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Hollis-Hansen K, Vogelzang J, Bode B, Markworth A, Rivera RL, Heydarian N, Russell R, Clarke EW. The Need to Prioritize People With Disabilities in Nutrition Education. J Nutr Educ Behav 2024; 56:119-120. [PMID: 38453318 DOI: 10.1016/j.jneb.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Affiliation(s)
- Kelseanna Hollis-Hansen
- UT Southwestern Medical Center, O'Donnell School of Public Health, Dallas, TX; Harold C. Simmons Comprehensive, Cancer Center, Dallas, TX
| | | | - Bree Bode
- Michigan Fitness Foundation, Lansing, MI
| | | | - Rebecca L Rivera
- Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, Indianapolis, IN; Clem McDonald Center for Biomedical Informatics, Regenstrief Institute, Inc, Indianapolis, IN
| | - Nazanin Heydarian
- University of Texas Rio Grande Valley, School of Social Work, Edinburg, TX
| | - Rebecca Russell
- Curtin School of Population Health, Curtin University, Perth, Australia
| | - Emily Watt Clarke
- University of North Carolina at Chapel Hill, Center for Health Promotion and Disease Prevention, Chapel Hill, NC
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Qin Y, Rivera RL, Zhang Y, Wang Q, Tooze JA, Abbott AR, Maulding MK, Craig BA, Bailey RL, Eicher-Miller HA. A Randomized Intervention of Supplemental Nutrition Assistance Program-Education Did Not Improve Dietary Outcomes Except for Vitamin D Among Lower-Income Women in Indiana. J Acad Nutr Diet 2023; 123:284-298.e2. [PMID: 35781080 DOI: 10.1016/j.jand.2022.06.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 06/23/2022] [Accepted: 06/28/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND The goal of US Department of Agriculture Supplemental Nutrition Assistance Program-Education (SNAP-Ed) is to improve the likelihood that those eligible for SNAP will make healthy choices aligned with the Dietary Guidelines for Americans, 2020-2025. OBJECTIVE The objective of the study was to evaluate the long-term effects of a direct SNAP-Ed intervention in which participants actively engage in learning with educator instruction about dietary quality and usual intake of key nutrient and food groups among Indiana SNAP-Ed-eligible women participants as an example sample in the context of no similar existing evaluation. DESIGN The study design was a parallel-arm, randomized controlled, nutrition education intervention, with follow-up at 1 year. PARTICIPANTS/SETTING Participants (18 years and older; n = 97 women) eligible for SNAP-Ed and interested in receiving nutrition education lessons were recruited from 31 Indiana counties from August 2015 to May 2016 and randomized to an intervention (n = 53) or control (n = 44) group. INTERVENTION The intervention comprised core lessons of Indiana SNAP-Ed delivered between 4 and 10 weeks after baseline assessment. Each participant completed a baseline and 1-year follow-up assessment. Dietary intake was assessed using repeated 24-hour dietary recalls (up to 2). MAIN OUTCOME MEASURES Mean usual nutrient, food group intake, diet quality (ie, Healthy Eating Index-2010 scores), and proportion of intervention and control groups meeting Dietary Guidelines for Americans, 2020-2025 recommendations and Dietary Reference Intake indicators of requirement or adequacy, were determined using the National Cancer Institute method and the simple Healthy Eating Index-2010 scoring algorithm method. Dietary changes between intervention and control groups were examined over time using mixed linear models. STATISTICAL ANALYSES PERFORMED Bonferroni-corrected significance levels were applied to the results of the mixed linear models for comparisons of usual intake of nutrients and foods. RESULTS No differences in diet quality, intake of food group components, food group intake, or nutrients were observed at 1-year follow-up, except that vitamin D intake was higher among those who received SNAP-Ed compared with the control group. CONCLUSIONS A direct SNAP-Ed intervention did not improve diet quality, food group intake, or key nutrient intake, except for vitamin D, among Indiana SNAP-Ed-eligible women up to 1 year after the nutrition education.
