Matthew Landry
Member, Maternal & Child Health Research Institute (MCHRI)
Bio
Current research focuses on identifying the optimal diet (or diets) for chronic disease prevention and addressing the challenges of designing, implementing and reporting clinical trials that test dietary patterns. Particularly interested behavioral interventions that promote plant-forward and plant-based diets. Passionate advocator for policies that address nutrition-related health inequalities particularly in low resource settings and/or with communities experiencing health inequalities related to food insecurity and structural disparities.
Assistant Professor of Population Health and Disease Prevention at University of California, Irvine (effective July 1, 2023)
Honors & Awards
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Ethan Sims Young Investigator Award, The Obesity Society (2022)
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Fellow of the Academy of Nutrition and Dietetics, Academy of Nutrition and Dietetics (2022)
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Recognized Young Dietitian of the Year, California Academy of Nutrition and Dietetics (2022)
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Nutrition Education and Behavioral Science Early Career Award, American Society for Nutrition (2021)
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Faculty Fellowship Award, Commission on Dietetic Registration (2020)
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Outstanding Student Award, Texas Academy of Nutrition and Dietetics (2020)
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Science Policy Fellow, American Society for Nutrition (2020)
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Excellence Award in Hunger and Environmental Nutrition, Hunger and Environmental Nutrition Dietetic Practice Group Excellence Award (2019)
Boards, Advisory Committees, Professional Organizations
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Committee on Advocacy and Science Policy, American Society for Nutrition (2021 - Present)
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Legislative and Public Policy Committee, Academy of Nutrition and Dietetics (2021 - Present)
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Spokesperson, The Obesity Society (2021 - Present)
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Advisory Committee for Public Policy, Society for Nutrition Education and Behavior (2019 - Present)
Professional Education
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BS, Louisiana State University, Nutrition and Food Sciences (2015)
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PhD, The University of Texas at Austin, Nutritional Science (2019)
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RDN, Commission on Dietetic Registration, Dietetics (2020)
All Publications
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Advancing College Food Security: Priority Research Gaps.
Nutrition research reviews
2023: 1-34
Abstract
Despite over a decade of both quantitative and qualitative studies, food insecurity among United States college/university students remains a pervasive problem within higher education. The purpose of this perspective piece was to highlight research gaps in the area of college food insecurity and provide rationale for the research community to focus on these gaps going forward. A group of food insecurity researchers from a variety of higher education institutions across the United States identified five thematic areas of research gaps: screening and estimates of food insecurity; longitudinal changes in food insecurity; impact of food insecurity on broader health and academic outcomes; evaluation of impact, sustainability, and cost effectiveness of existing programs and initiatives; and state and federal policies and programs. Within these thematic areas, 19 specific research gaps were identified that have limited or no peer-reviewed, published research. These research gaps result in a limited understanding of the magnitude, severity, and persistence of college food insecurity, the negative short- and long-term impacts of food insecurity on health, academic performance, and overall college experience, and effective solutions and policies to prevent or meaningfully address food insecurity among college students. Research in these identified priority areas may help accelerate action and interdisciplinary collaboration to alleviate food insecurity among college students and play a critical role in informing the development or refinement of programs and services that better support college student food security needs.
View details for DOI 10.1017/S0954422423000094
View details for PubMedID 37158045
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Effect of a Ketogenic Diet versus Mediterranean Diet on HbA1c in Individuals with Prediabetes and Type 2 Diabetes Mellitus: the Interventional Keto-Med Randomized Crossover Trial.
The American journal of clinical nutrition
2022
Abstract
Consensus has not been reached on what constitutes an optimal diet in individuals with prediabetes and type 2 diabetes (T2DM), especially between low-carbohydrate options.To compare two low-carbohydrate diets with 3 key similarities (incorporate non-starchy vegetables and avoid added sugars and refined grains) and 3 key differences (incorporate vs avoid legumes, fruits, and whole intact grains), for their effects on glucose control and cardiometabolic risk factors in individuals with prediabetes and T2DM.Keto-Med was a randomized, crossover, interventional trial. Forty participants aged ≥ 18 years with prediabetes or T2DM followed a Well Formulated Ketogenic Diet (WFKD) and Mediterranean-Plus diet (Med-Plus) for 12-weeks each, in random order. Diets shared 3 key similarities noted above. Med-Plus incorporated legumes, fruits, and whole intact grains while WFKD avoided them. Primary outcome was % change in HbA1c after 12-weeks on each diet. Secondary and exploratory outcomes included % change in body weight, fasting insulin, glucose, and blood lipids, glucose (continuous glucose monitor), and nutrient intake.Primary analysis had n = 33 with complete data. HbA1c did not differ between diets at 12-weeks. Triglycerides decreased more for WFKD (% change(SEM)): -16%(4%) vs -5%(6%), p = 0.02) and LDL-C was higher for WFKD (+10%(4%) vs -5%(5%), p = 0.01). Weight decreased 8%(1%) vs 7%(1%) and HDL-C increased 11%(2%) vs 7%(3%) for WFKD vs Med-Plus, respectively; however, there was a significant interaction of diet by order for both. Participants had lower intakes of fiber and 3 nutrients on WFKD vs Med-Plus. Twelve-week follow-up data suggested Med-Plus diet was more sustainable.HbA1c was not different between diet phases after 12-weeks, but improved from baseline on both diets, likely due to several shared dietary aspects. WFKD was beneficial for greater decrease in triglycerides, but also had potential untoward risks from elevated LDL-C, and lower nutrient intakes from avoiding legumes, fruits, and whole intact grains, as well as being less sustainable.clinicaltrials.gov NCT03810378.
View details for DOI 10.1093/ajcn/nqac154
View details for PubMedID 35641199
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Perspective: Early Life Nutrition Research Supported by the U.S. National Institutes of Health from 2018-2020.
Advances in nutrition (Bethesda, Md.)
2022
Abstract
The Dietary Guidelines for Americans, 2020-2025 includes guidelines for pregnancy, lactation, and children from birth to age 24-months (B-24) to reflect the growing body of evidence about appropriate nutrition during the earliest stages of life. Guidelines are based on a thorough review of the existing scientific evidence by the 2020 Dietary Guidelines Advisory Committee (DGAC). This study's objective was to enumerate early life (pregnancy, lactation, and B-24) nutrition research needs that are already being addressed by the scientific community and to identify remaining research gaps. The Scientific Report of the 2020 Dietary Guidelines Advisory Committee was reviewed, and 138 research gaps relevant to early life were identified. Research gaps were consolidated into 13 topic areas. A total of 1,632 nutrition and early life focused research projects funded by the National Institutes of Health (NIH) between 2018-2020 were manually coded using title, abstract, and public health relevance statement available on NIH RePORTER. Projects were coded if they addressed a research gap within one of the 13 research gap topic areas. Of reviewed and coded projects, 235 (14.4%) addressed any early life nutrition research gap. Between Fiscal Years 2018 to 2020, total costs of projects addressing any gap represented only 15% of total costs for all projects reviewed. Complementary foods, breastfeeding (never versus ever), and frequency of eating were research gap areas most frequently coded as being addressed by a funded project. Iron supplementation, seafood consumption, and maternal diet food allergens were research gap areas least frequently coded as being potentially addressed by a funded project. This analysis highlights opportunities for changes in the federal government investment in maternal and child nutrition research to support development of effective, evidence-based dietary guidelines for improvement of early life nutrition practices and overall public health.STATEMENT OF SIGNIFICANCE: The National Institutes of Health (NIH) funded 1,632 research projects between 2018-2020 focused on early life nutrition. Of these, less than 15% intended to address any early life related dietary research gap identified by the Scientific Report of the 2020 Dietary Guidelines Advisory Committee. Results suggest an opportunity for more strategic investment in maternal and child nutrition research by the NIH to support the development of effective evidence-based dietary guidelines for pregnancy, lactation, and infants and toddlers aged birth to 24-months.
View details for DOI 10.1093/advances/nmac044
View details for PubMedID 35438148
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Food Insecurity on College and University Campuses: A Context and Rationale for Solutions Comment
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
2022; 122 (3): 519-524
View details for DOI 10.1016/j.j.2021.10.021
View details for Web of Science ID 000759587900006
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Benefits of Low Carbohydrate Diets: a Settled Question or Still Controversial?
Current obesity reports
2021
Abstract
PURPOSE OF REVIEW: The purpose of this review was to provide an update on the available data on the benefits of low-carbohydrate (low-carb) diets for weight management and type 2 diabetes (T2DM) and determine if low-carb diets were a settled question or still controversial.RECENT FINDINGS: Most of the recent published literature in this area consists of reviews of past trials, with a relatively smaller number of recent trials. Low-carb is most commonly compared to low-fat, with problematically inconsistent definitions of both. There are numerous challenges in trying to draw clear conclusions about efficacy and effectiveness. Short-term vs. long-term effects can differ, which is likely impacted by adherence. Adherence is very different between metabolic chamber or feeding studies vs. free-living. Body weight alone is a crude measure that fails to capture potentially important differences in lean-mass, fat-mass, and body water. Benefits for glycemic control need to be balanced with impacts on non-glycemic outcomes such as LDL-cholesterol, the microbiome, and inflammation. It is important to differentiate between low-carb and very-low carbohydrate diets (VLCD). To date no large-scale long-term clinical trials have been conducted testing whether low-carb diets can prevent T2DM. Many issues regarding benefits and risks of low-carb diets remain controversial or unresolved, particularly for VLCD. Some of the recent, better studies highlighted in this review suggest strategies for resolving these controversies.
View details for DOI 10.1007/s13679-021-00451-z
View details for PubMedID 34297345
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Adherence to Ketogenic and Mediterranean Study Diets in a Crossover Trial: The Keto-Med Randomized Trial.
Nutrients
2021; 13 (3)
Abstract
Adherence is a critical factor to consider when interpreting study results from randomized clinical trials (RCTs) comparing one diet to another, but it is frequently not reported by researchers. The purpose of this secondary analysis of the Keto-Med randomized trial was to provide a detailed examination and comparison of the adherence to the two study diets (Well Formulated Ketogenic Diet (WFKD) and Mediterranean Plus (Med-Plus)) under the two conditions: all food being provided (delivered) and all food being obtained by individual participants (self-provided). Diet was assessed at six time points including baseline (×1), week 4 of each phase when participants were receiving food deliveries (×2), week 12 of each phase when participants were preparing and providing food on their own (×2), and 12 weeks after participants completed both diet phases and were free to choose their own diet pattern (×1). The adherence scores for WFKD and Med-Plus were developed specifically for this study. Average adherence to the two diet patterns was very similar during both on-study time points of the intervention. Throughout the study, a wide range of adherence was observed among participants-for both diet types and during both the delivery phase and self-provided phase. Insight from this assessment of adherence may aid other researchers when answering the important question of how to improve behavioral adherence during dietary trials. This study is registered at clinicaltrials.gov NCT03810378.
View details for DOI 10.3390/nu13030967
View details for PubMedID 33802709
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Nutrition Study Design Issues-Important Issues for Interpretation.
American journal of health promotion : AJHP
2020; 34 (8): 951–54
View details for DOI 10.1177/0890117120960580d
View details for PubMedID 33076690
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Corrigendum: Weight, insulin resistance, blood lipids, and diet quality changes associated with ketogenic and ultra low-fat dietary patterns: a secondary analysis of the DIETFITS randomized clinical trial.
Frontiers in nutrition
2023; 10: 1275498
Abstract
[This corrects the article DOI: 10.3389/fnut.2023.1220020.].
View details for DOI 10.3389/fnut.2023.1275498
View details for PubMedID 37876614
View details for PubMedCentralID PMC10593439
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Ethnicity/race, parent educational attainment, and obesity associated with prediabetes in children.
