bluuebunny/crossref_metadata_2025 huggingface dataset:
Early Childhood Cognitions of Food, Nutrition, and Health
Authors: Ramsay Samantha , Tsao Ling‐Ling , Ferrante Mackenzie , Lanigan Jane , Susan Johnson
Published: June 2021

Objective

Identify the capacity, content, and reliability of preschoolers' knowledge and cognitions of food, nutrition, and health.

Methods

Twenty‐six young children participated in two interviews scheduled six weeks apart. During both interviews, the children were asked eight open‐ended questions regarding food and health, and they were given a picture and toy of five food items to place on a MyPlate image in the corresponding food groups. Interviews were audio‐recorded, transcribed, and the MyPlate placement was recorded.

Analysis

Two researchers conducted a content analysis of the responses to identify themes. Reliability of MyPlate food group placement was measured using Spearman's Rho.

Results

Most children correctly labeled the five food items, but fewer foods were correctly placed into MyPlate categories. MyPlate placement correlated for strawberries (ρ = .64, p= 0.001), but no other food items; indicating low reliability. Interviews regarding children's nutrition cognitions revealed: limited knowledge about what food does for the body, food reported to come from the store; and children described food preparation based on their experiences. Four themes emerged from children's responses to the question about health: 1) term “healthy” was not understood; 2) parent statements about food and health were repeated; 3) to be healthy, children indicated one needs to eat; 4) some accurate nutrition information was stated but more concepts were incorrect.

Implications

Nutrition education for early childhood should be developmentally appropriate through child‐centered learning experiences that sequence ideas to support children's later abilities and understandings.
Maternal Dietary Quality Affects Breast Milk Composition
Authors: Penfield‐Cyr Annie , Panagos Patoula , Shivappa Nitin , Wirth Michael , Hebert James , Sen Sarbattama
Published: June 2021

Background

Previously, we have shown that breastmilk (BM) of obese (Ob) mothers has a pro‐inflammatory fatty acid (FA) profile. Nutrition provided in infancy has a profound impact on obesity risk in offspring. Maternal diet, through changes in BM composition, could also impact offspring growth. Here we use a literature‐derived population‐based Dietary Inflammatory Index (DII), a predictor of dietary inflammatory potential, to determine whether BM composition is influenced by modifiable maternal dietary factors.

Objective

To examine the relationship between maternal DII, BM composition and infant growth.

Methods

BM was collected 4‐10 weeks post‐partum from 21 lean (BMI 18‐25kg/m2) and 21 Ob (BMI>30kg/m2) women. These samples were analyzed for micronutrient and macronutrient composition. Food diaries were collected and specific food parameter estimates were used to calculate a DII for each subject. A higher DII score indicates a pro‐inflammatory diet. Infant growth was obtained at the same time point.

Results

Ob women had a higher DII (p=0.059). BM from Ob mothers had a higher omega (n)‐6:n‐3 FA ratio (p<0.01) compared to lean mothers. The DII was strongly positively correlated with BM saturated FA (R=0.46, p<0.01), and strongly negatively correlated with BM n‐3 FA (R= ‐0.46, p<0.01). BM n6:n3 was positively correlated with infant z‐score (R=0.43, p<0.05). These relationships remained significant after adjustment for maternal BMI.

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Conclusions

Our study suggests that maternal diet is a major modifiable factor that affects the inflammatory composition of BM.
Quality of the Early Infant Diet across the Eight Low and Middle Income Countries from the Malnutrition and Enteric Disease (MAL‐ED) Study
Authors: Chandyo Ram , Maciel Bruna , Ambikapathi Ramya , Patil Crystal , Bose Anuradha , Amour Caroline , Islam Munirul , Turab Ali , Bessong Pascal , Caulfield Laura
Published: June 2021

We explored breastfeeding practices and the quality of the early complementary feeding from birth to eight months of age according to WHO core indicators across the eight sites in South Asia (Bangladesh, India, Nepal and Pakistan), Africa (South Africa, Tanzania) and Latin America (Brazil, Peru). We prospectively follow up cohorts of ~200 mother‐newborn dyads at each site. We categorized exclusive breastfeeding and the quality of the complementary feeding utilizing the WHO Core Indicators by twice weekly surveillance visits and monthly food frequency survey. Overall, 2145 children were enrolled across eight sites. By six months of age, exclusive breastfeeding rates ranged from 1 to 4% in India, Nepal, Brazil, and Peru to 10.3% in Bangladesh. No children in Pakistan, South Africa, or Tanzania were EBF for their entire first six months of life. Only Brazil had acceptable minimum diet diversity (72.2%), acceptable diet (70.5%), meal frequency (90%) and consumption of iron rich foods (71%), while in all sites it ranged from 4‐15%, 0‐14%, 11‐95% and 3‐44%, respectively. Exclusive breastfeeding in the first 6 months and quality of complementary foods at 6‐8 months of age were heterogeneous and sub‐optimal in most of the sites.
Design and Implementation of a Sensory‐based Exotic Fruit and Vegetable Nutrition Education Classroom Intervention targeting Pre‐K through First Grade Children in Southern Illinois
Authors: KANNAN SRIMATHI
Published: June 2021

