Digesting detention: how to document eating patterns in jail

People incarcerated experience significant health inequities compared to the non-incarcerated population, including higher rates of many diet-related diseases. Despite widespread acceptance of the association between diet and health, research documenting the dietary intake and nutritional status of individuals incarcerated in jail is limited. Food intake is notoriously difficult to measure, and current measurement tools are not designed for the jail setting. This study aimed to assess the acceptability and feasibility of a comprehensive tool to assess food intake during incarceration.

The cycle menu and commissary list from a rural county jail in the Southwest United States were used to design a dietary assessment questionnaire tailored to the carceral setting. The instrument included structured tables listing all menu items by meal (breakfast, lunch, and dinner), allowing participants to indicate the foods and proportions consumed (none, less than half, about half, more than half but not all, all, or more than one serving). Additional items captured the type and quantity of foods obtained and consumed from the commissary. Participants completed the food intake questionnaire over a 4-day period. At the end of the four days, participants provided feedback on the questionnaire's appropriateness and feasibility during group listening sessions. Verbal and written feedback was compiled and coded to identify common themes. Daily total and mean caloric, macronutrient, and micronutrient intakes were estimated using NutritionCalc Plus® and compared to appropriate Dietary Reference Intakes.

Of the 65 people recruited, 64 agreed to participate in the study and 61 participants completed all four days of the questionnaire. Participants reported that they enjoyed reflecting on their diets and recommended several modifications to the questionnaire design to improve accuracy when documenting intake. Women reported consuming excess total calories and men reported consuming deficient total calories. Macronutrient consumption was within the recommended ranges for men and women, while sodium exceeded healthy recommendations. Participants also reported consuming inadequate amounts of fruits, vegetables, and minerals.

With specific modifications to improve documentation accuracy, the food intake questionnaire can be used in future research assessing nutritional status in jails, prisons, and other controlled food environments.