bluuebunny/crossref_metadata_2025_split huggingface dataset:
Milk osteopontin regulates immune responses in mice stimulated by lipopolysaccharide (LPS)
Authors: Jiang Rulan , Prell Christine , Lönnerdal Bo 
Published: November 2023

Osteopontin (OPN) is a highly acidic phosphorylated glycoprotein. It is a pleiotropic protein and has been reported to be involved in a wide range of biological processes including initiation of immune responses, biomineralization, cell survival and cell proliferation. OPN appears in most bodily fluids and is present high concentration in human milk. However, the functions of milk OPN remain to be defined. OPN expression was found in mouse mammary glands and it is present at a high level in mouse milk. Therefore, mouse pups fed by wild type (control) or OPN knockout (OPN‐deficient group) dams were utilized to investigate functions of milk OPN on immune responses in early life. To examine effects of milk OPN on immune responses, mouse pups (D20, D30 and D40) were treated with an intraperitoneal injection of E. coli LPS, serotype O111:B4 (1.25 mg/kg, Sigma) in sterile saline. Mouse pups were then euthanized and plasma samples were collected for cytokine measurement (ELISA assays, R&D Systems) at different time points (0.5, 1, 2, 4, 8 & 24 h). Diarrhea symptoms were seen starting at 4 h and body weight was reduced by around 12.5% in all groups at 24 h. Plasma OPN and TNF‐α were significantly up‐regulated in both control and OPN‐deficient groups after LPS injection, but a considerably higher increase in plasma OPN and TNF‐α was observed in the OPN‐deficient group, indicating that milk OPN has anti‐inflammatory properties upon LPS administration. Similarly, plasma IFN‐γ was dramatically enhanced in response to the LPS challenge in both control and OPN‐deficient groups, but the control group showed a significantly higher increase in IFN‐γ. In conclusion, milk OPN may contribute to resistance to LPS administration (bacterial infection) by altering immune responses.Support or Funding InformationSupported by Mead Johnson Nutrition.
Consumption of a Corn‐Sugar Based Infant Formula Is Associated with Higher C‐peptide Secretion Compared to Lactose Based Formula among Exclusively Formula Fed Infants
Authors: Young Bridget E , Tang Minghua , Griese Kayla , Krebs Nancy F 
Published: November 2023

Lactose is the predominant source of the carbohydrate (CHO) in human milk, and provides approximately 40% of infant calories. In contrast, the CHO source provided in infant formula varies widely among types and brands of commercial infant formulas for healthy term infants. Common sources of CHO in US infant formulas include lactose, various formulations of corn sugar (corn syrup, corn syrup solids, maltodextrin, glucose syrup, etc.), sucrose, and starch. Lactose is a disaccharide of glucose and galactose which has a lower glycemic index than the various formulations of corn sugar which are all varying polymer lengths of glucose. The young infants’ pancreatic response to exclusive consumption of these various non‐lactose CHO sources has not been studied.C‐peptide is secreted in equimolar amounts to insulin and provides a stable marker of endogenous insulin secretion. We conducted a cross‐sectional pilot study to compare urinary C‐peptide in exclusively formula fed infants who consumed an infant formula with 100% of CHO from corn‐sugar to infants who habitually consumed a formula with 100% of CHO from lactose. Infant urine samples were collected in a standardized manner. Formula choice had been determined by parents. Urinary C‐peptide to creatinine ratio was measured.Twenty seven infants were studied; 12 from the corn‐sugar and 15 from the lactose‐based group. Infants were on average 5.4 ± 0.5 months of age. The two groups did not differ in terms of infant sex, birth weight, weight gain, or anthropometric z‐scores at the time of study. Mean (± SD) urinary c‐peptide to creatinine ratio was 2.3 ± 4.2 ng/g for the lactose group vs 8.4 ± 11.8 for the corn‐sugar group (p = 0.08).These preliminary results suggest that further research is warranted to determine the short and long‐term effects of non‐lactose based CHO exposure on pancreatic and metabolic function in young infants. Given the prevalence of corn‐sugar based infant formulas on the US market, the long‐term effects of CHO source on infant metabolic function and programming need to be determined.Support or Funding InformationUniversity of Colorado CCTSI UL1 RR025780; NIH‐NIDDK K24‐DK083772; National Pork Board; National Cattlemen's Beef Association; American Heart Association; Abbott Nutrition
Application of the new “Guidelines, for sale and distribution of prepared and processed foods and beverages in schools” in the National School System, during the lunch in Mexico
Authors: del Carmen Morales Ruán María , Shamah‐Levy Teresa , Jimenez‐Aguilar Alejandra 
Published: November 2023

