bluuebunny/crossref_metadata_2025 huggingface dataset:
Total Energy Expenditure of Infants with Congenital Heart Disease Post‐surgical Intervention
Authors: Trabulsi Jillian , Irving Sharon , Papas Mia , Hollowell Chelsea , Ravishankar Chitra , Stallings Virginia , Medoff‐Cooper Barbara
Published: June 2021

Background

Growth failure is common in infants with congenital heart disease (CHD), however it is unclear if it is due to increased total energy expenditure (TEE).

Objectives

To determine if TEE of infants with CHD post‐surgical intervention differs from healthy infants, and evaluate the accuracy of equations used to calculate TEE.

Design

Infants with CHD and surgical intervention within 30 days of life, and healthy 3‐ and 12‐month old infants, were enrolled. TEE was measured via doubly labeled water at 3‐months (n=15 CHD, 12 healthy) and 12‐months (n=11 CHD, 12 healthy). Multiple linear regression models were fit to examine the association between health status (CHD vs. healthy) and TEE. Regression/summary statistics were used to assess accuracy of equations for calculating TEE.

Results

3‐month TEE did not differ significantly between CHD vs. healthy infants; TEE was 36.4 kcal/day higher for CHD vs. healthy (95% CI: ‐46.3, 119.2 kcal/day; p=0.37). 12‐month TEE was also not significantly different, with CHD 31.7 kcal/day higher than healthy (95%CI: ‐71.5, 134.8; p=0.53). The 2002 DRI equation had the smallest difference between calculated and measured TEE (mean difference 79 kcal/d); the 1989 RDA had closest agreement (R2=0.62, p<0.001) to measured TEE.

Conclusions

TEE in infants with CHD post‐surgical intervention was not greater than healthy infants at 3 and 12 months. When calculating TEE of CHD infants 蠄12 months post‐surgery, the 2002 DRI/1989 RDA equations are most accurate.

Support: NIH R01‐NR002093, MO1‐RR00240, UL1‐RR024134.
Exclusive Breastfeeding Protective for Growth Trajectory to 5 Years in a WIC Cohort
Authors: Arevalos Lindsey , Nicholson Lisa , Papathakis Peggy
Published: June 2021

OBJECTIVE

The impact of exclusive breastfeeding (EBF) on child body mass index (BMI) from birth through 60 months of age was investigated.

METHODS

60,190 mothers and children attending Women, Infant and Children (WIC) clinics in the central coast counties of California provided data on breastfeeding duration, maternal pre‐pregnancy BMI, and child weight‐for‐length (WL) were measured at 3 month intervals until 5 years of age. Missing time points were interpolated in determining child BMI/WL z‐score trajectories plotted on the Center of Disease Control infant and child growth curves. Multivariate analysis of variance was used to contrast the impact of not EBF, EBF from 0‐3 months, and EBF from 0‐6 months in Hispanic (n=43,360) versus Other (n=16,830) children, controlling for maternal pre‐pregnancy BMI.

RESULTS

Duration of EBF from 0‐3 and 0‐6 months of age was protective against child BMI z‐scores being above the average growth trajectory (P=0.0001). A significant inverse association between EBF and overall BMI/WL z‐scores for both males and females (P<0.0001) was found. Impact of EBF on child growth trajectory began to weaken at 15 months for females and 18 months for males. Children who were not EBF had higher mean BMI/WL z‐scores at every time point than those who were EBF. Those who were EBF for 0‐3 months had a lower BMI; those who were EBF for 0‐6 months had even lower BMI z‐scores by 5 years of age. Hispanic children had a higher BMI growth curve than non‐Hispanic children even after adjusting for EBF and pre‐pregnancy BMI. Mothers with a higher pre‐pregnancy BMI tended to have children with higher BMI/WL z‐scores (P<0.0001).

CONCLUSION

The study supports public health efforts to encourage EBF for at least 3 months and optimally for 6 months.
Live Well Springfield (LWS): Neighborhood‐Level Baseline Survey Results of a Collaborative Community Transformation Movement
Authors: Carbone Elena , Puleo Elaine , Mushenko Jesse , Paradis Timothy , Stenger Hannah , Nelson Peterman Jerusha , Wicks Kathy , Ratte Catherine , Collins Jessica
Published: June 2021

In 2012, Springfield, MA received CDC funding to promote healthy behaviors and health equity via expansion of the LWS initiative. Strategies include: (1) opening a full‐line grocery store, (2) increasing access to fresh produce, (3) increasing pedestrian way usage, and (4) creating a comprehensive pedestrian/bicycle plan. While strategies are designed to impact the city, several neighborhoods were specifically targeted because of significant health disparities. A baseline survey was administered in summer 2013 to examine eating and activity behaviors, food access and acquisition, and neighborhood characteristics. A follow‐up survey was administered in fall 2014 and was available in multiple languages. Of the 280 baseline surveys, 45% were from targeted neighborhoods. These residents reported a higher proportion of people who take over an hour to get to a full‐line grocery and walk for transportation; a lower percentage of residents who feel safe; and more barriers to purchasing fresh produce than residents in surrounding neighborhoods. Although all of Springfield will benefit from increased awareness of healthy behaviors, access to healthy foods and opportunities for increased physical activity, this neighborhood‐level information will aid in focusing targeted interventions. Results will inform future city‐wide and neighborhood‐level policy advocacy, educational programming, and contribute to ongoing media campaigns.
Greater Home Fruit and Vegetable Availability among Underserved Families after Participating in a Nutrition Program: The Athletes for Life Study
Authors: Chavez Adrian , Crespo Noe , Ghan Emily , Hartmann Leopoldo , Bruening Meg , Vega‐López Sonia
Published: June 2021

Objective

To compare home fruit and vegetable (FV) availability between previous Athletes for Life (AFL) participants and a comparison group (CG).

