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Beck LC, Woo JG. The contribution of dietary composition over 25 years to cardiovascular risk factors in childhood and adulthood: the Princeton Lipid Research Study. Br J Nutr 2024:1-12. [PMID: 39381972 DOI: 10.1017/s0007114524001521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2024]
Abstract
Diet is a contributing factor to CVD risk, but how diet quality changes over the long term and contributes to CVD risk is less well studied. Diet data were analysed from parents and offspring from the Princeton Lipid Research Study (24-h recall in the 1970s; Block FFQ in 1998). Diet quality was assessed using an 8-point Dietary Approaches to Stop Hypertension nutrient-based scoring index, including a new method for scoring in children, as well as examining twelve key macro/micronutrients. Outcomes included blood glucose, blood pressure, serum lipids and BMI. The analysis included 221 parents (39 % male, mean age 38·9 ± 6·5 at baseline and 66·6 ± 6·6 at follow-up) and 606 offspring (45 % male, 11·9 ± 3·2 at baseline and 38·5 ± 3·6 at follow-up). Parents' Dietary Approaches to Stop Hypertension score increased slightly from baseline to follow-up (1·4 ± 1·0 and 2·1 ± 1·3, respectively, P < 0·001), while offspring remained consistent (1·6 ± 0·9 and 1·6 ± 1·1, respectively, P = 0·58). Overall, the Dietary Approaches to Stop Hypertension score, adjusted for age, race, sex and BMI, was not significantly associated with any examined outcomes. Of the macro/micronutrients at follow-up, saturated and total fat were associated with increased diabetes and dyslipidaemia in parents, while the inverse was seen with niacin. Among offspring, niacin was associated with lower rates of hypertension and dyslipidaemia. In conclusion, no relationship was detected between Dietary Approaches to Stop Hypertension adherence and disease outcomes. However, both saturated fat and niacin were associated with components of CVD risk, highlighting the need for improved diet quality overall.
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Affiliation(s)
- Leah C Beck
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jessica G Woo
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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2
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Saxe-Custack A, Egan S, Sadler R, Wojciechowski T. Relative impacts of a virtual cooking and nutrition program for children and families. Appetite 2023; 191:107041. [PMID: 37709149 DOI: 10.1016/j.appet.2023.107041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 09/05/2023] [Accepted: 09/08/2023] [Indexed: 09/16/2023]
Abstract
Among the many factors contributing to increased consumption of ultraprocessed foods, a societal decline in cooking skills is a barrier to achieving healthy dietary patterns among children and adolescents. The current study assessed the effectiveness of a healthy cooking program, its geographic reach, and whether program format (child only, in-person format vs. family-based, virtual format) influenced outcomes. This was a quasi-experimental comparison study using youths' (8-18 years old) pre-post surveys, paired t-tests, propensity score matching, and hot spot analysis. Children participated in one of two healthy cooking programs: Flint Kids Cook (FKC)] in-person or [Flint Families Cook (FFC) virtual. FKC was facilitated inside a farmers' market commercial kitchen, whereas FFC took place virtually, in families' homes. Youth were eligible to participate in FKC if they were age 8-18 years, spoke English, and had not participated in a prior session. Families were eligible to participate in FFC if they had a child(ren) age 8-18 years, spoke English, and had not participated in a prior session of FKC or FFC. A total of 246 children (152 FKC; 94 FFC) completed assessments. FFC participants reported improved cooking self-efficacy (p < 0.001), intake of vegetables (p = 0.04), health-related quality of life (HRQoL; p = 0.01), and physical functioning (p < 0.001). Geographic reach, cooking self-efficacy, attitude towards cooking, and HRQoL exit scores did not differ between virtual or in-person programs. However, virtual program participants reported higher intake of whole grains (p = 0.02) and total fruits (p = 0.02) than in-person participants. Differences in outcomes based on program format included notable dietary improvements among youth who participated in the family-based virtual program.
