bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lunchroom environmental factors related to having school salad bars: Prevalence and findings from a state‐wide survey in Arizona
Authors: Bruening Meg , Adams Marc , Ohri‐Vachaspati Punam , Hurley Jane 
Published: June 2021

ObjectiveTo assess the prevalence of and factors related having salad bars in Arizona K‐12 schools.MethodsSchool nutrition managers (n=653; 72% response rate) completed a 71‐item web‐based survey assessing prevalence and predictors of school salad bars in Arizona from March‐October, 2014. Logistic regression examined associations between having a salad bar and factors such as respondents' years in current position, time available for lunch, mixed versus single grade lunch periods, the number of lunch periods per day, recess/free recreation time at lunch, and having a registered dietitian (RD) on staff.ResultsThe prevalence of salad bars in Arizona schools was 62.0%; 27.4% of schools never had salad bars, with 10.6% once having had salad bars. Schools that served lunches to single grades during a lunch period were 47% more likely to have salad bars compared to schools that served lunches to multiple grades each period (p<0.001). The odds of having a salad bar were 89% greater if schools had recess/recreation time at lunch (p=0.002) and 2.87 times greater if a RD was on staff full or part‐time (p<0.001). No statistically significant differences were observed in the schools that had salad bars and respondents' years in their position (mean=6.4±6.0 years) or the time available for students to eat lunch (mean=31.8±19.6min).ConclusionThe prevalence of salad bars was relatively high in Arizona. Certain factors such as having a RD on staff and having recess/recreation time at lunch were related to having a salad bar, indicating that administrative support of health‐related practices that create a more healthful environment may promote higher implementation of salad bars.
Effect of a Low Glycemic Index Diet on Markers of Oxidative Damage in Type 2 Diabetes
Authors: Mirrahimi Arash , Chiavaroli Laura , Reiser Erika , Srichaikul Korbua , Nishi Stephanie , Augustin Livia , Sievenpiper John , Kendall Cyril , Leiter Lawrence , Jenkins David 
Published: June 2021

AimsLarger glycemic excursions are linked to greater oxidative stress and low GI diets have been shown to improve glycemic control. We therefore assessed the effect of a low glycemic index (GI) diet on oxidative damage to LDL in type 2 diabetes.MethodsIn 151 type 2 diabetic subjects who completed either 6 months of low GI or high cereal fiber diets thiobarbituric acid reactive substances (TBARS) and conjugated dienes (CDs), as markers of LDL oxidation, were measured.ResultsThe low GI diet reduced HbA1c but did not significantly change markers of oxidative damage. Pooled data from the two treatments showed change in oxidized LDL measured as TBARS and CDs related to low GI carbohydrate intake (r=‐0.17, N=150, P=0.042 and r=‐0.22, n=151, P=0.008, respectively). Moreover, those with reductions in glycemic excursions over the day (individuals with a reduction in HbA1c but no reduction in fasting blood glucose) showed greater reduction in oxidized LDL compared to a group with a predicted rise in glycemic excursions (P=0.040).ConclusionLow GI carbohydrates are associated with reduction in oxidized LDL.Funding Barilla
Adiposity, Aerobic and Anaerobic Fitness in Middle School Aged Children
Authors: Nieman David , Dew Dustin , Krasen Pamela 
Published: June 2021

National data suggest that aerobic fitness and adiposity are negatively correlated in children, but this relationship was established using submaximal exercise tests and skinfold measurements (NCHS Data Brief. 2014 May;(153):1‐8). This study extended previous investigations by evaluating the influence of adiposity on both aerobic and anaerobic fitness in N=458 male and N=304 female middle school aged students (mean±SD, age 13.3±0.6 y). BMI averaged 22.2±5.2 and 22.9±5.2 kg/m2 in boys and girls, respectively, with 37% of boys and 36% of girls classified as overweight or obese using CDC BMI‐for‐age growth charts. Adiposity was assessed using air‐displacement plethysmography (BOD POD, Cosmed, Rome, Italy), VO2max through a maximal, graded treadmill test (Bruce protocol) with continuous metabolic measurement (Cosmed Fitmate system, Rome, Italy), and aerobic fitness with the 30‐second Wingate test (Lode cycle ergometer, Groningen, The Netherlands). Average test scores for male and female students were as follows: body fat, 19.8±11.0 and 24.6±8.7 %, respectively; anaerobic capacity, 7.2±1.4 and 5.7±1.2 watts/kg; and VO2max, 45.1±10.8 and 33.9±8.1 ml.kg‐1.min‐1. Body fat % was negatively correlated with VO2max in boys (r=‐0.65) and girls (r=‐0.56), and with anaerobic capacity in boys (r=‐0.71) and girls (r=‐0.58) (all P<0.001). Aerobic fitness was below adequate levels (boys 42 and girls 36 ml.kg‐1.min‐1) in 39% of boys and 60% of girls, with proportions increasing in direct proportion to adiposity (P<0.001). These data indicate that over one‐third of the N=762 middle school‐aged boys and girls tested were classified as overweight/obese, and that body fat % was inversely related to aerobic and anaerobic fitness.Funding, Golden Leaf Foundation STEM Initiative
Leptin as a Mediator of Tumor‐Stromal Interactions Promotes Breast Cancer Stem Cell Activity.
Authors: Catalano Stefania , Giordano Cinzia , Panza Salvatore , Chemi Francesca Chemi , Barone Ines , Bonofiglio Daniela , Cordella Angela , Hashim Adnan , Simoes Bruno , Clarke Robert , Weisz Alessandro , Andò Sebastiano 
Published: June 2021