Methods

The AFL group completed AFL 3 months prior to data collection. AFL was a twice weekly‐10 week health promotion intervention delivered in a community center to underserved families with a 6‐11 year old child. Parent sessions included a 45‐min nutrition lesson that utilized education, hands‐on activities, and behavior change strategies to promote improvements in dietary habits and the home food environment. Child sessions included a 10‐min interactive nutrition lesson. CG were families with a 6‐11 year old child who received no intervention prior to data collection. Trained research assistants assessed home FV availability at participants' homes via a modified Home Food Inventory that included 26 fruits and 20 vegetables. Analyses were a cross‐sectional comparison between AFL and CG. An independent samples t‐test examined differences in FV availability between groups.

Results

AFL parents (n=14) were 36.5±5.6 years, 100% Latino immigrants, 93% living with partner, 71% BMI > 25, with 2.9±1.6 children. CG (n=20) parents were 38.3±8.1 years, 90% Latino, 80% immigrants, 90% living with partner, 94% BMI > 25, with 2.6±1.1 children. The AFL group had significantly higher vegetable (9.1±3.3 vs. 7.3±2.0; p<0.05) but not fruit (7.6±3.6 vs. 5.9±2.0; p>0.05) availability than the CG. Combined FV availability was significantly higher in the AFL group (p<0.05).

Conclusion

The AFL program shows promise for improving availability of vegetables in the home, which may influence family dietary patterns.
Visitation and Physical Activity Intensity at Rural and Urban Parks
Authors: Roemmich James , Johnson LuAnn
Published: June 2021

Less physical activity among rural residents may contribute to health disparities. This study compared park visitation and activity intensity at 15 urban and 15 rural parks matched for acreage and amenities.

Parks were observed in the morning, afternoon, and evening on 3 weekdays and 1 weekend day to determine the number of child, teen and adult visitors, their activity intensity (sitting, standing, moderate, or vigorous), and amenity use.

A total of 5486 visitors were observed with no differences in the percentages of males (55.5% vs 53.9%) and females (44.5% vs 46.1%) observed in rural and urban parks. Neither the percentages of weekday (82.4% vs 81.9%) nor weekend (17.6% vs 18.1%) visitors differed (p>0.96) between rural and urban parks. The probability of visitors being observed sitting was greater (p<0.02) and the probability to be observed in moderate intensity activity was lower (p<0.003) at rural parks than at urban parks. The probability of children (0‐5 yr) being observed was lower (p<0.001) at a rural park. A greater (p<0.001) proportion of children (25.0% vs 14.5%) in rural parks, but of teens in urban parks (8.0% vs 69.6%) were observed on sport fields. A greater (p<0.001) proportion of adults in urban areas (12.5% vs 46.0%) were observed spectating sports. Greater (p<0.001) proportions of rural children (10.9% vs 3.5%), teens (34.1% vs 12.4%), and adults (38.9% vs 10.1%) were observed using shelters. There were no differences in the proportions of rural and urban visitors observed using courts.

With similar numbers and types of amenities available, rural and urban parks are used differently likely due to differences in park programming (e.g., sports). Results from studies of urban parks cannot be wholly applied to the needs of parks in rural communities.
The Direct and Indirect Effects of Socioeconomic Status and Acculturation on Physical Activity and BMI within Country Rural‐to‐Urban Migrants
Authors: Hilmers Angela , Bernabe‐Ortiz Antonio , Gilman Robert , McDermott Ann , Smeeth Liam , Miranda Jaime
Published: June 2021

Background

To investigate whether socioeconomic status (SES) and acculturation predict overweight/obesity risk as well as the mediating effect of physical activity (PA) in the context of internal migration.
Methods: Cross‐sectional study of 587 rural ‐ to ‐ urban migrants participating in the PERU MIGRANT Study. Analyses were conducted using logistic regression and structural equation modeling. All models were controlled for age, gender, education, SES and acculturation.

Results: Only SES was a significant predictor of overweight/obesity risk. Lower SES decreased the odds of being overweight or obese by 51.4 percent. This association did not vary by gender nor was it explained by PA.

Discussion: Mechanisms underlying the relationship between SES and overweight/obesity may differ depending on the geographic location and sociocultural context of the population studied. Research on internal migration and health would benefit from the development of tailored acculturation measures and the evaluation of an exploratory model that includes diet.
Prevalence and Risk Factors of Reported Infections among Pregnant Adolescents
Authors: Akoh Christine , Pressman Eva , Cooper Elizabeth , Queenan Ruth Anne , O'Brien Kimberly
Published: June 2021

Health disparities exist for sexually‐transmitted infections (STIs) as African‐Americans are at elevated risk. Teens and young adults (ages 15‐24 y) constitute a large percentage of new STIs (20%‐70%). Although the US has one of the highest teen pregnancy rates among developed nations, little is known about risk factors for infection in the pregnant teen population. This retrospective study aimed to assess the prevalence and risk factors associated with maternal infections in a group of 158 teens (ages 13‐18 y) followed longitudinally across pregnancy (wk 12‐42 of gestation). Of those studied 63.3% were African‐American, 35.4% were Caucasian, and 24.7% were Hispanic. In this group, at least one clinically‐documented infection was evident for each of the following infections: 19% upper respiratory, 26% urinary tract, 58% sexually‐transmitted, and 64% of teens studied had a vaginal infection. African‐American teens were 4 times more likely to have bacterial vaginosis (BV) (OR=4.0, P=0.003) compared to Caucasian teens. Additionally, the prevalence of BV was significantly higher among the overweight and obese teens (81.6%, N=38, P=0.01). Younger age at conception was associated with an increased odds of having gonorrhea (OR=2.9, P=0.02) and trichomoniasis (OR=1.9, P=0.04). Together, these data provide new insight on risk factors associated with infection prevalence among pregnant teens.