The purpose of this pilot study is to design and implement a innovative classroom‐based nutrition education study that involves using the five senses (sight, smell, touch, taste, hearing) in order to teach preschool children about exotic, locally available fruits and vegetables. During the six‐week project time‐frame, trained student research project assistants introduced the children (n=180) to the respective fruit or vegetable for that day through an activity, which involved music, dance, book reading, arts and crafts, or movement. Children tasted pre‐weighed portions of the featured fruit/vegetable upon completion of lesson plan for that day. Using videotaped observations and rating scales, research assistants observed the children and recorded sensory‐based explorations and interactions using the Willingness to Engage and Willingness to Taste Rating scale with the fruit or vegetable and peer interactions. This presentation will highlight methodological protocols planned for video‐coding the sensory observations and peer interactions.
Commercial Complementary Foods in Nine Countries
Authors: Wallingford John
Published: June 2021

Information on complementary foods, especially commercially prepared complementary foods (CCF) in diets of older infants and young children is limited in most countries. Nine target countries of differing levels of economic development (Brazil, Cameroon, Egypt, France, Indonesia, Mexico, New Zealand, Philippines, United States) were selected to describe the role of CCF in the nutritional intake of 6‐month to 24‐month‐old children in context of published scientific reports. CCF were identified from country‐level market basket and DHS surveys; foods were assigned to a WHO dietary indicator food category and nutrition information from labels was used to characterize these foods for their content of iron, zinc, calcium, vitamin A, sodium, sugars and fat. Cereals were the most common CCF in each country, providing significant proportions of recommended levels of iron and often zinc. CCF foods in higher SES countries were more diverse; CCF could improve diet diversity in developing countries. Fortification levels vary: CCF had higher iron and vitamin A levels content in countries where deficiencies of these are common and variety is limited. Declared levels of sugars, fat and salt in CCFs were in line with recommendations for a balanced diet. Where CCFs are commonly used and diet survey data are available CCF contribute a substantial portion of the nutritional intake. In most countries diet surveys are needed to determine the quantitative the nutritional contribution of CCF. Forecasts of growth of CCF in less developed countries suggests increased prevalence or duration of use of CCF are needed for these foods to improve intake of key nutrients in the diets of young children.
Production And Quality Evaluation of Weaning Food from Soybean (GlycineMax), Maize (ZeaMays) And Sweet Potato(IpomoeaBatatas) Blends
Authors: Banjoko Immaculata , Oyelola Olukemi , Fakorede Ruqayah , Banjoko Oludotun
Published: June 2021

It is becoming increasingly mandatory to ensure the availability of Vit A in foods especially those provided for infants. Furthermore, availability must meet demands at an affordable price importantly in developing countries of the world like Nigeria.Weaning food was produced from sprouted soybean, extruded maize and fortified with pro‐vitamin A from the orange sweet potatoto to meet these demands of infants. The four samples,coded ABC, DEF, GHI and SMC were formulated at different ratios of extruded maize: sprouted soybean: pregelatinized sweet potato respectively with sample ABC ( 60% : 20% : 20%). Sample DEF( 55% : 20% : 25%)and Sample GHI ( 50%: 20% : 30%) while sample SMC is the control (Soybean and maize). The four coded samples were subjected to proximate analysis, functional analysis, pasting characteristics and vitamin A analysis. The result of proximate analysis in the produced weaning food showed a significant increase at (p>0.05) in the protein content,crude fiber,moisture content and fat content for all experimental samples when compared to the control. The protein content ranged from (15.07% ‐ 15.67% ),crude fiber ranged from (2.39% ‐ 5.87%),moisture content ranged from (8.66% ‐ 9.49%),fat content ranged from (4.08% ‐ 5.49%) for the experimental samples. However carbohydrates content and ash content showed a significant decreases at (p >0.05) when compared to the control sample. Sensory evaluation result indicated that of all the experimental samples, sample GHI (50%:20%:30%) had the highest score in terms of overall acceptability.
Caregiver Feeding Style Questionnaire: Reduced Version for Toddlers
Authors: Edelson Lisa , Mokdad Cassandra , van der Horst Klazine
Published: June 2021

Objective

To create a shorter version of the Caregiver Feeding Style Questionnaire (CFSQ) to be used in studies with families of 1‐3 year‐old children.

Methods

An online questionnaire including the CFSQ was administered to 1005 American families with children between 12‐36 months. From this data, models were run to identify the 30 best subsets of 8, 9, or 10 of the original 19 items of the questionnaire. These models were compared for their predictive value of scores from the whole questionnaire and a best model was selected. To explore generalizability, the selected model was also applied to a separate sample of 332 families with children in the same age range in Michigan.

Results

The best subset of questions included items: 1, 4, 6, 7, 8, 12, 13, 17‐19 from the original questionnaire (see table). The new demandingness subscale predicted the original scores with an adjusted r2=0.94; for responsiveness, r2=0.83. Adjusting the cutoff points between feeding styles from 2.8 to 3.0 for demandingness and 1.16 to 1.17 for responsiveness reduced the errors in categorizing parents. Similar results were found with the second sample of families (demandingness r2=0.91; responsiveness r2=0.81).

Item Number from Original CFSQ (* = incl. in responsiveness scale)
CFSQ Item Wording, "How often do you..."

1
Physically struggle with your child to get him or her to eat (for example, physically putting your child in the chair so he or she will eat).

4*
Ask your child questions about the food during dinner.

6*
Reason with your child to get him or her to eat (for example, “Milk is good for your health because it will make you strong”).

8*
Allow your child to choose the foods he or she wants to eat for dinner from foods already prepared.

9*
Compliment your child for eating food (for example, “What a good boy! You’re eating your beans”).

12
Warn your child that you will take away something other than food if he or she doesn’t eat (for example, “If you don’t finish your meat, there will be no play time after dinner”).

