bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementing Health Coaching in Primary Care: Results from a Pilot Study
Authors: Mann Jeffrey Matthew , Locke Amy , Segar Michelle , Orizondo Carissa , McKenna Jessica , Moore Heather , Judge Jessyca , Djuric Zora 
Published: November 2023

Health coaching is potentially a cost‐effective method by which individuals can obtain assistance in achieving and maintaining healthy lifestyles in primary care. In health coaching, the counselor partners with the patient, helping patients discover their own strengths, challenges, and solutions. Currently, there is little research on health coaching with regard to integration within a primary care setting. The aim of this study is to determine whether medical assistants can assist primary care providers in achieving a healthier lifestyle for their patients. We recruited and trained two medical assistants in basic health coaching techniques using self‐determination theory. The program consists of 12 weeks of telephone coaching with in‐person visits at the beginning and end of the program. The focus areas for health coaching are improvement in diet, physical activity, and sleep habits. Thus far, 65 subjects have enrolled in the study. All of the subjects who volunteered for the study were either overweight or obese, and 75% or more of enrolled subjects selected improving diet or physical activity as their primary goal. Thus far 28 subjects have completed 12 weeks of study participation. Mean fruit intakes increased from 1.6 to 2.0 servings per day (p=0.21), and mean vegetable intakes increased from 2.4 to 3.5 servings per day (p=0.03). Physical activity increased by a mean of 110 minutes/week and the percentage of subjects meeting the Centers for Disease Control recommendations for being physically active increased from 44% to 62% (p=0.05). Mean BMI decreased from 34.5 to 33.1 kg/m2 (p=0.09). Encouraging changes also were seen in the motivation of the subjects for health behavior change. Intrinsic motivation for eating a healthy diet and being physically active each increased after 12 weeks of coaching. Issues with implementation that were resolved included involving physicians in referrals, incorporating coaching notes into the medical record, and scheduling coaching calls amongst other medical assistant duties. Study evaluations indicated that subjects were pleased with the program. Of the 28 subjects who have completed 12 weeks of study, 27 agreed or mostly agreed that all family medicine practices should offer health coaching for their patients, and 27 of 28 intended to keep working on their health coaching goals. These pilot results indicate that the role medical assistants have in a primary care setting can be expanded to include health coaching for preventive health behaviors.Support or Funding InformationFunding from the Patient‐Centered Medical Homes initiative in the Department of Family Medicine is acknowledged.
The Prevalence of Adult Obesity in Africa
Authors: Einstein George P , Obidi O F , Tulp Orien L , Oyesile T C 
Published: November 2023

BackgroundAdult obesity, a major risk factor for premature mortality from cardiovascular diseases and diabetes is on the rise in many African countriesObjectivesTo investigate the incidence of adult obesity and its associated risk factors in Africa over a twenty–year period. (1992–2012).MethodsA literature search was performed using Pubmedcentral, google scholar and other sources. The quality of studies was assessed with the use of meta‐analysis. For each study, a Mantel–Haenzel, adjusted relative risks with 95% confidence intervals (CI) were performed for possible confounding factors. For each study, a multivariate logistic regression analysis of the adjusted odds ratio was performed to identify the risk factors on the incidence and prevalence of obesity.Separate meta–analyses were performed on results from studies grouped with similar characteristics.FindingsFive research studies were selected and utilized for the meta–analysis. Quality of individual studies rages from 0.51–0.78 (median, 0.62). Meta‐analysis based on the prevalence of obesity gave pooled odds ratios 2.97 (95% CI; 2.35–3.68). In the multivariate logistic regression, gender, educational attainment and socio–economic status were found to be independent predictors for obesity.ConclusionThe findings suggests an apparently high prevalence of obesity in African adults which requires urgent attention.Support or Funding InformationSupported by Institutional Resources of USAT, the Einstein Institute, and the University of Lagos
Validation of a Food Frequency Questionnaire to Assess Nutrient Intake for Diabetes Intervention Trial
Authors: Al Abdrabalnabi Ahmed , Segovia‐Siapco Gina , Heim Lauren , Sabaté Joan , Wien Michelle 
Published: November 2023