Nutrition & diabetes
2023; 13 (1): 15
Abstract
Obesity and other predictors of type 2 diabetes disproportionally affect Hispanic and Black children in the US compared to non-Hispanic White (NHW) children. Yet, the prevalence of prediabetes in children remains unestablished, and guidelines for screening young children are lacking. This study examined the relationships between demographic factors and prediabetes in vulnerable youth in central Texas.This is a cross-sectional analysis of baseline data from 976 3rd-5th graders (7-12 years) who participated in TX Sprouts, a school-based gardening, nutrition, and cooking trial in 16 elementary schools serving mainly children from minority backgrounds and lower-income households. Measures collected included age, sex, ethnicity, free/reduced-priced school lunch (FRL) status, parent educational attainment (questionnaires), BMI from height (stadiometer) and weight (TANITA scale), and prediabetes status from fasting plasma glucose (FPG) and HbA1c. Regressions examined cross-sectional associations between demographics and FPG, HbA1c, and prediabetes.Children were 47% male, 67% Hispanic, and 10% Black, with a mean age of 9.3 years; 71% received FRL, 50% had overweight/obesity, and 26% had prediabetes. Prediabetes rates were 2.8 and 4.8 times higher in Hispanic and Black children compared to NHW children, respectively (p ≤ 0.001), and 1.5 times higher in children with obesity versus normal BMI (p = 0.02). Children of parents with only an 8th-grade education, some high school education, or a high school degree had 3.1, 2.7, and 2.2 times higher odds of having prediabetes compared to children of college graduates, respectively (p ≤ 0.004). Analyses with FPG and HbA1c yielded similar results.These findings suggest a potential need for earlier screening, more comprehensive testing guidelines, and prevention programs tailored toward minority children, children with obesity, and children of parents with low educational attainment. Future research should explore this finding in a larger, nationally representative sample.
View details for DOI 10.1038/s41387-023-00244-4
View details for PubMedID 37689792
View details for PubMedCentralID 7783927
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Weight, insulin resistance, blood lipids, and diet quality changes associated with ketogenic and ultra low-fat dietary patterns: a secondary analysis of the DIETFITS randomized clinical trial.
Frontiers in nutrition
2023; 10: 1220020
Abstract
The DIETFITS trial reported no significant difference in 12-month weight loss between a healthy low-fat and healthy low-carbohydrate diet. Participants were instructed to restrict fat or carbohydrates to levels consistent with a ketogenic or ultra low-fat diet for 2 months and to subsequently increase intakes until they achieved a comfortable maintenance level.To compare 3- and 12-month changes in body weight and cardiometabolic risk factors between a subsample of participants who reported 3-month fat or carbohydrates intakes consistent with either a ketogenic-like diet (KLD) or ultra low-fat diet (ULF).3-month and 12-month weight and risk factor outcomes were compared between KLD (n = 18) and ULF (n = 21) sub-groups of DIETFITS participants (selected from n = 609, healthy overweight/obese, aged 18-50 years).Less than 10% of DIETFITS participants met KLD or ULF criteria at 3-months. Both groups achieved similar weight loss and insulin resistance improvements at 3-months and maintained them at 12- months. Significant differences at 3-months included a transient ~12% increase in LDL cholesterol (LDL-C) for KLD with a concomitant greater reduction in log(TG/HDL), a measure of LDL-C's atherogenic potential. The latter was maintained at 12-months, despite substantial diet recidivism for both groups, whereas LDL-C levels were similar for ULF at baseline and 12-months. KLD participants achieved and maintained the greatest reductions in added sugars and refined grains at 3- months and 12-months, whereas ULF participants reported a 50% increase in refined grains intake from baseline to 12-months.Among the ~10% of study participants that achieved the most extreme restriction of dietary fat vs. carbohydrate after 3 months, weight loss and improvement in insulin sensitivity were substantial and similar between groups. At 12 months, after considerable dietary recidivism, the few significant differences in diet quality and blood lipid parameters tended to favor KLD over ULF.
View details for DOI 10.3389/fnut.2023.1220020
View details for PubMedID 37502720
View details for PubMedCentralID PMC10369076
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Food Insecurity and Chronic Kidney Disease: Considerations for Practitioners.
Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation
2023
Abstract
The COVID-19 pandemic has exacerbated existing health disparities related to food security status. Emerging literature suggests individuals with Chronic Kidney Disease (CKD) who are also food insecure have a greater likelihood of disease progression compared to food secure individuals. However, the complex relationship between CKD and food insecurity (FI) is under studied relative to other chronic conditions. The purpose of this practical application article is to summarize the recent literature on the social-economic, nutritional, to care through which FI may negatively impact health outcomes in individuals with CKD. While several studies have reported on the cross-sectional prevalence of FI among persons with CKD, literature is lacking about the severity and duration of exposure to FI on CKD outcomes. Future research is needed to better understand how FI impairs CKD care, nutritional and structural barriers that impact disease prevention and disease progression, and effective strategies to support patients.
View details for DOI 10.1053/j.jrn.2023.06.001
View details for PubMedID 37331455
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Effects of a school-based gardening, cooking, and nutrition cluster randomized controlled trial on unprocessed and ultra-processed food consumption.
The Journal of nutrition
2023
Abstract
School-based gardening and nutrition education interventions report improvements in dietary intake, notably through fruit and vegetables. However, gardening, cooking, and nutrition randomized controlled trials (RCT) are limited in evaluating dietary quality, and none have examined processed food consumption to date.The objective of the study was to examine the effects of Texas Sprouts (TX Sprouts), a gardening, cooking, and nutrition education intervention vs. control on unprocessed and ultra-processed food (UPF) consumption in predominately low-income, Hispanic children.TX Sprouts was a school-based cluster RCT that consisted of 16 elementary schools randomly assigned to either the TX Sprouts intervention (n=8 schools) or control (delayed intervention; n=8 schools) over three years (2016-2019). TX Sprouts schools received an outdoor teaching garden and 18 one-hour lessons taught by trained educators throughout the school year. Dietary intake data via two 24-hour dietary recalls were collected on a random subsample (n=468) at baseline and post-intervention. All foods and beverages were categorized using the NOVA food classification system (e.g., unprocessed, processed, ultra-processed). Generalized linear mixed effects modeling tested changes in percent calories and grams of NOVA groups between the intervention and control estimates with schools as random clusters.Of the sample, 63% participated in the free and reduced-price lunch program and 57% were Hispanic, followed by non-Hispanic White (21%) and non-Hispanic Black (12%). The intervention compared to control resulted in an increase in consumption of unprocessed foods (2.3% vs. -1.8% grams; p < 0.01) and a decrease in UPF (-2.4% vs. 1.4% grams; p=0.04). Hispanic children in the intervention group had an increase in unprocessed food consumption and a decrease in UPF consumption compared to non-Hispanic children (-3.4% vs. 1.5% grams; p < 0.05).Study results suggest school-based gardening, cooking, and nutrition education interventions can improve dietary intake, specifically increasing unprocessed food consumption and decreasing UPF consumption.U.S. National Institutes of Health, U.S. National Library of Medicine, NCT02668744, https://clinicaltrials.gov/ct2/show/NCT02668744.
View details for DOI 10.1016/j.tjnut.2023.04.013
View details for PubMedID 37116658
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Barriers and facilitators to implementing and sustaining campus food insecurity initiatives
STUDIES IN HIGHER EDUCATION
2023
View details for DOI 10.1080/03075079.2023.2195414
View details for Web of Science ID 000962796700001
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Dietary psychosocial mediators of vegetable intake in schoolchildren from low-income and racial/ethnic U.S. minority families: Findings from the Texas Sprouts intervention.
Journal of the Academy of Nutrition and Dietetics
2023
Abstract
Numerous school-based interventions have used cooking and gardening approaches to improve dietary intake; however, research is limited on the mediation effect of dietary psychosocial factors on the link between the intervention and increased vegetable intake, particularly in children from low-income and racial/ethnic U.S. minority families.To examine: 1) the effects of the Texas Sprouts intervention on dietary psychosocial factors related to intake of vegetables; and 2) whether these psychosocial factors mediate the link between the intervention and increased intake of vegetables in schoolchildren from low-income and racial/ethnic U.S. minority families.This is an analysis of data on secondary outcomes from the Texas Sprouts program, a one-year school-based gardening, nutrition, and cooking cluster-randomized controlled trial consisting of elementary schools that were randomly assigned to either the Texas Sprouts intervention or to control.2,414 3rd-5th grade students from low-income and racial/ethnic U.S. minority families from 16 schools (8 intervention and 8 control) in Austin, TX.The intervention group received 18 60-minute gardening, nutrition, and cooking student lessons in an outdoor teaching garden, and nine monthly parent lessons throughout the academic year.Child psychosocial and dietary measures were collected at baseline and post-intervention via validated questionnaires.Generalized-linear-mixed models assessed the intervention effects on dietary psychosocial factors. Mediation analyses examined if these psychosocial factors mediated the link between the intervention and increased child vegetable intake.Children in Texas Sprouts, compared to control, showed significant increases in the mean scores of gardening attitudes, cooking self-efficacy, gardening self-efficacy, nutrition and gardening knowledge, and preferences for fruit and vegetables (all p<0.001). Each of the above dietary psychosocial factors mediated the association between the Texas Sprouts intervention and child vegetable intake.Besides targeting dietary behaviors, future school-based interventions should also focus on understanding the mechanisms through which teaching children to cook and garden influence dietary psychosocial factors as mediators of change in healthy eating behaviors.
View details for DOI 10.1016/j.jand.2023.03.015
View details for PubMedID 36996935
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Supporting Food and Nutrition Security Among Migrant, Immigrant, and Refugee Populations.
Journal of nutrition education and behavior
2023; 55 (2): 83-84
View details for DOI 10.1016/j.jneb.2022.12.003
View details for PubMedID 36764801
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Supporting Food and Nutrition Security Among Migrant, Immigrant, and Refugee Populations
JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR
2023; 55 (2): 83-84
View details for Web of Science ID 000950531400001
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Effects of a School-Based Nutrition, Gardening, and Cooking Intervention on Metabolic Parameters in High-risk Youth: A Secondary Analysis of a Cluster Randomized Clinical Trial.
JAMA network open
2023; 6 (1): e2250375
Abstract
Importance: Although school-based gardening programs for children have consistently been shown to improve dietary behaviors, no cluster randomized clinical trial (RCT) has evaluated the effects of a school-based gardening intervention on metabolic outcomes.Objective: To evaluate the effects of a school-based gardening, nutrition, and cooking intervention (Texas Sprouts) on changes in metabolic outcomes in elementary schoolchildren.Design, Setting, and Participants: This study was a secondary analysis of a cluster RCT, conducted over 3 years from 2016 to 2019, at low-income elementary schools with majority Hispanic students in the greater Austin, Texas, area. Data were analyzed from January to August 2022.Interventions: Texas Sprouts was 1 school year long (9 months) and consisted of (1) Garden Leadership Committee formation; (2) a 0.25-acre outdoor teaching garden; (3) 18 student gardening, nutrition, and cooking lessons taught by trained educators throughout the school year; and (4) 9 monthly parent lessons. The delayed intervention was implemented the following academic year and received an identical intervention.Main Outcomes and Measures: The following measures were obtained at baseline and postintervention (9 months): demographics via survey; measured height, weight, and body mass index parameters; and glucose, insulin, homeostatic model assessment of insulin resistance, and a lipid panel via an optional fasting blood draw.Results: Sixteen elementary schools were randomly assigned to either Texas Sprouts intervention (8 schools) or to delayed intervention (control, 8 schools). A total of 3302 children (aged 7-12 years) were enrolled in Texas Sprouts, and fasting blood samples were obtained from 1104 children (or 33% of those enrolled) at baseline. The final analytic sample included 695 children (307 boys [44.17%]; mean [SE] age, 9.28 [0.04] years; 480 Hispanic children [69.02%]; 452 [65.03%] eligible for free or reduced lunch) with complete demographic data and baseline and postintervention (9-month) fasting blood draws. Compared with control schools, children from Texas Sprouts schools had a 0.02% reduction in mean hemoglobin A1c (95% CI, 0.03%-0.14%; P=.005) and a 6.40 mg/dL reduction in mean low-density lipoprotein cholesterol (95% CI, 3.82-8.97 mg/dL; P=.048). There were no intervention effects on glucose, insulin, homeostatic model assessment of insulin resistance, or other lipid parameters.Conclusions and Relevance: In this cluster RCT, Texas Sprouts improved glucose control and reduced low-density lipoprotein cholesterol in high-risk youth. These findings suggest that elementary schools should incorporate garden-based interventions as a way to improve metabolic parameters in children.Trial Registration: ClinicalTrials.gov Identifier: NCT02668744.