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Affiliation(s)
- Amy Saxe-Custack
- Charles Stewart Mott Department of Public Health, College of Human Medicine, Michigan State University, 200 E 1st Street, Flint, MI, 48502, USA.
| | - Sarah Egan
- Charles Stewart Mott Department of Public Health, College of Human Medicine, Michigan State University, 200 E 1st Street, Flint, MI, 48502, USA
| | - Richard Sadler
- Charles Stewart Mott Department of Public Health, College of Human Medicine, Michigan State University, 200 E 1st Street, Flint, MI, 48502, USA; Department of Family Medicine, College of Human Medicine, Michigan State University, 788 Service Rd., East Lansing, MI, 48824, USA
| | - Thomas Wojciechowski
- Department of Criminal Justice, College of Social Science, Michigan State University, 655 Auditorium Rd., East Lansing, MI, 48824, USA
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Sadler RC, Saxe-Custack A. 'Nobody Shops at the Neighborhood Store': Leveraging a Community's Pediatric Fresh Produce Prescription Program to Inform Future Participating Store Redemption Locations. CITIES & HEALTH 2023; 8:70-81. [PMID: 38585045 PMCID: PMC10997326 DOI: 10.1080/23748834.2023.2281764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 11/06/2023] [Indexed: 04/09/2024]
Abstract
Research examining the nature of food shopping often considers proximity to the nearest or overall distance travelled to multiple stores. Such studies make up a portion of new work on so-called 'food deserts' and the issues inherent in the term, including that most people do not shop at their nearest store, and mobility challenges vary vastly from one person to the next. Increasing the knowledge base on shopping characteristics could be useful for behavioral interventions and programs aimed at increasing healthy food shopping. In this study, we examined the shopping characteristics of 627 caregivers whose children were enrolled in a pediatric fresh produce prescription program at one of three large pediatric clinics in Flint, Michigan. We compared these characteristics to the potential of a new food cooperative to improve geographic accessibility to healthy food. In particular, we propose the expansion of the prescription program to this new cooperative for health-related as well as local economic development reasons. Our work bridges topics of interest to researchers and practitioners working in nutrition, food access, and economic development.
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Affiliation(s)
- Richard C. Sadler
- Departments of Public Health and Family Medicine, Michigan State University, Flint, MI, USA
| | - Amy Saxe-Custack
- Departments of Public Health and Food Science & Human Nutrition, Michigan State University, Flint, MI, USA
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The technique 'joint and individual variance explained' highlights persistent aspects of the diet using longitudinal food frequency data. Br J Nutr 2022; 128:2054-2062. [PMID: 34915946 DOI: 10.1017/s0007114521004955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Dietary pattern analysis is typically based on dimension reduction and summarises the diet with a small number of scores. We assess 'joint and individual variance explained' (JIVE) as a method for extracting dietary patterns from longitudinal data that highlights elements of the diet that are associated over time. The Auckland Birthweight Collaborative Study, in which participants completed an FFQ at ages 3·5 (n 549), 7 (n 591) and 11 (n 617), is used as an example. Data from each time point are projected onto the directions of shared variability produced by JIVE to yield dietary patterns and scores. We assess the ability of the scores to predict future BMI and blood pressure measurements of the participants and make a comparison with principal component analysis (PCA) performed separately at each time point. The diet could be summarised with three JIVE patterns. The patterns were interpretable, with the same interpretation across age groups: a vegetable and whole grain pattern, a sweets and meats pattern and a cereal v. sweet drinks pattern. The first two PCA-derived patterns were similar across age groups and similar to the first two JIVE patterns. The interpretation of the third PCA pattern changed across age groups. Scores produced by the two techniques were similarly effective in predicting future BMI and blood pressure. We conclude that when data from the same participants at multiple ages are available, JIVE provides an advantage over PCA by extracting patterns with a common interpretation across age groups.
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Neves MEA, Souza MR, Gorgulho BM, Pereira RA, Cunha DB, Souza AM, Muraro AP, Ferreira MG, Rodrigues PRM. Restricted dietary pattern may contribute to lowering blood pressure in adolescents with obesity: Study of Cardiovascular Risk in Adolescents. J Hypertens 2022; 40:785-793. [PMID: 35175959 DOI: 10.1097/hjh.0000000000003078] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Dieting is one of the main target factors for interventions that seek to control and prevent rising blood pressure. This study identified dietary patterns and analyzed their association with adolescents' blood pressure. METHODS This is a cross-sectional study with a probabilistic and nationally representative sample of adolescents aged 12-17 years, who participated in the Study of Cardiovascular Risk in Adolescents (ERICA), carried out in 2013-2014 with Brazilian adolescents (N = 36 956). Food consumption was assessed by 24 h recall. Dietary patterns were identified using the Reduced Rank Regression method, and considering waist circumference, fasting insulin, and dietary polyunsaturated fat/saturated fat ratio as intermediate variables. Multiple linear regression models stratified by weight were developed; SBP and DBP were the dependent variables, and dietary pattern scores were the independent ones, with adjustment for potential confounding factors. RESULTS The following patterns were identified: 'Brazilian common', 'Restricted' and 'Added sugar'. The 'Restricted' pattern, which included diet/light foods, chicken and chicken-based dishes, leafy greens, vegetables and spices, red meats and dishes based on red meats and tubers, was inversely associated with SBP (β = -1.55; 95% CI = -2.26 to -0.83) and DBP (β = -1.19; 95% CI = -1.70 to -0.68) in adolescents with obesity. CONCLUSION In adolescents with obesity, a low-energy density diet was associated with reduced blood pressure. These findings are consistent with international recommendations for preventing elevated blood pressure.