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Affiliation(s)
- Yue Qin
- Department of Nutrition Science, Purdue University, West Lafayette, IN
| | - Rebecca L Rivera
- Department of Nutrition Science, Purdue University, West Lafayette, IN
| | - Yumin Zhang
- Department of Statistics, Purdue University, West Lafayette, IN
| | - Qi Wang
- Department of Statistics, Purdue University, West Lafayette, IN
| | - Janet A Tooze
- School of Medicine, Wake Forest University, Winston-Salem, NC
| | - Angela R Abbott
- Health and Human Sciences Extension, Purdue University, West Lafayette, IN
| | - Melissa K Maulding
- Department of Nutrition and Dietetics, Eastern Illinois University, Charleston
| | - Bruce A Craig
- Department of Statistics, Purdue University, West Lafayette, IN
| | - Regan L Bailey
- Department of Nutrition Science, Purdue University, West Lafayette, IN
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Wright BN, Tooze JA, Bailey RL, Liu Y, Rivera RL, McCormack L, Stluka S, Franzen-Castle L, Henne B, Mehrle D, Remley D, Eicher-Miller HA. Dietary Quality and Usual Intake of Underconsumed Nutrients and Related Food Groups Differ by Food Security Status for Rural, Midwestern Food Pantry Clients. J Acad Nutr Diet 2020; 120:1457-1468. [DOI: 10.1016/j.jand.2020.04.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 04/06/2020] [Indexed: 11/27/2022]
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Eicher-Miller HA, Rivera RL, Sun H, Zhang Y, Maulding MK, Abbott AR. Supplemental Nutrition Assistance Program-Education Improves Food Security Independent of Food Assistance and Program Characteristics. Nutrients 2020; 12:nu12092636. [PMID: 32872411 PMCID: PMC7551191 DOI: 10.3390/nu12092636] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 11/16/2022] Open
Abstract
The purpose of this project was to determine whether consistent food assistance program participation or changes in participation over time mediated or moderated the effect of federal nutrition education through the Supplemental Nutrition Assistance Program-Education (SNAP-Ed) on food security and determine the associations of SNAP-Ed program delivery characteristics with change in food security. This secondary analysis used data from a randomized controlled trial from September 2013 through April 2015. SNAP-Ed-eligible participants (n = 328; ≥18 years) in households with children were recruited from 39 counties in Indiana, USA. The dependent variable was one year change in household food security score measured using the United States Household Food Security Survey Module. Assessment of mediation used Barron-Kenny analysis and moderation used interactions of food assistance program use and changes over time with treatment group in general linear regression modeling. Program delivery characteristics were investigated using mixed linear regression modeling. Results showed that neither consistent participation nor changes in food assistance program participation over time mediated nor moderated the effect of SNAP-Ed on food security and neither were SNAP-Ed program delivery characteristics associated with change in food security over the one year study period. SNAP-Ed directly improved food security among SNAP-Ed-eligible Indiana households with children regardless of food assistance program participation and changes over time or varying program delivery characteristics.
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Affiliation(s)
- Heather A. Eicher-Miller
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA;
- Correspondence: ; Tel.: +1-765-494-6815; Fax: +1-765-494-0906
| | - Rebecca L. Rivera
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA;
- Richard M. Fairbanks School of Public Health and the Regenstrief Institute, Inc., Indiana University, Indianapolis, IN 46202, USA
| | - Hanxi Sun
- Department of Statistics, Purdue University, West Lafayette, IN 47907, USA; (H.S.); (Y.Z.)
| | - Yumin Zhang
- Department of Statistics, Purdue University, West Lafayette, IN 47907, USA; (H.S.); (Y.Z.)
| | - Melissa K. Maulding
- Health and Human Sciences Cooperative Extension, Purdue University, West Lafayette, IN 47907, USA; (M.K.M.); (A.R.A.)
- College of Health and Human Services, Eastern Illinois University, Charleston, IL 61920, USA
| | - Angela R. Abbott
- Health and Human Sciences Cooperative Extension, Purdue University, West Lafayette, IN 47907, USA; (M.K.M.); (A.R.A.)