View details for DOI 10.1001/jamanetworkopen.2022.50375
View details for PubMedID 36626172
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SWAP-MEAT Athlete (study with appetizing plant-food, meat eating alternatives trial) - investigating the impact of three different diets on recreational athletic performance: a randomized crossover trial.
Nutrition journal
2022; 21 (1): 69
Abstract
BACKGROUND: Plant-based diets are known to be beneficial for cardiovascular health and promote environmental sustainability. However, many athletes avoid plant-based diets due to concerns of protein inadequacy.OBJECTIVES: To investigate the impact of two predominately plant-based diets-whole food plant-based (WFPB) and plant-based meat alternatives (PBMA)-vs. an omnivorous diet, favoring red meat and poultry (Animal), on endurance and muscular strength.METHODS: 12 recreational runners and 12 resistance trainers were assigned to three diets-WFPB, PBMA, and Animal-for 4weeks each, in random order. Primary outcomes for runners (12-minute timed run) and resistance trainers (composite machine strength) were collected at baseline and after diets, along with secondary performance outcomes and dietary data.RESULTS: 22 recreational athletes completed the study (age: 26.2±4.4years; sex: 10 female, 12 male; BMI: 23.1±2.4kg/m2). Mean differences in 12-minute timed run - WFPB vs. Animal (-23.4m; 95% CI: -107 to 60.0m) and PBMA vs. Animal (-2.9m; 95% CI: -119 to 113m) - were not significant. Mean percent differences in composite machine strength - WFPB vs. Animal (-2.7%; 95% CI: -5.8 to 0.4% and PBMA vs. Animal (-0.7%; 95% CI: -3.5 to 2.2%) - were not significant. Average protein intake for all diets met International Society for Sports Nutrition recommendations.CONCLUSIONS: Our findings suggest recreational athletes can maintain athletic performance on both an omnivorous diet and two diets that are predominately plant-based.TRIAL REGISTRATION: NCT05472701. Retrospectively registered.
View details for DOI 10.1186/s12937-022-00820-x
View details for PubMedID 36384651
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Creating a Culture that Supports Food Security and Health Equity at Higher Education Institutions.
Public health nutrition
2022: 1-18
Abstract
Food insecurity on college campuses is a major public health problem and has been documented for the last decade. Sufficient food access is a crucial social determinant of health, thus campuses across the country have implemented various programs, systems and policies to enhance access to food which have included food pantries, campus gardens, farmers' markets, meal share or voucher programs, mobile food applications, campus food gleaning, food recovery efforts, meal deliveries, and task force/working groups. However, little is understood about how to best address food insecurity and support students who are struggling with basic needs. The impact of food insecurity on students' academic and social success, in addition to their overall well-being, should be investigated and prioritized at each higher education institution. This is especially true for marginalized students, such as minority or first-generation students, who are at heightened risk for food insecurity. In order to create a culture of health equity, in which most at-risk students are provided resources and opportunities to achieve optimal well-being, higher education institutions must prioritize mitigating food insecurity on the college campus. Higher education institutions could benefit from adopting comprehensive and individualized approaches to promoting food security for marginalized students in order to facilitate equal opportunity for optimal scholastic achievement among students of all socio demographic backgrounds.
View details for DOI 10.1017/S1368980022002294
View details for PubMedID 36321438
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Assessing the effects of alternative plant-based meats v. animal meats on biomarkers of inflammation: a secondary analysis of the SWAP-MEAT randomized crossover trial
JOURNAL OF NUTRITIONAL SCIENCE
2022; 11
View details for DOI 10.1017/jns.2022.84
View details for Web of Science ID 000858917300001
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Sex and Gender Data Collection in Nutrition Research: Considerations through an Inclusion, Diversity, Equity and Access Lens.
Journal of the Academy of Nutrition and Dietetics
2022
View details for DOI 10.1016/j.jand.2022.09.014
View details for PubMedID 36116772
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Campus-based programmes to address food insecurity vary in leadership, funding and evaluation strategies.
Nutrition bulletin
2022; 47 (3): 322-332
Abstract
College food insecurity is a known detriment to student success, but little is known about the implementation of campus-based programmes to help address this issue on campus in the United States. The objective of this research study was to determine the types of food insecurity initiatives implemented and assess how such programmes are managed, funded, and evaluated. A cross-sectional, 23-item online survey was administered among individuals involved with campus food insecurity initiatives identified through professional networks. Food pantries were the most common (97.1%) and mobile food sharing applications were the least common (14.7%) food security initiatives. A majority of respondents (69.7%) stated that at least one programme on their campus was evaluated, although the methods varied and uncertainty about the methods used was common. An allocated budget was provided at some institutions (38.9%), but funding mechanisms varied. Student Life Offices were most commonly reported as being responsible for programme management. Most respondents (75.3%) reported there had been programme changes due to COVID-19. This research confirmed that food insecurity programmes are widely available, although the type, funding, and leadership of these programmes vary. A coordinated approach on campus to align programming efforts is needed.
View details for DOI 10.1111/nbu.12570
View details for PubMedID 36045103
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Perspective: Early-Life Nutrition Research Supported by the US National Institutes of Health from 2018 to 2020.
Advances in nutrition (Bethesda, Md.)
2022; 13 (5): 1395-1401
Abstract
The Dietary Guidelines for Americans, 2020-2025, included guidelines for pregnancy, lactation, and children from birth to age 24 mo (B-24) to reflect the growing body of evidence about appropriate nutrition during the earliest stages of life. Guidelines were based on a thorough review of the existing scientific evidence by the 2020 Dietary Guidelines Advisory Committee (DGAC). This study's objective was to enumerate early-life (pregnancy, lactation, and B-24) nutrition research needs that are already being addressed by the scientific community and to identify remaining research gaps. The Scientific Report of the 2020 Dietary Guidelines Advisory Committee was reviewed, and 138 research gaps relevant to early life were identified. Research gaps were consolidated into 13 topic areas. A total of 1632 nutrition- and early-life-focused research projects funded by the NIH between 2018 and 2020 were manually coded using title, abstract, and public health relevance statement available on NIH RePORTER. Projects were coded as affirmative if they addressed a research gap within 1 of the 13 research gap topic areas. Of coded projects, 235 (14.4%) addressed any early-life nutrition research gap. Between fiscal years 2018 to 2020, total costs of projects addressing any gap represented only 15% of total costs for all projects reviewed. Complementary foods, breastfeeding (never vs. ever), and frequency of eating were research gap areas most frequently coded as being addressed by a funded project. Iron supplementation, seafood consumption, and maternal diet food allergens were research gap areas least frequently coded as being potentially addressed by a funded project. This analysis highlights opportunities for changes in the federal government investment in maternal and child nutrition research to support development of effective, evidence-based dietary guidelines for improvement in early-life nutrition practices and overall public health.
View details for DOI 10.1093/advances/nmac044
View details for PubMedID 36774051
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Research at the Academy of Nutrition and Dietetics: What, How, and Why?
Journal of the Academy of Nutrition and Dietetics
2022
Abstract
Research is essential to further advance our understanding of the role of nutrition and dietetics in maintenance and improvement of health. Research is also essential for nutrition and dietetics professionals to create and provide evidence-based interventions, including medical nutrition therapy (MNT) provided by registered dietitian nutritionists (RDNs). Given this critical role of research, the Academy of Nutrition and Dietetics (Academy) has a variety of resources to assist its members in accessing, understanding, participating in, conducting, and disseminating nutrition research. These resources are comprehensive and include opportunities to participate in research (e.g., Nutrition Research Network (NRN) and Data Science Center (DSC)), tools to aggregate practice data (Nutrition Care Process and Terminology (NCPT) and the Academy of Nutrition and Dietetics Informatics Infrastructure (ANDHII)), funding opportunities to support primary research (e.g., Academy Foundation), resources to understand the latest research informing evidence-based practice (EBP) (e.g., Evidence Analysis Center (EAC)), and avenues for sharing research findings (e.g., Food and Nutrition Conference and Expo (FNCE)). The aim of this paper is to encourage members to get involved in research by describing Academy-based research resources and opportunities to contribute to nutrition and dietetics research, as well as describe specific examples of research conducted at Academy. The information presented can serve as a framework to guide members in engaging in research through the Academy.
View details for DOI 10.1016/j.jand.2022.08.123
View details for PubMedID 35998865
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Effects of a school-based garden program on academic performance: a cluster randomized controlled trial.
Journal of the Academy of Nutrition and Dietetics
2022
Abstract
School gardening programs have consistently been shown to improve dietary behaviors in children. While several quasi-experimental studies also show that school gardens can enhance academic performance, to date, no randomized controlled trial has been conducted to substantiate this.The objective was to examine the effects of Texas (TX) Sprouts, a gardening, nutrition, and cooking program, versus control on academic performance in primarily low-income, Hispanic children.This is a secondary analysis of the grade-level academic scores from schools that participated in the TX Sprouts program, a school-based cluster randomized controlled trial, consisting of 16 elementary schools that were randomly assigned to either: (1) TX Sprouts intervention (n=8 schools) or (2) control (delayed intervention; n=8 schools).Analysis included 16 schools with students in 4th- 5th grade in Austin, TX from 2016-2019 that had a majority Hispanic population and a majority of children participating in the free and reduced lunch program.The intervention consisted of 18 one-hour gardening, nutrition and cooking lessons taught in an outdoor teaching garden by trained educators throughout the academic year.Texas Education Agency (TEA) grade level data for the State of Texas Assessments of Academic Readiness (STAAR) were obtained via the TEA website for the corresponding year of the intervention or control condition.Repeated measures general linear models with the pre- and post-intervention STAAR scores as the dependent variable were run, adjusting for the percent of free and reduced lunch (FRL) and school district as covariates.Schools that received the TX Sprouts intervention had a 6.5 percentage point increase in 4th grade reading STAAR scores compared to control schools (p=0.047, respectively). There were no significant differences in reading scores for 5th grade students or math scores for either 4th and 5th grade students between groups.Study findings provide evidence that school gardening programs may have some modest effects on academic achievement.
View details for DOI 10.1016/j.jand.2022.08.125
View details for PubMedID 35998864
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Reply to T Kalayjian and EC Westman.
The American journal of clinical nutrition
2022
View details for DOI 10.1093/ajcn/nqac201
View details for PubMedID 35883212
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Campus-based programmes to address food insecurity vary in leadership, funding and evaluation strategies
NUTRITION BULLETIN
2022
View details for DOI 10.1111/nbu.12570
View details for Web of Science ID 000826762700001
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The quest to advance assessment of dietary intake: metabolomic meat markers.
The American journal of clinical nutrition
2022
View details for DOI 10.1093/ajcn/nqac143
View details for PubMedID 35731849
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Breakfast Consumption May Improve Fasting Insulin, HOMA-IR, and HbA1c Levels in Predominately Low-Income, Hispanic Children 7-12 Years of Age.