Grant Funding Source: USDA AFRI 2012‐67017
Validation of a Sun Exposure Questionnaire among Subjects with Type 2 Diabetes Residing in South Florida
Authors: Huffman Fatma , Exebio Joel , Zarini Gustavo , Vaccaro Joan , Ajabshir Sahar
Published: June 2021

The aim was to validate a sun exposure questionnaire against objective measures of change in skin color and to assess its validity in predicting serum vitamin D in a sample of African Americans and Hispanics with type 2 diabetes. Ninety participants were enrolled. The sun exposure score was calculated by multiplying the time spent outdoors times the skin exposed score. Skin color was determined by reflectance colorimetry. The relationship between serum vitamin D, skin exposure score and stomach skin color was evaluated by a multi‐linear regression model. The unadjusted model showed that skin exposure score (P=0.037), and stomach skin color (P=0.021) were associated with serum vitamin D. This relationship remained significant only for stomach skin color (P=0.020) after controlling for covariates. The color of the skin is a better predictor of serum vitamin D in this particular population than sun exposure behaviors. Funding for this research was provided through an NIH/NIDDK sponsored grant.
Fast Food Environment among Low‐Income Communities in the Pacific Region: Findings from the Children's Healthy Living Program
Authors: Dela Cruz‐Talbert Elise , Li Fenfang , Fialkowski Marie , Wilkens Lynne , Leon‐Guerrero Rachael , Kim Jang , Bersamin Andrea , Novotny Rachel
Published: June 2021

Understanding community fast food environments is important to address obesity, particularly in low‐income populations. This study examines menus of fast food restaurants (FFR) across 4 US Affiliated Pacific Regions in the Children's Healthy Living Program.
A total of 91 FFR were surveyed using a modified Fast Food Observation Form from the Bridging the Gap Community Obesity Measures Project, including 40 in Alaska, 9 in the Commonwealth of the Northern Mariana Islands (CNMI), 5 in Guam, and 37 in Hawaii. Burger and Fries, Sandwich/Sub Shop, Plate Lunch/Lunch Truck, and Chinese/Pan‐Asian were the top 4 FFR types.
Food and beverages offered on the menu were assessed in 80 FFR. The most common foods were salad (48%), sandwich (44%), fries (44%), and cheeseburger (36%). The most common beverages were fountain drink (73%), bottled water (71%), can/bottled soda (56%), and 100% juice (48%). Among 87 FFR assessed for fruit and vegetable (FV) dishes on the menu, 75% had at least one. Among 16 FFR with a dollar menu, 56% had FV, salad, or yogurt (FVSY) items. Among 34 restaurants with a children's menu, 76% had FVSY items and 76% had skim/1% milk, 100% juice, or bottled water. Significant regional differences were found on the availability of FV as sides (p<0.01, with Alaska highest, CNMI lowest) or of FVSY items on a children's menu (p=0.04, with Hawaii highest, CNMI lowest).
Intervention messages aimed at changing eating behaviors among families in low‐income communities can focus on availability and identification of healthy food and beverage options among FFR.
Comparative Performance of NEMS‐S Surveys in Latino Corner Stores in the Greater Boston Area
Authors: Caplan Emily , Kanter Rebecca , Bearup Richelle , Solomons Noel , Bermudez Odilia
Published: June 2021

Background

In diverse areas, culturally‐sensitive tools may better assess the food environment associated with diet.

Objective

To determine the availability of healthy foods in Latino corner stores (bodegas) to elucidate its relationship with culture.

Methods: Three bodegas were selected from low‐income urban areas in Somerville, MA by field enumeration. The reference Nutrition Environment Measures Survey for Stores (NEMS‐S) and a Guatemala NEMS‐S version were used to assess healthy food vs. regular food availability in bodegas. Both surveys were conducted in each bodega. Frequency and proportion of items were determined. Chi‐square tests assessed differences in availability by survey method across stores.

Results: Bodegas have limited healthy foods as measured by the reference NEMS‐S. A greater availability of healthy foods in bodegas is indicated by the Guatemala NEMS‐S. All stores had 100% of the time, regular: milk, baked goods, soda, juice, chips, bread; diet soda; and 100% juice. Often, stores had skim milk, low‐sugar cereal, and wheat bread; but rarely, frozen dinners and low fat baked goods. Of the three vegetables added to the Guatemala NEMS‐S, at least one was available in two of the three stores; and of the six fruits added at least two were available in each store. No significant differences in availability by store were found.

Conclusions

The Guatemala NEMS‐S indicates a greater availability of healthy foods in bodegas than the reference NEMS‐S. Therefore, culture may impact food availability, as stores may cater towards specific ethnic populations. The existence of culturally‐specific stores needs consideration when creating healthy food policies.