Breast cancer stem‐like cells (BCSC) are responsible for tumor initiation, maintenance, and metastases. BCSC rely for their properties on complex interactions with the tumor microenvironment through networks of cytokines and growth factors. Leptin, a well‐known cytokine involved in breast cancer progression, plays a crucial role in the tumor‐stromal crosstalk. Thus, we investigated how tumor microenvironmental factors and especially leptin may affect BCSC activity using MCF‐7 breast cancer cells and patient‐derived samples.Treatment of mammosphere cultures with conditioned media (CM) from cancer associated fibroblasts and breast adipocytes resulted in a significant increase in mammosphere‐forming efficiency (MFE). Depletion of leptin from stromal cell‐CM completely abrogated this effect. Accordingly, mammosphere cultures exhibited increased leptin receptor expression and leptin exposure enhanced MFE. Microarray analyses revealed a similar expression profile of genes involved in stemness and cell proliferation in mammospheres treated with stromal cell‐CM and leptin. Finally, leptin significantly increased MFE in patient‐derived samples (metastatic ascites and pleural effusion fluid) and leptin mRNA levels in peritumoral adipose tissue of breast cancer patients were positively correlated with MFE (r= 0.449; P 蠄 0.05).Our study highlights leptin as an important paracrine molecule that mediates the microenvironment effects on BCSC activity.
Maternal Weight Loss Increases Preterm Birth in Kenya
Authors: Barr Blake , Natamba Barnabas , Sumba Odada , Baresel Paul , Opinya Fredrick , Dent Arlene , Toko Eunice , Rochford Rosemary , Mehta Saurabh 
Published: June 2021

Appropriate gestational weight gain is necessary for optimal pregnancy outcomes. We examined if this relationship holds in our perinatal cohort in Kenya by determining the effect of maternal weight change on preterm birth and adverse pregnancy outcomes.One‐hundred and ninety‐one women were followed up through delivery and information on birth outcomes was recorded. Data on weight was available for four antenatal visits over the course of the pregnancy. Rate of weight change was defined as the difference between last observed weight and enrollment weight divided by the corresponding time difference. Weight loss was defined as negative rate of weight change and low birth weight (LBW) as birth weight less than 2,500 grams. Preterm delivery was defined as delivery at less than 37 weeks of pregnancy. Binomial regression was used to estimate risk ratios and p‐values for the association between weight loss and pregnancy outcomes.The median gestational age at enrollment was 22 weeks (IQR: 18‐26 weeks). The median rate of weight change over the course of pregnancy was 0.25 kg/week (IQR: 0.12‐0.44kg/week). 26% of women lost weight over the course of pregnancy. 6% of neonates had LBW and 21% of all births were preterm. On adjusting for maternal age and BMI at enrollment, women who lost weight had 2.22 greater risk of preterm birth than women who did not lose weight (95% CI =1.03, 4.77; p=0.04).Over 1 in 4 women in our study lost weight during the course of pregnancy. Future studies need to identify appropriate interventions for improving weight gain and optimizing birth outcomes.Funding: National Institutes of Health
Level of Dietary Adherence to WCRF/AICR Recommendations among 81,079 Adventist Health Study‐2 Participants
Authors: Le Lap , Sirirat Rawiwan , Jaceldo‐Siegl Karen 
Published: June 2021

