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Ramirez A, Fox K, Melo Herrera Y, Gans KM, Risica PM, McCurdy K, Jennings E, Tovar A. Goals, Barriers, and Facilitators of Caregivers Who Participated in an In-Home Intervention to Improve Food Parenting Practices and Child Diet Quality. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:521-531. [PMID: 38691079 PMCID: PMC11305948 DOI: 10.1016/j.jneb.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/28/2024] [Accepted: 04/01/2024] [Indexed: 05/03/2024]
Abstract
OBJECTIVE To explore the goals, barriers, and facilitators set by caregivers of preschool-aged children to improve food parenting practices and household food environments. DESIGN Secondary qualitative analysis of collaborative goal sheets completed during in-home and telephone visits as part of a home-based pilot intervention. PARTICIPANTS Thirty-three Hispanic/Latinx caregivers, predominantly of low income. PHENOMENON OF INTEREST Patterns in goal content and anticipated barriers and facilitators. ANALYSIS Thematic analysis of goal sheets with a mixed inductive-deductive approach. RESULTS Almost half of the goals were to support a healthy environment (40.7%) by increasing the availability of healthy foods through food shopping and meal planning. Other goals were to increase structure (33.7%) by establishing food-related routines and decreasing distractions. Goals related to autonomy support (25.4%) included involving their children (eg, cooking together). Caregivers' perceived barriers encompass individual (eg, stress, lack of time), interpersonal (eg, other family members' eating behaviors), and environmental-level (eg, food availability) factors. Caregivers only identified facilitators at the individual and interpersonal levels (eg, motivation). CONCLUSIONS AND IMPLICATIONS Understanding goals, barriers, and facilitators can be used to tailor key messages to improve food parenting practices and children's diets. Future interventions can target broader environmental barriers while increasing awareness of individual, interpersonal, and environmental-level facilitators.
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Affiliation(s)
- Andrea Ramirez
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI.
| | - Katelyn Fox
- Weight Control and Diabetes Research Center, The Miriam Hospital & Alpert Medical School of Brown University, Providence, RI
| | | | - Kim M Gans
- Human Development and Family Sciences, University of Connecticut, Storrs, CT
| | | | - Karen McCurdy
- Department of Human Development and Family Science, University of Rhode Island, Kingston, RI
| | - Ernestine Jennings
- Department of Psychiatry and Human Behavior, The Miriam Hospital & Alpert Medical School of Brown University, Providence, RI
| | - Alison Tovar
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI
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Lawson Y, Mpasi P, Young M, Comerford K, Mitchell E. A review of dairy food intake for improving health among black infants, toddlers, and young children in the US. J Natl Med Assoc 2024; 116:228-240. [PMID: 38360504 DOI: 10.1016/j.jnma.2024.01.014] [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: 01/11/2024] [Accepted: 01/12/2024] [Indexed: 02/17/2024]
Abstract
Adequate nutrition is paramount for proper growth and musculoskeletal, neurocognitive, and immunological development in infants, toddlers, and young children. Among breastfeeding mother-child dyads, this critical window of development, is impacted by both maternal and offspring dietary patterns. For mothers, their dietary patterns impact not only their own health and well-being, but also the nutrition of their breast milk - which is recommended as the sole source of food for the first 6 months of their infant's life, and as a complementary source of nutrition until at least 2 years of age. For infants and toddlers, the breast milk, formulas, and first foods they consume can have both short-term and long-term effects on their health and well-being - with important impacts on their taste perception, microbiome composition, and immune function. According to dietary intake data in the US, infants and young children meet a greater number of nutrient requirements than older children and adults, yet numerous disparities among socially disadvantaged racial/ethnic groups still provide significant challenges to achieving adequate nutrition during these early life stages. For example, Black children are at greater risk for disparities in breastfeeding, age-inappropriate complementary feeding patterns, nutrient inadequacies, food insecurity, and obesity relative to most other racial/ethnic groups in the US. For infants who do not receive adequate breast milk, which includes a disproportionate number of Black infants, dairy-based infant formulas are considered the next best option for meeting nutritional needs. Fermented dairy foods (e.g., yogurt, cheese) can serve as ideal first foods for complementary feeding, and cow's milk is recommended for introduction during the transitional feeding period to help meet the nutrient demands during this phase of rapid growth and development. Low dairy intake may put children at risk for multiple nutrient inadequacies and health disparities - some of which may have lifelong consequences on physical and mental health. A burgeoning body of research shows that in addition to breast milk, cow's milk and other dairy foods may play critical roles in supporting physical growth, neurodevelopment, immune function, and a healthy gut microbiome in early life. However, most of this research so far has been conducted in White populations and can only be extrapolated to Black infants, toddlers, and young children. Therefore, to better understand and support the health and development of this population, greater research and education efforts on the role of milk and dairy products are urgently needed. This review presents the current evidence on health disparities faced by Black children in the US from birth to four years of age, and the role that dairy foods can play in supporting the normal growth and development of this vulnerable population.
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Affiliation(s)
- Yolanda Lawson
- Associate Attending, Baylor University Medical Center, Dallas, TX, United States
| | - Priscilla Mpasi
- ChristianaCare Health System, Assistant Clinical Director Complex Care and Community Medicine, Wilmington, DE, United States
| | - Michal Young
- Emeritus, Howard University College of Medicine, Department of Pediatrics and Child Health, Washington D.C., United States
| | - Kevin Comerford
- OMNI Nutrition Science; California Dairy Research Foundation, Davis, CA, United States.
| | - Edith Mitchell
- Sidney Kimmel Cancer at Jefferson, Philadelphia, PA, United States
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Tsai MM, Anderson CE, Whaley SE, Yepez CE, Ritchie LD, Au LE. Associations of Increased WIC Benefits for Fruits and Vegetables With Food Security and Satisfaction by Race and Ethnicity. Prev Chronic Dis 2024; 21:E19. [PMID: 38547021 PMCID: PMC10996387 DOI: 10.5888/pcd21.230288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024] Open
Abstract
Introduction The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides nutrition support for racially and ethnically diverse populations. In 2021, the monthly cash value benefit (CVB) for the purchase of fruits and vegetables increased from $9 to $35 and was later adjusted to $24. This study investigated, by racial and ethnic groups, whether CVB increases were associated with increases in CVB redemption, household food security, child fruit and vegetable intake, satisfaction with CVB amount, and likelihood of continued participation in WIC if the CVB returned to $9 per month. Methods We conducted a longitudinal study of WIC participants (N = 1,770) in southern California at 3 time points, from April 2021 through May 2022; the CVB amount was $9 at baseline, $35 at Survey 2, and $24 at Survey 3. Racial and ethnic groups were Hispanic English-speakers, Hispanic Spanish-speakers, non-Hispanic Asian, non-Hispanic Black, non-Hispanic Other, and non-Hispanic White. We used mixed-effect and modified Poisson regressions to evaluate outcomes by group. Results At baseline, groups differed significantly in dollars of CVB redeemed, percentage of CVB redeemed, household food security, and satisfaction with CVB amount. After the increase in CVB, we found increases in all groups in CVB redemption, household food security, and satisfaction. Non-Hispanic Black and Hispanic English-speaking groups, who had low levels of satisfaction at baseline, had larger increases in satisfaction than other groups. Reported likelihood of continued WIC participation if the monthly CVB returned to $9 also differed significantly by group, ranging from 62.5% to 90.0%. Conclusion The increase in CVB for children receiving WIC benefited all racial and ethnic groups. Continued investment in an augmented CVB could improve health outcomes for a racially and ethnically diverse WIC population.