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Affiliation(s)
- Morgana E A Neves
- Faculdade de Nutrição, Universidade Federal de Mato Grosso, Avenida Fernando Corrêa da Costa, Bairro Boa Esperança, Cuiabá, Mato Grosso
| | - Marielly R Souza
- Faculdade de Nutrição, Universidade Federal de Mato Grosso, Avenida Fernando Corrêa da Costa, Bairro Boa Esperança, Cuiabá, Mato Grosso
| | - Bartira M Gorgulho
- Faculdade de Nutrição, Universidade Federal de Mato Grosso, Avenida Fernando Corrêa da Costa, Bairro Boa Esperança, Cuiabá, Mato Grosso
| | - Rosangela A Pereira
- Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Avenida Carlos Chagas Filho, 373. Edifício do Centro de Ciências da Saúde, Bloco J, 2° andar, Cidade Universitária
| | - Diana B Cunha
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier, 524, Pavilhão João Lyra Filho, 7° andar
| | - Amanda M Souza
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Endereço: Avenida Horácio Macedo, s/n - Próximo a Prefeitura Universitária da UFRJ. Ilha do Fundão - Cidade Universitária
| | - Ana Paula Muraro
- Instituto de Saúde Coletiva, Universidade Federal de Mato Grosso, Avenida Fernando Correa da Costa, 2367, Bairro Boa Esperança, Cuiabâ, Mato Grosso, Brazil
| | - Márcia G Ferreira
- Faculdade de Nutrição, Universidade Federal de Mato Grosso, Avenida Fernando Corrêa da Costa, Bairro Boa Esperança, Cuiabá, Mato Grosso
| | - Paulo R M Rodrigues
- Faculdade de Nutrição, Universidade Federal de Mato Grosso, Avenida Fernando Corrêa da Costa, Bairro Boa Esperança, Cuiabá, Mato Grosso
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Roberto DMT, Kupek E, Assis MAA, Lobo AS, Belchor ALL, Spanholi MW, Cezimbra VG, Oliveira MT, Pereira LJ, Vieira FGK, Hinnig PDF. Most meal and snack patterns are stable over a 3‐year period in schoolchildren in southern Brazil. NUTR BULL 2022; 47:79-92. [DOI: 10.1111/nbu.12541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 01/05/2022] [Accepted: 01/06/2022] [Indexed: 11/30/2022]
Affiliation(s)
| | - Emil Kupek
- Department of Public Health Center for Health Sciences Federal University of Santa Catarina Florianópolis Brazil
| | | | - Adriana Soares Lobo
- Center for Health Sciences Federal University of Santa Catarina Florianópolis Brazil
| | - Ana Luisa Lages Belchor
- Department of Public Health Center for Health Sciences Federal University of Santa Catarina Florianópolis Brazil
| | | | - Vanessa Guimarães Cezimbra
- Department of Public Health Center for Health Sciences Federal University of Santa Catarina Florianópolis Brazil
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Saxe-Custack A, Todem D, Anthony JC, Kerver JM, LaChance J, Hanna-Attisha M. Effect of a pediatric fruit and vegetable prescription program on child dietary patterns, food security, and weight status: a study protocol. BMC Public Health 2022; 22:150. [PMID: 35062926 PMCID: PMC8778506 DOI: 10.1186/s12889-022-12544-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 01/07/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Although nutrients in fruits and vegetables are necessary for proper development and disease prevention, most US children consume fewer servings than recommended. Prescriptions for fruits and vegetables, written by physicians to exchange for fresh produce, address access and affordability challenges while emphasizing the vital role of diet in health promotion and disease prevention. Michigan’s first fruit and vegetable prescription program (FVPP) exclusively for children was introduced in 2016 at one large pediatric clinic in Flint and expanded to a second clinic in 2018. The program provides one $15 prescription for fresh produce to all pediatric patients at every office visit. Prescriptions are redeemable at a year-round farmers’ market or a local mobile market. The current study will assess the impact of this FVPP on diet, food security, and weight status of youth.