ObjectiveTo evaluate school snack consumption in the context of the Guidelines to establish basis for public policy to preventing child obesity.MethodsA descriptive study was performed in 110 public elementary schools in Mexico. A questionnaire about breakfast in the home and lunch in the school was applied to 182 children from 46 schools. Additionally the food and beverages intake was observed during the lunch time.ResultsThe 82.4% of children reported to breakfast or eat something prior attending to the school. The 19.9% of the children are beneficiaries of the DIF (Family Integral Development System) scholar breakfast program from which 68% reported eating it.The 67.9% of children told to take a lunch with them to the school. Only 10.6% mentioned to include a daily fruit in such lunch and 36.7% reported to have it once or twice per week. The 48.7% reported to never include vegetables in their lunch, and 37.3% only once/twice per week. The 43.3% informed to carry pure water with them, 8.5% industrialized sweetened beverages or soft drinks and 24.5% industrialized juices.ConclusionsThe inclusion of pure water and fruits in the children's lunch has being accomplished, however reinforcement in public policies aimed to guide about healthy food consumption in children is still required.Support or Funding InformationSupported by Bloomberg Philanthropies
Wellness Program at the Workplace Promotes Healthy Eating Lifestyle: Analysis of Employee Wellness Data in a Longitudinal Retrospective Study
Authors: Soliman Ghada A. , Kim Jungyoon , Lee Jung‐Min , High Robin , Wehbi Nizar K , Canedy James T. 
Published: November 2023

IntroductionA majority of work places offers wellness programs to their employees. To determine the effectiveness of wellness programs in improving participants’ behavior towards healthy choices; we investigated the impact of Nebraska‐based Wellness Programs on employees’ consumption of food groups.MethodsWorkplace wellness health‐risk questionnaires were collected from 16153 employees who participated in Nebraska‐based wellness programs across several organizations for three years during 2004 through 2013. Changes in intakes of fruits, vegetables, and whole grain from their first to the third year were compared among participants to determine the impact of the wellness programs on desirable behavior towards healthier food choices. McNemar test was used to compute the p‐values for the paired data.ResultsThe percentage of employees who increased their consumption of fruits (14%) was significantly greater than the percentage of those who decreased their intake (10%, p<0.001). Similarly, the percentage of participants who showed a desirable behavioral change in increasing vegetable intake (14%) was significantly greater than the percentage of participants who showed an undesirable behavioral change (10%, p<0.001). Additionally, the percentage of participants who increased their consumption of dark green leafy vegetables (12%) was also significantly greater than that of those who decreased their intake (7%, p<0.001). There was a slight difference between the percentage of participants in regards to the number of servings of grains (5% versus 6%, p<0.001). However, the percentage of participants who increased their intake of whole grains (15%) was significantly greater than percentage of participants who consumed mainly refined grains (11%, p<0.001).ConclusionsThe Wellness management program has positive impact on increasing the number of participants who select healthier food choices such as increasing the intake of fruits, vegetables, dark green vegetables, and whole grains in a 3‐year follow‐up program.
Development of a nutrition Entrustable Professional Activity for pediatric residents
Authors: Manders Aaron J. , Ireland Kathy A. , Schumacher Daniel J. , Collier Sharon B. , Distler Catherine L. , Lenders Carine M. 
Published: November 2023