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Affiliation(s)
- Marisa M Tsai
- Nutrition Policy Institute, University of California, Division of Agriculture and Natural Resources, Oakland, California
- University of California, Division of Agriculture and Natural Resources, 1111 Franklin St, 11th Floor, Oakland, CA 94607
| | - Christopher E Anderson
- Public Health Foundation Enterprises WIC Program, Division of Research and Evaluation, City of Industry, California
| | - Shannon E Whaley
- Public Health Foundation Enterprises WIC Program, Division of Research and Evaluation, City of Industry, California
| | - Catherine E Yepez
- Public Health Foundation Enterprises WIC Program, Division of Research and Evaluation, City of Industry, California
| | - Lorrene D Ritchie
- Nutrition Policy Institute, University of California, Division of Agriculture and Natural Resources, Oakland, California
| | - Lauren E Au
- Department of Nutrition, University of California, Davis
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Heerman WJ, Kenney E, Block JP, Fiechtner L, McMahon E, Kruse L, Sharifi M, Edmondson EK, Virudachalam S. A Narrative Review of Public Health Interventions for Childhood Obesity. Curr Obes Rep 2024; 13:87-97. [PMID: 38172483 DOI: 10.1007/s13679-023-00550-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/05/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE OF REVIEW Public health interventions that intervene on macrolevel systems hold the promise of reducing childhood obesity at the population level through prevention. The purpose of this review is to highlight some of the recent and best scientific evidence related to public health interventions for the prevention of childhood obesity. We provide a narrative review of scientific evidence for six categories of public health interventions and their impact on childhood obesity: federal nutrition assistance programs, programs implemented in early care and education centers, interventions to support healthy nutrition and physical activity in schools, community-based programs and policies, labeling policies and marketing to children, and taxes on sugar sweetened beverages (SSB). RECENT FINDINGS Federal nutrition assistance programs have the strongest evidence to support reduction in childhood obesity and serve populations with the highest prevalence of childhood obesity. Other interventions including SSB taxes, community-wide interventions, and interventions at schools and early care and education centers also show significant improvements in child weight status. Overall public health interventions have strong evidence to support widespread implementation in service of reducing childhood obesity rates at the population level. To effectively address the recalcitrant childhood obesity epidemic, multi-pronged solutions are needed. The current evidence for public health obesity interventions is consistent with the paradigm that recognizes the importance of macrolevel systems influences on childhood obesity: interventions that are most effective intervene at macrolevels.
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Affiliation(s)
- William J Heerman
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, USA.
| | - Erica Kenney
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Jason P Block
- Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, USA
| | - Lauren Fiechtner
- Division of Pediatric Gastroenterology and Nutrition, Mass General for Children, The Greater Boston Food Bank, Boston, USA
| | - Ellen McMahon
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, USA
| | - Lauren Kruse
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, USA
| | - Mona Sharifi
- Department of Pediatrics, Yale School of Medicine, New Haven, USA
| | - Emma K Edmondson
- Department of Pediatrics and Leonard Davis Institute of Health Economics at University of Pennsylvania Perelman School of Medicine, Division of General Pediatrics, PolicyLab, and Clinical Futures at Children's Hospital of Philadelphia, Philadelphia, USA
| | - Senbagam Virudachalam
- Department of Pediatrics and Leonard Davis Institute of Health Economics at University of Pennsylvania Perelman School of Medicine, Division of General Pediatrics, PolicyLab, and Clinical Futures at Children's Hospital of Philadelphia, Philadelphia, USA
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Duh-Leong C, Ortiz R, Messito MJ, Katzow MW, Kim CN, Teli R, Gross RS. Household Food Insecurity and Maternal-Toddler Fruit and Vegetable Dietary Concordance. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:100-109. [PMID: 38142387 PMCID: PMC10922249 DOI: 10.1016/j.jneb.2023.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 10/28/2023] [Accepted: 10/31/2023] [Indexed: 12/25/2023]
Abstract
OBJECTIVE To examine whether prenatal or concurrent household food insecurity influences associations between maternal and toddler fruit and vegetable (FV) intake. DESIGN Application of a life-course framework to an analysis of a longitudinal dataset. SETTING Early childhood obesity prevention program at a New York City public hospital. PARTICIPANTS One-hundred and fifty-six maternal-toddler dyads self-identifying as Hispanic or Latino. VARIABLES MEASURED Maternal and toddler FV intake was measured using Centers for Disease Control and Prevention dietary measures when toddlers were aged 19 months. Household food insecurity (measured prenatally and concurrently at 19 months) was measured using the US Department of Agriculture Food Security Module. ANALYSIS Regression analyses assessed associations between adequate maternal FV intake and toddler FV intake. Interaction terms tested whether prenatal or concurrent household food insecurity moderated this association. RESULTS Adequate maternal FV intake was associated with increased toddler FV intake (B = 6.2 times/wk, 95% confidence interval, 2.0-10.5, P = 0.004). Prenatal household food insecurity was associated with decreased toddler FV intake (B = -6.3 times/wk, 95% confidence interval, -11.67 to -0.9, P = 0.02). There was a significant interaction between the level of maternal-toddler FV association (concordance or similarity in FV intake between mothers and toddlers) and the presence of food insecurity such that maternal-toddler FV association was greater when prenatal household food insecurity was not present (B = -11.6, P = 0.04). CONCLUSIONS AND IMPLICATIONS Strategies to increase FV intake across the life course could examine how the timing of household food insecurity may affect intergenerational maternal-child transmission of dietary practices.