13
Tell your child to eat something on the plate (for example, “Eat your beans”).

17*
Help your child to eat dinner (for example, cutting the food into smaller pieces).

18
Encourage your child to eat something by using food as a reward (for example, “If you finish your vegetables, you will get some fruit”).

19
Beg your child to eat dinner.

Conclusions

For epidemiological surveys, phone interviews, or other situations in which the number of survey items is very limited, a 10‐item version of the CFSQ may be valuable and can provide similar dimension scores to the full version. Although when cutoff points were used, some parents changed feeding style categorization, this was due to the normal distribution of scores, with the bulk falling near the cutoff point (mean).
Disordered Eating Behaviors Among College Students: Does Nutrition Major Matter?
Authors: Yu Zhiping , Snyder Jill , Tan Michael , Ross Jenifer , Shank Jacqueline
Published: June 2021

Objective

The evidence of whether nutrition professionals are free from food‐related issues or at higher risk for disordered eating behaviors (e.g. dieting, emotional eating, and lack of oral control) is inconsistent. The current study aimed to assess and compare disordered eating behaviors between nutrition major and non‐nutrition major college students.

Methods: College students (n=967, ages 18‐25, female 72.7%, white 74.8%) enrolled at a public university in 2014 were recruited to take an online survey. The survey includes demographic characteristics and three validated questionnaires measuring specific disordered eating behaviors and attitude.

Results: Many participants engaged in disordered eating behaviors. Overall, 27% are at a high level of concern about dieting, body weight or problematic eating behavior. About 10.3% meet the criteria for “food dependence” diagnosis. When comparing nutrition major, health‐related non‐nutrition major, and other major students, there were no significant differences in nearly all behaviors such as dieting, bulimia, oral control, cognitive restraint, emotional eating and food dependence symptom count.

Conclusion

The findings suggest that prevention and nutrition intervention for college students may be needed to address disordered eating behaviors. Enrollment in nutrition major seems not a factor affecting the rate of disordered eating behaviors among college students.
Effects of Neighborhood Social Norms on Children's Diets and Weight Outcome in China
Authors: Xue Hong , Wang Huijun , Wang Youfa
Published: June 2021

Objectives

Examine influences of community social norms on school children's dietary intake and body mass index (BMI).

Methods

Contextual effect models were fit using data from the 1991‐2011 China Health and Nutrition Survey for school‐age children (6‐18 y, n=6034), from 9 provinces and over 200 communities across China. Local community level average dietary intake was used as the proxy of food consumption norms in a given reference social context (“community”). Dietary intakes were measured using 24‐hour dietary recalls. Weight and height were measured. Rich data on community were collected from key informants.

Results

The contextual (social norms) effects on child dietary intake, namely fat, carbohydrate, and protein were significant. In 1991, every 10g daily fat intake increase was associated with a 6.4g fat intake increase at individual (P>0.01). The effect became slightly smaller in 2011 with about a 5.5g increase (P>0.01). For carbohydrate and protein intake, every 10g daily intake increase was associated with about 6g increase for both in 1991 (P>0.01), but the effect decreased to 4.9g (P>0.01) for carbohydrate and increased to 6.6 for protein in 2011. All the temporal changes were not statistically significant indicating fairly strong and stable contextual effect overtime. We did not find significant association between the contextual effect of the community dietary intake and child BMI.

Conclusions

Chinese children's dietary intake was influenced by the neighborhood context. Child BMI was not found associated with the community social norm of child dietary intake as indicated by average intakes.

Funding

NIH U54 center grant, HD070725
The prevalence and associated factors of diabetes in pulmonary tuberculosis patients in rural China
Authors: Cai Jing , Ma Aiguo , Wang Yu , Wang Qiuzhen , Han Xiuxia , Zhao Shanliang , Ma Yunbo
Published: June 2021

The co‐morbidity of diabetes (DM) and pulmonary tuberculosis (PTB) represents a double burden with significant public health implications. We conducted this study to determine the current prevalence of DM and identify the factors for the presence of DM among PTB patients in rural China. We selected 5146 newly‐diagnosed PTB patients (蠅18 years) registered in county PTB clinics from September 2010 to March 2013 in rural area of Shandong province, China, meanwhile 3744 non‐PTB residents living in the same community as the controls. A structured questionnaire were administered including BMI. The prevalence of DM in PTB patients (6.0%) was higher than in controls (5.0%, P<0.05). PTB patients had higher odds of having DM compared with controls (adjusted OR=1.31, 95% CI: 1.07–1.59). Then participants were divided into 4 groups based on whether the fasting plasma glucose was higher than 6.1 mmol/L in PTB cases or controls: PTB+DM group, PTB group, DM group and non (PTB+DM) group. We found that BMI of PTB+DM and PTB groups were significantly lower than the other groups (P<0.05), and underweight was risk factor but overweight was protective factor. Rate of current smoking was similar between PTB+DM (22.9%) and PTB group (23.5%), which was higher than the other groups (P<0.05). Furthermore, current smoking was positively associated with PTB group (OR=1.27, P=0.000). In conclusion, the prevalence of DM in PTB patients was higher than non‐PTB controls. While we confirmed beneficial effect of underweight and smoking in higher DM prevalence, and overweight was somewhat protective in co‐morbidity of PTB and DM.

