Objectives: Helping residents select nutrient-dense foods is a strategy to improve their diet quality. However, communication based on the nutrient-dense foods as a positive attribute has not been widely used in nutritional education. This study aimed to develop an educational tool based on the picture and guidance of "Chinese food guide pagoda (2022) ", extend it with the concept of nutrient density, and investigate its acceptance by Chinese residents from Henan province.
Methods: Three examples (one-day diet with high, medium, and low nutrient-rich food (NRF) 9.2 score, an indicator for evaluating dietary nutrient density) were designed for developing a dietary nutrient density educational tool. A self-designed questionnaire was conducted to investigate the acceptance of the "dietary nutrient density educational tool" among college students from Henan province on the basis of the theory of planned behavior.
Results: Among the three one-day diets used in the tool, with the decrease in the NRF9.2 score, the energy intake increased from 1686 kcal to 2363 kcal, the dietary fat-to-energy ratio increased from 28 to 42%, and the mean adequacy ratio (MAR) decreased from 0.97 to 0.87. A total of 851 college students completed the acceptance questionnaire. The average score of the acceptance was 4.07, with a total score of 5. This study showed that resident's intention to use the tool was correlated with family residence, perceptual behavior control, and subjective norms. These three factors accounted for 83.5% of the variation in behavior intention.
Conclusion: To encourage residents choosing healthier foods, a dietary nutrient density educational tool was developed to expanding the current instructional tool-the Chinese food guide pagoda (2022). The acceptance questionnaire survey revealed that residents had good acceptance of the tool, and family residence, perceptual behavior control, subjective norms may strongly contribute to their acceptance and the intention to use of the tool.
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