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Affiliation(s)
- Carol Duh-Leong
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY.
| | - Robin Ortiz
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY; Department of Population Health, New York University Grossman School of Medicine, New York, NY; Institute for Excellence in Health Equity, New York University Langone Health, New York, NY
| | - Mary Jo Messito
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY
| | - Michelle W Katzow
- Department of Pediatrics, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY
| | - Christina N Kim
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY; Department of Population Health, New York University Grossman School of Medicine, New York, NY
| | - Radhika Teli
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY; Department of Population Health, New York University Grossman School of Medicine, New York, NY
| | - Rachel S Gross
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY; Department of Population Health, New York University Grossman School of Medicine, New York, NY
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Sanjeevi N, Monsivais P. Consumption Trends and Eating Context of Lentils and Dried Peas in the United States: A Nationally Representative Study. Nutrients 2024; 16:277. [PMID: 38257171 PMCID: PMC10819653 DOI: 10.3390/nu16020277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 01/04/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Incorporation of lentils and dried peas could form the basis of a nutrient-rich diet; yet, they are among the least-consumed legumes in the United States (US). The objective of this study was to examine the prevalence of lentils/dried peas consumption in the US over time and across socio-demographic groups, as well as to examine the eating context of these foods. METHODS Analyses included adults (aged 18 years or older) and children (aged 3-17 years) participating in National Health and Nutrition Examination Survey (NHANES) 2003-2004 through 2017-2018. Participants consuming lentils/dried peas on one or both of the 24-h dietary recalls were categorized as consumers. RESULTS Although an increasing time trend in prevalence of consumption was observed over the study period, prevalence of lentils/dried peas consumption was less than 7% in NHANES 2017-2018 in adults and children. Demographic differences were observed, such that a greater proportion of non-Hispanic Asians were classified as consumers. Lentils/dried peas were primarily obtained from grocery stores and supermarkets. CONCLUSIONS Although there are signs of rising acceptance of dried peas and lentils, the low prevalence of lentils/dried peas consumption suggests that understanding barriers to consumption of these foods could further identify opportunities to improve their consumption.
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Affiliation(s)
- Namrata Sanjeevi
- Department of Nutrition and Exercise Physiology, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA 99202, USA;
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Thompson D, Mirabile Y, Islam N, Callender C, Musaad SMA, Miranda J, Moreno JP, Dave JM, Baranowski T. Diet Quality among Pre-Adolescent African American Girls in a Randomized Controlled Obesity Prevention Intervention Trial. Nutrients 2023; 15:2716. [PMID: 37375620 DOI: 10.3390/nu15122716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 05/31/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
Consuming an unhealthy diet increases health risks. This study assessed the impact of a culturally adapted behaviorally innovative obesity prevention intervention (The Butterfly Girls and the Quest for Founder's Rock) on diet quality in pre-adolescent non-Hispanic Black/African American girls. The RCT consisted of three groups (experimental, comparison, and waitlist control); block randomization allocated participants to each group. The two treatment groups varied in terms of whether or not they set goals. Data were collected at baseline (prior to receiving the intervention), post 1 (3 months post-baseline), and post 2 (6 months post-baseline). Two dietitian-assisted 24 h dietary recalls were collected at each timepoint. Healthy Eating Index 2015 (HEI-2015) was used to determine diet quality. A total of 361 families were recruited; 342 completed baseline data collection. No significant differences in overall HEI score or component scores were observed. To attain more equitable health outcomes, future efforts to promote dietary intake change among at-risk children should explore other behavior change procedures and employ more child-friendly dietary assessment methods.
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Affiliation(s)
- Debbe Thompson
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
| | - Yiming Mirabile
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
| | - Noemi Islam
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
| | - Chishinga Callender
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
| | - Salma M A Musaad
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
| | - Julie Miranda
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
| | - Jennette P Moreno
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
| | - Jayna M Dave
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
| | - Tom Baranowski
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
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Zaki BM, Hussein AH, Hakim TA, Fayez MS, El-Shibiny A. Phages for treatment of Klebsiella pneumoniae infections. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2023; 200:207-239. [PMID: 37739556 DOI: 10.1016/bs.pmbts.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
Abstract
Klebsiella pneumoniae is an opportunistic pathogen involved in both hospital- and community-acquired infections. K. pneumoniae is associated with various infections, including pneumonia, septicemia, meningitis, urinary tract infection, and surgical wound infection. K. pneumoniae possesses serious virulence, biofilm formation ability, and severe resistance to many antibiotics especially hospital-acquired strains, due to excessive use in healthcare systems. This limits the available effective antibiotics that can be used for patients suffering from K. pneumoniae infections; therefore, alternative treatments are urgently needed. Bacteriophages (for short, phages) are prokaryotic viruses capable of infecting, replicating, and then lysing (lytic phages) the bacterial host. Phage therapy exhibited great potential for treating multidrug-resistant bacterial infections comprising K. pneumoniae. Hence, this chapter emphasizes and summarizes the research articles in the PubMed database from 1948 until the 15th of December 2022, addressing phage therapy against K. pneumoniae. The chapter provides an overview of K. pneumoniae phages covering different aspects, including phage isolation, different morphotypes of isolated phages, in vitro characterization, anti-biofilm activity, various therapeutic forms, in vivo research and clinical studies.
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Affiliation(s)
- Bishoy Maher Zaki
- Center for Microbiology and Phage Therapy, Zewail City of Science and Technology, Giza, Egypt; Microbiology and Immunology Department, Faculty of Pharmacy, October University for Modern Sciences and Arts (MSA), Giza, Egypt
| | - Assmaa H Hussein
- Center for Microbiology and Phage Therapy, Zewail City of Science and Technology, Giza, Egypt
| | - Toka A Hakim
- Center for Microbiology and Phage Therapy, Zewail City of Science and Technology, Giza, Egypt
| | - Mohamed S Fayez
- Center for Microbiology and Phage Therapy, Zewail City of Science and Technology, Giza, Egypt
| | - Ayman El-Shibiny
- Center for Microbiology and Phage Therapy, Zewail City of Science and Technology, Giza, Egypt; Faculty of Environmental Agricultural Sciences, Arish University, Arish, Egypt.
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Sanjeevi N, Freeland-Graves JH, Wright GJ. Food Security Status, WIC Participation, and Early Childhood Caries in a Nationally Representative Sample of Children. J Acad Nutr Diet 2023; 123:276-283. [PMID: 35792360 DOI: 10.1016/j.jand.2022.06.223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 06/20/2022] [Accepted: 06/29/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Despite the potential role of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in mitigating the adverse effects of food insecurity on oral health, to our knowledge, no study has examined whether WIC participation could modify the association between food insecurity with caries in young children. OBJECTIVE Our aim was to investigate the impact of WIC participation in modifying the association between food insecurity and early childhood caries. DESIGN This was a cross-sectional study. PARTICIPANTS/SETTING Using 2011-2018 National Health and Nutrition Examination Survey data, children aged 2 through 5 years; with household income ≤185% of the Federal Poverty Level; and with data on WIC participation, food security, and dental examinations were included (n = 1,921). STUDY EXPOSURES Food-security status and WIC participation were the study exposures. MAIN OUTCOME MEASURES Total and untreated dental caries were the main outcome measures. STATISTICAL ANALYSES Logistic regression examined associations of food security (household-level and child-level) and WIC participation with odds of caries. Interactions between food security and WIC participation were examined using multiplicative interaction terms. RESULTS Marginal child food security was significantly related to higher odds of total caries in income-eligible WIC nonparticipants (odds ratio 1.92; 95% CI 1.07 to 3.46); however, this relationship was not observed in WIC participants. Furthermore, food insecurity was significantly associated with greater odds of untreated caries only among income-eligible WIC nonparticipants (odds ratio 1.79; 95% CI 1.12 to 2.85). CONCLUSIONS In this sample of preschool-aged children, the relationship of food insecurity with caries differed by WIC participation status. Findings suggest that WIC participation could improve the oral health of income-eligible children with lower levels of food security.
