Abstract Current research suggests that the prevalence of obesity is higher among rural youth than urban youth. Due to the health implications that are associated with child and adolescent obesity, ...it is critical to understand systematic differences in diet and physical activity (PA) behaviors that may be contributing to this disparity in weight. However, varying definitions of rural and inconsistencies in study tools and methodologies may limit the generalizability of findings from research in this area. The objective of this narrative review was to synthesize and critically evaluate existing literature comparing diet and PA behaviors between rural and urban children and adolescents, providing recommendations for future research. Only five studies were found that reported on measures of diet in rural vs urban youth, whereas 16 were found that reported on measures of PA. Dietary assessment tools were generally standard and acceptable; however, differences existed in how dietary outcomes were defined. Few studies used assessment tools that objectively measured PA, and definitions for meeting PA recommendations varied among studies. Very few studies defined rural using the same criteria. Future research on the rural youth obesity disparity should focus on including a high-quality assessment of both diet and PA (as opposed to one or the other) and on using an appropriate and consistent definition of rural.
Dietary modulation of the gut microbiota impacts human health. Here we investigated the hitherto unknown effects of resistant starch type 4 (RS4) enriched diet on gut microbiota composition and ...short-chain fatty acid (SCFA) concentrations in parallel with host immunometabolic functions in twenty individuals with signs of metabolic syndrome (MetS). Cholesterols, fasting glucose, glycosylated haemoglobin, and proinflammatory markers in the blood as well as waist circumference and % body fat were lower post intervention in the RS4 group compared with the control group. 16S-rRNA gene sequencing revealed a differential abundance of 71 bacterial operational taxonomic units, including the enrichment of three Bacteroides species and one each of Parabacteroides, Oscillospira, Blautia, Ruminococcus, Eubacterium, and Christensenella species in the RS4 group. Gas chromatography-mass spectrometry revealed higher faecal SCFAs, including butyrate, propionate, valerate, isovalerate, and hexanoate after RS4-intake. Bivariate analyses showed RS4-specific associations of the gut microbiota with the host metabolic functions and SCFA levels. Here we show that dietary RS4 induced changes in the gut microbiota are linked to its biological activity in individuals with signs of MetS. These findings have potential implications for dietary guidelines in metabolic health management.
A systematic review and meta-analysis determined the effect of restaurant menu labeling on calories and nutrients chosen in laboratory and away-from-home settings in U.S. adults. Cochrane-based ...criteria adherent, peer-reviewed study designs conducted and published in the English language from 1950 to 2014 were collected in 2015, analyzed in 2016, and used to evaluate the effect of nutrition labeling on calories and nutrients ordered or consumed. Before and after menu labeling outcomes were used to determine weighted mean differences in calories, saturated fat, total fat, carbohydrate, and sodium ordered/consumed which were pooled across studies using random effects modeling. Stratified analysis for laboratory and away-from-home settings were also completed. Menu labeling resulted in no significant change in reported calories ordered/consumed in studies with full criteria adherence, nor the 14 studies analyzed with ≤1 unmet criteria, nor for change in total ordered carbohydrate, fat, and saturated fat (three studies) or ordered or consumed sodium (four studies). A significant reduction of 115.2 calories ordered/consumed in laboratory settings was determined when analyses were stratified by study setting. Menu labeling away-from-home did not result in change in quantity or quality, specifically for carbohydrates, total fat, saturated fat, or sodium, of calories consumed among U.S. adults.
Physicians at an integrated health system based in Sioux Falls, South Dakota launched an Extension for Community Healthcare Outcomes (ECHO) project to provide ongoing professional development and ...support for maternal health providers in rural and underserved areas. The ECHO model was chosen for its Web-based program delivery and 60-minute sessions that include both a didactic component and a case study discussion.1 Ultimately, the Perinatal Tele-ECHO aims to maintain the number of providers who are competent to manage maternal health care, particularly at low-birth-volume facilities. ...collective understanding of how to disseminate and implement best practices across diverse perinatal disciplines in South Dakota continues to improve and expand.
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Evidence of the relationship between dietary cost, diet quality, and socio-economic status is mixed. No studies have directly evaluated food-security status and dietary cost. This study investigated ...whether food-pantry clients with low and very low food-security status had less expensive daily diets than food-secure clients by comparing total cost, cost per gram, and cost per calorie of total daily dietary intake both per person and by individual food item, followed by evaluations of each food group. Mixed-model regression and Tukey-Kramer comparisons were used to compare food-security groups. There was no clear association between food-security status and cost of daily diet. Analyzed per person, total price and price per gram showed significant differences between low food-secure and food-secure groups. When analyzing individual food items, prices per calorie were significantly different between food-secure and very low food-secure groups. The directionality of the relationships by food-security status was inconsistent. Per person, those with lower food security had lower mean prices, and for individual foods this association was reversed. Therefore, the metric of food cost and the unit of analysis are critical to determining the relationship between food-security status and dietary cost.
Previous evidence suggests that children’s eating behaviors were largely influenced by the parent and home eating structure. This study examined the relationship between parenting styles (including ...authoritative, authoritarian, indulgent, and uninvolved), food parenting practices (within Structure, Coercive Control, and Autonomy Support constructs) and dietary intakes of preschoolers. Children aged 3–5 years and their parents were recruited from preschools/daycare centers and parents completed the surveys (n = 166). Dietary intakes were collected using the Harvard Service Food Frequency Questionnaire (HSFFQ), parenting style was assessed using the Parenting Dimensions Inventory-Short Version (PDI-S), and food parenting practices were measured using Comprehensive Home Environment Survey (CHES). The results showed that food parenting practices had a higher number of specific significant findings on children’s nutrient and food group intakes than parenting styles. Correlation analyses showed positive parenting practices within Structure were significantly related to healthier children’s intakes (e.g., vegetables, iron, and folate) and less unhealthy dietary intakes (e.g., sweets and total fats). Regression models show that children with authoritative parents consumed more fruits compared to children with authoritarian parents and indulgent parents. The results addressed the importance of parental influences for preschoolers’ healthy dietary intakes, which suggested that future interventions and educational programs could enhance parenting practices to impact child diet.