Nutrients
2022; 14 (11)
Abstract
Children from low-income households and minority families have high cardiometabolic risk. Although breakfast consumption is known to improve cardiometabolic health in children, limited randomized control trials (RCT) have explored this association in low-income and racial/ethnic U.S. minority families. This study conducted secondary analyses from TX Sprouts, a school-based gardening, cooking, and nutrition education RCT, to examine the intervention effect on breakfast consumption and how changes in breakfast consumption impact cardiometabolic risk in predominately low-income, multi-ethnic children. TX Sprouts consisted of 16 schools (8 intervention; 8 control) in greater Austin, TX. A total of 18 lessons were taught, including topics on breakfast consumption benefits and choosing healthy food options at school. Children completed clinical measures (e.g., anthropometrics, body composition via bioelectrical impedance), and the number of breakfast occasions (BO) per week (at home and school) was captured via validated survey at baseline and post-intervention. Post-study-Baseline changes in breakfast consumption were used to categorize students as: maintainers (BO -1 to 1 day/week), decreasers (BO ≤-2 day/week), and increasers (BO ≥2 day/week). Optional fasting blood draws were performed on a subsample. Generalized weighted linear mixed modeling tested differences between intervention and control, with schools as random clusters. Analysis of covariance and linear regression examined changes in breakfast consumption on cardiometabolic outcomes, controlling for age, sex, race/ethnicity, free and reduced-price school meal participation (FRL), school site, breakfast location, physical activity, baseline cardiometabolic measures, and BMI z-score. This study included 1417 children (mean age 9 years; 53% male; 58% Hispanic, 63% FRL; breakfast consumption patterns: 63% maintainers, 16% decreasers, and 21% increasers). There was no intervention effect on changes in breakfast consumption. Compared to decreasers, increasers had an increase in insulin (-0.3 IU/mL vs. +4.1 IU/mL; p = 0.01) and a larger increase in HOMA-IR (+0.4 vs. +1.5; p < 0.01). Every one-day increase in breakfast consumption decreased fasting insulin by 0.44 IU/mL, HOMA-IR by 0.11, and hemoglobin A1c by 0.01% (p ≤ 0.03). Increased breakfast consumption was linked to improved glucose control, suggesting breakfast can mitigate risk in a high-risk population. To better understand underlying mechanisms linking breakfast consumption to improved metabolic health, RCTs focusing on breakfast quality and timing are warranted.
View details for DOI 10.3390/nu14112320
View details for PubMedID 35684120
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Hunting-Based Food Donation Programs: Program Characteristics Across the US.
Journal of nutrition education and behavior
2022
Abstract
OBJECTIVE: Hunting-based food donation (HBFD) programs are unique food assistance programs because they provide under-resourced food bank participants with a quality protein source. This study aimed to summarize the characteristics of US HBFD programs and discuss the potential barriers and considerations to use or access these programs.METHODS: Data were collected via a web search for HBFD programs within all 50 states and the District of Columbia.RESULTS: Most states were found to have an active program (n = 36), whereas 14 states and the District of Columbia do not have programs. Game donation amounts vary greatly between states, and funding for these programs typically comes from a government agency.CONCLUSIONS AND IMPLICATIONS: Hunting-based food donation can positively impact the food security and nutritional status of vulnerable populations. Nutrition professionals can aid in promoting awareness of these programs and provide nutrition education around wild game nutrition, safety, and food preparation.
View details for DOI 10.1016/j.jneb.2022.03.003
View details for PubMedID 35595636
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Distinct racial and ethnic metabolic syndrome characteristics: A comparative assessment in low-income children 7-10years of age.
Pediatric obesity
2022: e12925
Abstract
BACKGROUND: Pediatric MetS prevalence varies due to lack of consensus on evaluative criteria and associated thresholds, with most not recommending a diagnosis <10years. However, MetS risk components are becoming evident earlier in life and affect races and ethnicities disproportionately.OBJECTIVES: To compare the prevalence of MetS based on existing definitions and elucidate racial- and ethnic-specific characteristics associated with MetS prevalence.METHODS: The baseline and follow-up samples included 900 and 557 children 7-10years, respectively. Waist circumference, BMI percentile, blood pressure, fasting plasma glucose (FPG), insulin, triglycerides, and high-density lipoprotein cholesterol (HDL-C) were measured. Agreement between MetS definitions was quantified via kappa statistics. MetS and risk factor prevalence and the predictability of metabolic parameters on MetS eight months later was evaluated via logistic regression. McFadden pseudo-R2 was reported as a measure of predictive ability, and the Akaike information criterion evaluated fit of each model.RESULTS: The baseline sample was 55.0% male and 71.6% Hispanic, followed by non-Hispanic White (NHW) (17.3%) and non-Hispanic Black (NHB) (11.1%), with an average age of 9.2years. MetS prevalence ranged from 7.6% to 21.4%, highest in Hispanic (9.0%-24.0%) and lowest in NHB children (4.0%-14.0%). Highest agreement was between Ford et al. and Cook et al. definitions (K=0.88) and lowest agreements were consistently with the International Diabetes Federation criteria (K≤0.57). Compared to NHW children, Hispanic children had higher odds for MetS (OR: 1.7; p=0.03) and waist circumference, HDL-C, and FPG risk factors (p<0.05), while NHB children had higher odds for the FPG risk factor (p≤0.007) and lower odds for the plasma triglycerides risk factor (p=0.002), across multiple MetS definitions. In longitudinal analyses, HDL-C was the strongest independent predictor of MetS in Hispanic and NHW children (p<0.001 and p<0.01, respectively), while plasma triglycerides was the strongest independent predictor of MetS in NHB children (p<0.05).CONCLUSIONS: MetS prevalence was high in children ≤10years, and proposed criteria are susceptible to racial and ethnic bias, diagnosing some populations more than other populations with high cardiovascular risk. Earlier preventative measures should be imposed in clinical settings, accounting for racial and ethnic differences, to mitigate disease onset.
View details for DOI 10.1111/ijpo.12925
View details for PubMedID 35560860
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The Impostor Phenomenon in the Nutrition and Dietetics Profession: An Online Cross-Sectional Survey.
International journal of environmental research and public health
2022; 19 (9)
Abstract
The impostor phenomenon (IP) (also known as impostor syndrome) describes high-achieving individuals who, despite their objective successes, fail to internalize their accomplishments and have persistent self-doubt and fear of being exposed as a fraud or impostor. This study aimed to assess the prevalence and predictors of IP within a sample of nutrition and dietetics students and practitioners. An online cross-sectional survey was conducted and utilized a non-random, convenience sampling approach. A total of 1015 students, dietetic interns, and currently practicing and retired registered dietitian nutritionists and nutrition and dietetic technicians registered provided complete responses. IP was assessed with the Clance Impostor Phenomenon Scale (CIPS). Self-reported job satisfaction and well-being were assessed using validated scales. Average CIPS score was 66.0 ± 16.3 (range 22-99), and higher scores indicate more frequent or severe IP experiences. Frequent or intense IP was reported by 64% of survey respondents (n = 655). Older age, greater educational attainment and professional level, and membership in Academy of Nutrition and Dietetics groups were associated with lower IP scores. Greater social media use was associated with higher IP scores. Job satisfaction and overall well-being were inversely correlated with IP (p < 0.001). Findings suggest that IP experiences were common among a majority of nutrition and dietetics students and practitioners surveyed. Additional research and development of preventative strategies and interventions is needed.
View details for DOI 10.3390/ijerph19095558
View details for PubMedID 35564953
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Comparison of School vs Home Breakfast Consumption with Cardiometabolic and Dietary Parameters in Low-Income, Multiracial/Ethnic Elementary School-Aged Children
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
2022; 122 (4): 833-847
View details for DOI 10.1016/j.j.2021.10.014
View details for Web of Science ID 000820477400013
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Call for Evaluation and Reporting of the Equity Impact of Culturally Responsive Nutrition Interventions.
Journal of nutrition education and behavior
2022; 54 (2): 97-98
View details for DOI 10.1016/j.jneb.2021.12.006
View details for PubMedID 35148873
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Changes in Ultra-Processed Food Consumption and Lifestyle Behaviors Following COVID-19 Shelter-in-Place: A Retrospective Study.
Foods (Basel, Switzerland)
2021; 10 (11)
Abstract
Ultra-processed food (UPF) consumption poses a potential risk to public health and may be related to shelter-in-place orders. This study utilized the level of food processing as a lens by which to examine the relationships between diet, weight change, and lifestyle changes (including cooking, snacking, and sedentary activity) that occurred during regional shelter-in-place orders. This study used a cross-sectional, retrospective survey (n = 589) to assess baseline demographics, changes in lifestyle behaviors using a Likert scale, and changes in dietary behaviors using a modified food frequency questionnaire from mid-March to May 2020; data were collected in the California Bay Area from August to October 2020. Foods were categorized by level of processing (minimally processed, processed, and ultra-processed) using the NOVA scale. Stepwise multiple linear regression and univariate linear regression models were used to determine the associations between these factors. Increased snacking was positively associated with a change in the percent of the calories derived from UPF and weight gain (beta = 1.0, p < 0.001; beta = 0.8 kg, p < 0.001) and negatively associated with the share of MPF calories consumed (beta = -0.9, p < 0.001). These relationships have public health implications as interventions designed around decreased snacking may positively impact diet and weight management and thereby mitigate negative health outcomes.
View details for DOI 10.3390/foods10112553
View details for PubMedID 34828834
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Ultra-processed Foods, Weight Gain, and Co-morbidity Risk.
Current obesity reports
2021
Abstract
PURPOSE OF REVIEW: The purpose of this review is to provide an update on the available data regarding the associations of Ultra-processed food (UPF) consumption with food intake and possible underlying mechanisms relating UPF consumption to weight gain and co-morbidities.RECENT FINDINGS: In primarily observational studies, UPF consumption is consistently associated with an increased risk for weight gain among adults and children and increased risk for adiposity-related co-morbidities in adults. In a single mechanistic study, consumption of UPFs led to increased energy intake and weight gain relative to whole foods. UPFs tend to be more energy-dense than nutrient-dense, and UPF consumption is associated with increased adiposity and co-morbidity risk. These data suggest that recommendations to limit UPF consumption may be beneficial to health - though further mechanistic studies are needed.
View details for DOI 10.1007/s13679-021-00460-y
View details for PubMedID 34677812
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Findings from Diet Comparison Difficult to Interpret in the Absence of Adherence Assessment. Comment on Trico et al. Effects of Low-Carbohydrate versus Mediterranean Diets on Weight Loss, Glucose Metabolism, Insulin Kinetics and beta-Cell Function in Morbidly Obese Individuals. Nutrients 2021, 13, 1345.
Nutrients
2021; 13 (11)
Abstract
We read, with interest, the recent publication by Trico et al. [...].
View details for DOI 10.3390/nu13113694
View details for PubMedID 34835950
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Comparison of School vs. Home Breakfast Consumption with Cardiometabolic and Dietary Parameters in Low-Income, Multi-Racial/Ethnic Elementary School-Aged Children.