Funding: Tufts Undergraduate Research Fund
Manganese Accumulation in Leaves and Radishes Grown in Manganese Supplemented Soils
Authors: Garcia Kortni , Douglas Hasani , Clarke‐Lambert Shellyann , Ruddock Karl , Skeete Dereck
Published: June 2021

Manganese (Mn), a naturally occurring element essential in trace amounts for living organisms, is potentially toxic in high amounts. Some occupations including mining, welding and steel manufacturing can expose workers to high levels of airborne Mn, leading to a clinical condition known as Manganism, which has Parkinson like symptoms. Recent studies report excess dietary Mn can impair immune and reproductive functions in birds. Previously we showed Mn is present in some commercial fertilizers. We hypothesize plants grown in soils high in Mn will accumulate Mn in leaves and fruits. To test this we grew radishes in soils supplemented with fertilizers containing Mn. Samples of each fertilizers as well as radish leaves were digested in HN)3 and analyzed for Mn using electrothermal vaporization with deuterium lamp background correction in an AA with a THGA graphite furnace. We found leaves accumulated Mn up to about 129.7 µg/gm tissue. Control leaves contained 66.50 µg/gm of Mn which was significantly less than the experimental groups. Soil supplemented with fertilizers containing Mn had higher concentrations of Mn than plant tissue. The highest concentration recorded in soil was 371.8 µg/gm, the lowest was 61.6 µg/gm. The study shows plants accumulate Mn from soil and use of fertilizers with high concentrations of Mn can increase the accumulations, possible creating a situation where animals and people ingesting the fruits and vegetables might be subjected to elevated Mn levels.
Decision to Frequent a Restaurant Type is Influenced by Individual Characteristics of Wisconsin Residents
Authors: Bhutani Surabhi , Schoeller Dale , Walsh Matthew , McWilliams Christine
Published: June 2021

Frequent eating at fast food (FF) and sit down (SD) restaurants is associated with increased BMI in six Wisconsin communities. However, information on variables influencing these recurrent restaurant visits is lacking in this population. Accordingly, we analyzed the role of demographic, socioeconomic and nutrition behavior variables on choice and frequency of eating at a FF and SD restaurant. Self‐reported survey data on above variables was collected from 1418 adults (age 48.2+0.5 yr, BMI 29.4 kg/m2, (39% obese;eating out 1.9 times/wk) as part of CDC Community Transformation Grant. Two regression models were created with frequency of eating out as a dependent variable. In model1, BMI and demographic variables were included as predictors of restaurant frequency. In model2, socioeconomic and nutrition behavior variables were added to model1. Frequency of eating FF was higher in male (β=0.4 times/wk, P=0.0002), lessereducated (high school; β=0.3 times/wk, P=0.009) and higher BMI individuals (β=0.02 times/wk, P=0.001). Younger populations frequented (P=0.008) FF while older frequented SD restaurants (P=0.004). Individuals describing their diet as healthy and believed their diet was keeping their weight controlled avoided (P<0.007) FF and SD restaurant. Lack of time (β=0.3 times/wk) and healthy food availability (β=0.5 times/wk) increased FF visits, while lack of cooking time (β=0.13 times/wk) and skills (β=0.26 times/wk) increased SD visits. This analysis confirms the role individual characteristics on frequent eating at FF and SD restaurants and suggests considering these variables when planning educational efforts. Caution should be exercised, however, as the cross‐sectional study design provides association and not causality.
Analysis of the Dietary Intakes of Canadian Adults
Authors: Ahmed Mavra , Arcand JoAnne , Schermel Alyssa , L'Abbe Mary
Published: June 2021

The objective of this study was to assess intakes of energy, macronutrients and vitamin and minerals in a nationally representative sample of Canadian adults in comparison with Dietary Reference Intakes (DRIs). The DRI cut‐point method and the probability approach (specifically for iron in women) were used to determine the adequacy of dietary intakes. Responses were obtained from 1,833 individuals (aged 18 and older) who completed a web‐based Canadian Diet History Questionnaire in the spring of 2012, a validated food frequency questionnaire estimating dietary intakes over the past month. The average energy intake was 1644 + 3126Kcal/day, with 49% of total energy from carbohydrates, 33% from total fat and 16% from protein. Energy intakes were lower in females (1386kcal/day) compared to males (1879kcal/day) (p<0.05). Compared to the DRIs, a large proportion of respondents had inadequate intakes of folate (62%), magnesium (58%), potassium (91%), calcium (78%) and dietary fibre (89%). In contrast, most had adequate intakes of phosphorus, zinc, vitamin C, vitamin A, riboflavin and vitamin B12. Males generally had adequate intakes of thiamin (72%), vitamin B6 (65%) and niacin (93%). In comparison, the proportion of females with adequate intake of these nutrients was lower. As well, females aged 50 years and younger had a lower intake of iron compared with those aged older than 50 years (87% vs. 34%). Although, Canadians in general have intakes within acceptable ranges based on DRI recommendations, strategies are required to optimize the adequacy of Canadian's dietary intakes and to communicate information on a balanced diet.

Funding Sources: UofT McHenry Chair research fund (ML); Dairy Farmers of Canada (ML); CIHR Public Health Policy Fellowship (MA).
Using an expert panel to test a new nutrient profiling system for pre‐packed food
Authors: Zhang Geng , Ma Ning , Wang Chunling
Published: June 2021

Objective

To examine the consistency between food nutrition scores given by a new nutrient profiling system, namely COFCO Nutrition Score (CNS), for pre‐packed foods and empirical ranking given by nutrition experts.

Methods

Two hundreds pre‐packed foods selected from USDA nutrient database were scored using CNS, based on food group‐specific weighted sums of percent Nutrient Reference Values for nutrients to encourage and for nutrients to limit. Individual food scores were calculated based on 100 kcal. Twenty seven nutrition professionals were asked to categorize the 200 foods into one of ten positions on the basis of their empirical views. The correlation between the two ranking methods were tested in nine food groups, including dairy products, beverages, staple foods, meats, cooking oil, snacks, mixed meals, legumes and legume products, flavoring and dressing.

Results

A good correlation was found between CNS and expert opinions across the nine food groups. The corresponding Spearman's correlation coefficient was 0.83 for dairy product, 0.73 for beverages, 0.75 for staple foods, 0.82 for meats, 0.57 for cooking oil, 0.57 for snacks, 0.64 for mixed meals, 0.57 for legumes and legume products, 0.67 for flavoring and dressing (all P < 0.05).

