Socioeconomic status and lifestyle factors modifies the association between snack foods intake and incidence of metabolic syndrome

Children's executive functioning and health behaviors across pediatric life stages and ecological contexts

Executive functioning (EF) has been linked to chronic disease risk in children. Health behaviors are thought to partially explain this association. The current cross-sectional study evaluated specific domains of EF and varied health behaviors in three pediatric life stages. Pediatric participants (early childhood n = 2074, Mage = 6.4 ± 0.9 y; middle childhood n = 3230, Mage = 9.6 ± 1.2 y; adolescence n = 1416, Mage = 15.2 ± 1.7 y) were part of the Environmental influences on Child Health Outcomes (ECHO) Program. They completed neurocognitive tasks measuring cognitive flexibility, behavioral inhibition, and working memory. Parent- and/or child-report measures of dietary intake, physical activity, sleep duration and quality, income, and positive parenting were also collected. Neighborhood crime and greenspace were calculated from publicly available census-tract level indices. After adjusting for study site, child body mass index, and demographics, working memory was related in the hypothesized direction to several dietary behaviors within all pediatric life stages. Working memory and cognitive flexibility were positively related to physical activity in middle childhood and adolescence. In adolescence, behavioral inhibition was positively related to physical activity and inversely related to sugar-sweetened beverage and total caloric intake. Associations with sleep were all non-significant. All significant associations reflected small effect sizes. Income, positive parenting, greenspace, and crime did not significantly influence any of the EF-health behavior associations. Findings highlight the need to consider EF domains, specific health behaviors, and developmental stage in creating intervention strategies that target EF to improve health behaviors. The small effect sizes reinforce the need for multi-tiered interventions to maximize health.

Health Behavior Adherence in a Metropolitan-Based Metabolic Syndrome Management Program during the COVID-19 Pandemic

Background

The COVID-19 pandemic increased the worldwide prevalence of metabolic syndrome. The purpose of this study was to assess health behavior adherence during the pandemic in adults who had engaged in a metabolic syndrome management program for at least 6 months. This assessment included an evaluation of health behavior changes, factors influencing adherence, and clinical parameters. The city-wide program was operated by the Seoul Metropolitan Government.

Methods

Baseline and follow-up data were compared in 116 participants who engaged in the program for at least 6 months prior to the pandemic. Health behaviors and clinical parameters were examined. Generalized estimating equation analysis was used to identify sociodemographic variables influencing health behavior adherence over time.

Results

Systolic blood pressure, waist circumference, and blood glucose improved (all P<0.05), and risk factors decreased (P<0.001) from baseline to follow-up (mean±standard deviation, 1.13±0.91 years). All six health behaviors, physical activity and weight control, eating habits, alcohol consumption and smoking, stress management, sleep and rest, and medication compliance and medical examination improved (all P<0.001) from baseline to follow-up (2.37±1.05 years). Smoking and employment negatively influenced adherence to health behaviors (P<0.05). Participants felt the most beneficial part of the program was receiving sequential medical examination results with follow-up consultations by public health professionals without charge.

Conclusion

Our study demonstrated the durability of the impact of the Seoul Program on all six targeted health behaviors as well as clinical parameters. Findings encourage participation in such broad-based programs and development of novel approaches to facilitate success for smokers and employed participants.

Association of main meal frequency and skipping with metabolic syndrome in Korean adults: a cross-sectional study

BACKGROUND

Reduced meal frequency can increase the risk of metabolic syndrome (MetS). However, limited studies have examined the association between meal frequency and skipping meals with MetS. This study aims to analyze the association between main meal frequency and meal skipping with MetS in Korean adults aged ≥ 19 years.

METHODS

In this study, we included data from 22,699 Korean adult participants from the 2016-2020 Korea National Health and Nutrition Examination Survey (KNHANES). The 24-h dietary recall method was used to classify the participants into three groups based on main meal frequency (one, two, or three meals per day) and seven groups based on the type of main meal they skipped. Multivariable logistic regression analysis was conducted to determine the association between main meal frequency and the types of main meals skipped with the odds of MetS and its associated components. Appropriate estimates were accounted for using sampling weights, stratification, and clustering.

RESULTS

The prevalence of MetS in the study population was 33.8%. The average age of the participants was 47.2 years with 42.6% being men, and 57.4% being women. Men who consumed two meals per day had higher odds of MetS than those who consumed three meals per day (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.01-1.33). Women who consumed two meals per day, and skipped breakfast had increased odds of having elevated fasting blood glucose levels (OR 1.18, 95% CI 1.02-1.35), and elevated triglycerides (OR 1.19, 95% CI 1.02-1.39). However, women who skipped dinner had reduced odds of having elevated fasting blood glucose levels (OR 0.74, 95% CI 0.58-0.94).

CONCLUSIONS

Our findings suggest that meal frequency and the type of main meal skipped may be associated with MetS and emphasize the importance of consuming breakfast to prevent MetS.

Seven decades of Ramadan intermittent fasting research: Bibliometrics analysis, global trends, and future directions

BACKGROUND AND AIMS

There is a large body of research focused on various aspects related to Ramadan intermittent fasting (RIF) and human health and disease. This study aimed to quantify the bibliometric data of RIF medical research over the past seven decades and explore these variables qualitatively via text mining analysis.