Journal of the Academy of Nutrition and Dietetics
2021
Abstract
BACKGROUND: Breakfast consumption is often associated with improving cardiometabolic parameters and diet quality. However, literature evaluating breakfast consumption with these outcomes between the school and home environments is limited.OBJECTIVE: This study examined relationships between breakfast consumption locations (home versus school) and cardiometabolic parameters, breakfast dietary intake, and daily dietary intake.DESIGN: This cross-sectional study used baseline data from TX Sprouts, a one-year school-based gardening, nutrition, and cooking cluster-randomized trial, implemented in 16 elementary schools in Austin, TX, in 2016-2019.PARTICIPANTS/SETTING: Analysis included 383 low-income, multi-racial/ethnic elementary school-aged children (mean age 9.2 years; 60.6% Hispanic; 70.5% free/reduced lunch; 58.5% home breakfast consumers).MAIN OUTCOME MEASURES: Cardiometabolic parameters were obtained via fasting blood draws, and dietary intake was assessed using one 24-hour dietary recall conducted on a random, unannounced weekday. Cardiometabolic and dietary parameters (i.e., energy intake, macronutrients, and food group servings) for breakfast and for the day were evaluated.STATISTICAL ANALYSES PERFORMED: Multivariate analysis of covariance was performed to examine cardiometabolic parameters and dietary intake between school and home breakfasts.RESULTS: School breakfast consumers (SBC) had lower fasting triglyceride levels than home breakfast consumers (HBC) (89.0 mg/dL vs. 95.7 mg/dL; P = 0.03). SBC had lower total fat for the day (P = 0.02) and lower total and saturated fat, sodium, and refined grains at breakfast (P ≤ 0.01) than HBC. However, SBC had lower protein at breakfast (P = 0.01) and higher carbohydrates, total sugar, and added sugar for the day and at breakfast (P ≤ 0.03) than HBC.CONCLUSION: SBC compared to HBC had lower fat intake, which may have contributed to the lower triglyceride level observed in SBC, but also had lower protein intake at breakfast and higher added sugar intake for the day and at breakfast. These results suggest dietary intake differed between the home and school environments, but more research is needed to evaluate if such differences are due to the School Breakfast Program guidelines.
View details for DOI 10.1016/j.jand.2021.10.014
View details for PubMedID 34634512
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Recommendations for the Use of the Veggie Meter for Spectroscopy-Based Skin Carotenoid Measurements in the Research Setting.
Current developments in nutrition
2021; 5 (8): nzab104
Abstract
Carotenoids are a class of phytochemical compounds found in a variety of fruits and vegetables (F/V) and, therefore, are commonly used as a biomarker for F/V intake. The Veggie Meter is a noninvasive research-grade instrument that detects and quantifies carotenoids in the skin. To determine current practices and examine variability among users, a survey was administered to researchers using the device (n=19, response rate=35.8%) and variation in anatomical site preparation, calibration, number of measurements, measurement site, and documentation was observed. A protocol was developed in partnership with Veggie Meter users to outline the preparation, calibration, and data collection procedures for using this device for research purposes. Although many protocol conditions will benefit from additional validation, this standardized protocol supports the development of a universal data repository to establish usual observed ranges, with the ultimate goal of examining associations between skin carotenoid scores and diet-related health outcomes.
View details for DOI 10.1093/cdn/nzab104
View details for PubMedID 34476333
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Communicating Nutrition: The Authoritative Guide (Book Review)
JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR
2021; 53 (6): 547
View details for DOI 10.1016/j.jneb.2021.01.010
View details for Web of Science ID 000672175400014
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Sustainable Diets for Cardiovascular Disease Prevention and Management.
Current atherosclerosis reports
2021; 23 (7): 31
Abstract
PURPOSE OF REVIEW: Healthy dietary patterns are recommended for prevention of cardiovascular disease, which remains the leading cause of morbidity and mortality globally. In this review, we discuss dietary patterns that are not only optimal for CVD prevention and management but also sustainable in maximizing health, environmental, and economic benefits.RECENT FINDINGS: The growing literature on sustainable diets in the context of environmental sustainability includes subtopics of climate change, land use, biodiversity loss, freshwater use, and reactive nitrogen emissions. Similarly, economic sustainability, beyond the retail cost of food, extends to healthcare costs and the economic costs of environmental destruction related to current agricultural practices and food choices. Dietary patterns that are high in plant foods and low in animal foods could maximize health, environmental, and economic benefits; however, questions remain about how to best promote these patterns to achieve wider adoption in an environmentally and economically sustainable way.
View details for DOI 10.1007/s11883-021-00929-0
View details for PubMedID 33970349
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You Are Not an Impostor: The Registered Dietitian Nutritionist and Impostor Phenomenon.
Journal of nutrition education and behavior
2021
Abstract
Impostor phenomenon (IP) interferes with the desire for taking advantage of career opportunities and pursuing career advancement. There is robust literature describing the effects of IP in other health care professions, yet an absence of research exists on IP within the nutrition and dietetics profession. This perspective will explore why nutrition and dietetics professionals may experience IP, specify what might be done to mitigate the negative effects of IP, and describe future research directions. Impostorism is an understudied phenomenon that could have significant implications for the profession of nutrition and dietetics on an individual and systemic level.
View details for DOI 10.1016/j.jneb.2021.02.008
View details for PubMedID 33775568
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School-based gardening, cooking and nutrition intervention increased vegetable intake but did not reduce BMI: Texas sprouts - a cluster randomized controlled trial.
The international journal of behavioral nutrition and physical activity
2021; 18 (1): 18
Abstract
BACKGROUND: Although school garden programs have been shown to improve dietary behaviors, there has not been a cluster-randomized controlled trial (RCT) conducted to examine the effects of school garden programs on obesity or other health outcomes. The goal of this study was to evaluate the effects of a one-year school-based gardening, nutrition, and cooking intervention (called Texas Sprouts) on dietary intake, obesity outcomes, and blood pressure in elementary school children.METHODS: This study was a school-based cluster RCT with 16 elementary schools that were randomly assigned to either the Texas Sprouts intervention (n=8 schools) or to control (delayed intervention, n=8 schools). The intervention was one school year long (9months) and consisted of: a) Garden Leadership Committee formation; b) a 0.25-acre outdoor teaching garden; c) 18 student gardening, nutrition, and cooking lessons taught by trained educators throughout the school-year; and d) nine monthly parent lessons. The delayed intervention was implemented the following academic year and received the same protocol as the intervention arm. Child outcomes measured were anthropometrics (i.e., BMI parameters, waist circumference, and body fat percentage via bioelectrical impedance), blood pressure, and dietary intake (i.e., vegetable, fruit, and sugar sweetened beverages) via survey. Data were analyzed with complete cases and with imputations at random. Generalized weighted linear mixed models were used to test the intervention effects and to account for clustering effect of sampling by school.RESULTS: A total of 3135 children were enrolled in the study (intervention n=1412, 45%). Average age was 9.2years, 64% Hispanic, 47% male, and 69% eligible for free and reduced lunch. The intervention compared to control resulted in increased vegetable intake (+0.48 vs. +0.04 frequency/day, p=0.02). There were no effects of the intervention compared to control on fruit intake, sugar sweetened beverages, any of the obesity measures or blood pressure.CONCLUSION: While this school-based gardening, nutrition, and cooking program did not reduce obesity markers or blood pressure, it did result in increased vegetable intake. It is possible that a longer and more sustained effect of increased vegetable intake is needed to lead to reductions in obesity markers and blood pressure.CLINICAL TRIALS NUMBER: NCT02668744 .
View details for DOI 10.1186/s12966-021-01087-x
View details for PubMedID 33485354
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Physical distancing physical inactivity.
Translational behavioral medicine
2021
Abstract
During this time of global health crisis, physical distancing, along with mask wearing, has emerged as the sine qua non social practice to protect ourselves and others from COVID-19. But as physical distancing ensues and all eyes remain fixed on the novel coronavirus, another, albeit careworn, pandemic rages on. Physical inactivity, the world's fourth leading cause of death, may indeed be exacerbated by physical distancing measures, such as sheltering at home and closing or limiting access to recreation and exercise facilities. The purpose of this paper is to urge public health and medical professionals not to forget the importance of physical activity to whole-person health, recognize the importance of physical activity as a potential COVID-19 mitigation strategy and to serve as advocates for promoting active lifestyles. It is imperative that the national call for physical distancing not be interpreted as a call for physical inactivity.
View details for DOI 10.1093/tbm/ibaa134
View details for PubMedID 33410492
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USDA Special Supplemental Nutrition Program for Women, Infants and Children (WIC) Vendor Criteria: An Examination of US Administrative Agency Variations.
International journal of environmental research and public health
2021; 18 (7)
Abstract
The food retail environment has been directly linked to disparities in dietary behaviors and may in part explain racial and ethnic disparities in pregnancy-related deaths. The Special Supplemental Nutrition Program for Women, Infants and Children (WIC), administered by the United States Department of Agriculture, is associated with improved healthy food and beverage access due to its requirement for minimum stock of healthy foods and beverages in WIC-eligible stores. The selection and authorization criteria used to authorize WIC vendors varies widely from state to state with little known about the specific variations. This paper reviews and summarizes the differences across 16 of these criteria enacted by 89 WIC administrative agencies: the 50 states, the District of Columbia, five US Territories, and 33 Indian Tribal Organizations. Vendor selection and authorization criteria varied across WIC agencies without any consistent pattern. The wide variations in criteria and policies raise questions about the rational for inconsistency. Some of these variations, in combination, may result in reduced access to WIC-approved foods and beverages by WIC participants. For example, minimum square footage and/or number of cash register criteria may limit vendors to larger retail operations that are not typically located in high-risk, under-resourced communities where WIC vendors are most needed. Results highlight an opportunity to convene WIC stakeholders to review variations, their rationale, and implications thereof especially as this process could result in improved policies to ensure and improve healthy food and beverage access by WIC participants. More work remains to better understand the value of state WIC vendor authorization authority, particularly in states that have provided stronger monitoring requirements. This work might also examine if and how streamlining WIC vendor criteria (or at least certain components of them) across regional areas or across the country could provide an opportunity to advance interstate commerce and promote an equitable supply of food across the food system, while ensuring the protection for local, community-oriented WIC vendors.
View details for DOI 10.3390/ijerph18073545
View details for PubMedID 33805495
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Food Insecurity on College and University Campuses: A Context and Rationale for Solutions.
Journal of the Academy of Nutrition and Dietetics
2021
View details for DOI 10.1016/j.jand.2021.10.021
View details for PubMedID 34718223
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Impact of a School-Based Gardening, Cooking, Nutrition Intervention on Diet Intake and Quality: The TX Sprouts Randomized Controlled Trial.
Nutrients
2021; 13 (9)
Abstract
School gardens have become common school-based health promotion strategies to enhance dietary behaviors in the United States. The goal of this study was to examine the effects of TX Sprouts, a one-year school-based gardening, cooking, and nutrition cluster randomized controlled trial, on students' dietary intake and quality. Eight schools were randomly assigned to the TX Sprouts intervention and eight schools to control (i.e., delayed intervention) over three years (2016-2019). The intervention arm received: formation and training of Garden Leadership Committees; a 0.25-acre outdoor teaching garden; 18 student lessons including gardening, nutrition, and cooking activities, taught weekly in the teaching garden during school hours; and nine parent lessons, taught monthly. Dietary intake data via two 24 h dietary recalls (24 hDR) were collected on a random subsample (n = 468). Dietary quality was calculated using the Healthy Eating Index 2015 (HEI-2015). The intervention group compared to control resulted in a modest increase in protein intake as a percentage of total energy (0.4% vs. -0.3%, p = 0.021) and in HEI-2015 total vegetables component scores (+4% vs. -2%, p = 0.003). When stratified by ethnicity/race, non-Hispanic children had a significant increase in HEI-2015 total vegetable scores in the intervention group compared to the control group (+4% vs. -8%, p = 0.026). Both the intervention and control groups increased added sugar intake; however, to a lesser extent within the intervention group (0.3 vs. 2.6 g/day, p = 0.050). School-based gardening, cooking, and nutrition interventions can result in significant improvements in dietary intake. Further research on ways to scale and sustain nutrition education programs in schools is warranted. The trial is registered at ClinicalTrials.gov (NCT02668744).
View details for DOI 10.3390/nu13093081
View details for PubMedID 34578959
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Digital Health Coaching for Type 2 Diabetes: Randomized Controlled Trial of Healthy at Home.