Conclusions

The results suggested that CNS ranks pre‐packed foods in accordance with the views of nutrition professionals.
Living alone showed significant associations with dietary quality and health among South Korean adults
Authors: Nam So‐Young , Lee Soo‐Kyung
Published: June 2021

As more number of people are living alone, whether individuals living alone would be at higher risk of nutritional status and health compared to those not living alone has gained interests. This study aimed to examine whether and how the status of living alone was associated with dietary quality and health among Korean adults using 1998‐2012 Korea National Health and Nutrition Examination Surveys. The proportion of individuals living alone were significantly different by year (p=0.000) with a slight increase (5.4 % in 1998 to 7.4% in 2012). In general, being a woman (p<0.05), elderly groups (p=0.000), rural region (p<0.05), lower education (p=0.000), lower income (p<0.000), and occupation (p<0.05) was significantly associated with Living alone. People living alone reported worse perceived health status (p=0.000) and showed higher prevalence of hypertension (p=0.000) than those not living alone throughout the years. Other diseases also tended to be higher among those living alone with less consistent statistical significance over years. Individuals living alone reported a lesser diet quality by less proportions of those meeting the level of EER for energy and EAR (RI) for major nutrients (p=0.000). The significant association between living alone and dietary quality were not found in multiple logistic analyses. In conclusion, people living alone appeared to have lower health status and diet quality with possible mediating effects from other socioeconomic factors. This study was supported by Inha University Faculty Grant.
Building Multisectoral Nutrition Systems: The Roles and Experiences of Boundary‐Crossing Actors in Four African Countries
Authors: Pelletier David , Gervais Suzanne , Hafeez‐ur‐Rehman Hajra , Sanou Dia , Tumwine Jackson
Published: June 2021

Fifty‐four countries have signed up for the Scaling Up Nutrition (SUN) movement and committed to using a multisectoral approach, one with many challenges. Here we describe the results of action research to identify and address the challenges, in four of the African SUN countries: Burkina Faso, Ethiopia, Mali and Uganda. Our theoretical orientation is to view the many multisectoral actors and organizations as complex adaptive systems; our role and mandate is to identify the multisectoral system requirements and bottlenecks, stimulate reflection among key stakeholders and help initiate appropriate actions; our data is derived from participant‐observations. Three key findings are discussed: 1) System level requirements for a multisectoral approach consist of twelve components, in addition to the coordinating committees; 2) All four countries face challenges in all twelve components; 3) Boundary‐crossing actors have helped address these challenges in all four countries through sensitizing concepts, knowledge and alliance brokering, consensus and conflict management and participation in operational tasks for reciprocity and relationship building. Further research to clarify the roles,strategies and skills of boundary‐crossing actors is needed in order to help stakeholders work effectively within complex adaptive systems.
Preliminary Characterization of Pediatric Oncology Patients Comparing Traditional Nutrition Assessment to Subjective Global Nutrition Assessment
Authors: Watts Kirsten , Gonzales‐Pacheco Diana , Abraham Shirley , Wong Craig
Published: June 2021

Study Objective

To compare the Subjective Global Nutrition Assessment (SGNA) tool with traditional measures of nutritional status in a cohort of pediatric oncology patients.

Background

SGNA has been validated in a number of pediatric populations our study aims to validate this tool in the pediatric oncology patient population.

Methods: A Registered Dietitian (RD) performed traditional nutrition assessment which included medical history, dietary assessment, anthropometrics, biochemical markers of nutrition status, and body composition analysis using bioelectrical impedance (BIA). SGNA included anthropometric data, adequacy of dietary intake, gastrointestinal issues that could alter nutrient intake, functional capacity, stress of metabolic disease and nutrition focused physical exam that looks for signs and symptoms of nutrient deficiency.

Results: Preliminary findings on the first patients (n=4) assessed indicate that SGNA is consistent with traditional nutrition assessment tools. SGNA captures muscle wasting in patients at low and high percent body fat.

Subject
Albumin gm/dL
PreAlbumin mg/dL
CRP mg/dL
BMI z‐score
Upper Arm Muscle Area (%tile)
%Body Fat
SGNA Score

#1
4.4
25.7
<0.3
‐1.5
5‐10th
15.3
Normal

#2
3.8
28.5
0.3
0.83
5‐10th
41.0
Normal

#3
3.7
34.9
<0.3
1.36
75‐85th
36.2
Normal

#4
4.2
31.2
<0.3
‐0.7
10‐15th
32.3
Moderate

Conclusion

SGNA is a feasible non‐invasive nutrition assessment tool easily used in the clinical setting and was positively received by pediatric oncology patients. With training inter‐rater reliability is high. As subjects are enrolled we will be able to determine correlations between traditional measures of nutrition assessment and SGNA.

Supported by the University of New Mexico Department of Pediatrics Research Allocation Committee
Circulating Biomarkers in Breast Cancer Prognosis and Survival: A Systematic Review
Authors: Cheng Junrui , Liu Shanshan , Zhang Fang Fang
Published: June 2021

Purpose

Previous studies of survivors of breast cancer have drawn heterogeneous conclusions regarding the association between circulating biomarkers and breast cancer prognosis and survival. We sought to determine the role of circulating biomarkers in breast cancer prognosis and survival through the conduct of a systematic review and meta‐analysis.

Methods

A MEDLINE search was performed from its inception through 2014. Studies met the inclusion criteria if they: (1) included at least 10 women diagnosed with breast cancer of any age, stage, and menopausal status; (2) assessed circulating biomarkers at least one year prior to ascertaining breast cancer prognosis and survival outcomes; (3) evaluated all‐cause mortality, breast cancer death, recurrence, or disease‐free survival.