BackgroundType 2 diabetes is an important global health issue. Since individuals with type 2 diabetes (T2D) are taught to use food exchanges when measuring their macronutrient intake, food frequency questionnaires (FFQ) using this familiar method is critical in the dietary intake assessment of this group.AimTo evaluate the ability of a FFQ developed for participants of a diabetes intervention trial in estimating nutrient intake against multiple unannounced 24‐hr recalls.MethodsPatients with type 2 diabetes (T2D) (n= 43; 25 females and 18 males), with mean age of 61.6 (SD 13.1) years and a mean BMI of 29.0 (SD 21.0), participated in a randomized, prospective 24‐week parallel‐group clinical intervention trial. Dietary intake was assessed using 6 unannounced 24‐hr recalls (24HDR) composed of 4 weekdays and 2 weekend days, and a self‐administered semi‐quantitative FFQ with 72 hard‐coded items that was developed for the study. Portion sizes in the FFQ were based on the 2014 American Diabetes Association and the Academy of Nutrition and Dietetics, Choose Your Foods food lists. Wilcoxon signed ranks test, correlation analyses with energy adjustment and deattenuation, and cross‐classification were used to evaluate the agreement between the FFQ and multiple 24HDR on intake of 25 nutrients.ResultsCompared to the 24HDR, the FFQ has significantly underestimated most of the nutrients except for total sugar, animal protein, arachiodonic acid, EPA, dietary fiber, calcium, and potassium. Deattenuated energy‐adjusted correlations ranged between 0.62 (calcium) and 0.07 (iron), with weak correlations (r<0.35) for 9 nutrients, moderate correlations (0.35≤r<0.50) for 5 nutrients and strong correlations (r≥0.50) for 10 nutrients. In the cross‐classification analyses, agreement within 1 quartile ranged from 66% (energy and sodium) to 91% (animal and vegetable proteins) while gross misclassifications ranged from 0% (vegetable protein) to 11% (sodium).ConclusionThe FFQ has a tendency to underestimate absolute intake of most nutrients; however, it has good ranking ability. Underreporting tendency in this group of mostly overweight/obese subjects is similar to findings in other studies. The FFQ developed for the intervention trial can be considered a reasonably valid tool in assessing intake of most nutrients.
Pattern of consumption of sugar‐sweetened drinks among elementary schoolchildren attending public schools in Amatitlán, Guatemala
Authors: Díaz‐Jereda Liza Alejandra , Oliva Raquel Campos , Solomons Noel W. 
Published: November 2023

BackgroundAlthough the consumption of sweetened drinks contributes to the energy requirements of children, high consumption of sugary drinks have been linked to the risk of chronic, non‐communicable diseases.ObjectiveTo describe the sources, volumes and costs of sugar‐sweetened beverages in a convenience sample of school‐aged children from public schools in a suburban setting in the greater metropolitan Guatemala City area.MethodsWe recruited a total of 150 schoolchildren, 67 boys and 83 girls, from grades 1 to 6 in 4 elementary schools in the municipality of Amatitlán, 27 km south of Guatemala City. They were given crayons and a pre‐formatted work booklet, along with instructions to make a pictorial record of each meal and snack over the following 24 h. Upon returning the booklets, participants were interviewed concerning the portion size of all items consumed. A full analysis of 24‐h energy intake from all sources was compiled. With a focus on liquid items, they were classified into subgroups, and the packaging and nutrition labeling on each sugary drink reported was consulted to determine energy content and sales price.ResultsMedian 1‐day consumption of all liquids was 1628 mL, providing 479 kcal of energy, with 390 mL as non‐caloric drinking water. Caloric density varied widely according to beverage group. The mean contribution of sweetened drinks was 428±237 kcal, representing 20.2% of the total daily energy intake. There were no significant differences in the pattern of drinks consumption between boys and girls. The most common beverage packaging was plastic bottles and Tetra Pak® cartons. The unit price by retail presentation ranged from Q.0.40 to 21.00. ($0.05 to 2.76 USD).ConclusionsPictorial recording of diet is a promising approach for child nutrition. Carbonated soda beverages were not the major sweetened drink in this sample, but the calories from all sugar‐containing drinks constitute a fifth of the reported energy for the single‐day records.
The Automated Self‐Administered 24‐Hour (ASA24) is Now Mobile and Can Collect Both 24‐Hour Recalls and Food Records
Authors: Subar Amy F. , Mittl Beth , Zimmerman Thea P. , Kirkpatrick Sharon I. , Schap TusaRebecca E. , Miller Amy , Wilson Magdalena M. , Kaefer Christie , Potischman Nancy 
Published: November 2023