Supported by NSFC‐81172662.
Diet during pregnancy and disparities in fetal growth: the NEST cohort
Authors: Mendez Michelle , Grabich Shannon , Nahm Sarah , Murphy Susan , Hoyo Cathrine
Published: June 2021

Diet in pregnancy is thought to potentially contribute to race/ethnic disparities in reproductive outcomes, but evidence is scarce. We assessed how Mediterranean diet (MD) adherence and “junk foods” (e.g. cakes/pastries) related to fetal growth among 788 women from the Newborn Epigenetic Study (NEST) using food frequency data. MD scores were based on intakes >median for 8 beneficial (fruit, vegetables, fish, dairy products, whole grains, nuts, legumes, mono:saturated fat) and <median for 2 less beneficial (processed and unprocessed meats) items. Compared with white women (mean birthweight [BW] 3391g), education‐adjusted differences in BW were ‐220±40g in Blacks. MD scores were lower in Black than white women, while junk food intakes were higher (P<0.05). In BW models, pre‐pregnancy BMI by MD adherence interactions were significant (P<0.10). High MD adherence (>7 points) was associated with increased BW in normal weight women (P<0.05), with benefits of this diet attenuated in overweight women. Associations between BW and/or low BW with MD components such as whole grains were positive, while associations with cakes/pastries were negative. However, adjusting for MD score or food groups only slightly attenuated race disparities in BW. Results highlight disparities in intake that may influence fetal growth, but suggest the role of diet in BW disparities is complex.
Efficacy Perceptions of Fruit and Vegetable Parenting Practices in Low‐income Diverse Mothers of Preschoolers
Authors: Shriver Lenka , Buehler Cheryl
Published: June 2021

Previous research has focused largely on controlling aspects of parental influences on children's eating. Less is known, however, about parenting practices that encourage healthy food consumption. This study contrasted efficacy perceptions of practices related to fruit and vegetables (FV) in ethnically diverse mothers of 3‐5 year old children recruited from 12 Head Start centers in North Carolina. Nine dimensions of FV parenting strategies were extracted from literature and subjects reported perceived efficacy on each. Principal component analysis revealed 2 factors within availability (availability, α=.83; serving, α=.71), with no racial/ethnic differences on efficacy perceptions. Efficacy perceptions of accessibility (α=.76), modeling (α=.78), reward (α=.81), and child inclusion (α=.88) did not differ by race/ethnicity. Efficacy perceptions differed by race/ethnicity for positive support, pressure, and restriction. Positive support (α=.74) and rules and routine (α=.60) practices were believed to be more effective to encourage FV intake by Hispanic mothers. Pressure items loaded on 2 factors (pressure, α=.84; coercion, α=.70), with African American mothers expecting coercion (p<.001) and Hispanic mothers expecting pressure to be more effective for encouraging FV (p<.001). Hispanic mothers viewed fried vegetables/juice restriction (α=.87) as a more effective strategy than did African American mothers (p<.05). Our findings revealed differences in efficacy expectations of parenting practices by race/ethnicity for encouraging children's FV intake. Research identifying specific practices that are positively correlated with actual FV intake in diverse populations of preschoolers is warranted.
Self‐Concept and Obesity Risk in Low Income Diverse Preschoolers
Authors: Cardel Michelle , Bellows Laura , Boles Richard , Davies Patricia , Gavin William , Johnson Susan
Published: June 2021

OBJECTIVE

Older obese children have reported lower levels of self‐esteem than normal weight children. The developmental course of weight‐related impacts on self‐concept has not been well‐documented. We examined associations among domains of self‐concept and child sex, ethnicity, and weight status in a sample of low‐income, diverse preschoolers.

METHODs

Self‐concept and pediatric weight status were collected at baseline as part of the Colorado LEAP study. Participants were 253 low income preschoolers (54.8% female; 39.5% Hispanic; mean age 4.65 y). Self‐concept was measured with an assessment that quantified children's self‐perceptions in 4 domains (Cognitive Competence, Physical Competence, Peer Acceptance, & Maternal Acceptance). Weight status and classification were calculated based on measured height and weight. Statistical analysis included Pearson's Correlations and independent t‐tests (α<.05).

RESULTS

Domains of self‐concept were highly inter‐correlated (p<0.01). Children with low perceived Maternal and Peer Acceptance also reported low Cognitive and Physical Competence, independent of weight status, sex, and ethnicity. Measures of self‐concept were not related to child weight status or classification and nor did they differ according to sex, ethnicity, or weight status.

CONCLUSIONS

Our results suggest that weight status in low‐income preschool‐aged children does not yet influence self‐perceptions related to maternal and peer acceptance or cognitive or physical competence.
Health‐related Risk Factors of Chinese Students in South Korea
Authors: Kim Junghee , Gao Ranran , Lee Jounghee
Published: June 2021

The main purpose of this study was to examine risk factors associated with the change in body mass index of Chinese students after migration in South Korea. More specifically, we aimed to investigate the association of demographic characteristics, dietary habits, lifestyle factors, acculturation and stress score with overweight and obesity. A total of 143 Chinese students were recruited between August and October 2013. We used SPSS 20 for statistical analyses in this study. The mean length of residence was 2.9 years in Chinese students. Most subjects aged 20‐29 years was immigrated to South Korea to achieve the academic degree. Among male Chinese students, 68% of male subjects has lived in a dormitory. However, 58% of female Chinese students has lived in their own place. Compared with female subjects, a significantly greater change of weight in male subjects. Mean weight of Chinese male subjects was 69.4 kg before migration, while their mean weight was 73.9 kg after migration(p<0.001). However, there was no significant change of weight in female subjects.