Results

Twenty‐six studies met the inclusion criteria for systematic review. Fourteen studies were subject to meta‐analysis that included a total of 11,954 breast cancer survivors. High circulating levels of C‐reactive protein (CRP) were associated with an increased risk of all‐cause mortality (HR = 1.7, 95% CI: 1.1‐2.5), breast cancer death (HR = 1.8, 95% CI: 1.4‐2.4), recurrence (HR = 1.3, 95% CI: 0.9‐1.9), and reduced disease‐free survival (HR = 1.9, 95% CI: 1.3‐2.2). High circulating levels of glucose were associated with an increased risk of all‐cause mortality (HR = 1.9, 95% CI: 1.2‐2.8) and breast cancer recurrence (HR = 1.6, 95% CI: 1.0‐2.6). Existing evidence did not support associations between other circulating biomarkers and breast cancer prognosis and survival.

Conclusions

Circulating CRP and glucose can serve as valuable biomarkers to predict breast cancer prognosis and survival.
Circulating folate levels and colorectal adenoma: a meta‐analysis
Authors: Youn Jiyoung , Lee Jung Eun
Published: June 2021

To investigate the effect of folate on colorectal neoplasia, we conducted a meta‐analysis of epidemiologic studies and examined whether circulating folate levels were associated with colorectal adenoma.

We searched the relevant published articles through the PubMed databases and also identified the reference lists of the retrieved articles. We also included our case‐control study examining the relation between circulating folate levels and colorectal adenoma in Korean adults. The study‐specific relative risks (RRs) and 95% confidence intervals (CIs) from individual studies were pooled using a random‐effects model and heterogeneity were analyzed using I2 statistic. Two cross‐sectional, four case‐control, and four randomized trial studies were included in the present meta‐analysis. We included only placebo group from randomized trial studies of folic acid supplementation. We observed a significant inverse association for colorectal adenoma (combined RR = 0.77; 95% CI, 0.66‐0.87), comparing the top versus bottom categories of circulating folate levels. When we limited our analysis to clinical trials of recurrent adenoma, the combined RRs (95% CIs) comparing the top with the bottom categories were 0.68 (95% CI: 0.54‐0.82). The findings from this meta‐analysis suggest the evidence that circulating folate levels has an inverse association with colorectal adenoma.
Coffee Consumption and Risk of Prostate Cancer
Authors: Nelson Shakira , Weinstein Stephanie , Albanes Demetrius
Published: June 2021

As one of the most commonly consumed beverages in the world, coffee is being increasingly examined in epidemiological studies. Recent studies have focused on coffee and its potential impact on the development of prostate cancer, where a material association could have a significant impact in public health. To examine the coffee‐prostate cancer association, we analyzed prospective data from the Alpha‐Tocopherol, Beta‐Carotene Cancer Prevention (ATBC) Study cohort that enrolled 50‐69 year old male smokers in southwest Finland between 1985 and 1988, and currently has nearly 30 years of follow‐up. Coffee consumption was assessed at baseline using a validated modified food frequency questionnaire. Participants contributed person‐time from the date of study randomization until a prostate cancer diagnosis, death (any cause), or the end of the follow‐up (December 31, 2012), and relative risk was examined with Cox proportional hazards regression models. Non‐coffee drinkers showed lower risk, with a hazard ratio (HR) of 0.81 (95% confidence interval (CI) = 0.58‐1.15) when compared to men who drank 0 ‐1 cups per day. Furthermore, consuming 4+ cups of coffee per day was associated with increased prostate cancer risk, where the HR was 1.16 (95% CI = 0.98‐1.36, p‐value for trend = 0.05). If confirmed, our findings may have implications regarding approaches to lowering prostate cancer risk.

Research supported by the Intramural Program of the National Cancer Institute, NIH.
Soy and cruciferous vegetables intake and side effects of endocrine therapy in Caucasian and Chinese breast cancer patients
Authors: Fung T , Gomez S , Hwang YT , Dash C , Allen L , Hilakivi‐Clarke L , Wang J
Published: June 2021

In this cross‐sectional analysis, we examined the relationship between soy and cruciferous vegetable intake and common endocrine therapy side effects among breast cancer patients.

Participants were 193 non‐Hispanic white and 207 Chinese women (mean age=57.0) with stage 0‐III breast cancer and at least one year post diagnosis. Vegetables and soy foods intake was obtained from a food frequency questionnaire. Treatment side effects symptoms were assessed by a telephone interview. Self reported counts of side effect symptoms were categorized into “yes/no”. Dietary intake was categorized into 3 categories and odds ratios for adverse effects were computed adjusting for multiple confounders.

48% of the women were postmenopausal and mean BMI=24.2. Most were inactive or minimally active. After multivariable adjustment, higher soy foods and isoflavones intake was associated with a lower odds of experiencing side effects of endocrine therapy such as hot flashes and vaginal dryness. Comparing highest to no intake of intake the OR for soy foods was 0.48 (95% CI=0.25, 0.93), and OR for isoflavones was 0.47 (95% CI=0.24, 0.91). Among Chinese women, higher isoflavones intake was associated with less self‐reported memory loss, OR=0.44 (95% CI=0.20, 0.99) and hair thinning 0.41 (95% CI=0.18, 0.93).

Higher intake of soy foods or isoflavones is associated with a lower odds of endocrine treatment side effects among breast cancer survivors.
Dietary Flavonoid Intake and Weight Change
Authors: Bertoia Monica , Rimm Eric , Mukamal Kenneth , Hu Frank , Willett Walter , Cassidy Aedin
Published: June 2021

Background

Higher flavonoid consumption may be associated with less weight gain over time through mechanisms related to energy balance, glucose metabolism, fat oxidation, and adipokine secretion.