ABSTRACT
BACKGROUND
School districts participating in the US Child Nutrition program are required to have a wellness policy. Many state agencies provide model policies to aid districts in policy ...creation. However, use of model wellness policies has not been associated with higher quality policies. Therefore, the purpose of the present study was to assess the quality of model wellness policies and to determine if federal regulations are more likely to be included than evidence‐based best practices.
METHODS
Model wellness polices available through state agency websites were analyzed for comprehensiveness and strength using the WellSAT 3.0 and item status as a federal regulation or best practice was assigned. We used linear regression to determine if federal regulation status was associated with inclusion in model wellness policies.
RESULTS
Overall, 34 states had model wellness policies available online. The total comprehensiveness and strength of model wellness policies was 59.3 ± 17.5 and 21.4 ± 17.6, respectively, out of 100 possible points. Among policy sections, comprehensiveness was highest within Nutrition Education (73.2 ± 31.6) and lowest in Wellness Promotion and Marketing (49.8 ± 27.2). On average, WellSAT items that were federal regulations were covered in 71% of model policies, while best practices were only covered in 54% of model policies (p = .008).
CONCLUSIONS
There is a need to improve the quality of model wellness policies. The development of a uniform model policy may be warranted to provide a comprehensive list of federal regulations and best practices, written with strong language, for inclusion within school wellness policies.
The objective was to determine if cooking skills and meal planning behaviors are associated with greater fruit and vegetable intake and lower body mass index (BMI) in first-year college students who ...are at risk for excessive weight gain. A cross-sectional analysis was conducted using baseline data from a multi-state research project aimed at preventing weight gain in first-year college students. Cooking type, frequency and confidence, self-instruction for healthful mealtime behavior intention, self-regulation of healthful mealtime behavior, and cup equivalents of fruits and vegetables (FV) were measured using validated surveys. BMI was calculated from measured height and weight. First-year students (
= 1108) considered at risk for weight gain from eight universities completed baseline assessments within the first month of entering college. Multiple linear regression was used to determine associations among independent variables of cooking patterns, meal planning behaviors, and dependent variables of fruit and vegetable intake and BMI, after controlling for the influence of sex. Cooking more frequently, cooking with greater skills, and practicing meal planning behaviors are associated with greater fruit and vegetable intake and lower BMI in first-year college students. Interventions aimed at improving health in college students may be enhanced by incorporating cooking and meal planning components.
The built environment contributes to an individual's health, and rural geographies face unique challenges for healthy eating and active living. The purpose of this descriptive study was to assess the ...nutrition and physical activity environments in rural communities with high obesity prevalence. One community within each of six high obesity prevalence counties in a rural Midwest state completed the Nutrition Environment Measures Survey for Stores (NEMS-S) and the Rural Active Living Assessment (RALA). Data were collected by trained community members and study staff. All communities had at least one grocery store and five had at least one convenience store. Grocery stores had higher mean total NEMS-S scores than convenience stores (26.6 vs. 6.0,
< 0.001), and higher scores for availability (18.7 vs. 5.3,
< 0.001) and quality (5.4 vs. 0,
< 0.001) of healthful foods (higher scores are preferable). The mean RALA town-wide assessment score across communities was 56.5 + 15.6 out of a possible 100 points. The mean RALA program and policy assessment score was 40.8 + 20.4 out of a possible 100 points. While grocery stores and schools are important for enhancing food and physical environments in rural areas, many opportunities exist for improvements to impact behaviors and address obesity.
Voices for Food was a longitudinal community, food pantry–based intervention informed by the social ecological model, and designed to improve food security, dietary intake, and quality among clients, ...which was carried out in 24 rural food pantries across 6 Midwestern states.
Our objective was to evaluate changes in adult food security, dietary intake, and quality from baseline (2014) to follow-up (2016), and to assess the role of adult food security on dietary outcomes.
A multistate, longitudinal, quasi-experimental intervention with matched treatment and comparison design was used to evaluate treatment vs comparison group changes over time and changes in both groups over time.
Adult food pantry clients (n = 617) completed a demographic food security survey, and up to three 24-hour dietary recalls at baseline (n = 590) and follow-up (n = 160).
Community coaching served as the experimental component, which only “treatment” communities received, and a food council guide and food pantry toolkit were provided to both “treatment” and matched “comparison” communities.
Change in adult food security status, mean usual intakes of nutrients and food groups, and Healthy Eating Index-2010 scores were the main outcome measures.
Linear mixed models estimated changes in outcomes by intervention group and by adult food security status over time.
Improvements in adult food security score (–0.7 ± 0.3; P = .01), Healthy Eating Index-2010 total score (4.2 ± 1.1; P < .0001), and empty calories component score (3.4 ± 0.5; P <.0001) from baseline to follow-up were observed in treatment and comparison groups, but no statistically significant changes were found for adult food security status, dietary quality, and usual intakes of nutrients and food groups between the 2 groups over time. The intervention effect on dietary quality and usual intake changes over time by adult food security status were also not observed.
Food pantry clients in treatment and comparison groups had higher food security and dietary quality at the follow-up evaluation of the Voices for Food intervention trial compared with baseline, despite the lack of difference among the groups as a result of the experimental coaching component.
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