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Rivera RL, Zhang Y, Wang Q, Maulding MK, Tooze JA, Wright BN, Craig BA, Bailey RL, Eicher-Miller HA. Diet Quality and Associations with Food Security among Women Eligible for Indiana Supplemental Nutrition Assistance Program-Education. J Nutr 2020; 150:2191-2198. [PMID: 32559278 PMCID: PMC7690761 DOI: 10.1093/jn/nxaa171] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 04/08/2020] [Accepted: 05/22/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The diet quality among adults receiving nutrition education lessons through Supplemental Nutrition Assistance Program-Education (SNAP-Ed) is currently unknown. OBJECTIVES The objectives of this study were to characterize the diet quality of Indiana SNAP-Ed-eligible women; estimate their mean usual intake of fruits, vegetables, dairy, and whole grains compared to Dietary Guidelines for Americans (DGA) recommendations; and determine if these dietary outcomes differed by food security status. METHODS SNAP-Ed paraprofessionals recruited participants from August 2015 to May 2016 for this secondary analysis of cross-sectional data collected as the baseline assessment for a randomized controlled trial. Participants were SNAP-Ed-eligible women aged ≥18 y interested in nutrition education lessons. Dietary outcomes were assessed by one or two 24-h dietary recalls. The Healthy Eating Index (HEI)-2010 was used to characterize diet quality. Mean usual intake of food groups was estimated using the National Cancer Institute Method. Food security status was classified using the US Household Food Security Survey Module. Data were analyzed in October 2019. RESULTS Mean ± SEM HEI-2010 total score was 42 ± 0.9 for the study sample. Mean ± SE usual intake of servings of fruits (0.61 ± 0.08 cups [144.32 ± 18.93 mL]), vegetables [1.4 ± 0.10 cups (331.2 ± 23.66 mL)], dairy [1.5 ± 0.11 cups (354.88 ± 26.02 mL)], and whole grains [0.48 ± 0.06 ounces (13.61 ± 1.70 g)] did not differ by food security subgroup. Mean HEI-2010 total score was significantly higher by 4.8 ± 2.0 points for the food-secure than for the food-insecure subgroup (P = 0.01). Mean HEI-2010 component scores were 1.1 ± 0.5 points higher for whole grain (P = 0.01) and 1.0 ± 0.5 points higher for dairy (P = 0.05) in the food-secure than in the food-insecure subgroup. The proportions of the study sample not meeting the DGA recommendations for food group intake were ≥85% for both food-secure and -insecure subgroups. CONCLUSIONS Indiana SNAP-Ed-eligible women reported poor diet quality, highlighting their need for nutrition interventions aiming to improve food security and diet as per DGA recommendations in low-income populations.
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Affiliation(s)
- Rebecca L Rivera
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
| | - Yumin Zhang
- Department of Statistics, Purdue University, West Lafayette, IN, USA
| | - Qi Wang
- Department of Statistics, Purdue University, West Lafayette, IN, USA
| | - Melissa K Maulding
- Department of Nutrition and Dietetics, Eastern Illinois University, Charleston, IL, USA
| | - Janet A Tooze
- School of Medicine, Wake Forest University, Winston-Salem, NC, USA
| | - Breanne N Wright
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
| | - Bruce A Craig
- Department of Statistics, Purdue University, West Lafayette, IN, USA
| | - Regan L Bailey
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
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Rivera RL, Maulding MK, Eicher-Miller HA. Effect of Supplemental Nutrition Assistance Program-Education (SNAP-Ed) on food security and dietary outcomes. Nutr Rev 2019. [PMID: 31077323 DOI: 10.1093/nutrit/nuz013+[doi]] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The Supplemental Nutrition Assistance Program-Education (SNAP-Ed) is the nutrition promotion component of SNAP, formerly known as food stamps. SNAP-Ed assists low-income populations in the United States improve dietary intake and reduce food insecurity through nutrition education. This narrative review summarizes current investigations of SNAP-Ed's effectiveness at improving food security and dietary outcomes, and it can help inform future policy and implementation of the program. There was stronger evidence for SNAP-Ed as an effective means of improving food security (n = 4 reports) than for its effects on nutrition or dietary outcomes (n = 10 reports). Inconsistency in measurement tools and outcomes and a lack of strong study designs characterized the studies that sought to evaluate the effectiveness of SNAP-Ed at improving nutrition or dietary outcomes. Additional rigorous study designs in diverse population groups are needed to strengthen the evidence. In the face of reduced financial SNAP benefits, SNAP-Ed may play an important role in helping to eliminate food insecurity and improve dietary outcomes and, ultimately, the health of low-income Americans.
