Factors Associated with Identification and Consumption of Whole-Grain Foods in a Low-Income Population

Background: US Dietary Guidelines include recommendations to increase whole-grain consumption, but most Americans, especially low-income adults, fail to consume adequate amounts. Objectives: The aim of this study was to determine major factors that may affect whole-grain consumption among low-income adults. Methods: A mixed methods approach including a whole-grain food identification activity and in-depth interview was used to determine the factors that influence whole-grain consumption based on the constructs of the integrative behavioral model. Participants were recruited from food pantries in the northeastern United States. Descriptive statistics were conducted for demographic data and survey scores, and logistic regression was used to examine differences in whole-grain accuracy by demographic characteristics. Results: Low-income adults (n = 169) completed a quantitative survey, with a subset (n = 60) recruited for an in-depth qualitative interview. When completing the whole-grain identification activity, most low-income adults identified popcorn incorrectly as refined grain (71%), whereas the refined-grain food commonly identified as whole grain was white rice (42%). Less than half of low-income adults (46%) identified the majority of whole-grain foods correctly. Age, race, and education were not associated with the ability to identify whole-grain foods correctly. However, younger adults (aged 18-49 y) were less likely to identify popcorn as a whole-grain food (OR = 0.42, P = 0.02) compared with older adults (aged >= 50 y). According to the qualitative results, additional barriers, such as perceived cost, may also affect whole-grain food consumption among low-income adults. Conclusions: Low-income adults' ability to correctly identify whole-grain foods and having a perception that whole-grain foods are higher in cost may be the overarching barriers to consuming adequate amounts. Future efforts should focus on strategies improving identification and seeking affordable whole-grain foods to increase whole-grain consumption in low-income adults.