ASA24 is a fully automated, web‐based, self‐administered 24‐hour dietary recall that provides a complete system for probing, coding, and calculating nutrient and food group intakes. The system is based on the U.S. Department of Agriculture's interviewer‐administered Automated Multiple‐Pass Method, the recall method used in the National Health and Nutrition Examination Survey (NHANES). It has been available to extramural investigators, clinicians, and educators at no cost since 2009. From 2009 until October 2015, more than 1,800 studies registered to use ASA24 and more than 204,000 recalls were completed. Modified versions are available for use with children and Canadian participants, and an Australian version is under development. All U.S. versions can be completed in English or Spanish, and the Canadian version will soon be available in French.By early 2016, the National Cancer Institute (NCI) and Westat will release a new mobile version of ASA24 that will be accessible using smart phones and tablets in addition to laptops and desktops. With this new version, researchers will be able to collect food records as well as 24‐hour recalls. The user interface has been modernized to reflect current best practices for web‐users, and includes new features for searching and filtering to find foods consumed, identifying favorites, and obtaining context‐specific help. Supplements are now reported using a more intuitive approach similar to the way in which foods and beverages are reported. The following databases have been updated: the list of foods and beverages provided to respondents, based on NHANES 2011–12; nutrients in foods/beverages, based on the Food and Nutrient Database for Dietary Studies 2011–12; food groups, based on the Food Patterns Equivalents Database 2011–12; the list of supplements and nutrient database associated with supplements, based on the NHANES Dietary Supplement Database 2011–12. The updated version will allow for expanded usage of ASA24, enabling the collection of high‐quality dietary intake data in a range of settings and study types. The NCI and other Institutes and Centers at the National Institutes of Health are committed to providing a low‐cost means for investigators to obtain high‐quality 24‐hour dietary recalls, and now, food records, in surveillance, epidemiologic, intervention, and clinical research.Support or Funding InformationNational Cancer Institute
Applications of the Healthy Eating Index‐2005 and ‐2010 between 2008 and 2015
Authors: Schap TusaRebecca , Kuczynski Kevin , Koegel Kristin , Hiza Hazel , Krebs‐Smith Susan , Reedy Jill , Subar Amy , Wilson Magdelina , Rihane Colette 
Published: November 2023

The Healthy Eating Index (HEI) is a measure of diet quality that is based on key recommendations of the Dietary Guidelines for Americans. Starting with the 2005 version, it has used a universal set of standards, which allows it to be applied to any set of foods and therefore have applications in a variety of research settings. We conducted a literature review to describe and assess the various research applications of the HEI‐2005 and HEI‐2010 from 2008 to 2015.There have been over 130 papers published using HEI‐2005 since its release in 2008. Over 65 papers have been published that used HEI‐2010, which was released in 2013. The number and scope of publications continued to grow each year; nearly 90 papers were published in 2015 alone. A majority of studies that used the HEI examined either the prospective or cross sectional association between overall diet quality and health outcomes. Examples of health outcomes studied included cancer, cardiovascular disease, type 2 diabetes, dental health, and ocular health. Additionally, the HEI was used to assess the impact of nutrition interventions on diet quality, to examine associations between single foods and overall diet quality, and to investigate the association between diet quality and biomarkers. Both versions of the HEI were used to examine diet quality of specific subgroups of the population such as children and adolescents, older adults, and specific race‐ethnic populations. A smaller number of studies examined the diet quality of a particular set of foods in the food environment, for example, foods provided in distribution programs or available in the US food supply.This literature review demonstrates the importance of the concept of diet quality as represented by the HEI to assess adherence to guidelines and investigate the relationship between diet quality and health outcomes across a variety of research settings. A better understanding of the current applications of HEI will inform future development of resources for researchers and policymakers.
Association of Total Antioxidant Capacity with Mortality of U.S. Adults in Follow‐up Study of NHANES 1988–1994 and 1999–2004
Authors: Kim Kijoon , Vance Terrence M. , Chen Ming‐Hui , Chun Ock K. 
Published: November 2023