Variables
Male (n=63)
Female (n=80)
Total (n=143)

Before migration
After migration
Before migration
After migration
Before migration
After migration

Body weight (kg)
69.4 ± 13.7
73.9 ± 15.1***
52.8 ± 7.0
53.3 ± 6.3
60.1 ± 13.3
62.3 ± 15.1***

Height (cm)
175.6 ± 6.5
174.2 ± 14.9
161.5 ± 5.4
161.6 ± 5.4
167.7 ± 9.2
167.2 ± 12.4

BMI
22.4 ± 3.9
23.8 ± 4.4***
20.3 ± 2.5
20.4 ± 2.2
21.2 ± 3.4
21.9 ± 3.7***

We also found there was an increase in skipping breakfast, irregular meals, and amount of meals and a decrease the frequency of eating fruits and vegetables among Chinese students in South Korea after migration. The main reason for this dietary problems was there was none who could cook for the subjects and food was more expensive in South Korea compared with China. We found higher acculturation group were significantly associated with overweight and obese subjects compared with normal weight subjects.

Variables
Low acculturation (n=78)
High acculturation (n=65)
Total (n=143)
t or x2‐value

Age (years)
25.4 ± 2.6
25.5 ± 2.8
25.4 ± 2.7
0.2

Nutritional status
Underweight (BMI <18.5)
6 (7.7)
11(16.9)
17 (11.9)
20.3***

Normal weight (BMI 18.5‐22.9)
60 (76.9)
27 (41.5)
86 (60.1)

Overweight (BMI 23.0‐24.9)
3 (3.8)
13 (20.0)
16 (11.2)

Obese 1 (BMI 25.0‐29.9)
7 (9.0)
11 (16.9)
18 (12.6)

Obese 2 ( BMI ≥ 30.0)
2 (2.6)
3 (4.6)
5 (3.5)

Gender
Male
30 (38.5)
33 (50.8)
63 (44.1)
2.2

Female
48 (61.5)
32 (49.2)
80 (55.9)

Duration for living in South Korea (years)
2.5 ± 1.9
3.5 ± 2.2
2.9 ± 2.1
37.2***

This study broadens understanding of factors associated with change in nutritional status of Chinese students after migration in South Korea.
The Impact of Crunchy Wednesdays on Happy Meal Fruit Orders in McDonald's Restaurants in France from 2009 to 2013
Authors: Drewnowski Adam , Michels Serge , Leroy Diane
Published: June 2021

The Crunchy Wednesday (“Mercredis à croquer”) (CW) campaign in France started in 2010, and offers free fruit with every Happy Meal sold on the first Wednesday of the month. The goal was to determine whether the provision of free fruit (typically apple slices or a pineapple spear) would spur additional fruit orders sold as the Happy Meal dessert. The four dessert choices in the French Happy Meal are yogurt, apple purée, apple slices, or seasonal fruit. The seasonal fruits rotate between ready‐to‐eat pieces of pineapple, cantaloupe melon, orange, kiwi, or watermelon. Sales data for over 350 million Happy Meals from 2009‐2013 for 1,296 McDonald's restaurants in France were analyzed. Frequency of choosing a fruit as dessert was 13.4% in 2009, rising to 14.5% in 2010. Following the launch of CW in September 2010, fruit desserts increased to 18.0% (p<0.001) in 2011 and to 19.4% in 2013. The provision of free fruit did not decrease fruit orders for dessert on CW as compared to regular Wednesdays. Orders of fruit for Happy Meal dessert were consistently higher on Wednesdays as compared to the whole week. The provision of free fruit and higher orders of fruit for dessert had minimal impact on the other components of the Happy Meal. The choices of French fried potatoes relative to cherry tomatoes and Happy Meal beverage options were virtually unchanged. The study demonstrates the value of analysing business sales data to assess viability of menu innovation programs. Since program inception, McDonald's France has distributed over 11,000,000 free fruit bags; the present data suggest that some consumer behaviors may have shifted as well. Business sales data and funds for data analyses were provided by McDonald's France.
Integration of a New Food into Daily Food Systems: A Story of Almond in South Korea
Authors: Lee Soo‐Kyung , Nam So Young , Kim Kyung Won , Kim Mi Kyung
Published: June 2021

It has been suggested that new foods get adapted and diffused more early by the young, if the new food is not a core food with a high replacibility. This study examined whether the similar trend existed when almond, a new food, was introduced to food enviornments in South Korea, using 1998‐2012 Korea National Health and Nutrition Examination Survey. Almond consumer was defined as individuals with any amount of almond consumption on the day of 24‐hr recall. Almond consumption increased (0.2% in 1998 to 6.3% in 2012, p=0.000), although the consumption amount remained low (6.06+1.24g/d in 1998 to 6.59+0.73g/d in 2012). Women (p=0.006), middle‐age groups (p=0.000), better educated (p=0.000), higher income (p=0.035), and occupation (p=0.000) was significantly associated with almond consumption. Among adult almond consumers, 64.3% reported having almond during meal times, while 33.7% as snack. Only 23.8% consumers had almond as a sole food, while 74.9% reported having almond mixed in a dish. Three consumption types were: 1) almond in baked goods, 2) almond replacing other nuts in traditional Korean dishes, and 3) almond alone. More almond consumers tended to meet EER or EAR (RI) of energy/major nutrients than non‐consumers (p=0.000), excluding almond contributions. In conclusion, while the level of almond integration in South Korea remained low, almond seemed to be picked up by individuals with higher SES and relatively good diet quality. Almond was not integrated as a core food, but started to replace existing similar foods. Therefore, new foods that are peripheral foods with replicability would better integrated in South Korea. This study was supported by Almond Board of California (#14‐KIMM‐01‐Lee).
Livestock Diversity and Food Security in Smallholder Farming Households in Haiti
Authors: Malard Julien , Melgar‐Quiñonez Hugo , Dallmann Diana , García Winder Miguel
Published: June 2021