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Affiliation(s)
- Namrata Sanjeevi
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, TX.
| | | | - Gary Joe Wright
- Dental Hygiene Program, Austin Community College, Austin, TX
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10
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Sanjeevi N, Freeland-Graves JH. The Special Supplemental Nutrition Program for Women, Infants, and Children food package revisions and anemia in children aged 2-5 years. Am J Clin Nutr 2022; 116:1030-1037. [PMID: 36055958 DOI: 10.1093/ajcn/nqac141] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/11/2022] [Accepted: 05/09/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides nutritional assistance to low-income women and children in the United States. The WIC food package was revised to align more closely to dietary recommendations in October 2009. The revised package included more fruits, vegetables, whole grains, and low-fat milk. OBJECTIVES The objective of this study was to examine the association of the revised WIC package with anemia indicators and iron intake in children. METHODS A quasi-experimental difference-in-difference design compared anemia and iron intake variables between WIC (n = 1497 and n = 1626 for anemia and iron intake variables, respectively) and WIC-eligible nonparticipating children (n = 1183 and n = 1322 for anemia and iron intake variables, respectively), aged 2-5 y, before and after the 2009 revisions. The NHANES 2003-2008 and 2011-2018 data represented the period pre- and post-2009 revisions, respectively. RESULTS The 2009 package revisions were significantly associated with reduced probability of anemia (-4.3% points; 95% CI: -7.5, -1.1% points) and nonthalassemic microcytic anemia (-1.7% points; 95% CI: -3.3, -0.1% points) in children from WIC-participating households. The revised WIC package also was significantly related to higher nutrient adequacy ratio (0.04; 95% CI: 0.02, 0.07) and greater probability of meeting the RDA (12.1% points; 95% CI: 3.2, 21.0% points) for iron among WIC participants. CONCLUSIONS This study found that the WIC 2009 revisions were associated with lower probability of nonthalassemic microcytic anemia and better adequacy of dietary iron intake, thereby suggesting the beneficial impact of WIC revisions on iron deficiency anemia in children. The current study findings suggest that nutritional policies could play a crucial role in supporting the health of vulnerable children in the United States.
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Affiliation(s)
- Namrata Sanjeevi
- Department of Nutritional Sciences, College of Natural Sciences, The University of Texas at Austin, Austin, TX, USA
| | - Jeanne H Freeland-Graves
- Department of Nutritional Sciences, College of Natural Sciences, The University of Texas at Austin, Austin, TX, USA
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Strieter L, Besana T, Arena R, Hall G. Where are we now? The intersection of healthy living medicine and social justice within our school systems. Prog Cardiovasc Dis 2022; 71:43-50. [PMID: 35523310 DOI: 10.1016/j.pcad.2022.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 04/26/2022] [Indexed: 11/27/2022]
Abstract
Alongside the tensions brought forth by the pandemic, such as health and safety concerns from transmission and economic insecurity, there was also a rise in racial and social tension, bringing issues of equity and justice to the forefront. Consequently, there has been a call for reform and an urgency for change in legal, political, economic, and healthcare spheres. Change only occurs through change, with a pivotal point to target the beginning stages in life which will have a greater likelihood to subsist throughout the lifecourse. The crossroads of healthy living medicine (HLM) and education are an appropriate context for necessary change. If healthy living medicine is to embody the ideals of social justice, then people need equal access to resources of well-being - physical, social, and emotional - in their school systems. This paper examines the current intersection of health and social justice within the school systems in the United States. It is both a critique of how school systems have not yet provided such an intersection and highlight those efforts that have proven valuable and successful in providing HLM resources to populations that are historically under-resourced and under-served. Ultimately, this paper looks to provide a path forward, providing ideas for sustainable, feasible, actionable change in school systems K-12 and in higher education.
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Affiliation(s)
- Lindsey Strieter
- Department of Physical Therapy, College of Applied Science, University of Illinois, Chicago, IL, United States of America; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, United States of America.
| | - Tiffany Besana
- Department of Physical Therapy, College of Applied Science, University of Illinois, Chicago, IL, United States of America
| | - Ross Arena
- Department of Physical Therapy, College of Applied Science, University of Illinois, Chicago, IL, United States of America; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, United States of America
| | - Grenita Hall
- Department of Physical Therapy, College of Applied Science, University of Illinois, Chicago, IL, United States of America; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, United States of America
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Zimmer M, Moshfegh AJ, Vernarelli JA, Barroso CS. Participation in the Special Supplemental Nutrition Program for Women, Infants, and Children and Dietary Intake in Children: Associations With Race and Ethnicity. Am J Prev Med 2022; 62:578-585. [PMID: 34969606 DOI: 10.1016/j.amepre.2021.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 10/21/2021] [Accepted: 10/25/2021] [Indexed: 11/01/2022]
Abstract
INTRODUCTION Establishing healthy dietary intake in pediatric populations is important for prevention of chronic disease across the lifespan. Federal nutrition assistance programs can support the dietary intake of U.S. children. The objective of this study was to assess the relationship between Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation status and dietary intake within racial and ethnic groups. METHODS Dietary intake of children aged 2-4 years in the cross-sectional National Health and Nutrition Examination Survey 2011-2016 was analyzed in 2021. Multivariable linear regression was used to compare stratum-specific mean estimates for nutrient and food group intake of children participating in Special Supplemental Nutrition Program for Women, Infants, and Children (reference group) with those of nonparticipants who were income eligible and income ineligible (i.e., above income limits) for the WIC program. Significance was set to Bonferroni-corrected p-values. RESULTS Hispanic WIC participants consumed less added sugar (8.9 [SE=0.5] teaspoons) than their higher-income counterparts (14.6 [SE=1.5] teaspoons, p<0.001). Hispanic WIC participants also consumed more fiber (13.0 [SE=0.6] grams) than income-eligible (11.4 [SE=0.7] grams, p=0.032) and income-ineligible (i.e., higher-income, 9.4 [SE=1.3] grams, p=0.019) nonparticipants, but this was not significant at the Bonferroni-adjusted p-value of 0.01. No differences in dietary intake were observed by WIC participation status for non-Hispanic White and non-Hispanic Black children. CONCLUSIONS Participation in WIC was associated with healthier dietary outcomes among Hispanic children; however, dietary intake of White and Black children was comparable by WIC participation status. Federal nutrition assistance programs should support sound nutrition, an important factor in reducing the risk of chronic disease, in all groups.