Antioxidant rich diets have been shown to reduce risk of chronic disease and mortality. However, studies on the association of total antioxidant intake and mortality using representative sample of the US population are limited. The aim of this study was to assess the relationship between dietary total antioxidant capacity (TAC) and all‐cause and disease specific mortality among US adults in NHANES 1988–1994 and 1999–2004. A total of 23,589 US adults aged 30 years and older participated in this study. TAC was calculated from one‐day 24‐h diet recall data at baseline and all‐cause, cancer and cardiovascular disease (CVD) mortality was through December 31, 2011. During a mean follow‐up of 13 years, 7,157 deaths occurred. Age‐standardized mortality rates per 100,000 population by all‐cause, cancer and CVD were 2164, 461 and 650, respectively. Under cause‐specific Cox proportional hazards models for sample survey data, inverse associations and dose‐response relationship were observed between TAC and all‐cause mortality (highest quartile (Q4) vs. Q1 ref. HR 0.75; 95% CI 0.68–0.82), cancer mortality (Q4 vs. Q1 ref. HR 0.68; 95% CI 0.55–0.84) and CVD mortality (Q4 vs. Q1 ref. HR 0.83; 95% CI 0.69–0.99) after adjusting for age, gender and total energy intake. The inverse association and dose‐response relationship still remained between TAC and all‐cause mortality (Q4 vs. Q1 ref. HR 0.88; 95% CI 0.79–0.98) and CVD mortality (Q4 vs. Q1 ref. HR 0.78; 95% CI 0.63–0.96) when further adjusted for relevant covariates. These findings support that greater consumption of antioxidants was beneficial to reducing risk of death from all‐cause and CVD.Support or Funding InformationThis study was supported by Allen Foundation Research Grant.
Carbohydrates but not Fats Trigger Coronary Heart Disease Risk: Findings from the Malaysia Lipid Study (MLS)
Authors: Chuah Khun Aik , Yeak Zu Wei , Balasubramanian Gaiyal , Se Chee Hee , Ng See Hoe , Sahathevan Sharmela , Chinna Karuthan , Sundram Kalyana , Karupaiah Tilakavati 
Published: November 2023

BackgroundCoronary heart disease (CHD) has traditionally being linked to fat consumption, particularly saturated fat (SFA) but findings from recent meta‐analyses and large population studies challenge the association of CHD with increased SFA intake.ObjectiveThis study aims to characterize cardiometabolic risk profile in an urban Malaysian population of 577 healthy adults comprising the 3 main ethnic groups of Malays, Chinese and Indians.MethodData included dietary macronutrient and fatty acid intake patterns, physical activity, body composition and cardiometabolic markers inclusive of lipid and lipoprotein profiles, lipoprotein particle size.ResultTotal energy intake was 1825±413 kcal/day for the MLS population and similar between ethnic groups (P=0.205). Indian subjects consumed the most carbohydrate (256.0±58.1 g/day) followed by Malays (248.4±58.5 g/day) and Chinese (237.7±55.5 g/day) but only intake comparisons between Indian and Chinese was significant (P=0.01). In contrast, Chinese were consuming more protein and fat (68.7±20.3 and 79.5±20.5 g/day) compared to Malays (62.4±16.9 and 61.8±18.3g/day) and Indians (57.9±17.1 and 60.3±19.3 g/day) (both P<0.001). Despite higher fat and protein intakes, Chinese were found to have significantly lower TC:HDL‐C ratio, TG:HDL‐C ratio, total LDL and small LDL particle concentrations compared to Malays and Indians (P<0.05). Chinese were also found to have significantly higher total HDL, large LDL particle concentrations and larger particle size for LDL and HDL compared to Malays and Indians (P<0.05). For the overall population, higher total energy intake was associated with increased TC:HDL‐C (β=0.0003, P<0.01), TG:HDL‐C (β=0.0002, P<0.01), small LDL concentration (β=0.082, P<0.01), but also associated with decreased LDL (β=−0.0002, P<0.01) and HDL particle sizes (β= −0.0002, P<0.01), even after adjusted for confounding factors, such as age, body mass index and physical activity. Similar trends were also observed for carbohydrate intake with increased carbohydrate intake was associated with increased TC:HDL‐C (β=0.0017, P<0.01), TG:HDL‐C (β=0.0016, P<0.01), small LDL concentration (β=0.537, P<0.01) but negatively associated with LDL (β= −0.0016, P<0.01) and HDL (β= −0.0012, P<0.01) particle sizes. These trends were not observed when total fat or SFA intake were increased (P>0.05).ConclusionCarbohydrate but not fat intake in an urban Malaysian population significantly associated with negative impacts on CHD risk evaluated against more advanced biochemical markers.Support or Funding InformationThis project is funded by Malaysian Palm Oil Council (MPOC), NN‐047‐2012.
Nut Intake and Incidence of Type 2 Diabetes in the Adventist Health Study‐2
Authors: EL‐AMARI SALEM S , DEHOM SALEM , SABATE JOAN 
Published: November 2023