While animal‐sourced foods and income can play central roles in the livelihoods of smallholder farmers, there is very little knowledge on how the diversity of these farmers' livestock holdings may impact their food security (FS). Using survey data from 500 smallholder Haitian farmers, this research addresses three crucial questions: (1) determining the most appropriate index for measuring smallholder farm livestock diversity, (2) evaluating the impact of this diversity on household FS, and (3) assessing impacts of the presence and diversity of different animal functional groups on household FS.
Of the five ecological diversity scores tested (along with several alternative weighting modifications), the unmodified Shannon Index was found to be the most appropriate and simplest animal diversity index for FS analyses. Our base model included household income, total livestock (tropical livestock units), and livestock diversity (Shannon Index). Interestingly, while all three variables positively impact FS, the impact of total livestock holdings is only observable at high livestock diversity levels.
Further analysis comparing diversity within and between livestock functional groups indicated that both the fraction of and diversity within a specific group of animals (mostly female animals producing a constant food supply; e.g. cows, chickens) was most protective against food insecurity, while diversity between different functional groups had no significant impact. These results represent an important contribution to the work of policymakers and practitioners to better design interventions meant to effectively impact FS among smallholder farmers.
Customers' perception of restaurant food environment by regions in Korea
Authors: Choe Jeong‐Sook , Kim Young , Park Younghee , Lee SangEun
Published: June 2021

The aim of this study was to assess the food environment, particularly focusing on restaurants in Korea. 662 persons were surveyed on customers' perceptions of food environment in Korean restaurants. A structured questionnaire composed of 30 questions on 7 factors_ sanitation(4 items), displaying information(5), food quality(12), information on nutritional and healthy food choice(6), restaurant's accessibility(1), availability(1), and affordability(1) was used. Scores(range of score : 1~7) of each factors assessing the restaurant food environmentwas 5.06 for sanitation factors, 5.05 for displaying information factors, 5.13 for taste & appearance factors, 4.35 for healthy menu factors. Informations on nutritional and healthy foodchoice showed a low rate. Only 16.24% of the subjects answered that there is a message encouraging choice of healthy foods and 27.4% answered that menu contains nutritional information. There were significant differences by regions(city, town, rural) in food environment. The restaurants food environment in rural area turned out to be poor than the other two areas. This study provided evidence for differences of restaurant food environment by regions in Korea. The rural area has a problem in restaurant's accessibility, availability, and affordability because of a lack of variety in menu items and restaurants. This results suggest that there is a need for more healthy food restaurants in rural area.
Intra‐month Availability of Sugar‐Sweetened Beverages (SSB) in the Homes of Supplemental Nutrition Assistance Program (SNAP) Preschoolers
Authors: Lora Karina , Ferris Ann , Wakefield Dorothy
Published: June 2021

Food availability is greater in SNAP homes at beginning of the SNAP cycle. Study hypothesis: Household availability of SSB will not differ during the beginning (baseline) or the end of the month (follow‐up) among homes participating only in SNAP and those not receiving assistance (non‐SNAP). Low‐income minority mothers of preschoolers (28 SNAP; 75 non‐SNAP) provided demographics and information on the availability of SSB in the home via a quantitative beverage inventory administered at baseline and follow‐up. Analysis was conducted using Wilcoxon and Kruskal‐Wallis tests. Compared to non‐SNAP homes, SNAP homes had a greater availability of SSB at baseline (Median Δ=184 fl. oz; P<0.001). Among SNAP homes, SSB availability was greater at baseline than at follow‐up (Median Δ=137.5 fl. oz; P<0.001). Among non‐SNAP homes, SSB availability also decreased between baseline and follow‐up (Median Δ=30 fl. oz; P<0.001). The difference in SSB availability from baseline to follow‐up between SNAP and non‐SNAP homes was significant (Median Δ=107.5 fl.oz; P<0.001). Consistent with the SNAP cycle, SNAP homes had greater availability of SSB early than late in the month. Although non‐SNAP homes followed a similar trajectory and considerably less availability of SSB was observed at both times, high household availability of SSB was found in both groups regardless of SNAP participation. Type of foods purchased throughout the SNAP cycle need to be investigated to understand fluctuation and allocation of resources in SNAP homes.
Total and Added Sugars: are Restrictive Guidelines Achievable?
Authors: Erickson Jennifer , Slavin Joanne
Published: June 2021

Sugar consumption, especially added sugars, is under attack. Various government and health authorities have suggested new sugar recommendations and guidelines as low as 5% of total calories from free sugars. Definitions for total sugars, free sugars, and added sugars are not standardized nor are there accepted nutrient databases for this information. Our objective was to measure total sugars and added sugars in sample meal plans created by USDA and the Academy of Nutrition and Dietetics. Utilizing the NDSR nutritional database, results found that plans created by the USDA and Academy of Nutrition and Dietetics averaged 5.6% and 3.7% calories from added sugar and 23.3% and 21.1% as total sugars respectively. Compliance with proposed added sugar recommendations would require strict dietary compliance and may not be sustainable for many Americans. Without an accepted definition and equation for calculating added sugar, added sugar recommendations are arbitrary and unlikely to improve public health. Added sugar should be consumed at a minimum as it has been correlated with excess calorie intake; however, compliance with low added sugar recommendations may not be achievable for the general public.
Socio‐demographic characteristics and active behaviors in schoolchildren of Arandas, Jalisco, Mexico
Authors: Vasquez‐Garibay Edgar , Miranda‐Rios Lizette , Romero‐Velarde Enrique , Nuño‐Cosío Maria , Campos‐Barrera Liliana
Published: June 2021

In order to explore the association between socio‐demographic characteristics of the family and sedentary behaviors in their schoolchildren a cross‐sectional study was conducted; that included 192 children of both sexes aged 5‐12 years randomly selected from public elementary school of Arandas Jalisco during May 2010 to May 2011. There was explored the bivariate association between behaviors related to physical activity and sedentary lifestyle and socio‐demographic variables. Those associations that were significant (p <0.05), or with a tendency for significance (p <0.2) were included in a logistic regression model adjusted by sex, Body Mass Index, and income.