METHODS

We used the Scopus search engine to identify published articles related to RIF from inception to December 31, 2021. All types of research articles were included. Scientometric and bibliometric measures were determined using Excel, Biblioshiny, and VOSviewer. This study proposed a bibliometric and text mining method to qualitatively and quantitatively recognize the RIF research trend.

RESULTS

The Scopus search returned 1915 relevant articles. Most citations pertained to publications from the last two decades, and most publications were original research articles. These publications had received around 27,000 citations, and the 20 most prolific publishing journals had an average h-index of 112.25. More than one-third of all medical publications were in open-access journals. There was a 13-fold increase in medical research on RIF over the past few decades. We identified the 10 most prolific publishing countries, institutes, journals, and authors. We also identified five scientific hotspots of RIF scientific literature, which were: diabetes, metabolic health, public health, physiology, and maternity.

CONCLUSION

This is the first comprehensive bibliometric analysis of medical research related to RIF. The research gaps identified will shape future research directions and foster collaborative research activities toward enhanced medical nutrition research revolving around RIF.

Snacking pattern of college students in Saudi Arabia: a cross-sectional study

BACKGROUND

Although unhealthy snack foods are commonly consumed by college students, snacking patterns among college students have not been comprehensively examined in Saudi Arabia. In our study, we aimed to investigate snacking patterns among Saudi college students and to assess sociodemographic data that affect adherence to these snacking patterns.

METHODS

Between January 2021 and March 2021 in Jeddah, Saudi Arabia, an online survey was conducted with 662 college students from a Saudi university. The survey included sociodemographic questions and a short food frequency questionnaire (FFQ) regarding the consumption of common snack foods. Snacking patterns were generated from the FFQ using the factor analysis method.

RESULTS

Factor analyses generated seven snacking patterns, which explained 64.5% of the variance in snacking. Students in their early academic years (1-3 years) had a higher score for the convenience snack and fast-food pattern (0.22 ± 0.48 and 0.31 ± 0.52, respectively) than senior students (4-6 years) (P = 0.03 and 0.04, respectively). Healthy snacks patterns were higher among students at higher income levels (P = 0.006) and active students (P < 0.001) than among students at low- or mid-income levels and inactive students. Higher adherence to the beverages pattern was observed among male students (P = 0.03), active students (P = 0.01), and students with obesity than their counterparts (P = 0.02). The dairy products pattern was higher among male students (P = 0.04), students at higher income levels (P = 0.04), and students with obesity (P = 0.03) than their counterparts.

CONCLUSIONS

Most snacking patterns identified among the study participants were considered unhealthy. Adherence to healthy snacks is influenced by physical activity and family income. These findings may be helpful in the future for developing adequate nutrition education programs that promote health by adhering to healthy snack choices in this critical age group. Further studies are needed to confirm these findings and to investigate snacking patterns among other age groups in Saudi Arabia.

Impact of the Intake of Snacks and Lifestyle Behaviors on Obesity among University Students Living in Jeddah, Saudi Arabia

Unhealthy eating habits increase the risk of obesity. This study investigated the association between obesity and the intake of snacks and lifestyle behaviors among university students in Saudi Arabia. The study included 662 students aged 18–29 years, studying at King Abdulaziz University. An online survey collected data on sociodemographic characteristics, height, and weight, to calculate body mass index (BMI), lifestyle behaviors, dietary habits, and snack intake. The prevalence of overweight and obese students was 18.6% and 12.7%, respectively. Sociodemographic characteristics and lifestyle behaviors had insignificant effects on obesity. Obese students consumed two meals daily and more cereals during breakfast. Non-obese students consumed more beverages at breakfast and had their daily meals with their families. The frequency of intake of snacks had an insignificant effect on obesity. However, obese students had a significantly higher intake of potato chips, popcorn, and biscuits, while non-obese students had a significantly higher intake of salads compared with obese students. Students consumed significantly less fruit and vegetables, chocolate, biscuits, nuts, and dairy products as snacks when inside the university compared to outside. To reduce obesity among students, universities should ensure access to healthy snacks, and provide health education programs to encourage healthy eating habits and lifestyles.

College Students' Perception of Snacks Sold in Vending Machines in the US: A Mixed-Methods Study

Introduction: Food in vending machines in US colleges contain limited nutritious foods available for purchase, which could affect the food choices made by students leading to poor diet quality. Interventions to improve college foodscapes usually follow a top-down approach and fail to affect dietary behavioral changes ultimately. This research aims to uncover what students want and ways to achieve change.

Methods: The mixed-methods approach included peer-led qualitative focus group discussions and a brief quantitative questionnaire on satisfaction from foods available in vending machines. A convenience sample of 20 students (15 females) was recruited from a Hispanic serving institution for this study.

Results: Vending machines were perceived as convenient, plentiful, and unhealthy. Students expressed dissatisfaction with both the variety and nutritional quality of snacks in vending machines. Suggestions for improvement included more fresh items (fruits and vegetables) and refrigerated items with higher protein content (low-fat yogurt, hummus, and peanut butter). To implement these improvements, participants discussed the cost and feasibility of perishable items. Increasing awareness and partnering strategies were proposed to mediate potential cost and buy-in obstacles as was elevating the appeal of healthy vending machines with technological enhancements that draw customers in and educate.

Conclusion and Implication for Practice: This group of college students was eager for positive changes in foods sold in vending machines and understand the major difficulties. The suggested changes may help this and other colleges develop policies to regulate the foods in vending machines to promote overall health and help prevent chronic diseases in the future.