BackgroundMore than 50 years of Adventist research on diet and disease risk, diet has been quantified by nutrients, food groups, and dietary patterns. An alternative and novel approach is the index‐based scoring method to evaluate overall diet quality.ObjectiveOur objective is to assess the degree of dietary adherence to the WCRF/AICR recommendations among the Adventist Health Study‐2 (AHS‐2) population, a cohort with unique and wide range of dietary patterns.MethodThe score is based on the operationalization of multiple dietary and lifestyle components recommended by the World Cancer Research Fund / American Institute of Cancer Research (WCRF/AICR), using data from AHS‐2 comprehensive questionnaires.ResultsAmong 81,079 study participants, 48% are non‐vegetarians, 6% are semi‐vegetarians, 10% are pesco‐vegetarians, 29% are lacto‐ovo‐vegetarians, and 8% are vegans. The average WCRF/AICR score in this population is 8.81 (SD, 1.70), ranging from 1.50 to 16.0, respectively. Vegans scored on average 2 points higher than non‐vegetarians. When stratified by gender and race, females consistently scored higher than males, and non‐blacks scored higher than blacks across all levels of dietary patterns.ConclusionsOverall, females have better diet quality than their male counterparts. Non‐blacks consistently have better diet quality than blacks. Similarly, vegans have better diet quality than non‐vegetarians irrespective of gender and race/ethnicity.
Do Changes in Body Composition Contribute to Decline in Muscle Strength? The BACH/Bone Study
Authors: Bartali Benedetta , Dagincourt Nicholas , Curto Teresa , Araujo Andre 
Published: June 2021

BackgroundDecline in muscle strength is a risk factor for dependence and disability in older persons. The role of changes in body composition on muscle strength decline is unclear. The aim of this study was to examine the relationship between changes in lean and fat mass on decline in muscle strength in a racially diverse population of men.MethodsThis study included 692 black, Hispanic, and white men aged 30‐80y participating to the baseline and 8‐y follow‐up assessments of the population‐based longitudinal Boston Area Community Health/Bone Survey. Fat and lean mass were measured by dual‐energy x‐ray absorptiometry, and muscle strength by hand dynamometer. Multivariable linear regression models were used to determine the marginal mean change in muscle strength according to decline in fat or lean mass.ResultsThere was a significant difference in change in muscle strength in men who declined in fat mass during 8‐y follow‐up compared to those who did not decline (p=.009; mean change for no decline= ‐.06; 95%CI:‐.24,0.12; mean change for decline: ‐.47, 95%CI:‐.72,‐.22). Differences in muscle strength were not statistically significant for decline in lean mass (p=.26; mean change for no decline=‐.17; 95% CI: ‐.38, .04; mean change for decline=‐.34; 95% CI: ‐.55,‐.12). The results did not substantially change after mutual adjustment for fat mass and lean mass at baselineConclusionsIn men, decline in fat mass contributes to decline in muscle strength independently of lean mass. These results suggest that adipose tissue‐related factors (e.g. endocrine function) may play a role on muscle strength decline in middle‐aged and older men.
Principles and a Decision‐Making Process for Accountable Partnership Engagement to Create Healthy Food and Active Living Environments in the United States
Authors: Kraak Vivica , Story Mary 
Published: June 2021

ObjectiveVoluntary engagement strategies are used by national governments, industry and non‐governmental organizations to address obesity and non‐communicable diseases (NCDs) through research, policy, programs and advocacy in the United States (U.S.) and globally. Clear principles and procedures are needed to ensure that alliances and cross‐sectoral partnerships with the food, beverage and entertainment industries are trusted, effective and accountable.DesignWe conducted a desk review of electronic databases, United Nations System and U.S. federal agency websites, and grey literature to identify principles, procedures and a decision‐making process to assist institutional stakeholders optimize voluntary engagement to address obesity and NCDs.ResultsExamples of philanthropic, transactional and transformative partnerships are describedimageWe propose five principles to guide public‐private partnerships (e.g., public interest, innovation, compatibility, stewardship and accountability) and a six‐step decision‐making process and toolkit to guide voluntary partnership engagementimage.ConclusionsA systematic and transparent approach that emphasizes principles, procedures and a decision‐making process can guide institutional partners to synergize efforts to create healthy food and active living environments to address obesity and NCDs.
Conducting Formative Research to Understand Patterns and Determinants of Small‐quantity LNS Utilization in Rural Malawi and Mozambique
Authors: Kodish Stephen , Aburto Nancy , Nseluke Hambayi Mutinta , Dibari Filippo , Buanausse Vasco , Gittelsohn Joel 
Published: June 2021