Table1. Logistic regression of active and sedentary behaviors of children and socio‐demographic characteristics of families

Variables
Crude OR
CI 95%
p
Adjusted OR
CI 95%
p

Practice of physical activity, exercise or sport (yes vs not)

Number of persons per room1
5.8
2.2‐15.1
<0.001
6.1
2.2‐17.3
0.001

Sex2
2.98
1.5‐6.0
0.002
3.0
1.4‐6.7
0.005

Transpotation to school (Active vs motorized)

Income3
2.8
1.2‐6.9
0.019
3.1
1.3‐7.7
0.013

Father´s occupation4
4.7
1.03‐20.9
0.030
5.1
1.1‐23.3
0.034

Television viewing (≤2 vs >2 h/d)

Family composition5
2.4
1.0‐5.5
0.046
2.7
1.1‐6.6
0.030

Outdoor playing (5‐7 vs 0‐2 times per week)

Father´s job situation6
2.7
1.2‐5.9
0.016
2.9
1.1‐8.1
0.038

1<3 vs ≥3; 2Male vs Female; 3 <2 vs ≥2 per capita daily USD; 4Mason/peasant vs Others; 5Composed, extended or other vs Nuclear; 6Temporary vs Permanent.

All characteristics of low socioeconomic status (lower income, low education, occupation and temporary job of fathers) were associated to active behaviors of children.
An Exploration of Health, Nutrition and Community Experiences of Gardeners at Wangari Gardens
Authors: George Tracy , Humphries Debbie , Kershaw Trace , Singer Josh
Published: June 2021

Background

Wangari Gardens is a community garden and garden education nonprofit located in the northwest region of Washington, DC. The gardens consist of 110 individual garden plots, public gardens open to harvest by any local resident of DC, and an outdoor classroom that holds free weekly workshops on gardening topics for all community members.

Objective

To explore the health and community related experiences of community members who hold garden plots at Wangari Gardens.

Methods

17 semi‐structured qualitative interviews were conducted at the community garden. Interviews lasted a half hour on average, and covered topics of how one chose to garden both broadly and at Wangari, benefits of gardening, and challenges associated with community gardening. Interviews were recorded and transcripts analyzed using qualitative data analysis software.

Results

Community members chose to begin gardening to improve nutrition, manage chronic disease symptoms, cultivate an ongoing hobby, and establish a greater connection with nature and their surrounding community. Community members continued gardening to maintain relationships created at the gardens, physical benefits, harvest from garden plots, and feelings of self‐efficacy.

Conclusion

Community gardens provide multi‐faceted benefits to community members, including individual level benefits such as a greater sense of physical well‐being and enjoyment of healthy food, and community level benefits such as bringing community members together and creating a sense of community ownership of the land and their health. This work adds to the growing body of literature on the benefits of utilizing green spaces in urban areas for community growth and health initiatives.
Elevated Serum Oxychlordane is Associated with Increased Risk of Metabolic Syndrome: Results from the National Health and Nutrition Examination Survey 1999‐2004
Authors: Gee David , Nikolaus Cassandra
Published: June 2021

Obesity, diet, and physical inactivity are risk factors commonly associated with metabolic syndrome (MetS). However, exposure to chlordane, a persistent organic pesticide that has been banned in the US since 1983, has been associated with metabolic risk. Chlordane continues to be found in indoor air of homes treated for termites as well as in foods. The objective of this research was to use the most recent non‐pooled NHANES data on chlordane exposure (1999‐2004) and its effect on metabolic syndrome risk. Data from NHANES were used to calculate odds ratios for metabolic syndrome, each of its five risk component measures, and related health markers in relationship with subjects' plasma oxychlordane concentrations. The logistic regression model used was adjusted for the influence of age, gender, ethnicity, BMI, and poverty income ratio. A total of 3465 adult subjects were used in this study. A significant relationship was found between plasma oxychlordane concentration (OR of highest quartile compared to the lowest quartile, 95% CI) and the prevalence of MetS (2.58, 1.80‐3.71), hypertriglyceridemia (3.26, 1.92‐5.46), elevated waist circumference (2.24, 1.34‐3.76), elevated blood pressure (2.58, 1.96‐3.38), and hyperglycemia (2.05, 1.23‐3.42). Additional post hoc analyses showed that high oxychlordane concentrations were also significantly related to elevated glycosylated hemoglobin, C‐reactive protein, and the homeostatic assessment of insulin resistance (HOMA‐IR). In conclusion, despite a nearly 20 year ban on its use, a significant association between plasma oxychlordane concentration and risk for metabolic syndrome exists.
Dairy Consumption and Metabolic Syndrome: A meta‐analysis of observational studies
Authors: Kim Youngyo , Je Youjin
Published: June 2021

Introduction

Emerging observational studies suggested that higher dairy consumption may reduce the risk of metabolic syndrome. However, there was no comprehensive review and meta‐analysis of dairy consumption and risk of metabolic syndrome.