Methods
Demographically similar pediatric patient groups with varying levels of exposure to the FVPP at baseline will be compared: high exposure (> 24 months), moderate exposure (12–24 months), and no previous exposure. Data collection will focus on youth ages 8–16 years. A total of 700 caregiver-child dyads (one caregiver and one child per household) will be enrolled in the study, with approximately 200 dyads at clinic 1 (high exposure); 200 dyads at clinic 2 (moderate exposure), and 300 dyads at clinic 3 (no previous exposure). Children with no previous exposure will be introduced to the FVPP, and changes in diet, food security, and weight status will be tracked over two years. Specific aims are to (1) compare baseline diet, food security, and weight status between pediatric patients with varying levels of exposure to the FVPP; (2) measure changes in diet, food security, and weight status before and after never-before-exposed children are introduced to the FVPP; and (3) compare mean 12- and 24-month follow-up measures of diet, food security, and weight status in the initial no exposure group to baseline measures in the high exposure group.
Discussion
Completion of study aims will provide evidence for the effectiveness of pediatric FVPPs and insights regarding the duration and intensity of exposure necessary to influence change.
Trial registration
The study was registered through clinicaltrials.gov [ID: NCT04767282] on February 23, 2021.
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Saxe-Custack A, LaChance J, Hanna-Attisha M, Goldsworthy M, Ceja T. Household Supplemental Nutrition Assistance Program Participation is Associated With Higher Fruit and Vegetable Consumption. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:1060-1065. [PMID: 34479817 DOI: 10.1016/j.jneb.2021.06.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 06/23/2021] [Accepted: 06/27/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Examine whether differences were present by Supplemental Nutrition Assistance Program (SNAP) participation in dietary patterns, achievement of dietary recommendations, and food security for children (aged 7-18 years) receiving free/reduced-price school meals. METHODS Cross-sectional study. Caregiver-child dyads at a pediatric clinic completed validated surveys. Food security, dietary patterns, and achievement of dietary recommendations were compared between child SNAP participants/nonparticipants. RESULTS Among 205 caregivers, 128 (62.4%) reported SNAP participation. Percentages of child SNAP participants/nonparticipants meeting recommendations were largely nonsignificantly different and overwhelmingly low. Supplemental Nutrition Assistance Program participants reported higher mean daily servings of vegetables (P = 0.01) and fruits (P = 0.01) than nonparticipants. Caregiver-reported household food security was not significantly different between SNAP participants and nonparticipants (P = 0.44). CONCLUSIONS AND IMPLICATIONS In this study, child-reported fruit/vegetable intakes were significantly higher among SNAP participants than nonparticipants, suggesting child SNAP participants may experience small but noteworthy benefits related to fruit/vegetable consumption. Additional supports are needed to achieve dietary recommendations.
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Affiliation(s)
- Amy Saxe-Custack
- Department of Food Science and Human Nutrition, Division of Public Health, Michigan State University-Hurley Children's Hospital Pediatric Public Health Initiative, Flint, MI.
| | - Jenny LaChance
- Division of Public Health, Michigan State University-Hurley Children's Hospital Pediatric Public Health Initiative, Flint, MI
| | - Mona Hanna-Attisha
- Department of Pediatrics and Human Development, Division of Public Health, Michigan State University-Hurley Children's Hospital Pediatric Public Health Initiative, Flint, MI
| | - Mallory Goldsworthy
- Division of Public Health, Michigan State University-Hurley Children's Hospital Pediatric Public Health Initiative, Flint, MI
| | - Tiffany Ceja
- Division of Public Health, Michigan State University-Hurley Children's Hospital Pediatric Public Health Initiative, Flint, MI
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Influence of a Pediatric Fruit and Vegetable Prescription Program on Child Dietary Patterns and Food Security. Nutrients 2021; 13:nu13082619. [PMID: 34444778 PMCID: PMC8399668 DOI: 10.3390/nu13082619] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 12/20/2022] Open
Abstract
Limited access to fresh foods is a barrier to adequate consumption of fruits and vegetables among youth, particularly in low-income communities. The current study sought to examine preliminary effectiveness of a fruit and vegetable prescription program (FVPP), which provided one USD 15 prescription to pediatric patients during office visits. The central hypothesis was that exposure to this FVPP is associated with improvements in dietary patterns and food security. This non-controlled longitudinal intervention trial included a sample of caregiver–child dyads at one urban pediatric clinic who were exposed to the FVPP for 1 year. Patients received one USD 15 prescription for fresh produce during appointments. A consecutive sample of caregivers whose children were 8–18 years of age were invited to participate in the study. Dyads separately completed surveys that evaluated food security and dietary behaviors prior to receipt of their first prescription and again at 12 months. A total of 122 dyads completed surveys at baseline and 12-month follow-up. Approximately half of youth were female (52%), and most were African American (63%). Mean caregiver-reported household food security improved from baseline to 12 months (p < 0.001), as did mean child-reported food security (p = 0.01). Additionally, child-reported intake of vegetables (p = 0.001), whole grains (p = 0.001), fiber (p = 0.008), and dairy (p < 0.001) improved after 12 months of exposure to the FVPP. This study provides evidence that pediatric FVPPs may positively influence food security and the dietary patterns of children.
