Diet quality, diet-related factors and disability status among male adults of reproductive age in the USA.

OBJECTIVE: To examine diet quality and diet-related factors among male adults of reproductive age with and without disabilities. DESIGN: Cross-sectional data from the National Health and Nutrition Examination Surveys, 2013-2018. SETTING: Disability was reported as serious difficulty hearing, seeing, concentrating, walking, dressing and/or running errands due to physical, mental or emotional conditions. Diet quality was assessed by the Healthy Eating Index (HEI)-2015 and diet-related factors included self-rated diet healthfulness, food security and food assistance programmes. Multivariable linear regression estimated differences in HEI-2015 scores. Multivariable Poisson regression estimated adjusted prevalence ratios (aPR) and 95 % CI for diet-related factors. PARTICIPANTS: In total, 3249 males, 18-44 years; of whom, 441 (13·4 %) reported having disabilities. RESULTS: Compared with males without disabilities, those with disabilities had a 2·69-point (95 % CI: -4·18, -1·20) lower mean total HEI-2015 score and approximately one-third to half of a point lower HEI-2015 component scores for greens and beans, total protein foods, seafood and plant proteins, fatty acids and added sugars. Males with any disabilities were more likely to have low food security (aPR = 1·57; 95 % CI: 1·28, 2·92); household participation in food assistance programmes (aPR = 1·61; 95 % CI: 1·34, 1·93) and consume fast food meals during the previous week (1-3 meals: aPR = 1·11; 95 % CI: 1·01-1·21 and 4 or more meals: aPR = 1·18; 95 % CI: 1·01-1·38) compared with males with no disabilities. CONCLUSIONS: Factors affecting diet and other modifiable health behaviours among male adults of reproductive age with disabilities require further investigation. Health promotion strategies that are adaptive to diverse populations within the disability community are needed.

Dietary Quality and Diet-Related Factors Among Female Adults of Reproductive Age With and Without Disabilities Participating in the National Health and Nutrition Examination Surveys, 2013-2018.

BACKGROUND: Female adults of reproductive age (18 to 44 years) with disabilities have higher rates of health-risk behaviors and chronic conditions compared with their counterparts without disabilities; however, there is limited examination of diet. OBJECTIVE: Our aim was to examine associations of self-reported disability status with diet quality and diet-related factors. DESIGN: Cross-sectional data were from the National Health and Nutrition Examination Surveys, 2013-2018. PARTICIPANTS/SETTING: Female adults aged 18 through 44 years were included. Disability was defined as serious difficulty hearing, seeing, concentrating, walking, dressing, and/or running errands due to physical, mental, or emotional conditions. MAIN OUTCOME MEASURES: The Healthy Eating Index-2015 assessed diet quality. Diet-related factors included self-rated diet healthfulness, meal characteristics, food security, and food assistance programs. STATISTICAL ANALYSIS: Multivariable linear regression estimated differences in Healthy Eating Index-2015 scores for a given day and multivariable Poisson regression estimated adjusted prevalence ratios and 95% CI of diet-related factors by disability status. RESULTS: Of 3,579 female adults, 557 (16%) reported any disabilities, 207 (6%) of whom reported having 2 or more types of disabilities. Differences in mean Healthy Eating Index-2015 scores for a given day were one-third to one-half a point lower for fruits, total protein foods, and seafood and plant proteins among female adults with 2 or more types of disabilities compared with those without disabilities. Female adults with any disabilities were more likely to rate their diet as poor, have low food security, participate in food-assistance programs, and consume frozen foods or pizza, compared with those without disabilities (adjusted prevalence ratio ranged from 1.35 to 1.93); they were less likely to be the main food planner or preparer or shopper for their households. CONCLUSIONS: Some indicators of diet quality and diet-related factors differed between female adults with and without disabilities. Additional investigation of dietary intakes and behaviors, as well as access to and availability of healthy foods, among female adults with disabilities is necessary.

Preconception Health and Disability Status Among Women of Reproductive Age Participating in the National Health and Nutrition Examination Surveys, 2013-2018.

Background: Preconception health is a critical determinant of health outcomes for women and their offspring. Given higher rates of prenatal and postpartum complications among women with disabilities, it is important to investigate a range of preconception health indicators in this population. Materials and Methods: Data were from women of reproductive age (18-44 years) who participated in the National Health and Nutrition Examination Surveys, 2013-2018. Disability was self-reported as serious difficulty hearing, seeing, concentrating, walking, dressing, and/or running errands due to physical, mental, or emotional conditions. Preconception health indicators were adapted from those developed by the Core State Preconception Health Indicators Working Group. Multivariable Poisson regression estimated adjusted prevalence ratios (aPRs) and 95% confidence intervals of preconception health indicators among women with disabilities compared with those without disabilities. Results: Of 4055 women, 601 (15%, weighted) reported having any disabilities, and of these women, 220 (6%) reported having 2 or more types of disabilities. Women with any disabilities were more likely to have suboptimal preconception health indicators compared with women without disabilities, including low education and household income, no recent dental visit, difficulty getting pregnant, current smoking, binge drinking, drug use, obesity, no multivitamin use, physical inactivity, long sleep durations, asthma, hypertension, and sexually transmitted infections (aPRs from 1.1 to 2.0). The greatest disparities between women with and without disabilities were for indicators of self-rated poor or fair general health, depression, and diabetes, with aPRs ranging from 2.4 to 3.8. Conclusions: Disparities in preconception health indicators are modifiable and may be addressed through adequate access to health care, interventions targeting lifestyle and health behaviors, and education and training for all health practitioners.

Weight Perception, Weight Control Intentions, and Dietary Intakes among Adolescents Ages 10⁻15 Years in the United States.

BACKGROUND: To examine associations of adolescents' weight status perception and weight control intentions with dietary intakes. METHODS: Cross-sectional data from adolescents aged 10⁻15 in the National Health and Nutrition Examination Surveys, 2005⁻2014 (n = 4940). Adolescents responded to questions regarding weight perception and if they were trying to change their weight. Intakes of calories, protein, carbohydrate, fat, saturated fat, sugar, and fiber were assessed using 24-h dietary recalls. Multivariable linear regression estimated associations of intakes with weight perception and weight control intentions. RESULTS: The majority of adolescents perceived their weight as "about right"; however, 45% and 46% of boys and girls, respectively, reported trying to change their weight. Weight perception was not associated with intakes, with the exception of lower sugar (-13.65 g, 95% CI: -23.06, -4.23) and higher percent calories from protein (1.01%, 95% CI: 0.16, 1.87) in boys with overweight/obesity who perceived themselves as overweight, as well as lower percent calories from saturated fat (-1.04%, 95% CI: -2.24, -0.17) among girls with normal weight who perceived themselves as overweight. Weight control intentions were associated with intakes in boys only. Compared to boys who never tried to lose weight, boys who tried to lose weight consumed fewer calories (-188.34 kcal, 95% CI: -357.67, -19.01), a lower percent of calories from fat (-1.41%, 95% CI: -2.80, -0.02), and a greater percent of calories from protein (1.48%, 95% CI: 0.41, 2.55). CONCLUSIONS: Despite perceiving weight as "about right", many adolescents reported trying to change their weight, which was associated with some dietary intakes. Efforts may be necessary to educate adolescents on healthy nutrition and weight management behaviors.