Frontiers in digital health
1800; 3: 764735
Abstract
Digital health coaching is an intervention for type 2 diabetes mellitus (T2DM) that has potential to improve the quality of care for patients. Previous research has established the efficacy of digital interventions for behavior change. This pilot study addresses a research gap in finding effective and accessible behavioral interventions for under-resourced individuals with T2DM. We examined the impact of Healthy at Home, a 12-week phone and SMS-based (short message service) digital health coaching program, on insulin resistance which is an upstream marker for T2DM progression. We compared this intervention to usual diabetic care in a family medicine residency clinic in a randomized controlled trial. Digital health coaching significantly improved participants' calculated Homeostatic Model Assessment for Insulin Resistance (HOMA2-IR) by -0.9 ± 0.4 compared with the control group (p = 0.029). This significance remained after controlling for years diagnosed with T2DM, enrollment in Medicaid, access to food, baseline stage of change, and race (p = 0.027). Increasing access to digital health coaching may lead to more effective control of diabetes for under-resourced patients. This study demonstrates the potential to implement a personalized, scalable, and effective digital health intervention to treat and manage T2DM through a lifestyle and behavioral approach to improve clinical outcomes (http://clinicaltrials.gov, NCT04872647).
View details for DOI 10.3389/fdgth.2021.764735
View details for PubMedID 34901926
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A School-Based Cluster Randomized Gardening, Nutrition, and Cooking Intervention: Effects on Lipids
WILEY. 2020: 44
View details for Web of Science ID 000585142900118
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Effect of a School-Based Gardening, Nutrition, and Cooking Cluster Randomized Trial on Diabetes Risk
WILEY. 2020: 83
View details for Web of Science ID 000585142900242
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Effects of a School-Based Obesity Intervention on Knowledge & Preference Towards Fruit & Vegetables
WILEY. 2020: 88
View details for Web of Science ID 000585142900257
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Associations between Child and Parent Knowledge of Added Sugar Recommendations and Added Sugar Intake in Multiethnic Elementary-Aged Children.
Current developments in nutrition
2020; 4 (9): nzaa140
Abstract
Background: A key goal of the Dietary Guidelines for Americans 2015-2020 is to reduce added sugar intake by increasing public knowledge about added sugars. However, research has not shown if knowledge of added sugar recommendations is associated with intake.Objectives: To determine the relation between parent and child knowledge of added sugar recommendations with added sugar intake in primarily low-income and Hispanic third- to fifth-grade students.Methods: Analysis examined baseline, cross-sectional data from TX Sprouts, a 1-y cooking, gardening, and nutrition clustered randomized controlled trial. Participants were 685 parent-child dyads from 16 elementary schools in the greater Austin area. Parents and children completed a survey to assess knowledge of added sugar recommendations. Children completed two 24-h dietary recalls to assess average intake of added sugars. Mixed effects linear regression models were used to estimate associations between child and parent knowledge of added sugar recommendations and average total added sugar intake.Results: Children who correctly identified the added sugar recommendation consumed lower amounts of added sugar compared with children who did not correctly identify the recommendation (34.8±2.7 compared with 41.0±2.5g; P=0.003), after adjusting for sociodemographic characteristics. Parent knowledge of added sugar recommendations was not associated with child intake.Conclusions: Child knowledge of added sugar recommendations was associated with lower intake of added sugars. Findings suggest that child nutrition education should focus on increasing knowledge of national recommendations. Future research should investigate a causal relation between added sugar knowledge and intake in elementary-aged children.
View details for DOI 10.1093/cdn/nzaa140
View details for PubMedID 32923924
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Faith in Fat: A Multisite Examination of University Students' Perceptions of Fat in the Diet.
Nutrients
2020; 12 (9)
Abstract
Despite recent relaxation of restrictions on dietary fat consumption in dietary guidelines, there remains a collective "fear of fat". This study examined college students' perceptions of health among foods with no fat relative to foods with different types of fats (unsaturated and saturated). Utilizing a multisite approach, this study collected data from college students at six university dining halls throughout the United States. Data were available on 533 students. Participants were 52% male and consisted largely of first-year students (43%). Across three meal types, the no-fat preparation option was chosen 73% of the time, the unsaturated fat option was selected 23% of the time, and the saturated fat option was chosen 4% of the time. Students chose the no-fat option for all meal types 44% of the time. Findings suggest that college students lack knowledge regarding the vital role played by the type and amount of fats within a healthy diet. Nutrition education and food system reforms are needed to help consumers understand that type of fat is more important than total amount of fat. Efforts across various sectors can encourage incorporating, rather than avoiding, fats within healthy dietary patterns.
View details for DOI 10.3390/nu12092560
View details for PubMedID 32846997
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Breakfast Consumption in Low-Income Hispanic Elementary School-Aged Children: Associations with Anthropometric, Metabolic, and Dietary Parameters.
Nutrients
2020; 12 (7)
Abstract
Breakfast consumption is associated with lower obesity prevalence and cardiometabolic risk and higher dietary quality (DQ) in children. Low-income, Hispanic populations are disproportionately affected by obesity and cardiometabolic risks. This study examined the relationship between breakfast consumption groups (BCG) on anthropometric, metabolic, and dietary parameters in predominately low-income, Hispanic children from 16 Texas schools. Cross-sectional data were from TX Sprouts, a school-based gardening, nutrition, and cooking randomized controlled trial. Anthropometric measurements included height, weight, body mass index, body fat percent via bioelectrical impedance, waist circumference, and blood pressure. Metabolic parameters included fasting plasma glucose, insulin, glycated hemoglobin, cholesterol, and triglycerides. DQ and BCG were assessed via two 24-h dietary recalls. Multivariate multiple regression examined relationships between BCG and anthropometric, metabolic, and dietary parameters. This study included 671 students (mean age 9 years, 58% Hispanic, 54% female, 66% free/reduced lunch, 17% breakfast skippers). No relationships were observed between BCG and anthropometric or metabolic parameters. BCG had higher DQ; higher daily protein, total sugar, and added sugar intake; and lower daily fat intake. Skipping breakfast was associated with lower DQ; higher daily fat intake; and lower daily protein intake. Longitudinal research examining breakfast quality on cardiometabolic outcomes in low-income, Hispanic children is warranted.
View details for DOI 10.3390/nu12072038
View details for PubMedID 32659982
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Barriers to Preparing and Cooking Vegetables Are Associated with Decreased Home Availability of Vegetables in Low-Income Households.
Nutrients
2020; 12 (6)
Abstract
Knowing which barriers to buying and preparing/cooking vegetables at home are linked with the home availability of vegetables and how food-security status impacts this relationship will facilitate the tailoring of future public health interventions. Baseline data were used from an elementary-school-based intervention. Data on household food-security status, availability of vegetables at home, and barriers to buying and preparing/cooking vegetables were collected from 1942 parents. Differences between food-secure and food-insecure households were examined for barriers to buying and preparing/cooking vegetables. Mixed-effects linear regression was used to estimate the associations between barriers to buying and preparing/cooking vegetables and food-security status on the home availability of vegetables. Food insecurity was reported in 27% of households. Food-insecure households were significantly more likely to report barriers to buying and preparing/cooking vegetables. The barriers to purchasing/cooking vegetables score was associated with a decrease in the home availability of vegetables score (beta = -0.77; 95% CI: -0.88, -0.65; p < 0.001). Compared to food-secure households, food-insecure households were 15% less likely to have home vegetable availability (beta = -1.18; 95% CI: -1.45, -0.92; p < 0.001). Although home availability of vegetables does not guarantee consumption, this study identified specific barriers that were associated with availability that can be targeted in future interventions seeking to improve vegetable consumption in the homes of low-income families.
View details for DOI 10.3390/nu12061823
View details for PubMedID 32570923
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Food Waste in K-12 Schools: An Opportunity to Create More Equitable and Sustainable Food Systems
JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR
2020; 52 (5): 463
View details for Web of Science ID 000532694500001
View details for PubMedID 32389239
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The Association Between Child Cooking Involvement in Food Preparation and Fruit and Vegetable Intake in a Hispanic Youth Population.
Current developments in nutrition
2020; 4 (4): nzaa028
Abstract
Background: Cooking interventions have been linked to reductions in obesity and improvements in dietary intake in children.Objective: To assess whether child cooking involvement (CCI) was associated with fruit intake (FI), vegetable intake (VI), vegetable preference (VP), and vegetable exposure (VE) in children participating in the Texas, Grow! Eat! Go! (TGEG) randomized controlled trial.Methods: Baseline data from TGEG included 1231 3rd grade students and their parents. Conducted in 28 low-income, primarily Hispanic schools across Texas, TGEG schools were assigned to: 1) Coordinated School Health (CSH) only (control group), 2) CSH plus gardening and nutrition intervention (Learn, Grow, Eat & Go! or LGEG group), 3) CSH plus physical activity intervention (Walk Across Texas or WAT group), and 4) CSH plus LGEG plus WAT (combined group). Height, weight, dietary intake, VE, VP, and CCI were collected at baseline and postintervention. Linear regressions were used to assess the relation between baseline CCI and fruit and vegetable (FV) intake, VE, and VP. A priori covariates included age, sex, race/ethnicity, and TGEG treatment group.Results: Children who were always involved in family cooking had higher VP and VE when compared with children who were never involved in family cooking (beta = 3.26; 95% CI: 1.67, 4.86; P< 0.01 and beta = 2.26; 95% CI: 0.67, 3.85; P< 0.01, respectively). Both VI and FI were higher for children who were always involved in family cooking compared with children who never cooked with their family (beta = 2.45; 95% CI: 1.47, 3.44; P< 0.01 and beta = 0.93; 95% CI: 0.48, 1.39; P< 0.01, respectively). VI and fruit consumption were higher for children who reported being sometimes involved in family cooking compared with children who were never involved in family cooking, (beta = 1.47; 95% CI: 0.51, 2.42; P< 0.01, and beta = 0.64; 95% CI: 0.20, 1.08; P< 0.01, respectively).Conclusions: Results show a positive relation between family cooking and FV intake and preference in high-risk, minority children.
View details for DOI 10.1093/cdn/nzaa028
View details for PubMedID 32258989
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Design and participant characteristics of TX sprouts: A school-based cluster randomized gardening, nutrition, and cooking intervention (vol 85, 105834, 2019)
CONTEMPORARY CLINICAL TRIALS
2020; 88: 105906
View details for DOI 10.1016/j.cct.2019.105906
View details for Web of Science ID 000509631300011
View details for PubMedID 31791858
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Child Compared with Parent Perceptions of Child-Level Food Security
CURRENT DEVELOPMENTS IN NUTRITION
2019; 3 (10): nzz106
Abstract
There is a need to directly and accurately conceptualize and measure food insecurity in children as part of surveillance and public health efforts.The aim of this study was to compare parent and child perceptions of child-level food security status via questionnaires within a large, ethnically diverse population.Cross-sectional baseline data from a cluster-randomized controlled trial involving primarily low-income, Hispanic third- to fifth-grade students and their parents were used for analysis. The sample consisted of 2408 dyadic (parent and child) pairs. Parents completed the 8-item child-referenced Household Food Security Survey Module and their responses were compared with an adaption of the 5-item Child Food Security Assessment completed by their child. Levels of association between child and parent perceptions within dyads were calculated using Goodman and Kruskal's γ statistic. A mixed-effects binomial logistic regression model was used to model discordance as a function of child, parent, and household sociodemographic characteristics.The child sample was 53% girls, mean age of 9 y, and 63% were Hispanic. The parent sample was 86% women and 65% Hispanic. Child and parent perceptions of child-level food security agreed only 21.7% of the time. There was a weak positive association between child and parent perceptions of child-level food security (γ = 0.162, P < 0.001). Children perceived themselves as less food secure than their parents' perception 70.1% of the time. Household receipt of Supplemental Nutrition Assistance Program benefits was associated with greater odds of discordant food security perceptions, whereas female children, older children, and parents not working were characteristics associated with lower odds of discordant perceptions.Results, in combination with the existing literature, suggest that parent perceptions of child-level food insecurity may underestimate child-level food insecurity experiences. Inaccurate estimations or underestimations of the true prevalence of child-level food insecurity could be detrimental to maternal and child health efforts. This trial was registered at clinicaltrials.gov as NCT02668744.