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Sangalli CN, Leffa PS, Valmórbida JL, Lumey LH, Vitolo MR. Impact of promoting healthy infant feeding practices on energy intake and anthropometric measures of children up to 6 years of age: A randomised controlled trial. J Hum Nutr Diet 2021; 34:771-783. [PMID: 34034359 DOI: 10.1111/jhn.12881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 02/22/2021] [Accepted: 02/25/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND The first 2 years of life are the window of opportunity to promote healthy feeding practices. Thus, the present study aimed to assess the impact of a health workers training in infant dietary guidelines on energy intake and anthropometric measurement into childhood. METHODS Cluster randomised field trial (NCT00635453) was conducted in Porto Alegre, Brazil. Healthcare centres were randomised into intervention (n = 9) and control (n = 11) groups. In intervention sites, health workers were trained to promote healthy feeding practices based on the Brazilian guideline for children's nutrition. Pregnant women who were in the last trimester of pregnancy were registered as potential mothers who would receive dietary counselling from the health workers. Energy and macronutrient intake and anthropometric measurements were obtained from children at ages 6 months, 12 months, 3 years and 6 years from low-income families. RESULTS At age 3 years, intervention group had lower consumption of energy [-92.5 kcal; 95% confidence interval (CI) = -153.5 to -31.5], carbohydrates (-11.9 g; 95% CI = -19.9 to -2.3), and total fat (-3.9 g; 95% CI = -6.2 to -1.2), compared to the control group. At 6 years of age, children in the intervention group had lower waist circumference (-1.3 cm; 95% CI = -2.7 to -0.0), triceps (-1.3 mm; 95% CI = -2.5 to -0.0) and subscapular skinfolds (-1.3 mm; 16 95% CI = -2.6 to -0.0) thickness measurements compared to those in the control group. CONCLUSIONS The health workers training to promote infant healthy feeding practices resulted in lower energy, carbohydrates and fat intake at 3 years and lower waist circumference, triceps and subscapular skinfolds measurements at 6 years.
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Affiliation(s)
- Caroline N Sangalli
- Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Paula S Leffa
- Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Júlia L Valmórbida
- Graduate Program in Pediatrics: Child and Adolescent Health Care, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - L H Lumey
- Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA
| | - Márcia R Vitolo
- Graduate Program in Pediatrics: Child and Adolescent Health Care, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
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Saxe-Custack A, Goldsworthy M, Lofton HC, Hanna-Attisha M, Nweke O. Family Perceptions of a Cooking and Nutrition Program for Low-Income Children and Adolescents. Glob Pediatr Health 2021; 8:2333794X21989525. [PMID: 33614838 PMCID: PMC7868466 DOI: 10.1177/2333794x21989525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 11/04/2020] [Accepted: 12/31/2020] [Indexed: 11/16/2022] Open
Abstract
Background. Flint Kids Cook, a nutrition and culinary program for children and adolescents, was created in October 2017 to address health concerns among youth and families in a low-income, urban community. In this study, researchers examined family experiences with the 6-week, chef-led program, which was taught in a farmers' market kitchen. Methods. At the conclusion of each session, researchers used an open-ended focus group format to assess program experiences, perceived impact on youth self-efficacy for cooking and healthy eating, and caregiver support. This qualitative study was guided by thematic analysis. Results. Between November 2017 and December 2018, 72 caregivers (n = 38) and students (n = 34) participated in separate focus groups. Caregivers were primarily female (74%) and African American (71%). Most students were African American (76%) and half were female. Recurrent themes included food acceptance, dietary modifications, confidence in the kitchen, and program design. Caregivers and students agreed that location and design of the program alongside facilitation by an experienced chef were important factors for program success. Conclusions. This study demonstrated that a chef-led healthy cooking program for youth was effective in improving perceived food acceptance, dietary habits, and confidence in the kitchen. The program could be modeled in similar communities to address diet and health of children and adolescents.