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Affiliation(s)
- Meghan Zimmer
- Epidemiology and Genomics Research Program, National Cancer Institute, NIH, Rockville, Maryland; Department of Public Health, Colleg of Education, Health, and Human Sciences, The University of Tennessee Knoxville, Knoxville, Tennessee
| | - Alanna J Moshfegh
- Food Surveys Research Group, USDA Agricultural Research Service, Beltsville, Maryland
| | | | - Cristina S Barroso
- Department of Public Health, Colleg of Education, Health, and Human Sciences, The University of Tennessee Knoxville, Knoxville, Tennessee; College of Nursing, The University of Tennessee Knoxville, Knoxville, Tennessee.
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Boelens M, Raat H, Wijtzes AI, Schouten GM, Windhorst DA, Jansen W. Associations of socioeconomic status indicators and migrant status with risk of a low vegetable and fruit consumption in children. SSM Popul Health 2022; 17:101039. [PMID: 35198723 PMCID: PMC8841774 DOI: 10.1016/j.ssmph.2022.101039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/18/2021] [Accepted: 01/30/2022] [Indexed: 11/21/2022] Open
Abstract
Background It is important to provide insight in potential target groups for interventions to reduce socioeconomic inequalities in children's vegetable/fruit consumption. In earlier studies often single indicators of socioeconomic status (SES) or migrant status have been used. However, SES is a multidimensional concept and different indicators may measure different SES dimensions. Our objective is to explore multiple associations of SES indicators and migrant status with risk of a low vegetable/fruit consumption in a large multi-ethnic and socioeconomically diverse sample of children. Methods We included 5,010 parents of 4- to 12-year-olds from a Dutch public health survey administered in 2018. Cross-sectional associations of parental education, material deprivation, perceived financial difficulties, neighbourhood socioeconomic status (NSES) and migrant status with low (≤4 days a week) vegetable and fruit consumption in children were assessed using multilevel multivariable logistic regression models. Results are displayed as odds ratios (OR) with 95% confidence intervals (CI). Results Of the 4- to 12-year-olds, 22.1% had a low vegetable consumption and 11.9% a low fruit consumption. Low (OR 2.51; 95%CI: 2.05, 3.07) and intermediate (OR 1.83; 95%CI: 1.54, 2.17) parental education, material deprivation (OR 1.45; 95%CI: 1.19, 1.76), low NSES (OR 1.28; 95%CI: 1.04, 1.58) and a non-Western migrant status (OR 1.94; 95%CI: 1.66, 2.26) were associated with a higher risk of a low vegetable consumption. Low (OR 1.68; 95%CI: 1.31, 2.17) and intermediate (OR 1.39; 95%CI: 1.12, 1.72) parental education and material deprivation (OR 1.63; 95%CI: 11.27, 2.08) were also associated with a higher risk of a low fruit consumption. Conclusion Our findings indicate associations of multiple SES indicators and migrant status with a higher risk of a low vegetable/fruit consumption in children and thus help to identify potential target groups. Vegetable and fruit consumptions on 4 days or less a week is reported for respectively 22.1% and 11.9% of children. Children's vegetable but not fruit consumption differs between neighbourhoods. A non-Western migrant status and a low socio-economic status of the neighbourhood are associated with low vegetable consumption. Low/intermediate education and material deprivation are associated with low vegetable and fruit consumption. This study provides clues to potential entry points for reducing inequalities in vegetable and fruit consumption.
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Panjwani AA, Cowan AE, Jun S, Bailey RL. Trends in Nutrient- and Non-Nutrient-Containing Dietary Supplement Use among US Children from 1999 to 2016. J Pediatr 2021; 231:131-140.e2. [PMID: 33340548 PMCID: PMC8005463 DOI: 10.1016/j.jpeds.2020.12.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/20/2020] [Accepted: 12/11/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To characterize dietary supplement use among US children, including product type, motivations, user characteristics, and trends over time with a primary focus on non-vitamin/non-mineral dietary supplements (NVNM). STUDY DESIGN Overall, NVNM, and vitamin and/or mineral dietary supplement only (VM-only) use; motivations for use; and trends in use over time were examined in children (≤19 years of age) using the National Health and Nutrition Examination Survey 1999-2016 data (n = 42 510). RESULTS Between 1999 and 2016, overall dietary supplement and VM-only dietary supplement use among all children remained relatively stable at ∼30%; yet, NVNM dietary supplement use increased from 2.9% to 6.4%, mainly due to increased use of omega-3 polyunsaturated fatty acids. NVNM use was greater in boys than in girls (3.9% vs 3.3%), and greater in older children than in younger children (Ptrend < .0001), the opposite of what was observed with VM-only dietary supplement use. Although both user groups shared 2 primary motivations, both motivations were reported by a significantly greater percent of vitamin and/or mineral dietary supplement users vs NVNM users: to maintain health (38.7% vs 23.1%) and to improve health (33.1% vs 22.6%). NVNM users were much more likely to use dietary supplement for relaxation, stress, and sleep; for mental health; and for colon and bowel health. CONCLUSIONS Although the prevalence of any dietary supplement and VM-only dietary supplement use among US children has both remained stable, the prevalence of NVNM use has increased substantially over time. Yet, NVNM use remains relatively low overall. NVNM use exhibited different patterns by sex, age, and motivations when compared with vitamin and/or mineral dietary supplement use. Despite increasing NVNM use, high-quality evidence supporting their use is lacking, especially in children.