ObjectiveTo understand household utilization of a 20‐gram, lipid‐based nutrient supplement (LNS) for children 6 – 23 monthsMethodsIn Malawi and Mozambique, we conducted home‐feeding trials with small‐quantity, LNS for 8 and 6 weeks, respectively. In‐depth interviews (n = 38), direct meal observations (n = 80), full‐day observations (n = 38), and spot checks of LNS supply (n = 23), were conducted (n = 35 in Malawi; n = 24 in Mozambique) as triangulation. We analyzed data drawing from Grounded Theory with Atlas.ti v7.0 and using basic statistics.ResultsThe LNS was utilized contrary to recommended use, with 50% of households in Malawi running out of stock early and 87% of households in Mozambique either over‐ or under‐using it. Salient patterns of LNS sharing occurred in three ways: 1) caregiver consumption of LNS, 2) caregiver sharing of LNS with children >2 years, and 3) theft by older children due to lack of storage. In Mozambique, it was common for caregivers to not only provide >1 LNS sachet to children 6 – 23 months, but also forget or not be permitted by husbands to provide it. In Malawi, caregivers often gave LNS leftovers to children >2 years. LNS utilization was largely governed by rational decision making in line with core cultural values and as coping mechanisms in light of food insecurity, rather than a mere disregard for program guidelines.ConclusionInterventions need to address reasons behind household choices to over‐ or under‐use a small‐quantity LNS and utilize strategies to intervene at key behavioral decision points to maximize adherence.Funded by Children's Investment Fund Foundation
Postprandial Endotoxemia Increases with Fat Amount in Obese Men: Inflammatory Impact of LPS Handling
Authors: Michalski Marie‐Caroline , Vors Cécile , Pineau Gaëlle , Drai Jocelyne , Malpuech‐Brugère Corinne , Vidal Hubert 
Published: June 2021

Objectives: LPS, so‐called endotoxins, are now recognized as a triggering factor of the low‐grade inflammation observed in obesity. Recent findings revealed that digestion of a lipid‐rich meal induces a postprandial endotoxemia contributing to increased metabolic risk. However, the possible nutritional modulation of postprandial endotoxemia by various fat amounts remains largely unknown in humans, especially regarding the impact of BMI.Methods: Normal‐weight (NW) and obese men ingested meals containing 10g or 40g fat. Endotoxemia was measured in plasma and chylomicrons during 8h, together with inflammatory mediators and LPS transporters.Results: Chylomicrons increased in all subjects according to ingested fat amount (P<0.01), but only obese men had higher postprandial endotoxemia after 40g fat (P<0.05). Their chylomicrons also got more enriched with LPS than in NW. We observed neither NFkB translocation, nor IL‐6 gene expression in leukocytes, regardless of BMI or meal. In both groups, fat amount did not modify postprandial response of plasma IL‐6. However, postprandial AUC of IL‐6 in obese was higher than in NW subjects (P<0.05) parallel to their higher fasting LPS‐Binding Protein (LBP, P<0.05). In fact, postprandial AUC of IL‐6 was correlated with LBP (P<0.01).ConclusionsFat amount contributes to modulate postprandial endotoxemia in obese subjects. The further endotoxin handling in plasma through chylomicrons and LPS transporters appears to be critical in driving the acute inflammatory response. This can contribute to the long term low‐grade inflammation, especially for high cardiometabolic risk individuals.
Accounting for the Influence of Inflammation on Retinol Binding Protein in a Population Survey of Liberian Preschool‐Aged Children
Authors: Larson Leila , Addo O.Yaw , Sandalinas Fanny , Baawo Kou , Faigao Katherine , Kupka Roland , Flores‐Ayala Rafael , Suchdev Parminder 
Published: June 2021

Vitamin A deficiency (VAD) is an important contributor to child morbidity and mortality. The prevalence of VAD, measured by retinol binding protein (RBP) and retinol, is overestimated in populations with a high prevalence of inflammation. We aimed to quantify and adjust for the effect of inflammation on VAD prevalence in a nationally representative survey of Liberian children 6 to 35 months of age.We compared four methods to adjust RBP for inflammation and estimate VAD prevalence: 1) ignoring inflammation, 2) excluding individuals with inflammation (elevated C‐reactive protein (CRP) or alpha1‐acid glycoprotein (AGP), 3) multiplying each individual's RBP by a correction factor, and 4) using regression (corrected RBP = RBP ‐ β1(CRPobs‐CRPref) ‐ β2(AGPobs‐AGPref). Corrected RBP was based on a regression model where CRP and AGP were set to the maximum of the lowest quintile.The unadjusted prevalence of VAD was 28%. Children with elevated CRP and/or AGP had significantly lower RBP concentrations (by 14%) than apparently healthy children. Using methods 2‐4 resulted in a prevalence of VAD of 20%, 18%, and 7%, respectively. Depending on the approach, ignoring inflammation would result in an overestimation of VAD prevalence of 28‐75%.Further quantification of the influence of inflammation on biomarkers of vitamin A status from national surveys is needed to compare and recommend the preferred adjustment method across populations.Support: BMGF, CDC, GAIN, NICHD
Early Introduction of Complementary Foods is Associated with Higher BMI‐for‐Age but Not % Body Fat at 3 Years in Breast Fed Infants
Authors: Gallo Sina , Abell Jennifer , Allice Farra , Vanstone Catherine , Weiler Hope 
Published: June 2021