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Affiliation(s)
- Amy Saxe-Custack
- Michigan State University-Hurley Children's Hospital Pediatric Public Health Initiative, Flint, MI, USA
| | - Mallory Goldsworthy
- Michigan State University-Hurley Children's Hospital Pediatric Public Health Initiative, Flint, MI, USA
| | | | - Mona Hanna-Attisha
- Michigan State University-Hurley Children's Hospital Pediatric Public Health Initiative, Flint, MI, USA
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12
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Appannah G, Murray K, Trapp G, Dymock M, Oddy WH, Ambrosini GL. Dietary pattern trajectories across adolescence and early adulthood and their associations with childhood and parental factors. Am J Clin Nutr 2021; 113:36-46. [PMID: 33181820 DOI: 10.1093/ajcn/nqaa281] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 09/14/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Although adolescent dietary patterns tend to be of poor quality, it is unclear whether dietary patterns established in adolescence persist into adulthood. OBJECTIVES We examined trajectories across adolescence and early adulthood for 2 major dietary patterns and their associations with childhood and parental factors. METHODS Using data from the Western Australian Pregnancy Cohort (Raine Study), intakes of 38 food groups were estimated at ages 14, 17, 20 and 22 y in 1414 participants using evaluated FFQs. Using factor analysis, 2 major dietary patterns (healthy and Western) were consistently identified across follow-ups. Sex-specific group-based modeling assessed the variation in individual dietary pattern z scores to identify group trajectories for each pattern between ages 14 and 22 y and to assess their associations with childhood and parental factors. RESULTS Two major trajectory groups were identified for each pattern. Between ages 14 and 22 y, a majority of the cohort (70% males, 73% females) formed a trajectory group with consistently low z scores for the healthy dietary pattern. The remainder had trajectories showing either declining (27% females) or reasonably consistent healthy dietary pattern z scores (30% males). For the Western dietary pattern, the majority formed trajectories with reasonably consistent average scores (79% males, 81% females) or low scores that declined over time. However, 21% of males had a trajectory of steady, marked increases in Western dietary pattern scores over time. A lower maternal education and higher BMI (in kg/m2) were positively associated with consistently lower scores of the healthy dietary pattern. Lower family income, family functioning score, maternal age, and being in a single-parent family were positively related to higher scores of the Western dietary pattern. CONCLUSIONS Poor dietary patterns established in adolescence are likely to track into early adulthood, particularly in males. This study highlights the transition between adolescence and early adulthood as a critical period and the populations that could benefit from dietary interventions.
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Affiliation(s)
- Geeta Appannah
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Kevin Murray
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia
| | - Gina Trapp
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia.,Telethon Kids Institute, Northern Entrance, Perth Children's Hospital, Perth, Western Australia
| | - Michael Dymock
- Centre for Applied Statistics, The University of Western Australia, Perth, Western Australia
| | - Wendy Hazel Oddy
- Menzies Institute for Medical Research, University of Tasmania, Medical Science Precinct, Hobart, Tasmania, Australia
| | - Gina Leslie Ambrosini
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia
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Yan H, Dang S, Zhang Y, Luo S. Dietary patterns of Chinese women of childbearing age during pregnancy and their relationship to the neonatal birth weight. Nutr J 2020; 19:89. [PMID: 32847595 PMCID: PMC7449039 DOI: 10.1186/s12937-020-00607-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 08/17/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To examine the type of maternal dietary patterns during pregnancy and the distribution characteristics of children's birth weight and the association between dietary patterns and neonatal birth weight in China. METHODS Data were derived from a cross-sectional program named "The prevalence and risk factors of birth defects in Shaanxi Province" in July to November in 2013. A stratified multistage random sampling method was used to select women and their children. The mother's diet during pregnancy was investigated using semi-quantitative food frequency questionnaire (FFQ) to collect the frequency and amount of food consumption, and the newborn birth weight as well as related social demographic information was collected at the same time. In our study, 0-1 year old children and their mothers with complete dietary survey data were selected as research objects. The main dietary patterns were identified according to factor analysis, and latent class analysis (LCA) was used to investigate the social demographic factors affecting dietary patterns. The logistic regression model was used to assess the association between birth weight and maternal dietary patterns during pregnancy by establishing three adjusting models and the data were stratified for further analysis by urban-rural and regions. RESULTS A total of 15,980 participants were involved in this study. Four dietary patterns were identified: "vegetarian pattern", "balance pattern", "traditional pattern" and "processing pattern". Compared with moderate tertile, women in the highest tertile of adherence to vegetarian pattern increased the risk of low birth weight in offspring in rural areas (OR = 1.61, 95%CI:1.06-2.93) and middle region (OR = 1.75, 95%CI:1.18-2.62), and the traditional pattern had greater odds of lower birth weight in the middle region (OR = 1.55, 95%CI:1.05-3.75). The processing pattern was found a protective factor for the occurrence of low birth weight in rural areas (OR = 0.98, 95%CI:0.43-0.99) but was a risk factor for low birth weight in the southern region (OR = 8.83, 95%CI:1.22-15.16). The balance pattern was a protective factor for the occurrence of low birth weight in the northern region(OR = 0.35, 95%CI:0.14-0.83). CONCLUSION The vegetarian and traditional pattern may be positively related to a higher risk of low birth weight while the balanced pattern may keep birth weight of offspring within the appropriate range. Health education of balanced diet and individual nutrition guidance during pregnancy should be strengthened, to make the dietary structure during pregnancy are more reasonable, reduce the occurrence of adverse birth weight of newborns.
