DESCRIPCIÓN DE REACCIONES Y PRODUCTOS

The USDA recommends that all Americans consume 1-2.5cups of fruits per day, 1- 4 cups of vegetables per day, and 1.5-5oz. equivalents of whole grains per day depending on individual caloric need (USDA Department of Health & Human Services, 2010). In general most Americans do not meet the dietary goals for fruit, vegetable and whole grain intakes set forth by the Dietary Guidelines for Americans 2010, the sample population for this study is no different (USDA Department of Health & Human Services, 2010). Based on the mean values in this study, participants are ½ cup below the lower limit for fruit intake per day, barely at the lower limit for vegetable intake per day and below the lower limit for whole grain consumption per day by ½ cup.

19 These findings are similar to a study conducted by Leung et al. determining the

dietary intake and diet quality of SNAP participants (Leung C. W., Ding, Catalano, Villamor, Rimm, & Willett, 2012). Leung and colleagues found that few low-income adults met the dietary standards. Median fruit consumption for participants in their study was 0.3 to 0.6 servings per day (Leung C. , Ding, Catalano, Villamor, Rimm, & Willet, 2012). Median vegetable consumption for participants in the Leung et al. study was 0.7- 1.0 servings per day, while whole grain consumption was 0.2 to 0.5 servings per day (Leung C. , Ding, Catalano, Villamor, Rimm, & Willet, 2012). While mean values for this study are quite similar to the findings of Leung et al. for fruit and vegetable intake (0.6 cups/day and 1.0 cups/day, respectively), whole grain consumption differs from the findings of Leung et al. Leung and colleagues found their sample population consumed 0.2 to 0.5 servings per day, while our sample consumes 0.7 to 1.5 ounces equivalents of whole grains per day (Leung C. , Ding, Catalano, Villamor, Rimm, & Willet, 2012). This discovery strengthens the argument that participants in the present study lack the

understanding of what food items are considered a whole grain and how they differ from regular grain products.

4.3 Limitations

A limitation of this study was a small sample size, which could result in low power to detect statistically significant differences between the ASA 24 and medium-term survey. Many barriers such as lack of internet access, low-computer illiteracy, length of

20 dietary recalls, low incentive, weather, flu season, and the transitive nature of low-income

adults prevented the researcher from attaining a larger sample population.

Additionally, the different ways the intakes are estimated by the medium term survey and the ASA 24 can also be considered a limitation. The medium term survey does not offer a reference period for participants to use when estimating how much they consume of each dietary component, making it unclear if their estimate is for the past week, month, or year. The ASA 24 does not ask participants to estimate their intake. When completing the ASA 24 participants indicate everything they consumed in the previous 24 hours and from this a usual intake is estimated. There is a fundamental difference in how “usual” intake is estimated between these two tools making comparing them to one another difficult.

4.4 Delimitations

Participants were all low-income adults enrolled in SNAP-Ed. Each participant completed both the medium term survey and 3 online ASA 24s. These multiple online recalls provided a more complete description of each participant’s usual intake for all dietary components.

CHAPTER 5. CONCLUSION

This study provides evidence that Indiana’s Family Nutrition Program medium term survey is a valid tool, using convergent validity, to assess self-reported fruit and

vegetable consumption when compared with the gold standard, multiple automated self- administered 24-hour dietary recalls (ASA 24). Whole grain consumption was found to be significantly different between the medium term survey and ASA 24, suggesting that the medium term survey is not a valid tool to assess this particular dietary component. While the medium term survey may be a valid tool to assess fruit and vegetable

consumption among a low-income population, more research could further investigate its construct validity and improve this tool.

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28 APPENDICES