OBJECTIVETo evaluate the potential link between nut intake and risk of type 2 diabetes in a North American cohort.RESEARCH DESIGN AND METHODS58,594 participants (64.7% female) from the Adventist Health Study 2 (AHS‐2), a cohort study relating several lifestyle features with health outcomes, with an average age of 58years was longitudinally analyzed. This cohort included 2118 incident case of type 2 diabetes. Subjects’ total nut intake (tree nuts plus peanuts) was derived from the baseline food frequency questionnaire (validity correlation for nuts= 0.57). Logistic regression analysis was performed controlling for various relevant demographic and biological confounders.RESULTSComparing high versus low intake of nuts (3rd tertile versus 1st tertile) in the multivariable adjusted model, participants with high nut intake had reduced risk of type 2 diabetes (OR 0.74, 95% CI 0.65, 0.85, p < 0.0001). Further adjustment for BMI attenuated this link and turned it non‐significant. On stratification analysis by BMI, the nut intake‐type 2 diabetes relation was significant among overweight/obese (BMI ≥ 25 kg/m2) but not in lean subjects.CONCLUSIONThe present analysis suggests that long term high nut intake lowers type 2 diabetes risk, particularly among individuals with high BMI. These findings are consistent with those of other cohort and long term intervention studies.Support or Funding InformationNational Cancer Institute funded the original study (5R01 CA094594).
Osteoporosis Prevention Program: Evaluation of Nutritional Intake, Cognition and Bone Density for Sub‐Metropolitan people in Taiwan
Authors: YANG PINCHUN , Chen Chihhwa , Chiou Hung‐Yi , Li Yu‐Ling , Hsu Guoo‐Shyng Wang 
Published: November 2023

Osteoporosis (OP) is a chronic metabolic bone disease, and people with osteoporosis could easily lead to fractures. In 2010, fifty thousand Taiwanese elderly had hip fractures, and the mortality rate of men within a year after the fracture occurred is 22 % and 15% for women. Nutritional intake, such as deficiency of calcium, vitamin D, and magnesium, and low physical activities may cause the change of bone growth and metabolism. The nutritional status is one of risk factors that cause the Taiwanese elderly suffered from osteoporosis. Therefore, this purpose of study is to survey the nutritional intake, cognition and bone status in Taiwanese elderly. One thousand forty‐two subjects whose ages over 45‐year‐old in sub‐metropolitan area were recruited in this study to measure the bone mass density by ultrasound scanner in 2013 and 2014. Meanwhile, food‐frequency questionnaire (FFQ), the use of supplement, the cognition of osteoporosis and One‐Minute Osteoporosis Risk Test from the International Osteoporosis Foundation (IOF) were collected. The assessment is for studying the prevalence, prevention, knowing, and treatment of osteoporosis and calculating the risk about osteoporosis in high‐risk population of the communities. The average of the subjects is 60.5 ± 12.1 years old, and the percentage of female is 74.3%. Moreover, the T value for bone mass density is −1.5 ± 0.9. In this area, the female whose T score below −2.5 is eight time higher than males. The educational level is significantly related to the classification of bone level (P<0.05). The knowing of osteoporosis is also related to bone density (P<0.05). There are 46% of subjects who have never tested their bone density before. The result of IOF risk test indicates that 52% of this population has moderate level of risk for osteoporosis. The dietary intake of calcium and vitamin D are significantly related to the bone density, but there is no significant relationship between nutritional knowledge and actual intake. In conclusion, the strategies of osteoporosis prevention should base on educational levels and the improvement of nutritional knowledge and intake related to osteoporosis prevention in Taiwanese elderly is crucial.Support or Funding InformationThe Taiwanese Osteoporosis Association, Taipei Medical University, and Fu Jen Catholic University