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Affiliation(s)
- Rebecca L Rivera
- Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA
| | - Melissa K Maulding
- Family Nutrition Program, Health and Human Sciences Cooperative Extension, Purdue University, West Lafayette, Indiana, USA
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Rivera RL, Maulding MK, Eicher-Miller HA. Effect of Supplemental Nutrition Assistance Program–Education (SNAP-Ed) on food security and dietary outcomes. Nutr Rev 2019. [DOI: 10.1093/nutrit/nuz013 [doi]] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
AbstractThe Supplemental Nutrition Assistance Program–Education (SNAP-Ed) is the nutrition promotion component of SNAP, formerly known as food stamps. SNAP-Ed assists low-income populations in the United States improve dietary intake and reduce food insecurity through nutrition education. This narrative review summarizes current investigations of SNAP-Ed’s effectiveness at improving food security and dietary outcomes, and it can help inform future policy and implementation of the program. There was stronger evidence for SNAP-Ed as an effective means of improving food security (n = 4 reports) than for its effects on nutrition or dietary outcomes (n = 10 reports). Inconsistency in measurement tools and outcomes and a lack of strong study designs characterized the studies that sought to evaluate the effectiveness of SNAP-Ed at improving nutrition or dietary outcomes. Additional rigorous study designs in diverse population groups are needed to strengthen the evidence. In the face of reduced financial SNAP benefits, SNAP-Ed may play an important role in helping to eliminate food insecurity and improve dietary outcomes and, ultimately, the health of low-income Americans.
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Affiliation(s)
- Rebecca L Rivera
- Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA
| | - Melissa K Maulding
- Family Nutrition Program, Health and Human Sciences Cooperative Extension, Purdue University, West Lafayette, Indiana, USA
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Rivera RL, Maulding MK, Eicher-Miller HA. Effect of Supplemental Nutrition Assistance Program–Education (SNAP-Ed) on food security and dietary outcomes. Nutr Rev 2019; 77:903-921. [PMID: 31077323 DOI: 10.1093/nutrit/nuz013] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AbstractThe Supplemental Nutrition Assistance Program–Education (SNAP-Ed) is the nutrition promotion component of SNAP, formerly known as food stamps. SNAP-Ed assists low-income populations in the United States improve dietary intake and reduce food insecurity through nutrition education. This narrative review summarizes current investigations of SNAP-Ed’s effectiveness at improving food security and dietary outcomes, and it can help inform future policy and implementation of the program. There was stronger evidence for SNAP-Ed as an effective means of improving food security (n = 4 reports) than for its effects on nutrition or dietary outcomes (n = 10 reports). Inconsistency in measurement tools and outcomes and a lack of strong study designs characterized the studies that sought to evaluate the effectiveness of SNAP-Ed at improving nutrition or dietary outcomes. Additional rigorous study designs in diverse population groups are needed to strengthen the evidence. In the face of reduced financial SNAP benefits, SNAP-Ed may play an important role in helping to eliminate food insecurity and improve dietary outcomes and, ultimately, the health of low-income Americans.
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Affiliation(s)
- Rebecca L Rivera
- Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA
| | - Melissa K Maulding
- Family Nutrition Program, Health and Human Sciences Cooperative Extension, Purdue University, West Lafayette, Indiana, USA
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Rivera RL, Maulding MK, Abbott AR, Craig BA, Eicher-Miller HA. SNAP-Ed (Supplemental Nutrition Assistance Program-Education) Increases Long-Term Food Security among Indiana Households with Children in a Randomized Controlled Study. J Nutr 2016; 146:2375-2382. [PMID: 27683869 DOI: 10.3945/jn.116.231373] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 08/22/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Food insecurity is negatively associated with US children's dietary intake and health. The Supplemental Nutrition Assistance Program-Education (SNAP-Ed) aims to alleviate food insecurity by offering nutrition, budgeting, and healthy lifestyle education to low-income individuals and families. OBJECTIVE The objective of this study was to evaluate the long-term impact of the Indiana SNAP-Ed on food security among households with children. METHODS A randomized, controlled, parallel study design with SNAP-Ed as an intervention was carried out during a 4- to 10-wk intervention period. Intervention group participants received the first 4 Indiana SNAP-Ed curriculum lessons. Study participants (n = 575) were adults aged ≥18 y from low-income Indiana households with ≥1 child living in the household. Both treatment groups completed an assessment before and after the intervention period and 1 y after recruitment. The 18-item US Household Food Security Survey Module was used to classify the primary outcomes of food security for the household and adults and children in the household. A linear mixed model was used to compare intervention with control group effects over time on food security. RESULTS Mean ± SEM changes in household food security score and food security score among household adults from baseline to 1-y follow-up were 1.2 ± 0.4 and 0.9 ± 0.3 units lower, respectively, in the intervention group than in the control group (P < 0.01). The mean change in food security score from baseline to 1-y follow-up among household children was not significantly different in the intervention group compared with the control group. CONCLUSIONS SNAP-Ed improved food security over a longitudinal time frame among low-income Indiana households with children in this study. SNAP-Ed may be a successful intervention to improve food security.