Objective

To examine whether intake of specific flavonoid sub‐classes is associated with weight change over time.

Methods

We examined the association between change in intake of the range of flavonoid sub‐classes and change in weight in three large prospective cohorts of 124,102 men and women participating in the Health Professionals Follow‐up Study (HPFS), Nurses' Health Study (NHS), and Nurses' Health Study II (NHS II). From 1986 to 2006, these associations were examined within multiple 4‐year time intervals, adjusting for simultaneous changes in other lifestyle factors including other aspects of diet, smoking status, and physical activity. Results were combined using a fixed effects meta‐analysis.

Results

Increased consumption of all flavonoid sub‐classes was inversely associated with weight change over 4‐year time intervals. The greatest magnitude of association was observed for anthocyanins (‐0.52 lbs, 95% CI ‐0.74 to ‐0.30 lbs per additional SD/day, 22 mg).

Conclusions

These data may help to refine previous dietary recommendations for the prevention of obesity. This research was supported by the NIH, the Danish Council for Strategic Research, and the Rose Traveling Fellowship.

Table. 4‐Year Weight Change (lbs, 95% CI) Associated with Increased Daily Flavonoid Intake (1 SD/day)

HPFS
NHS
NHS II
Pooled

SD
n=20,541
n=39,423
n=64,138
n = 124,102

Flavonols
13 mg
‐0.28 (‐1.37, ‐0.19)
‐0.15 (‐0.22, ‐0.09)
‐0.41 (‐0.48, ‐0.34)
‐0.28 (‐0.44, ‐0.12)

Flavones
1.9 mg
‐0.15 (‐0.26, ‐0.05)
‐0.37 (‐0.45, ‐0.28)
‐0.42 (‐0.49, ‐0.35)
‐0.32 (‐0.47, ‐0.17)

Flavanones
37 mg
‐0.17 (‐0.29, ‐0.06)
‐0.09 (‐0.17, ‐0.00)
‐0.05 (‐0.11, 0.01)
‐0.09 (‐0.16, ‐0.03)

Flavan‐3‐ols
61 mg
‐0.13 (‐0.21, ‐0.04)
‐0.03 (‐0.10, 0.03)
‐0.16 (‐0.22, ‐0.09)
‐0.10 (‐0.18, ‐0.03)

Anthocyanins
22 mg
‐0.42 (‐0.51, ‐0.32)
‐0.41 (‐0.48, ‐0.34)
‐0.72 (‐0.79, ‐0.66)
‐0.52 (‐0.74, ‐0.30)

Polymers
271 mg
‐0.22 (‐0.31, ‐0.13)
‐0.14 (‐0.21, 0.08)
‐0.33 (‐0.40, ‐0.26)
‐0.23 (‐0.35, ‐0.12)

Total flavonoids
298 mg
‐0.26 (‐0.35, ‐0.17)
‐0.16 (‐0.23, ‐0.10)
‐0.37 (‐0.43, ‐0.30)
‐0.26 (‐0.39, ‐0.14)

Adjusted for age and change in BMI, smoking status, physical activity, hours of sitting, hours of sleep, and diet.
Plasma Nutrient Biomarkers are Associated with Waist‐to‐Height Ratio in Youth with Type 1 Diabetes: SEARCH for Diabetes in Youth Nutrition Ancillary Study
Authors: Wang Shanshan , Crandell Jamie , Couch Sarah , King Irena , Lawrence Jean , Dabelea Dana , Lamichhane Archana , Kim Grace , Bell Ronny , Zhu Shankuan , Mayer‐Davis Elizabeth
Published: June 2021

Background

Plasma nutrient biomarkers may be associated with waist‐to‐height ratio (WHtR) in youth with type 1 diabetes (T1D).

Design

1,416 youth aged 3‐20 years at diagnosis were included at baseline and 1,178 youth had a follow‐up visit after 23 (range 16‐40) months. Data on plasma phospholipid fatty acids, desaturase activities and vitamins were obtained at baseline. Multiple linear regression was used with adjustment for demographic and diabetes‐related confounders. Findings were stratified by weight status when significant (P<0.05) effect modification was observed.

Results

In cross‐sectional analysis, palmitic acid (P=0.001), dihomo‐γ‐linolenic acid (DGLA, P=0.003) and Δ6‐desaturase (D6D, P=0.0004) were positively; oleic acid (P=0.014), linoleic acid (LA, P=0.002) and vitamin D (VD, P<0.0001) were negatively associated with WHtR. In normal weight youth, VD (P=0.003) was negatively associated with WHtR. In obese youth, DGLA (P<0.0001) and D6D (P<0.0001) were positively; Δ9‐desaturase‐18 activity (P=0.011) and VD (P<0.0001) were negatively associated with WHtR. In longitudinal analysis, baseline LA (P=0.017), n‐6/n‐3 fatty acid ratio (P=0.017), VD (P=0.003) and vitamin E (P=0.0001) were negatively associated with WHtR at follow‐up only in obese youth.