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Affiliation(s)
- Anita A. Panjwani
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA
| | - Alexandra E. Cowan
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA
| | - Shinyoung Jun
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA
| | - Regan L. Bailey
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA
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Bailey AD, Fulgoni III VL, Shah N, Patterson AC, Gutierrez-Orozco F, Mathews RS, Walsh KR. Nutrient Intake Adequacy from Food and Beverage Intake of US Children Aged 1-6 Years from NHANES 2001-2016. Nutrients 2021; 13:nu13030827. [PMID: 33802295 PMCID: PMC8002201 DOI: 10.3390/nu13030827] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 02/26/2021] [Accepted: 02/28/2021] [Indexed: 11/26/2022] Open
Abstract
The early years, between the ages of one and six, are a period of rapid physical, social and cognitive growth and a nutritionally adequate diet is an important factor for optimum development. We investigated the micronutrient adequacy and status of young US children aged 1–6 years (n = 9848) using 24-h dietary recall interviews completed by parents and caregivers participating in the National Health and Nutrition Examination Survey (NHANES) 2001–2016. data. The proportion of the sample not meeting the Dietary Reference Intakes (DRI) increased with increasing age and was most pronounced for calcium. Despite adequate iron intake, 7.4% and 2.5% had signs of iron deficiency and anemia based on serum ferritin and hemoglobin levels, with younger children and WIC participants at most risk and Non-Hispanic Black children the least. Vitamin B6 intake was adequate, but 6.4% had serum pyridoxal-5-phosphate deficiency. For vitamin E, 69% had intakes below the estimated average requirement (EAR), yet serum deficiency was only detected in 0.9%. Vitamin D intake was inadequate for 87%, but true deficiency may be overestimated. Mean DHA intake was 24 mg/d, well below expert recommendations of 70–100 mg/day. Iron and vitamin B6 deficiency and inadequate calcium, fiber, choline, potassium and DHA intakes are a concern for a significant percentage of young children. The discrepancy between nutrient intakes and serum deficiency levels needs to be further investigated.
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Affiliation(s)
- Ariana D.L. Bailey
- Medical and Scientific Affairs, RB|Mead Johnson Nutrition Institute, Evansville, IN 47721, USA; (N.S.); (A.C.P.); (F.G.-O.); (K.R.W.)
- Correspondence:
| | | | - Neil Shah
- Medical and Scientific Affairs, RB|Mead Johnson Nutrition Institute, Evansville, IN 47721, USA; (N.S.); (A.C.P.); (F.G.-O.); (K.R.W.)
- Gastroenterology Department, Great Ormond Street Hospital, London WC1N 3JH, UK
| | - Ashley C. Patterson
- Medical and Scientific Affairs, RB|Mead Johnson Nutrition Institute, Evansville, IN 47721, USA; (N.S.); (A.C.P.); (F.G.-O.); (K.R.W.)
| | - Fabiola Gutierrez-Orozco
- Medical and Scientific Affairs, RB|Mead Johnson Nutrition Institute, Evansville, IN 47721, USA; (N.S.); (A.C.P.); (F.G.-O.); (K.R.W.)
| | | | - Kelly R. Walsh
- Medical and Scientific Affairs, RB|Mead Johnson Nutrition Institute, Evansville, IN 47721, USA; (N.S.); (A.C.P.); (F.G.-O.); (K.R.W.)
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Race, ethnicity, WIC participation, and infant health disparities in the United States. Ann Epidemiol 2021; 58:22-28. [PMID: 33626410 DOI: 10.1016/j.annepidem.2021.02.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/20/2021] [Accepted: 02/09/2021] [Indexed: 01/30/2023]
Abstract
PURPOSE This study examines the association between race and ethnicity, participation in The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and a series of infant health outcomes including infant mortality, low birth weight, preterm birth, extended infant hospitalization, and stays in the neonatal infant care unit (NICU). METHODS Data are from the Pregnancy Risk Assessment Monitoring System (PRAMS), 2009-2017. Moderation analyses were conducted to assess the association between maternal race and ethnicity, WIC participation, and infant health. RESULTS Results indicate infants born to Black women and to a lesser extent Hispanic woman are in worse health than those born to White mothers in the United States. However, participation in WIC is associated with reductions in the gap in infant health experienced by racial and ethnic minorities. CONCLUSIONS Prenatal WIC participation is associated with improvements in the health of Black and Hispanic infants and reduced racial and ethnic disparities in infant health outcomes.
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Ghanchi H, Patchana T, Wiginton J, Browne JD, Ohno A, Farahmandian R, Duong J, Cortez V, Miulli DE. Racial Disparity Amongst Stroke Patients During the Coronavirus Disease 2019 Pandemic. Cureus 2020; 12:e10369. [PMID: 33062492 PMCID: PMC7549889 DOI: 10.7759/cureus.10369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 09/10/2020] [Indexed: 12/22/2022] Open
Abstract
Introduction The global coronavirus disease 2019 (COVID-19) pandemic has had deleterious effects on our healthcare system. Lockdown measures have decreased the number of patients presenting to the hospital for non-respiratory illnesses, such as strokes. Moreover, there appears to be a racial disparity among those afflicted with the virus. We sought to assess whether this disparity also existed for patients presenting with strokes. Methods The Get with the Guidelines National Stroke Database was reviewed to assess patients presenting with a final diagnosis of ischemic stroke, transient ischemic attack (TIA), subarachnoid hemorrhage (SAH), or spontaneous/nontraumatic intraparenchymal hemorrhage (IPH). The period of February - May 2020 was chosen given the surge of patients affected with the virus and national shutdowns. Data from this same time during 2019 was used as the control population. Our hospital numbers and four additional regions were assessed (California hospitals, Pacific State hospitals, Western Region hospitals, and all hospitals in the United States). Patients were categorized by race (White, Black/African American, Asian, Native American, Hispanic) in each cohort. The primary endpoint of this study is to compare whether there was a significant difference in the proportion of patients in each reported racial category presenting with stroke during the COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Results A downward trend in total number of patients was noted in all five regional cohorts assessed. A statistically significant increase in the number of Black and Hispanic patients presenting with strokes was noted in California, Pacific hospitals, Western hospitals, and all hospitals in the United States during various months studied comparing 2020 to 2019. A statistically significant increase in the Hispanic population was noted in February and March in all California hospitals (p=0.005 and 0.02, respectively) and Pacific Coast hospitals (p=0.005 and 0.039, respectively). The Western region and all national hospitals noted a significant increase in strokes in the Hispanic population in April (p=0.039 and 0.023, respectively). A statistically significant increase of strokes in the Black population was noted in April in Pacific hospitals, Western region hospitals, and all national hospitals (p=0.039, 0.03, and 0.03, respectively). Conclusion The COVID-19 pandemic has adversely affected certain racial groups more than others. A similar increase is noted in patients presenting with strokes in these specific racial populations. Moreover, lack of testing for the SARS-CoV-2 virus may be missing a possible link between racial disparity for patients infected with the virus and patients presenting with stroke. The authors advocate for widespread testing for all patients to further assess this correlation.