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Affiliation(s)
| | - Melissa K Maulding
- Health and Human Sciences Extension, Purdue University, West Lafayette, IN
| | - Angela R Abbott
- Health and Human Sciences Extension, Purdue University, West Lafayette, IN
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Carreiro AL, Dhillon J, Gordon S, Jacobs AG, Higgins KA, McArthur BM, Redan BW, Rivera RL, Schmidt LR, Mattes RD. The Macronutrients, Appetite, and Energy Intake. Annu Rev Nutr 2016; 36:73-103. [PMID: 27431364 PMCID: PMC4960974 DOI: 10.1146/annurev-nutr-121415-112624] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Each of the macronutrients-carbohydrate, protein, and fat-has a unique set of properties that influences health, but all are a source of energy. The optimal balance of their contribution to the diet has been a long-standing matter of debate. Over the past half century, thinking has progressed regarding the mechanisms by which each macronutrient may contribute to energy balance. At the beginning of this period, metabolic signals that initiated eating events (i.e., determined eating frequency) were emphasized. This was followed by an orientation to gut endocrine signals that purportedly modulate the size of eating events (i.e., determined portion size). Most recently, research attention has been directed to the brain, where the reward signals elicited by the macronutrients are viewed as potentially problematic (e.g., contribute to disordered eating). At this point, the predictive power of the macronutrients for energy intake remains limited.
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Affiliation(s)
- Alicia L Carreiro
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907
| | - Jaapna Dhillon
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907
| | - Susannah Gordon
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907
| | - Ashley G Jacobs
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907
| | - Kelly A Higgins
- Department of Food Science, Purdue University, West Lafayette, IN 47907
| | | | - Benjamin W Redan
- Department of Food Science, Purdue University, West Lafayette, IN 47907
| | - Rebecca L Rivera
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907
| | - Leigh R Schmidt
- Department of Food Science, Purdue University, West Lafayette, IN 47907
| | - Richard D Mattes
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907
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Rivera RL, Maulding MK, Abbott AR, Wang Q, Eicher‐Miller HA. Improvement in Long‐term Household Food Security among Indiana Households with Children did not Differ between Rural and Urban Counties after a Supplemental Nutrition Assistance Program‐Education Intervention. FASEB J 2016. [DOI: 10.1096/fasebj.30.1_supplement.674.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | - Angela R Abbott
- Health & Human Sciences ExtensionPurdue UniversityWest LafayetteIN
| | - Qi Wang
- StatisticsPurdue UniversityWest LafayetteIN
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Dhillon J, Craig BA, Leidy HJ, Amankwaah AF, Osei-Boadi Anguah K, Jacobs A, Jones BL, Jones JB, Keeler CL, Keller CEM, McCrory MA, Rivera RL, Slebodnik M, Mattes RD, Tucker RM. The Effects of Increased Protein Intake on Fullness: A Meta-Analysis and Its Limitations. J Acad Nutr Diet 2016; 116:968-83. [PMID: 26947338 DOI: 10.1016/j.jand.2016.01.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 01/08/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Higher protein intake has been implicated in weight management because of its appetitive properties. However, the effects of protein intake on appetitive sensations such as fullness have not been systematically assessed. Meta-analysis is a useful technique to evaluate evidence of an intervention's effect on testable outcomes, but it also has important limitations. OBJECTIVE The primary aim of this study was to synthesize the available evidence on the effect of protein intake on fullness using a quantitative meta-analysis and a secondary directional analysis using the vote-counting procedure. A tertiary aim was to address limitations of meta-analyses as they pertain to findings from this meta-analysis. DESIGN We searched multiple databases for interventional studies that evaluated the effect of increased protein intake on fullness ratings. Inclusion criteria for both analyses were as follows: healthy human participants, preload studies that utilized intact dietary protein, delivery of protein load orally, and studies reporting fullness as an outcome. For the meta-analysis, an additional criterion was that the studies also needed to report 2- to 4-hour area under the curve value for fullness. RESULTS Five studies met all criteria for the meta-analysis. Twenty-eight studies met all criteria for the directional analysis. The meta-analysis indicated higher protein preloads have a greater effect on fullness than lower protein preloads (overall effect estimate: 2,435.74 mm.240 min, (95% CI 1,375.18 to 3,496.31 mm.240 min; P<0.0001). The directional analysis also revealed a positive effect on fullness with higher protein preloads (P<0.01). Many related scientifically rigorous studies were excluded from the analysis because analytical criteria required a narrowly focused research question. CONCLUSIONS The present analyses show that higher protein preloads increase fullness ratings more than lower protein preloads under tightly defined conditions. Extrapolation of findings to common conditions outside the specified criteria of this analysis must be made cautiously, as must speculation about the influence of fullness sensations on ingestive behavior, body weight, and various health outcomes.