View details for DOI 10.1093/cdn/nzz106
View details for Web of Science ID 000504325000008
View details for PubMedID 31637366
View details for PubMedCentralID PMC6794475
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Design and participant characteristics of TX sprouts: A school-based cluster randomized gardening, nutrition, and cooking intervention
CONTEMPORARY CLINICAL TRIALS
2019; 85: 105834
Abstract
To outline the study design, outcome measures, protocol and baseline characteristics of enrolled participants of Texas (TX) Sprouts, a one-year school-based gardening, nutrition, and cooking cluster randomized trial.Eight schools were randomly assigned to the TX Sprouts intervention and eight schools to the delayed intervention over three years (2016-2019). The intervention arm received: formation/training of Garden Leadership Committees; a 0.25-acre outdoor teaching garden; 18 student lessons including gardening, nutrition, and cooking activities, taught weekly during school hours by hired educators throughout one school year; and nine parent lessons taught monthly to families. The delayed intervention was implemented the following academic year and received the same protocol as the intervention arm. Primary outcomes included: dietary intake, dietary-related behaviors, obesity, and metabolic parameters. Child measures included: height, weight, waist circumference, body composition, blood pressure, and dietary psychosocial variables. A subsample of children were measured for glucose, hemoglobin-A1C, and 24-hour dietary recalls. Parent measures included: height and weight, dietary intake, and related dietary psychosocial variables.Of the 4239 eligible students, 3137 students consented and provided baseline clinical measures; 3132 students completed child surveys, with 92% of their parents completing parent surveys. The subsamples of blood draws and dietary recalls were 34% and 24%, respectively. Intervention arm baseline descriptives, clinical and dietary data for children and parents are reported.The TX Sprouts intervention targeted primarily low-income Hispanic children and their parents; utilized an interactive gardening, nutrition, and cooking program; and measured a battery of dietary behaviors, obesity and metabolic outcomes.
View details for DOI 10.1016/j.cct.2019.105834
View details for Web of Science ID 000497244700002
View details for PubMedID 31449880
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Child-Report of Food Insecurity Is Associated with Diet Quality in Children
NUTRIENTS
2019; 11 (7)
Abstract
Food insecurity (FI) is adversely associated with physical and mental wellbeing in children. The mechanism underlying this association is assumed to be dietary intake; however, evidence has been mixed. This study examined the relationship between self-reported FI and dietary quality among low-income children. Cross-sectional data were used from TX Sprouts, a school-based cooking, gardening, and nutrition intervention. A sample of 598 children completed two 24-h dietary recalls and a questionnaire including an adapted version of the 5-item Child Food Security Assessment (CFSA). Food security was categorized as food secure or FI based on summed CFSA scores. Dietary quality was assessed using the Health Eating Index-2015 (HEI-2015). Mixed effects linear regression models examined associations between FI and dietary quality. Children were 64% Hispanic, 55% female, and were 9.2 years old on average. Adjusting for sociodemographic characteristics, BMI percentile, and energy intake, FI was associated with lower HEI-2015 total scores (β = -3.17; 95% CI = -5.28, -1.06; p = 0.003). Compared to food secure children, FI children had lower greens and beans (2.3 vs. 1.9, p = 0.016), seafood and plant protein (2.0 vs. 1.6, p = 0.006), and added sugar (7.4 vs. 8.0, p = 0.002) component scores. Interventions targeting low-income and FI children should investigate ways to improve dietary quality.
View details for DOI 10.3390/nu11071574
View details for Web of Science ID 000478885400032
View details for PubMedID 31336880
View details for PubMedCentralID PMC6683069
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Association of breastfeeding and gestational diabetes mellitus with the prevalence of prediabetes and the metabolic syndrome in offspring of Hispanic mothers
PEDIATRIC OBESITY
2019; 14 (7): e12515
Abstract
The effects of breastfeeding (BF) on metabolic syndrome (MetS) and diabetes mellitus in children exposed to gestational diabetes mellitus (GDM) in utero have rarely been evaluated.This study assessed BF and GDM in relation to the prevalence of prediabetes and MetS in Hispanic children and adolescents (8-19 y).This is a longitudinal study with 229 Hispanic children (8-13 y) with overweight/obesity, family history of diabetes, and an average of four annual visits (AV). Participants were categorized as follows: never (negative for prediabetes/MetS at all AVs), ever (positive for prediabetes/MetS at any visit), intermittent (positive for prediabetes/MetS at 1-2 AVs), and persistent (positive for prediabetes/MetS at greater than or equal to 3 AVs).Compared with GDM offspring who were not BF (referent), GDM offspring who were BF had lower odds of persistent prediabetes (OR = 0.18; 95% CI, 0.04-0.82; P = 0.02) and MetS (OR = 0.10; 95% CI, 0.02-0.55; P = 0.008). Compared with referent group, non-GDM offspring who were BF, and non-GDM offspring not BF had lower odds of persistent prediabetes (OR = 0.10; 95% CI, 0.03-0.39; P = 0.001; OR = 0.05; 95% CI, 0.01-0.11; P < 0.001) and MetS (OR = 0.14; 95% CI, 0.04-0.59; P = 0.01 and OR = 0.04; 95% CI, 0.01-0.11; P < 0.001).These results show BF is protective against prediabetes and MetS in offspring regardless of GDM status.
View details for DOI 10.1111/ijpo.12515
View details for Web of Science ID 000470005100007
View details for PubMedID 30734524
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Child and Parent Knowledge of Added Sugar Recommendations Is Associated with Decreased Added Sugar Intake in Multiethnic Elementary Aged Children (P16-021-19).
Current developments in nutrition
2019; 3 (Suppl 1)
Abstract
Objectives: Due to the adverse health effects of added sugar consumption, the 2015-2020 Dietary Guidelines for Americans (DGA) have encouraged reduced intake of added sugars. While education is a key component of the DGA, no research has studied whether knowledge of the recommendations for added sugar is associated with decreased intake. The aim of this study was to determine the impact of parent and child knowledge of added sugar recommendations on added sugar intake in a sample of multiethnic 3rd to 5th grade students.Methods: This study examined cross-sectional data from TX Sprouts, a 1-year cooking, gardening, and nutrition clustered randomized control trial. A sample of 685 children and one of their parents completed questionnaires to assess knowledge of added sugar recommendations. Two 24-hour dietary recalls were used to assess average child energy and added sugar intake. Multiple linear regression was used to examine associations between child and parent knowledge and a child's added sugar intake while controlling for child age, ethnicity, gender, and energy intake and parent ethnicity and gender.Results: Only 38% of children were able to identify the correct recommendation for added sugar intake, compared to 46% of parents. Parent knowledge of the added sugar recommendation was associated with a lower intake of added sugar (40.1 vs 35.6 grams, P<0.01). Child knowledge of the added sugar recommendation was associated with a lower intake of added sugar (39.9 vs 35.9 grams, P<0.02).Conclusions: The findings of this study suggest that knowledge of added sugar guidelines is associated with lower intake of added sugar. Nutrition education for children and their parents should focus on increasing knowledge of national guidelines and recommendations to improve dietary intake and overall health.Funding Sources: This research was supported by funding from the National Institutes of Health - National Heart, Lung, and Blood Institute.
View details for DOI 10.1093/cdn/nzz050.P16-021-19
View details for PubMedID 31224029
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Association of Breastfeeding and Sugar-Sweetened Beverage Consumption with Obesity Prevalence in Offspring Born to Mothers with and Without Gestational Diabetes Mellitus (P11-098-19).
Current developments in nutrition
2019; 3 (Suppl 1)
Abstract
Objectives: Prenatal and early life factors such as Gestational Diabetes Mellitus (GDM), exclusive breastfeeding (EBF), and early exposure to sugar-sweetened beverages (SSBs) may contribute to obesity in children. The relationship of EBF and SSBs with obesity prevalence in children exposed to GDM has rarely been evaluated. This study examined the association of EBF and early SSBs consumption with obesity prevalence in children (1-5y) born to mothers with and without GDM.Methods: This study used data from the 2014 Los Angeles County Women, Infants, and Children(WIC) Survey, which included 3,707 mothers and their children (1-5y). Infants (1-2y) with weight-for-height≥97.7thpercentile were classified as subjects with high weight-for-length and children (2-5y) were classified as subjects with obesity if their BMI-for-age was≥95thpercentile.Results: The individual and combination interaction effects of GDM, SSBs intake, and EBF on obesity prevalence were all significant (P<0.05). Compared to GDM offspring, with low SSBs intake, and who were EBF (referent), those who were GDM, with high SSBs intake and who were EBF had approximately a five-fold increase in odds of obesity (OR=4.77, 95%CI 1.55-8.60, P=0.03). Compared to the GDM referent group, GDM offspring who were not EBF with low and high SSBs intake had 4.3- and 4.4-times higher odds of obesity, respectively (OR=4.33, 95%CI 1.42- 8.07, P=0.01; OR=4.38, 95%CI 1.39- 8.16, P=0.01). Using non-GDM, EBF and low SSBs as referent, those who were not EBF, with either high or low SSBs had approximately a 4-fold increase in odds of obesity (OR=3.62, 95%CI: 2.16-6.05, P<0.0001; OR=3.83, 95%CI: 2.26-6.48, P<0.0001).Compared to the non-GDM referent group, those who were EBF and had high SSBs intake had 77% higher odds of obesity (OR=1.77, 95%CI 0.93-3.37, P=0.001).Conclusions: In non-GDM offspring, EBF was protective against odds of obesity in both high and low SSBs consumers. In GDM offspring, EBF was only protective against obesity when SSBs intake was low. Surprisingly, GDM offspring who were EBF and had high SSBs consumption had a 4- to 5-fold increase in odds of obesity compared to those not EBF with either low or high SSBs intake. These results suggest that interventions should focus on the combined protective effects of EBF and low SSBs intake, particularly in GDM offspring.Funding Sources: First 5 LA.
View details for DOI 10.1093/cdn/nzz048.P11-098-19
View details for PubMedID 31225178
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Food Insecurity Is Associated with Higher Added Sugar and Sugar-Sweetened Beverage Intake Among Low-Income Elementary Aged Children (P04-059-19).
Current developments in nutrition
2019; 3 (Suppl 1)
Abstract
Objectives: Food insecurity is adversely associated with physical and mental health and wellbeing in children. The mechanism that underlies this association is assumed to be dietary intake; however, evidence linking food insecurity to child dietary intake has been mixed. This study examined the relationship between self-reported food insecurity and dietary intake among low-income 7-12 year old children.Methods: Cross-sectional data were used from TX Sprouts, a school-based cooking, gardening, and nutrition intervention in 16 central Texas schools. A sample of 680 children completed two 24-hour dietary recalls (24hDR) and a questionnaire that included an adapted version of the 5-item Child Food Security Assessment (CFSA). Four ordinal groups, High Food Security (HFS), Marginal Food Security (MFS), Low Food Security (LFS), and Very Low Food Security (VLFS), were generated based on summed scores from the CFSA. The Health Eating Index-2015 and dietary components (total energy, macronutrients, and servings of fruits, vegetables, whole grains, and sugar-sweetened beverages (SSBs)) were derived from 24hDR. Multivariate linear regression models were used to examine the associations between food security and dietary outcomes. A priori covariates included sex, age, ethnicity, and daily energy.Results: Children in the study were 45% male, 54% Hispanic, and had an average age of 9.3 years. Main effects of food security were significant for added sugar (P<0.03) and SSBs (P<0.04). Compared to children with HFS (referent), those who were LFS and VLFS consumed more added sugar (33.2 g vs. 39.9 g and 40.6 g, P<0.03 and P<0.003; respectively). Compared to the HFS referent group, those who were MFS and VLFS had higher mean intakes of SSBs (0.6 vs. 0.8 and 0.9 servings, P<0.03 and P<0.01; respectively). There were no significant associations between food security and other dietary outcomes.Conclusions: Self-reported food insecurity among children (7-12 years of age) was associated with higher added sugar and SSB intake. Future research should assess if the positive association between food insecurity and added sugar and SSB intake contributes to adverse health outcomes.Funding Sources: This study was supported by funding from the National Institutes of Health, National Heart, Lung, and Blood Institute (NHLBI).