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Affiliation(s)
- Hammad Ghanchi
- Neurosurgery, Riverside University Health System Medical Center, Moreno Valley, USA
| | - Tye Patchana
- Neurosurgery, Riverside University Health System Medical Center, Moreno Valley, USA
| | - James Wiginton
- Neurosurgery, Riverside University Health System Medical Center, Moreno Valley, USA
| | - Jonathan D Browne
- Neurosurgery, California University of Science and Medicine, San Bernardino, USA
| | - Ai Ohno
- Neurosurgery, California University of Science and Medicine, San Bernardino, USA
| | - Ronit Farahmandian
- Neurosurgery, California University of Science and Medicine, San Bernardino, USA
| | - Jason Duong
- Neurosurgery, Riverside University Health System Medical Center, Rancho Cucamonga, USA
| | - Vladimir Cortez
- Neurosurgery, Riverside University Health System Medical Center, Moreno Valley, USA
| | - Dan E Miulli
- Neurosurgery, Arrowhead Regional Medical Center, Colton, USA
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Kinderknecht K, Harris C, Jones-Smith J. Association of the Healthy, Hunger-Free Kids Act With Dietary Quality Among Children in the US National School Lunch Program. JAMA 2020; 324:359-368. [PMID: 32721008 PMCID: PMC7388023 DOI: 10.1001/jama.2020.9517] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 05/18/2020] [Indexed: 02/06/2023]
Abstract
Importance The Healthy, Hunger-Free Kids Act of 2010, implemented nationwide in 2012, was intended to improve the nutritional quality of meals served in the National School Lunch Program (NSLP). Objective To assess whether there was an association between the Healthy, Hunger-Free Kids Act of 2010 and dietary quality of lunch for students participating in the NSLP, stratified by income. Design, Setting, Participants Serial cross-sectional study design, using National Health and Nutrition Examination Survey (NHANES) data from 2007-2008, 2009-2010, 2013-2014, and 2015-2016, of students who were surveyed in the NHANES and were attending schools participating in the NSLP. Individuals who were aged 5 to 18 years, in kindergarten through 12th grade, enrolled in a school that served school lunch, and had a reliable weekday dietary recall were included. Exposures The Healthy, Hunger-Free Kids Act of 2010 (prepolicy period: 2007-2010; postpolicy period: 2013-2016), with participation in the NSLP estimated based on an algorithm. Main Outcomes and Measures The primary outcome was dietary quality of intake for lunch, measured by the Healthy Eating Index-2010 (HEI-2010) score (range, 0-100; 0 indicates a diet with no adherence to the 2010 Dietary Guidelines for Americans and 100 indicates a diet with complete adherence to the guidelines). Results Among 6389 students included in the surveys (mean age, 11.7 [95% CI, 11.6-11.9] years; 3145 [50%] female students; 1880 [56%] were non-Hispanic white), 32% were low-income, 12% were low-middle-income, and 56% were middle-high-income students. A total of 2472 (39%) were participants in the NSLP. Among low-income students, the adjusted mean prepolicy HEI-2010 score was 42.7 and the postpolicy score was 54.6 among NSLP participants and the adjusted mean prepolicy score was 34.8 and postpolicy score was 34.1 among NSLP nonparticipants (difference in differences, 12.6 [95% CI, 8.9-16.3]). Among low-middle-income students, the adjusted mean prepolicy HEI-2010 score was 40.4 and postpolicy score was 54.8 among NSLP participants and the adjusted mean prepolicy score was 34.2 and postpolicy score was 36.1 among NSLP nonparticipants (difference in differences, 12.4 [95% CI, 4.9-19.9]). Among middle-high-income students, the adjusted mean HEI-2010 prepolicy score was 42.7 and postpolicy score 55.5 for NSLP participants and the adjusted mean prepolicy score was 38.9 and prepolicy score was 43.6 for NSLP nonparticipants (difference in differences, 8.1 [95% CI, 4.2-12.0]). Conclusions and Relevance In a serial cross-sectional study of students, the Healthy, Hunger-Free Kids Act of 2010 was associated with better changes in dietary quality for lunch among presumed low-income, low-middle-income, and middle-high-income participants in the NSLP compared with nonparticipants.
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Affiliation(s)
- Kelsey Kinderknecht
- Nutritional Sciences Program, University of Washington School of Public Health, Seattle
| | - Cristen Harris
- Nutritional Sciences Program, Department of Epidemiology, University of Washington School of Public Health, Seattle
| | - Jessica Jones-Smith
- Department of Health Services and Department of Epidemiology, University of Washington School of Public Health, Seattle
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Cuadrado-Soto E, López-Sobaler AM, Jiménez-Ortega AI, Aparicio A, Bermejo LM, Hernández-Ruiz Á, Lara Villoslada F, Leis R, Martínez de Victoria E, Moreno JM, Ruiz-López MD, Soto-Méndez MJ, Valero T, Varela-Moreiras G, Gil Á, Ortega RM. Usual Dietary Intake, Nutritional Adequacy and Food Sources of Calcium, Phosphorus, Magnesium and Vitamin D of Spanish Children Aged One to <10 Years. Findings from the EsNuPI Study. Nutrients 2020; 12:E1787. [PMID: 32560110 PMCID: PMC7353376 DOI: 10.3390/nu12061787] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/26/2020] [Accepted: 06/12/2020] [Indexed: 02/06/2023] Open
Abstract
Bone problems in the population begin to be establish in childhood. The present study aims to assess the usual calcium, phosphorus, magnesium, and vitamin D intakes, along with the food sources of these nutrients, in Spanish children participating in the EsNuPI (Estudio Nutricional en Población Infantil Española) study. Two 24 h dietary recalls were applied to 1448 children (1 to <10 years) divided into two sub-samples: one reference sample (RS) of the general population [n = 707] and another sample which exclusively included children consuming enriched or fortified milks, here called "adapted milks" (AMS) [n = 741]. Estimation of the usual intake shows that nutrient intake increased with age for all nutrients except vitamin D. Using as reference the Dietary Reference Values from the European Food Safety Authority (EFSA), calcium and magnesium intakes were found to be below the average requirement (AR) and adequate intake (AI), respectively, in a considerable percentage of children. Furthermore, phosphorus exceeded the AI in 100% of individuals and vitamin D was lower than the AI in almost all children studied. The results were very similar when considering only plausible reporters. When analyzing the food sources of the nutrients studied, milk and dairy products contributed the most to calcium, phosphorus, magnesium, and vitamin D. Other sources of calcium were cereals and vegetables; for phosphorus: meat, meat products, and cereals; for magnesium: cereals and fruits; and, for vitamin D: fish and eggs. These results highlight the desirability of improving the intake concerning these nutrients, which are involved in bone and metabolic health in children. The AMS group appeared to contribute better to the adequacy of those nutrients than the RS group, but both still need further improvement. Of special interest are the results of vitamin D intakes, which were significantly higher in the AMS group (although still below the AI), independent of age.
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Affiliation(s)
- Esther Cuadrado-Soto
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040 Madrid, Spain; (E.C.-S.); (A.A.); (L.M.B.); (R.M.O.)
- UCM Research Group VALORNUT-920030, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040 Madrid, Spain;
| | - Ana M. López-Sobaler
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040 Madrid, Spain; (E.C.-S.); (A.A.); (L.M.B.); (R.M.O.)