Nutrition during the first months of life can affect the long term development of obesity. Previous studies were limited by retrospective analysis of infant feeding. We aimed to establish whether timing of complementary foods was associated with BMI and body composition at 3 years of age using a longitudinal design. Healthy breastfeeding infants were recruited from the vitamin D dose response study (NCT00381914) in Montreal, Quebec. Age of first solid food introduction and infant's diet were recorded during the first year. Children were evaluated at 3 years of age for weight and height to calculate BMI‐for‐age Z‐scores using CDC growth charts. Body composition was assessed using dual‐energy x‐ray absorptiometry. Timing of introduction of solids was significantly associated with BMI‐for‐age Z‐score but not % body fat or lean mass at 3 years of age (Table 1). In a multivariate regression model, introduction of solids 蠄4 months, predicted a +0.96 (95% CI: 0.28, 1.64) increase in BMI‐for‐age Z‐score compared to starting solids between 4 ‐ 6 months. This sample represents some selection bias; however, suggests timing of complementary foods may impact growth by 3 y of age.Table 1 Mean ± SD (n) BMI‐for‐age Z‐score and body composition at 3 years by timing of solid food introduction (n=65)

At 3 years
Timing of Introduction of Solids
P‐value

≤ 4 months (n=8)
4 ‐ 6 months (n=46)
≥ 6 months (n=11)

BMI for age Z‐score, CDC growth charts
1.37 ± 0.85
0.48 ± 0.71
0.14 ± 0.89
0.003

n (%) Overweight, ≥ 85th and &lt;95th percentile
4 (50%)
10 (22%)
3 (27%)
0.048

n (%) Obese, ≥ 95th percentile
1 (12.5%)
0
0

% Body Fat
30.5 ± 4.1
29.8 ± 4.2
27.0 ± 5.7
0.138

% Lean Mass
65.6 ± 4.0
66.2 ± 4.2
68.8 ± 5.5
0.176

Grant Funding Source: Canadian Institutes of Health Research
Tocotrienol Attenuates Insulin Resistance through Inhibition of Nlrp3 Inflammasome Activation in Diabetic Leptin Receptor Knockout Mice
Authors: Chung Soonkyu , Wang Wei 
Published: June 2021

We have demonstrated that tocotrienol (T3) supplementation reduces adipose inflammation, M1 macrophage infiltration, and insulin resistance. However, mechanisms remain unrevealed. Emerging evidence suggests that obesity activates Nod‐like receptor 3 (Nlrp3) inflammasome instigating the pathogenesis of type 2 diabetes. In this study, we hypothesized that T3 supplementation inhibits activation of Nlrp3‐dependent inflammasome. To test this, leptin receptor‐deficient (db/db) mice were fed with or without 0.1% T3 for 8 weeks. T3 supplementation substantially delayed the onset of diabetes by reducing hyperglycemia, hyperphagia, diabetic thirst, and polyuria. Consistently, infiltration of M1 macrophage (F4/80+/CD11b+) into adipose tissue was markedly decreased in T3‐fed mice. To determine whether attenuated insulin resistance is attributed to an inhibition of Nlrp3 inflammasome activation, peritoneal macrophages (PM) were isolated. T3 supplementation significantly decreased 1) Nlrp3 gene expression, 2) caspase1 cleavage, and 3) Nlrp3 inflammasome‐dependent IL‐1b and IL‐18 expression and 4) autophagy activation in PM. Intriguingly, co‐treatment with autophagy inhibitor and T3 abolished inhibitory effects of Nlrp3 inflammasome activation. Taken together, our results suggest that T3‐mediated autophagy activation attenuates Nlrp3‐inflammasome in macrophage, which in turn disconnects proinflammatory signaling axis between macrophage and adipocyte leading to an improvement of insulin sensitivity.Funding Source: American Heart Association Scientist Development Grant