Snacks are a staple of the American diet, contributing to approximately 20% of energy intake. Most U.S. adults consume one to three snacks/day, yet few reviews have focused on snacking among this population. This scoping review was conducted to characterize snacks and snacking occasions among U.S. adults to further inform healthy eating practices. The protocol was prepared following the PRISMA-Extension for Scoping Reviews. Three web databases were used to identify articles using snacking or eating occasions as primary or secondary outcomes among U.S. adults. A search strategy was developed using subject headings, truncation, and phrase searching in the title and abstract of articles published between 2010 and 2022. A two-stage, multi-step screening process identified 31 of 4795 publications as meeting the inclusion criteria. Findings included identification of snacking themes, e.g., cues and motivations; diet composition; and weight management. Food quality, time of consumption, and convenience emerged as characteristics of snacking; time of day was found to influence food choice. Snacks contribute to or detract from a healthy diet. Strategic selection of healthy snack options can improve diet quality. Applied to nutrition education, this information can help strengthen programs or policies, ultimately contributing to health and wellbeing.

Background: Many types of diet intervention can achieve negative energy balance and successful weight loss in persons with obesity. However, within any dietary strategy, there is large inter-individual variation in the weight loss response. The aim of this study is to determine factors that predict weight loss success for diet interventions that vary by macronutrient and caloric composition.Methods: Participants with BMI 30.0 to 49.9 kg/m² self-selected one of three diet intervention trials for weight loss: low carbohydrate (LOW CHO), low fat (LOW FAT), or low calorie (LOW KCAL). Multivariable regression models were developed to determine the significance of predictor demographic, body composition, metabolic, clinical, and dietary variables for each diet type.Results: Weight loss over 12–16 weeks averaging −5.1 ± 4.0 kg from baseline weight, p < 0.001, was not significantly different among diet types. Several different factors were identified that account for the inter-individual variance in weight loss success. Regardless of diet type, the most robust predictor of weight loss success was completion of the intervention, accounting for 20–30% of the variance. Factors predicting diet intervention completion were age, physical activity level, blood leptin level, blood pressure, and the amount of weight loss occurring. Differences by diet type in cardiometabolic risk factor reduction were identified with LOW CHO decreasing glycemia/insulinemia factors, LOW FAT decreasing lipidemia factors, and LOW KCAL decreasing inflammatory factors.Conclusion: These data provide evidence to inform more precise and personalized approaches to diet intervention for weight loss and cardiometabolic health.

The community-based Small Changes, Healthy Habits (SCHH) program was developed to teach skills and techniques to help adults in Louisiana make and maintain small behavioral changes in their food selection, preparation, and consumption, and in physical activity routines. The content of this four-week program included habit formation and goal setting techniques; physical activity guidance; strategies for a healthier home food environment; a grocery store tour focused on label reading for healthier food selections; basic knife and cooking skills. The program was piloted at ten sites throughout the state. A survey with 14 core items was applied before and after the program to evaluate participant acquisition of skills and behaviors associated with topic areas. A total of 47 participants provided complete data sets. Post-program, these participants reported increased confidence in preparing healthy meals at home (p = 0.04); changes in fats (p = 0.03) and salt (p = 0.01) intake; increased frequency of reading nutrition labels (32%); decreased frequency of meals eaten outside the home (Improvement Index = 0.27); and decreased time/day spent sitting (p < 0.05). These short-term results suggest that the SCHH program has potential to positively affect healthy eating and to reduce sedentary behaviors, both of which are fundamental to good health and wellness.

The home food environment (HFE), the availability and accessibility of foods and food products within the home, has a strong influence on healthy eating behaviors. Studies assessing the HFE commonly utilize a home food inventory (HFI) for data collection. However, this approach tends to be burdensome for participants. This study validated a low-burden digital photo method for assessing the home food environment and confirmed that this method is preferred by participants. Study participants completed an HFI, submitted photos of household foods, then identified preference for the HFI or photo reporting method. Researchers completed an HFI based on each participant’s photo submissions. Researcher-to-participant and researcher-to-researcher comparisons were made through ANOVA and randomized block analyses to determine concurrent validity and inter-rater reliability. Method preference was assessed using the Z-test. The participant group (N = 53) was predominantly female (68%), young adult (90.5%), and Hispanic or Latino (71.7%). Concurrent validity was initially moderate (ĸ = 0.54); adjustments yielded substantial agreement (ĸ = 0.61). The inter-rater reliability (p = 0.98) demonstrated significant consistency among reviewers. The photo-documentation method was found to be valid and preferred (p = 0.01) for reporting on the HFE. The photo method can be used advantageously to collect quality data.

Childhood obesity and related health consequences are associated with sugar-sweetened beverage consumption and present significant health challenges in the U.S., particularly among minoritized and low-income populations. Louisiana, with some of the highest obesity and cardiometabolic disease rates in the U.S., exemplifies these concerns. Dining out increases sugar-sweetened beverage intake and underscores the need for interventions. This observational study examines the proportion of restaurants offering beverages with children’s meals on printed and QR code menus, the types of beverages they offer, and correlates of offering these beverages across 287 restaurants in New Orleans, Louisiana, before its healthy default beverage policy was implemented and in Baton Rouge, Louisiana, which does not have a healthy default beverage policy. On-site environmental assessments were conducted in restaurants offering children’s menus. Only 14.6% of restaurants with children’s meals offered only healthy default beverage options, 39.4% offered sugar-sweetened beverages, and 46% did not specify children’s beverages on their menus. Logistic regression analysis indicated that restaurants categorized as fast food, affiliated with a chain, or offering children's meals with age restrictions were significantly more likely to include beverages in their children's meals. Furthermore, chain and fast-food restaurants were more likely than fast-casual restaurants to include only healthy default beverages on the children’s menus. Ultimately, this research contributes to the broader discourse on improving nutritional environments in restaurant settings and underscores the need for evidence-based interventions to mitigate the impact of sugar-sweetened beverage consumption on childhood obesity and health outcomes. The findings provide a foundation for future studies evaluating the effectiveness of healthy default beverage policies.

Healthy Default Beverage (HDB) ordinances have been implemented across the United States to reduce sugar sweetened beverage (SSB) intake by making healthier options the default for children's meals. This study explored restaurant staff knowledge and perceptions of the HDB ordinance and its potential impact one year after its implementation in New Orleans, Louisiana, United States. We conducted 21 in-person interviews with restaurant staff across 20 restaurants from March to May 2024, including independent, national chain, and local chain establishments. The interviews focused on the popularity of children's meals, beverages offered, restaurant staff knowledge and perceptions of the ordinance, and potential policy-related health benefits. The majority of restaurant staff supported the policy but expressed concerns about its implementation. Restaurant staff estimated that most children's meals were still ordered with SSBs. Staff felt the policy alone may not change behavior. They highlighted the need for broader public education on the health risks of SSBs. This study identified key factors that may impact the effectiveness of the HDB ordinance, including the need for clearer guidelines, stronger enforcement mechanisms, and better support from public health authorities. Findings suggest that both restaurant staff and parents require further education to ensure the policy's success, especially in marginalized communities. Future research should focus on societal, cultural, and enforcement factors to optimize the impact of HDB policies in improving children's health outcomes.