- UCM Research Group VALORNUT-920030, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040 Madrid, Spain;
| | - Ana Isabel Jiménez-Ortega
- UCM Research Group VALORNUT-920030, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040 Madrid, Spain;
- Pediatric Gastroenterology Unit, San Rafael Hospital, 28016 Madrid, Spain
| | - Aránzazu Aparicio
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040 Madrid, Spain; (E.C.-S.); (A.A.); (L.M.B.); (R.M.O.)
- UCM Research Group VALORNUT-920030, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040 Madrid, Spain;
| | - Laura M. Bermejo
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040 Madrid, Spain; (E.C.-S.); (A.A.); (L.M.B.); (R.M.O.)
- UCM Research Group VALORNUT-920030, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040 Madrid, Spain;
| | - Ángela Hernández-Ruiz
- Iberoamerican Nutrition Foundation (FINUT), Av. Del Conocimiento 12, 3ªpta, Armilla, 18016 Granada, Spain; (Á.H.-R.); (M.D.R.-L.); (M.J.S.-M.); (Á.G.)
| | | | - Rosaura Leis
- Department of Pediatrics, Unit of Pediatric Gastroenterology, Hepatology and Nutrition, University Clinical Hospital of Santiago, IDIS, University of Santiago de Compostela, 15706 Santiago de Compostela, Spain;
- CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Emilio Martínez de Victoria
- Department of Physiology, Faculty of Pharmacy, University of Granada, Campus de Cartuja, s.n, 18071 Granada, Spain;
- Institute of Nutrition and Food Technology “José Mataix”, Biomedical Research Center, University of Granada, Parque Tecnológico de la Salud, Avenida del Conocimiento s/n, Armilla, 18100 Granada, Spain
| | - José Manuel Moreno
- Pediatric Department, University of Navarra Clinic, Calle Marquesado de Sta. Marta, 1, 28027 Madrid, Spain;
| | - María Dolores Ruiz-López
- Iberoamerican Nutrition Foundation (FINUT), Av. Del Conocimiento 12, 3ªpta, Armilla, 18016 Granada, Spain; (Á.H.-R.); (M.D.R.-L.); (M.J.S.-M.); (Á.G.)
- Institute of Nutrition and Food Technology “José Mataix”, Biomedical Research Center, University of Granada, Parque Tecnológico de la Salud, Avenida del Conocimiento s/n, Armilla, 18100 Granada, Spain
- Department of Nutrition and Food Sciences, Faculty of Pharmacy, University of Granada, Campus de Cartuja, s.n, 18071 Granada, Spain
| | - María José Soto-Méndez
- Iberoamerican Nutrition Foundation (FINUT), Av. Del Conocimiento 12, 3ªpta, Armilla, 18016 Granada, Spain; (Á.H.-R.); (M.D.R.-L.); (M.J.S.-M.); (Á.G.)
| | - Teresa Valero
- Spanish Nutrition Foundation (FEN), c/General Álvarez de Castro 20, 1ªpta, 28010 Madrid, Spain; (T.V.); (G.V.-M.)
| | - Gregorio Varela-Moreiras
- Spanish Nutrition Foundation (FEN), c/General Álvarez de Castro 20, 1ªpta, 28010 Madrid, Spain; (T.V.); (G.V.-M.)
- Department of Pharmaceutical and Health Sciences, Faculty of Pharmacy, CEU San Pablo University, Urb. Montepríncipe, crta. Boadilla km. 5.3, Boadilla del Monte, 28668 Madrid, Spain
| | - Ángel Gil
- Iberoamerican Nutrition Foundation (FINUT), Av. Del Conocimiento 12, 3ªpta, Armilla, 18016 Granada, Spain; (Á.H.-R.); (M.D.R.-L.); (M.J.S.-M.); (Á.G.)
- CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Institute of Nutrition and Food Technology “José Mataix”, Biomedical Research Center, University of Granada, Parque Tecnológico de la Salud, Avenida del Conocimiento s/n, Armilla, 18100 Granada, Spain
- Department of Biochemistry and Molecular Biology II University of Granada, University of Granada, Campus de Cartuja, s.n, 18071 Granada, Spain
| | - Rosa M. Ortega
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040 Madrid, Spain; (E.C.-S.); (A.A.); (L.M.B.); (R.M.O.)
- UCM Research Group VALORNUT-920030, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040 Madrid, Spain;
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20
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Zimmer MC, Rubio V, Kintziger KW, Barroso C. Differences in Consumption of NASEM Priority Nutrients and Food Groups by Race/Ethnicity Among Women Living in WIC-Participating Households. Am J Health Promot 2020; 34:791-795. [PMID: 32363883 DOI: 10.1177/0890117120920849] [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: 11/17/2022]
Abstract
PURPOSE To examine racial/ethnic differences in dietary intake of women in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). DESIGN Cross-sectional study. SETTING Data from the US National Health and Nutrition Examination Survey. PARTICIPANTS Women 19 to 50 years of age living in WIC-participating households. MEASURES Nutrient/food group intake from one 24-hour dietary recall. ANALYSIS Multivariable linear regression was used to evaluate the relationship between race/ethnicity and nutrient/food group intake. RESULTS Compared to non-Hispanic white women, Hispanic women had lower dietary energy density (1.7 ± 0.1 vs 2.2 ± 0.1 kcal/g, P < .001), and better nutrient intake, including more folate (429 ± 20 vs 364 ± 29 µg, P = .024), fiber (20.1 ± 0.9 vs 13.6 ± 0.9 g, P ≤ .001), and potassium (2575 ± 78 vs 2251 ± 66 mg, P = .012). This may be related to greater consumption of total vegetables (1.67 ± 0.16 vs 1.17 ± 0.17 cup equivalents [c-eq], P = .029), including more red and orange vegetables (0.64 ± 0.11 vs 0.32 vs 0.09 c-eq, P = .013) and more legumes (0.17 ± 0.04 vs 0.07 ± 0.02 c-eq, P = .006). Both Hispanic and non-Hispanic black women consumed more sodium (Hispanic: P = .015; non-Hispanic black: P = .008), but less added sugars (Hispanic: P ≤ .001; non-Hispanic black: P = .015), than non-Hispanic white women. CONCLUSION These findings highlight differences in dietary intake by race/ethnicity and can inform nutrition messages of WIC nutrition educators and dietitians.
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Affiliation(s)
- Meghan C Zimmer
- Department of Public Health, 4285The University of Tennessee, Knoxville, TN, USA
| | - Veronica Rubio
- Department of Nutrition, 4285The University of Tennessee, Knoxville, TN, USA
| | - Kristina W Kintziger
- Department of Public Health, 4285The University of Tennessee, Knoxville, TN, USA
| | - Cristina Barroso
- Department of Public Health, 4285The University of Tennessee, Knoxville, TN, USA
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