View details for DOI 10.1093/cdn/nzz051.P04-059-19
View details for PubMedID 31224723
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The Relationship Between Beverage Consumption and Prediabetes in Predominantly Low-Income Hispanic Children (P11-110-19).
Current developments in nutrition
2019; 3 (Suppl 1)
Abstract
Objectives: Previous studies have established a strong positive relationship between soda consumption and prediabetes in adolescents and adults; however, the same relationship in children younger than 10 years has not yet been examined. Furthermore, the associations of 100% fruit juice and artificially sweetened beverage (ASB) consumption with prediabetes remain elusive. The objective of this study was to examine the relationship between prediabetes and beverage consumption (sodas, ASBs, and 100% fruit juice) in predominantly low-income Hispanic 3rd-5th graders.Methods: This study used baseline data from 793 3rd-5th grade students who participated in TX Sprouts, a cluster randomized nutrition, gardening, and cooking intervention at 16 elementary schools in and around Austin, TX. The following measures were collected at baseline: frequency of soda, ASB, and 100% fruit juice consumption via validated dietary screener, fasting plasma glucose via fasting blood draw, age and sex via questionnaire, height via stadiometer, and weight via TANITA scale. Glucose values of 100-125 mg/dL were categorized as prediabetic based on American Diabetes Association 2018 guidelines. Logistic regression models were run to assess the relationship between beverage consumption and prediabetes, controlling for age, sex, and BMI.Results: Participants were 52.4% female and 66.4% Hispanic, with an average age of 9.2 years. The average fasting plasma glucose was 93.3 mg/dL, with 28.5% of students classified as prediabetic. Participants reporting consumption of two or more sodas per day (n=98) had a 65% higher odds of having prediabetes compared to those reporting no soda consumption on any given day (n=431) (OR=1.65; 95% CI 1.04-2.61; P=0.035). No significant differences were found in consumption of 100% fruit juice or ASBs with prediabetes status.Conclusions: This is the first study to show a positive relationship between soda consumption and prediabetes in children younger than 10 years, replicating findings in adolescent and adult populations. This study did not find a relationship between ASB and 100% fruit juice consumption and prediabetes. These results suggest that interventions should focus on reducing primarily soda consumption to potentially reduce prediabetes in pediatric populations.Funding Sources: This study was supported by funding from the National Institutes of Health, National Heart, Lung, and Blood Institute (NHLBI).
View details for DOI 10.1093/cdn/nzz048.P11-110-19
View details for PubMedID 31224498
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Relationship Between Dark Green, Orange, and Yellow Vegetable Intake and Skin Carotenoids (P02-003-19).
Current developments in nutrition
2019; 3 (Suppl 1)
Abstract
Objectives: Skin carotenoid status assessed by Resonance Raman spectroscopy (RRS) has emerged as a promising new biomarker of vegetable intake. As a result, only few studies have compared the relationship between free living vegetable and fruit intake and skin carotenoids in youth populations. The overall objective is toassess how vegetable intake correlates with skin carotenoids in primarily, Hispanic children.Methods: Baseline data from TX Sprouts, a 1-year school-based gardening, cooking, and nutrition randomized controlled trial were used, which included 465 low-income 3rd-5thgrade students from nine schools in central Texas. The following data were collected: demographics via questionnaires, dietary intake viatwo 24-hour dietary recalls collected via telephone, and skin carotenoid status assessed via RRS. Partial correlations were run between vegetable servings per day and changes in vegetable servings per day, controlling for school site, ethnicity/race, sex, age, ethnicity, and energy intake.Results: Students were 45% male and 70% Hispanic with a mean age of 9.4±0.9 years. Intake of dark green/orange/yellow vegetables (servings/day) was positively correlated with RRS scores (r=0.12; P=0.012). Total vegetable intake or fruit intake was not correlated to RRS scores.Conclusions: The correlation was significant, albeit small, between dark green, yellow, red, and orange vegetable intakes and RRS scores. This is one of the first free-living studies in youth to show that nutrient rich vegetable intake is positively linked to skin carotenoids. These results highlight that the RRS can provide a non-invasive and objective measure of vegetable intake that can be used in school settings with children.Funding Sources: This research was supported by funding from the National Institutes of Health - National Heart, Lung, and Blood Institute (grant number R01HL123865).
View details for DOI 10.1093/cdn/nzz029.P02-003-19
View details for PubMedID 31224739
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The Relationship Between Dietary Intake and Parental Support with Child Cooking Involvement in a Youth Population (FS16-03-19).
Current developments in nutrition
2019; 3 (Suppl 1)
Abstract
Objectives: This study assessed how child cooking involvement (CCI) and parental support in food preparation (PS) are related to vegetable preference (VP), vegetable intake (VI), and fruit intake (FI) in children participating in the Texas, Grow! Eat! Go! (TGEG) randomized controlled trial.Methods: Baseline data from the TGEG intervention, conducted in 28 low-income, primarily Hispanic schools across Texas, was used for this study, and included 1325 3rd grade students and their parents. Schools were assigned to: (1) control group; (2) school garden intervention [Learn, Grow, Eat & Go! (LGEG)]; (3) physical activity intervention [Walk Across Texas (WAT)]; or (4) combined group (LGEG plus WAT). Height (via stadiometer), weight (via Tanita scale), dietary intake and CCI (via child questionnaire), and PS (via parent questionnaire) were collected. General Linear Models examined variations in baseline VP, VI, and FI with baseline CCI and PS. A priori covariates for all analyses included: TGEG treatment group, age, sex, and ethnicity.Results: Students were 49.2% male and 42.4% Hispanic with a mean age of 8.3±0.6; 78.3% of the population had overweight/obesity. Children who never cooked with their families preferred fewer vegetables than children who sometimes/always cooked with their parents (7.0±0.6 vs. 8.7±0.5 and 9.4±0.5 vegetables, respectively; P<0.001). Children who never cooked with their families ate less vegetables than children who sometimes/always cooked with their parents (1.9±0.4 vs. 2.6±0.3 and 3.5±0.3 servings/day, respectively; P=0.003 and P=0.000, respectively). Children who never cooked with their families ate less fruit than children who sometimes/always cooked with their parents (1.2±0.2 vs. 1.5±0.1 and 2.09±0.1 servings/day, respectively; P<0.001).Conclusions: Interventions including family cooking activities with children may be an effective way to increase vegetable preference and intake, and fruit intake, especially in high-risk, minority children.Funding Sources: The research was supported by funding from the USDA Agriculture and Food Research Initiative, (grant 2011-68001-30138).
View details for DOI 10.1093/cdn/nzz050.FS16-03-19
View details for PubMedID 31223942
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Diet Quality Is an Indicator of Disease Risk Factors in Hispanic College Freshmen
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
2019; 119 (5): 760–68
Abstract
No studies have assessed the relationship between diet quality, using the Healthy Eating Index (HEI), and adiposity, physical activity, and metabolic disease risk factors in a Hispanic college population.To assess associations between diet quality and adiposity, metabolic health, and physical activity levels in a Hispanic college freshman population.This was a cross-sectional study. Measurements were obtained during a 4-hour in-person visit and included demographic information via questionnaire, height, weight, waist circumference, body mass index, body fat via BodPod, hepatic fat, visceral adipose tissue (VAT) and subcutaneous adipose tissue via magnetic resonance imaging, glucose, insulin, homeostatic model assessment of insulin resistance (HOMA-IR), and lipids via blood draw from fasting subjects, physical activity (ie, step counts per day and time spent in different intensity levels) via 7-day accelerometry, and dietary intake via three to four 24-hour dietary recalls. Dietary quality was calculated using the HEI-2015.Hispanic college freshmen (n=92), 18 to 19 years, 49% male, who were enrolled at University of Texas at Austin from 2014 to 2015.Main outcome measures were diet quality and adiposity, metabolic health, and physical activity levels.Linear regressions determined if dietary quality is related to adiposity, metabolic, and physical activity outcomes. A priori covariates included sex, body fat, and body mass index percentile (for metabolic models), and moderate and vigorous physical activity (MVPA, for adiposity and metabolic models).The average HEI-2015 total score was 54.9±13.4. A 1-point increase in HEI score was associated with 1.5 mL lower VAT (P=0.013); 8 minutes per day higher light activity (P=0.008), and 107 more step counts per day (P=0.002); and 0.10 μg/mL lower insulin (P=0.046) and 0.5 U lower HOMA-IR (P<0.001).Results suggest that small improvements in diet quality may be positively associated with a reduction in metabolic disease risk, during a critical time period in a young person's life.
View details for DOI 10.1016/j.jand.2018.12.002
View details for Web of Science ID 000465445600007
View details for PubMedID 30799284
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Cooking and Gardening Behaviors and Improvements in Dietary Intake in Hispanic/Latino Youth
CHILDHOOD OBESITY
2019; 15 (4): 262–70
Abstract
Background: School gardening interventions typically include cooking and gardening (CG) components; however, few studies have examined associations between CG psychosocial behaviors (attitudes, self-efficacy, and motivation), dietary intake, and obesity parameters. This study assessed the association between changes in CG behaviors with changes in dietary intake and obesity in participants of the LA Sprouts study, an after-school, 12-week, randomized controlled CG intervention conducted in four inner-city elementary schools in Los Angeles. Methods: Process analysis using data from 290 low-income, primarily Hispanic/Latino third through fifth-grade students who were randomized to either the LA Sprouts intervention (n = 160) or control group (n = 130). Height, weight, waist circumference, dietary intake via questionnaire, and CG behaviors were collected at baseline and postintervention. Linear regressions determined whether changes in CG behaviors predicted changes in dietary intake and obesity outcomes. Results: There were no differences in changes in CG psychosocial behaviors between intervention and control groups, therefore groups were combined. Participants were 49% male, 87% Hispanic/Latino, and an average age of nine. Increases in cooking behaviors significantly predicted increases in dietary fiber intake (p = 0.004) and increases in vegetable intake (p = 0.03). Increases in gardening behaviors significantly predicted increased intake of dietary fiber (p = 0.02). Changes in CG behaviors were not associated with changes in BMI z-score or waist circumference. Conclusions: Results from this study suggest that school-based interventions should incorporate CG components, despite their potentially costly and time-intensive nature, as these behaviors may be responsible for improvements in dietary intake of high-risk minority youth.
View details for DOI 10.1089/chi.2018.0110
View details for Web of Science ID 000462155500001
View details for PubMedID 30907624
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Impact of food security on glycemic control among low-income primarily Hispanic/Latino children in Los Angeles, California: A cross-sectional study
JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION
2019; 14 (5): 709–24
Abstract
Studies examining the impact of food insecurity on metabolic markers are limited, specifically in Hispanic youth. This study was a cross-sectional analysis of 218 3rd-5th grade students (83% Hispanic and 49% male). Anthropometrics, blood glucose, insulin, and lipids via fasting blood draw, dietary intake via Block screener, and a 5-item food security scale were collected. HOMA-Insulin Resistance was calculated. Multivariate analyses of covariance were used to examine differences in glucose and insulin indices, adiposity, metabolic and dietary intake variables between categories of food security. Food secure children had greater glycemic control and decreased insulin resistance compared to food insecure children.
View details for DOI 10.1080/19320248.2018.1491367
View details for Web of Science ID 000483002400008
View details for PubMedID 31749895
View details for PubMedCentralID PMC6867803