ObjectiveDescribe the process of developing a nutrition Enstrustable Professional Activity (EPA) for pediatric residents in the Boston Combined Residency Program (Boston Medical Center and Boston Children's Hospital).IntroductionThe top three causes of mortality in the United States are nutrition‐related and preventable. Unfortunately, most physicians feel unprepared to address nutrition‐related conditions, even those that are common in pediatric practice. The American Association of Medical Colleges (AAMC) has developed an educational framework that includes competencies (physician descriptors) and EPA (work descriptors) to train and assess residents, which can be used to support inter‐professional medical residents training in nutrition, metabolism, and lifestyle behaviors.MethodsAfter establishing the need for improved nutrition training for residents, a meeting was scheduled with residency educators to write a proposal to improve residency training in pediatric nutrition in February 2014. Funding was obtained in December 2014. EPA were defined as an important method to improve resident training in nutrition. A multidisciplinary group of health care professionals was identified and composed of registered dietitians, physician educators, a pediatric resident, and a physician nutrition specialist. We used the approached described in Cate (2013) to guide our creation of a full EPA description. A focus group approach rather than a Delphi method approach was used in meetings. Several face‐to‐face and telephonic meetings, with later work being done individually and reviewed by the group until completion of the EPA.ResultsThe group identified the five major components that needed to be addressed to create a pediatric nutrition EPA: (1) Target resident population, (2) Target patient population, (3) Target location of care, (4) EPA structure and presentation, and (5) Logistics. Challenges during development included defining the scope of the EPA, appreciating and properly balancing the content requirements with the limitations of the EPA structure, and potential barriers to implementing an EPA in practice. The end result of this process was the development of the first nutrition EPA for pediatrics, titled, “manage pediatric nutrition in the ambulatory setting.”DiscussionThe creation of the EPA was the first step in establishing nutrition as an entrustable professional activity for residents. This is the first EPA for pediatric residents focused primarily on nutrition. The development of an EPA is a complicated process that requires a team with sufficient and varied expertise, and adequate resources are needed for its implementation.Support or Funding InformationSupport from New Balance Foundation
Integrating Food Insecurity Assessment in Medical School Curriculum as an Important Health Indicator
Authors: Uhley Virginia , Farr A. Celeste 
Published: November 2023

Food insecurity is associated with an increase in chronic disease risk and negative health outcomes. Gaining an understanding of how to assess for food insecurity is an important skill for health care professionals to integrate into their clinical practice. Medical students need to have the opportunity to learn how to integrate the assessment of food insecurity within the context of the doctor‐patient relationship and clinical assessment. The implementation of the Affordable Care Act will increase the probability that more individuals at risk for food insecurity will enter the health care system, further emphasizing the need for this important assessment skill.To integrate the assessment of food insecurity into our medical school curriculum, we developed and implemented problem‐based longitudinal clinical patient case scenarios and a lecture based presentation in partnership with our local Health department which identified community health programs that were designed to help address food insecurity into our second year Promotion and Maintenance of Health course. We present here an overview of this innovative curriculum. Medical students were required to review their assigned case scenario and to assess their patient's nutrition risks and identify community health resources that would help support their patient's nutrition and health needs. A review of our medical student's completed case responses indicated that this case‐based approach was successful in allowing our student's the opportunity to integrate food insecurity into a clinical assessment and further they were able to incorporate community resources to help address the social determinants of the health of their assigned patients.We conclude that providing problem‐based longitudinal clinical case scenarios is an effective way to integrate skill based food insecurity and associated social determinants of health assessment into the medical school curriculum.
Interprofessional Clinical Training of Nutrition and Dental Students/Residents: Examining Drug‐ Nutrient/Dietary Supplement Interactions and their Impact on Diet/Nutrition and Oral Health
Authors: Ziegler Jane , Spivack Evan , Heir Gary , Radler Diane Rigassio , Touger‐Decker Riva 
Published: November 2023

ObjectiveTo describe an interprofessional model to train students in the dental school clinic setting on exploration of drug‐diet/nutrient interactions.MethodsStudents and residents from the Rutgers’ Department of Nutritional Sciences, School of Health Related Professions and the School of Dental Medicine engage in interprofessional patient care. Nutrition and dental students/residents review patients’ medical histories, physical findings, medications, dietary supplements and chief complaints as a team under the guidance of dental and nutrition faculty. Using live patients or case studies, students/residents engage in interprofessional collaborative practice to identify potential medication‐ dietary supplement interactions that impact nutrition/diet status and oral health. Detailed diet histories and diagnostic test results are evaluated to determine potential deficiencies or interactions and appropriate interventions.Summary of ResultsInterprofessional approaches to practice provide role modeling for students/residents to emulate as they enter the practice setting. Effective interprofessional training integrates a variety of approaches; identification of drug, dietary supplement interactions and patient history, along with physical and diagnostic findings that impact diet/nutrition status and the orofacial region allows dental and nutrition students/residents to actively engage in learning while providing patients with comprehensive care in the dental school clinics. Students/residents learn collaborative decision‐making, problem solving and team‐based communication to deliver best practices.ConclusionCollaborative interprofessional team training and practice during clinical rotations allows students/residents to learn and appreciate the distinctive perspectives, knowledge and skills other disciplines bring to patient care. Student/resident feedback has been consistently positive.Support or Funding InformationN/A
Understanding Nutrition‐related Care in General Pediatric Outpatient Clinical Settings from the Pediatric Provider Perspective: A Qualitative Study
Authors: Kaar Jill Landsbaugh , Schievelbein Sara , Gonzalez‐Pacheco Paola , Caponigro Kelly , Graham Alishia , Goodell L. Suzanne , Thompson Darcy A 
Published: November 2023