Method

To provide a quantitative assessment of this association, we conducted a meta‐analysis of observational (cohort or cross‐sectional) studies published up to September 2014 through a search of MEDLINE databases and the reference lists of the retrieved articles. Information on participant characteristics, measurement of dairy consumption and outcomes, adjustment for potential confounders and estimates of associations was extracted.

Results

We identified six cohort studies and eight cross‐sectional studies of dairy consumption and metabolic syndrome, including 58,444 participants, and calculated pooled relative risks (RRs) with 95% confidence intervals (CIs) using a random‐effects model. The pooled adjusted RR of cohort studies was 0.79 (95% CI, 0.68‐0.92) for the highest category of dairy consumption compared with the lowest dairy consumption category. The inverse associations did not differ substantially by geographical region and follow‐up times. No evidence of publication bias was found (Begg's and Egger's p‐values > 0.20). In the dose‐response meta‐analysis, the pooled adjusted RR for a 1 serving/day increment of dairy consumption was 0.86 (95% CI, 0.80‐0.93).The pooled adjusted RR of cross‐sectional studies was 0.73 (95% CI, 0.67‐0.81) for the highest category of dairy consumption compared with the lowest dairy consumption category.

Conclusion

Our findings suggest that greater dairy consumption is associated with a reduced risk of metabolic syndrome. (NRF‐2014R1A1A1002736).
Early Growth and Dysmetabolism at 11.5 years: A Cohort Analysis of the PROBIT Study
Authors: Oken Emily , Tilling Kate , Rifas‐Shiman Sheryl , Patel Rita , Thompson Jennifer , Kramer Michael , Martin Richard
Published: June 2021

Background

Rapid infant weight gain predicts higher BMI in later life, but few studies have examined interactions with size at birth or associations with other cardiometabolic risk markers.

Methods: In 13,576 Belarusian children enrolled at birth in the Promotion of Breastfeeding Intervention Trial, we modeled weight gain trajectories from birth to 8.5 years and at 11.5 years we measured BMI and calculated an internal metabolic risk z‐score from fasting insulin, glucose, SBP, Apo A1 and waist circumference. Using linear regression models we adjusted for parental sociodemographics and BMI, and child weight & length at prior ages.

Results: Faster postnatal weight gain in all age periods was associated all markers of cardio‐metabolic risk except ApoA1, with increasingly stronger estimates at successively older ages. Associations were strongest for adiposity outcomes. Effect estimates (all expressed as kg/year) of weight gain on overall metabolic z‐score were 0.03 (95% CI: 0.02, 0.04) for 0‐3 months; 0.08 (0.06, 0.09) for 3‐12 months; 0.21 (0.18, 0.23) for 12‐34 months, and 0.31 (0.29, 0.33) for 34 months – 8.5 years.In SGA, AGA, and LGA infants growth during infancy had similar associations with outcomes, but faster weight gain after 12 months was much more strongly associated with adverse outcomes in SGA vs. LGA or AGA infants, whereas effects were similar in LGA vs. AGA children. In all 3 groups, associations with adverse outcomes were strongest for growth at older vs. younger ages.

Conclusion

Faster growth in later childhood predicted adverse metabolic outcomes more strongly compared with growth during infancy.
BREASTFEEDING IS ASSOCIATED WITH LOWER ADIPOSITY AND CARDIOMETABOLIC ALTERATIONS AT 4 Y OF AGE
Authors: Ramírez‐ Silva Ivonne , Rivera Dommarco Juan , Trejo‐Valdivia Belem , Martorell Reynaldo , Stein Aryeh D , Ramakrishnan Usha , Romieu Isabelle , Barraza‐Villarreal Albino
Published: June 2021

To evaluate the association between breastfeeding and adiposity and cardiometabolic markers (CM) at age 4y, we studied children of Mexican women who were followed up to 4y. Anthropometry and breastfeeding information were obtained from birth‐4y (n=727) and cardiometabolic markers at 4 y (n=524). Breastfeeding (BF) status at 3 months was classified as exclusive or predominant (EBF‐PreBF), partial (PaBF) and non‐breastfeeding (NBF) and total duration of any BF (TDBF) was classified as <3 mo, 3 to 6 mo, >6 to 12 mo and >12 mo. We used path analysis to model associations of BF and adiposity (BMI, sum of skinfolds (SSF) and arm circumference (AC)) and CM (serum total cholesterol (TCH) and LDL cholesterol (LDL‐C), triglycerides (TG) and Insulin (In)) at 4 y. Children who were NBF or PaBF at 3 mo had higher BMI [0.46 kg/m2 (95%CI: 0.16‐0.76), and 0.31 kg/m2 (95%CI: 0.07‐0.54)], SSF [6% change (95% IC: 0.02‐0.11), both BF categories] and AC [0.97cm (95% IC: 0.33‐1.60) and 1.24cm (95% IC: 0.43‐2.05)], respectively, than EBF or PreBF (P <0.01). Children who were NBF had higher concentrations of TCH (8.02 mg/dl; 95% CI: 1.39‐14.64) and log‐In (0.07; 95% CI: 0.02‐0.13, mediated through AC) at 4y than EBF or PBF children. Children breastfed <3 mo had higher BMI, SSF and AC at 4 y than those breastfed for >12 mo. EBF and PBF at 3 mo and BF duration were associated with lower adiposity and cardiometabolic alterations at 4 y of age.