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Fialkowski MK, Ettienne R, Shvetsov YB, Rivera RL, Van Loan MD, Savaiano DA, Boushey CJ. Ethnicity and acculturation: do they predict weight status in a longitudinal study among Asian, Hispanic, and non-Hispanic White early adolescent females? Adolesc Health Med Ther 2015; 6:1-7. [PMID: 25624775 PMCID: PMC4296880 DOI: 10.2147/ahmt.s67511] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background The prevalence of overweight and obesity among adolescents has increased over the past decade. Prevalence rates are disparate among certain racial and ethnic groups. This study sought to longitudinally examine the relationship between overweight status (≥85th percentile according to the Centers for Disease Control and Prevention growth charts) and ethnic group, as well as acculturation (generation and language spoken in the home) in a sample of adolescent females. Methods Asian (n=160), Hispanic (n=217), and non-Hispanic White (n=304) early adolescent girls participating in the multistate calcium intervention study with complete information on weight, ethnicity, and acculturation were included. Multiple methods of assessing longitudinal relationships (binary logistic regression model, linear regression model, Cox proportional-hazards regression analysis, and Kaplan–Meier survival analysis) were used to examine the relationship. Results The total proportion of girls overweight at baseline was 36%. When examining by ethnic group, the proportion varied with Hispanic girls having the highest percentage (46%) in comparison to their Asian (23%) and Non-Hispanic White (35%) counterparts. Although the total proportion of overweight was 36% at 18 months, the variation across the ethnic groups remained with the proportion of Hispanic girls becoming overweight (55%) being greater than their Asian (18%) and non-Hispanic White (34%) counterparts. However, regardless of the statistical approach used, there were no significant associations between overweight status and acculturation over time. Conclusion These unexpected results warrant further exploration into factors associated with overweight, especially among Hispanic girls, and further investigation of acculturation’s role is warranted. Identifying these risk factors will be important for developing targeted obesity prevention initiatives.
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Affiliation(s)
- Marie K Fialkowski
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
| | - Reynolette Ettienne
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - Yurii B Shvetsov
- Epidemiology Program, University of Hawai'i Cancer Center, Honolulu, HI, USA
| | - Rebecca L Rivera
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
| | - Marta D Van Loan
- United States Department of Agriculture, ARS Western Human Nutrition Research Center, Obesity and Metabolism Unit, Davis, CA, USA
| | - Dennis A Savaiano
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
| | - Carol J Boushey
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
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Abstract
Learning about one's sexuality is an important developmental task for the adolescent and has implications for a lifelong process of becoming a sexual being and reaching sexual maturity. Learning about intimacy in relationship with others is another important developmental task for the adolescent. The occurrence of interpersonal violence, particularly sexual, physical, or psychological violence, disrupts the development of intimacy which informs the process for becoming a sexual being. Society can assist adolescent females experiencing interpersonal violence to understand their sexual nature and make informed sexual decisions throughout their lifetime. This assistance requires a contextual understanding of the relationship between adolescent sexual development and the effects of interpersonal violence on this process. This study presents the groundwork needed to understand the contextual meanings of sexual relationships of adolescent females with a history of interpersonal violence and discusses the evolution of these adolescents' attitudes and beliefs for sexual health promotion.
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Affiliation(s)
- Jane Dimmitt Champion
- University of Texas Health Science Center at San Antonio, Family Nursing Care, San Antonio, TX 78801, USA.
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