Conclusions

Plasma nutrient biomarkers are associated with WHtR in T1D youth, most commonly among those who are obese.
PREVALENCE, RISK FACTORS, KNOWLEDGE OF HYPERTENSION AND DIETARY INTAKE OF GHANIAN NURSES IN NORTHERN REGION
Authors: Kubuga Clement , Owusu Emmanuel , Zanu Jacob , Lee Kyung Won , Song Won
Published: June 2021

Mortality and morbidity of CVD hypertension coexist with undernutrition in Ghana. Little data are available to address the public health issues. Since nurses are the first line contacts with the general public and patients in providing nutrition and health education, we aimed to document nurses' prevalence, determinants, knowledge and dietary intake of hypertension in northern region of Ghana. A total of 246 nurses (74 men, 172 women) were recruited between May‐July, 2014 to have blood pressure measured in four hospitals and complete questionnaires on their risk factors, knowledge of hypertension and dietary intake for a day. The determinants and differences in knowledge on hypertension among normotensive(<120/80mmHg, n=141, 57%), prehypertensive(120/80‐140/90mmHg, n=95, 39%) and hypertensive(>140/90mmHg, n=10, 4%) nurses were determined by chi‐square tests using SPSS. Significant determinants of hypertension were age, rank in nursing, family history, physical activity levels and knowledge of prevention of hypertension, whereas gender, marital status, religion, BMI, and knowledge of causes, and food and hypertension did not differ among the groups. The majority (73% and 88%, resp) had inadequate K and Ca intake and excess Na, Mg, and P (57%, 74% and 72%, resp); those with inadequate calcium intake had a high odd ratio of pre/hypertension (OR=3.54; 95% CI, 1.09‐11.48). We conclude that nutrition and health education of nurses on risk factors; knowledge and dietary practices are needed for their own health and to empower them to help the public.
Pilot Evaluation of a Nutrition Training Intervention for Pre‐Registration Pharmacists in Northern Ireland
Authors: Douglas Pauline , McGuffin Lynn , Laur Celia , Burnett Kathryn , Ray Sumantra , McCarthy Helen
Published: June 2021

Pharmacists are one of the largest and most accessible community healthcare professions and can engage up to four times more with patients than general practitioners. They are ideally placed to provide first line primary care advice to patients and the general population. The aim of this study was to evaluate the impact of a nutrition training intervention pilot for pre‐registration pharmacists. A 21 item questionnaire with demographic, knowledge, attitude and practice (KAP) type questions was administered to participants immediately before and after a nutrition training session. Questions related to the topics covered in the two day training session and included lectures, small group practical workshops and case studies. A Wilcoxon Signed Rank Test compared KAP scores. Ten pre‐registration pharmacists attended the course and obtained a significantly improved KAP score after the training [P=0.008; median (25th, 75th percentiles); before: 29.5 (28, 32); after: 34.0 (32, 34)]. All participants rated the session in terms of content and delivery as excellent (n=7) or good (n=3) with reasons such as 'very informative' and 'practical' provided. The pilot session suggests that there is scope for improving pre‐registration pharmacists' nutrition KAP in practice and larger scale delivery of this intervention is warranted with potential for positive patient outcomes.
Dietetics Professionals Recognize Beans as Different Carbohydrate for Adults with Type 2 Diabetes
Authors: Winham Donna , Hutchins Andrea
Published: June 2021

Dietary adherence is difficult for persons with type 2 diabetes (T2DM). Several studies suggest ethnic groups are cautioned against eating traditional beans. The views about beans in T2DM recommendations by Registered Dietitians (RDs) were solicited via an online survey. Of the 380 invited, 357 RDs provided information on their recommendation frequency (never, sometimes, often, almost always) for several statements about beans for T2DM. Results are reported for two groups: those who counsel for T2DM (66.9%) vs. not counsel at all or do not counsel for T2DM (33.1%). The majority (57%) never or rarely told clients that ‘beans were the same as any other carbohydrate source’ and almost all ‘agreed’ or ‘strongly agreed’ that beans could help control blood glucose. However, a concerning minority of those who counseled for T2DM (4.8%) and of those who did not (3.5%) ‘disagreed’ on this statement. Significant differences were observed for ‘almost always’ recommendations of 'beans for good nutrition' (31.9% counsel T2DM vs. 52.6% not counsel; p=0.001), 'eat beans to increase fiber' (54.4% counsel T2DM vs. 73.3% not counsel; p=0.005). Almost 64% of RDs who did not counsel for T2DM said they would 'often' or 'almost 'always' tell clients to eat beans to help control blood glucose, but only 53.7% of RDs who counseled suggest this to clients (p=0.000). Over 3% of the RDs stated they would tell clients to avoid beans because of having T2DM. These findings suggest that RDs who counsel adults with T2DM may be more conservative in their recommendations of bean consumption. Greater outreach is needed to educate RDs about beans and glucose control benefits.
Perceptions and Practices of Meal Preparation among College Students Participating in Cooking Classes
Authors: Alsing Sarah , Pope Benjamin , Wyatt Melissa , Tsui Chiayi , Wells Michael , Farr Kiah , Hongu Nobuko
Published: June 2021

The purpose of this study was to examine meal preparation practices among college students who attended hour‐long, hands‐on, cooking classes that were offered during after school hours. The three cooking classes introduced Mediterranean diet inspired recipes that were fitted to students' time constraints. For recruitment, an IRB approved flyer was distributed through email listservs of various majors (e.g. Nutrition, Physiology, Neuroscience, Psychology, and Public Health, etc.) at the University of Arizona. The participants (n=21, 62% female, age 21.1 ± 2.8 years) answered the short survey of questions about their current meal preparations, and past cooking experiences, as well as the reasons for attending the cooking classes. One‐way ANOVA and Fisher's exact test were used to assess the association of age, between meal preparation practice and cooking experiences. 38% (4 women, 4 men) cook for themselves and eat out sometimes. 29% of the participants (5 women, 1 man) cook meals themselves. 24% (3 women, 2 men) buy a majority of their meals from restaurants. 9% (1 woman, 1 man) eat cooked meals with their families on a daily basis. There was no association between gender, past cooking experience, and current primary meal preparations. (p>0.05) Participants reported interests in the cooking classes because it helps make healthier life practices; cooking is a social event with friends and family; and it is cost effective. This study found that young college students are interested in cooking classes held on campus with various reasons regardless of their current meal preparation practices and previous cooking experiences.