the message that properly using a meat thermometer is the only way to ensure meat is cooked to a safe end point temperature.


Subject(s)
Consumer Product Safety/standards , Cooking/methods , Lighting , Poultry Products/standards , Animals , Hot Temperature , Meat/standards , Poultry , Turkeys , United States
20.
J Food Prot ; 82(2): 200-206, 2019 Feb.
Article in English | MEDLINE | ID: mdl-30673351

ABSTRACT

Salmonella and Campylobacter are among the most common causes of foodborne disease in the United States. Most illnesses are associated with eating raw or undercooked poultry or cross-contamination. Young children and older adults are more susceptible to contracting foodborne illness and have serious infections compared with other age groups. We conducted a Web-based survey of parents of young children ( n = 1,957) and older adults ( n = 1,980) to estimate adherence to recommended food safety practices for raw poultry and to identify differences in practices between the two groups. The findings present adherence rates for 20 practices. In both groups, less than 50% of respondents reported adherence to seven practices; thus, improvements are needed in these areas. Parent respondents were significantly more likely than older adult respondents to report following eight practices, with most related to avoiding cross-contamination and using a food thermometer. For example, parents (39%) were significantly more likely than older adults (31%) to report not rinsing or washing raw poultry ( P < 0.001). Older adult respondents were significantly more likely than parent respondents to report following seven practices, with most related to chilling to proper temperatures and thawing. For example, older adults (87%) were significantly more likely than parents (69%) to report cooking, freezing, or discarding raw poultry within 1 to 2 days of purchase as recommended ( P < 0.001). For the remaining five practices, no differences were found between groups. To motivate behavior change, food safety messages and materials must target specific at-risk populations as their practices are different. Additional research is needed to better understand how parents of young children and older adults like to receive food safety information and how to tailor the information to different generations.


Subject(s)
Consumer Product Safety , Food Handling/methods , Foodborne Diseases , Poultry , Aged , Animals , Child , Child, Preschool , Cooking , Female , Food Microbiology , Food Safety , Health Knowledge, Attitudes, Practice , Humans , Male , United States
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