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Affiliation(s)
- Hui Yan
- The Children’s Hospital Affiliaten to Zhengzhou University; Henan Children’s Hospital, Zhengzhou Children’s Hospital, Zhengzhou, 450018 China
| | - Shaonong Dang
- School of Public Health, Xi’an Jiaotong University, Xi’an, 710061 China
| | - Yaodong Zhang
- The Children’s Hospital Affiliaten to Zhengzhou University; Henan Children’s Hospital, Zhengzhou Children’s Hospital, Zhengzhou, 450018 China
| | - Shuying Luo
- The Children’s Hospital Affiliaten to Zhengzhou University; Henan Children’s Hospital, Zhengzhou Children’s Hospital, Zhengzhou, 450018 China
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Saxe-Custack A, Sadler R, LaChance J, Hanna-Attisha M, Ceja T. Participation in a Fruit and Vegetable Prescription Program for Pediatric Patients is Positively Associated with Farmers' Market Shopping. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124202. [PMID: 32545578 PMCID: PMC7344709 DOI: 10.3390/ijerph17124202] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/05/2020] [Accepted: 06/08/2020] [Indexed: 12/16/2022]
Abstract
Objectives: The primary objective was to investigate the association between participation in a farmers’ market fruit and vegetable prescription program (FVPP) for pediatric patients and farmers’ market shopping. Methods: This survey-based cross-sectional study assessed data from a convenience sample of 157 caregivers at an urban pediatric clinic co-located with a farmers’ market. Prescription redemption was restricted to the farmers’ market. Data were examined using chi-square analysis and independent samples t-tests. Results: Approximately 65% of respondents participated in the FVPP. Those who received one or more prescriptions were significantly more likely to shop at the farmers’ market during the previous month when compared to those who never received a prescription (p = 0.005). Conclusions: This is the first study to demonstrate that participation in a FVPP for pediatric patients is positively associated with farmers’ market shopping.
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Affiliation(s)
- Amy Saxe-Custack
- Department of Food Science and Human Nutrition, Division of Public Health, Michigan State University-Hurley Children’s Hospital Pediatric Public Health Initiative, Flint, MI 48502, USA
- Correspondence:
| | - Richard Sadler
- Department of Family Medicine, Division of Public Health, Michigan State University College of Human Medicine, Flint, MI 48502, USA;
| | - Jenny LaChance
- Division of Public Health, Michigan State University-Hurley Children’s Hospital Pediatric Public Health Initiative, Flint, MI 48502, USA; (J.L.); (T.C.)
| | - Mona Hanna-Attisha
- Department of Pediatrics and Human Development, Division of Public Health, Michigan State University-Hurley Children’s Hospital Pediatric Public Health Initiative, Flint, MI 48502, USA;
| | - Tiffany Ceja
- Division of Public Health, Michigan State University-Hurley Children’s Hospital Pediatric Public Health Initiative, Flint, MI 48502, USA; (J.L.); (T.C.)
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15
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Child Consumption of Whole Fruit and Fruit Juice Following Six Months of Exposure to a Pediatric Fruit and Vegetable Prescription Program. Nutrients 2019; 12:nu12010025. [PMID: 31877635 PMCID: PMC7019436 DOI: 10.3390/nu12010025] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 12/17/2019] [Accepted: 12/18/2019] [Indexed: 12/16/2022] Open
Abstract
Public health recommendations suggest limiting child consumption of fruit juice in favor of whole fruit due to juice’s high sugar content, lack of fruit fiber, and potential for excess intake. However, replacing juice with whole fruit may be particularly challenging for low-income and minority children, who report the highest intake of 100% juice. To address access and affordability challenges among low-income children, researchers partnered with pediatricians in an urban food desert community, to introduce a fruit and vegetable prescription program (FVPP) that provided a $15 prescription for fresh produce to every child during each office visit. Participating vendors included a farmers’ market and local mobile market. This study assessed changes in daily consumption of total fruit and whole fruit among 108 pediatric patients following six months of exposure to the FVPP. Child-reported mean daily intake of whole fruit increased significantly from the baseline to the 6-month follow-up (p = 0.03): 44% of children reported an increased intake of at least ¼ cup per day, and 30% reported an increased intake of at least ½ cup per day. Changes in total fruit intake (including fruit juice) were not significant. Results suggest a pediatric FVPP may have meaningful impacts on children’s dietary behaviors, particularly with regard to the intake of whole fruits.
