Nurgül Fitzgerald, PhD, RD: Rutgers Grace Damio, MS, CD/N:Hispanic Health Council (HHC)

Nutrition Knowledge, Food Label Use, and Food Intake Patterns among Latinas with and

without Type 2 Diabetes

Nurgül Fitzgerald, PhD, RD: RutgersGrace Damio, MS, CD/N:Hispanic Health Council (HHC)

Sofia Segura-Pérez, MS, RD: HHCRafael Pérez-Escamilla, PhD: University of Connecticut

Fitzgerald, et al.

J Am Diet Assoc . 108(6), Jun. 2008

JOURNAL OF THEAMERICAN DIETETICASSOCIATION

Nutrition Knowledge, Food Label Use, and Food Intake Patterns among Latinas with and without

Type 2 DiabetesStudy 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

Fitzgerald, et al.

J Am Diet Assoc . 108(6) ,Jun. 2008


Control(n=101)

Diabetes(n=100)

Age, mean ± standard deviation 47.3 ± 5.9 50.6 ± 6.9*

Ethnicity: Puerto Rican, % Other Latina, %

84.115.9

85.015.0

Education: < High school diploma, % High school diploma, %

61.438.6

66.034.0

Employed, %Unemployed, %

30.769.3

26.074.0

Marital status: Have partner, % No partner, %

40.659.4

40.060.0

Acculturation score: median, % > median, %

45.554.5

60.0 40.0*

BMI, mean ± standard deviation 31.2 ± 8.2 34.7 ± 8.6** p<0.05

Nutrition Knowledge, Food Label Use, and Food Intake Patterns among Latinas with and without Type 2 Diabetes

Participant Characteristics

Fitzgerald, et al.




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).

0

10

20

30

40

50

60

%

F&V Meats Softdrinks

Sweets Snacks

Food label user Nonuser

0

10

20

30

40

50

60

%

F&V Meats Softdrinks

Sweets Snacks

High nutrition knowledge Low nutrition knowledge

Associations of nutrition knowledge and food label use with food intakefrequency (>median) among Latinasa

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; *: p0.05 determined by Chi-square test.

* ** * *

Fitzgerald, et al.



0

1

2

3

F&V Soft drinks Sweets Salty snacks

Od

ds

ra

tio

Less acculturation Use FL to select healthy foodsHigh knowledge score Use FL for fiberHigh education Use FL for sodiumHave diabetes

* *

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; *: p0.05 determined by logistic regression analyses.

**

*

*


Determinants of consuming fruits and vegetables, regular soft drinks, sweets, and salty snacks frequently (>median) among Latinas

* *

Fitzgerald, et al.

J Am Diet Assoc. 108(6), Jun. 2008



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.

Fitzgerald, et al.



Nurgül Fitzgerald, PhD, RD: Rutgers Grace Damio, MS, CD/N:Hispanic Health Council (HHC)

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