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17
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Fruit and Vegetable Prescriptions for Pediatric Patients Living in Flint, Michigan: A Cross-Sectional Study of Food Security and Dietary Patterns at Baseline. Nutrients 2019; 11:nu11061423. [PMID: 31242555 PMCID: PMC6627167 DOI: 10.3390/nu11061423] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 06/18/2019] [Accepted: 06/19/2019] [Indexed: 01/31/2023] Open
Abstract
Though fruit and vegetable consumption is essential for disease prevention and health maintenance, intake among children fails to meet dietary recommendations. Limited access to and the affordability of fresh produce, particularly among low-income youth, are barriers to adequate intake. To address these challenges, researchers and pediatricians in Flint, Michigan, expanded a successful fruit and vegetable prescription program that provides one $15 prescription for fresh fruits and vegetables to every child at every office visit. Vendors include the downtown farmers' market and a local mobile market. This study describes baseline characteristics, dietary patterns, food access, and food security among 261 caregiver-child dyads enrolled August 2018-March 2019. The child-reported mean daily intake of vegetables (0.72 cups ± 0.77), dairy products (1.33 cups ± 1.22), and whole grains (0.51 ounces ± 0.49) were well below recommendations. Furthermore, 53% of children and 49% of caregivers who completed the food security module indicated low or very low food security. However, there were no statistically significant differences in the child consumption of fruits and vegetables between households that reported high versus low food security (p > 0.05). Results validate and raise deep concerns about poor dietary patterns and food insecurity issues facing Flint children, many of whom continue to battle with an ongoing drinking water crisis. Additional poverty-mitigating efforts, such as fruit and vegetable prescription programs, are necessary to address these gaps.
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Dietary Patterns and Association with Obesity of Children Aged 6⁻17 Years in Medium and Small Cities in China: Findings from the CNHS 2010⁻2012. Nutrients 2018; 11:nu11010003. [PMID: 30577428 PMCID: PMC6356437 DOI: 10.3390/nu11010003] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 11/16/2018] [Accepted: 11/30/2018] [Indexed: 12/20/2022] Open
Abstract
Childhood obesity is associated with both near- and longer-term health implications. Few studies have been conducted to explore the associations between dietary patterns and obesity among Chinese children and adolescents. The present study was designed to identify dietary patterns and their relationships with childhood obesity in medium and small cities. This is a cross-sectional study of children participants aged 6⁻17 years old in the 2010⁻2012 China Nutrition and Health Survey (CNHS). Socio-demographics, life-style, physical activity, anthropometric variables, and hundred-item food frequency questionnaires (FFQs) were collected. Household income was classified as low, middle, and high. Traffic tools, from non-advanced to advanced, included walking, biking, bus, and car. Dietary patterns were identified using factor analysis of data from FFQs. Two dietary patterns were identified: a Westernized pattern (i.e., high cakes, snacks, sugary beverages, aquatic products, red meat, fruits, and nuts) and a Traditional Chinese pattern (i.e., high cereals, tubers, legumes, fried cereal food, and vegetables). The Westernized pattern was positively correlated with energy intake, household income, traffic tools, and negative correlated with age and housework time. The Traditional Chinese pattern was positively correlated with age, energy intake, and housework time, and negatively correlated with household income and traffic tools. After adjusting for confounding factors, the Westernized pattern was found to be associated with BMI increment, yielding β coefficients (95% confidence interval, 95% CI) of 0.57 (0.40, 0.85) for the fourth quartile. In addition, the Westernized pattern was also found to be significantly associated with an increased risk of obesity, yielding an odds ratio (OR, 95% CI) of 1.49 (1.21, 1.84) from fully-adjusted confounders. Promoting healthier eating patterns could help to prevent obesity in Chinese children. The findings of this study could be used to guide the development of evidence-based preventive nutrition interventions to curb childhood obesity epidemic in small⁻medium cities in China.
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