ObjectiveNutrition counseling continues to be a concern for pediatric providers. This study aims to provide an in‐depth understanding of the experiences of general pediatric providers regarding nutrition‐related care.MethodsIndividual semi‐structured qualitative interviews were conducted with outpatient generalist pediatric providers recruited from a children's hospital and local pediatric clinics using a purposive sampling technique. Interviews were conducted in‐person or via telephone, recorded, and transcribed. A thematic approach was used for data analysis.Results23 in‐depth interviews were completed, of which 14 providers’ reported no formal nutrition training during their medical education. Providers reported spending an average of 3.9 minutes of clinical visit time on nutrition topics with their patients. Four themes emerged from the data including 1) provider's insecurity regarding nutrition counseling; 2) lack of training in nutrition care; 3) lack of tools to assist providers in delivering nutrition care; and 4) cultural competency related to food. Providers in our sample defined nutrition care as the process of giving parents advice regarding the specific age related nutritional information needed for their child and further agreed it is their role to educate patients and families on what is appropriate nutrition. Nutritional concerns most often discussed include; types of formula, food allergies, supplement use, picky eating or perceived inadequate intake. Providers reported a need to build confidence in their ability to counsel their patients on nutrition topics. To do this effectively and efficiently, they noted a specific need for easy to use tools. Pediatric providers also reported that many nutrition related topics interrelate with family cultures and dynamics.ConclusionsTo improve nutrition counseling in the general pediatric clinics, providers need targeted training and counseling tools that fit within their existing framework. In order to achieve this, training modules need to be designed on specific nutrition topics as well as include topics on cultural competency. Additionally, novel tools that can be utilized quickly to educate patients on nutrition topics are essential for clinicians.Support or Funding InformationUniversity of Colorado School of Medicine, Department of Pediatrics‐ Medical Education
The Supplemental Nutrition Assistance Program Education (SNAP‐Ed) Elementary School Students had Self‐Reported and Observed Behavior Changes
Authors: McCullough Lauren , Farrell Vanessa , Hartz Vern , LeGros Theresa , Jacobs Laurel , Misner Scottie 
Published: November 2023

The Supplemental Nutrition Assistance Program Education (SNAP‐Ed) provides multi‐level obesity prevention interventions in the school setting. The SNAP‐Ed goals for Arizona are to ensure that SNAP‐eligible youth: 1) meet the dietary recommendations for fruit and vegetable consumption, 2) meet dietary recommendations for calcium from low‐fat or fat‐free diary, 3) make half of grains consumed whole grains, and 4) engage in the recommended amount of physical activity (PA) per a day (60 minutes). Interventions in schools may include: nutrition and PA education, taste testing of fruits and vegetables, Local Wellness Policy development, implementation, and revision support. These interventions aim to change student nutrition and PA behaviors. A youth and a teacher survey were used to support interpretation of behavior changes and strengthen the quality of findings.A randomized cohort of students in 4th and 5th grade school classrooms were recruited to participate in youth surveys that assessed nutrition and PA behavior. The youth surveys were administered in the Fall and Spring of 2014–2015. Youth surveys were matched to the students; 536 students took the pre‐survey and 543 took the post survey. Unmatched surveys were excluded for a sample size of 382. Paired t‐tests were used for continuous variables, and the McNemar test was applied to binary data. A multiple choice questionnaire was also given to the 4th and 5th grade teachers in the Spring (N=12), post‐intervention, to assess the teachers’ observations of students’ behaviors. Descriptive statistics were reported for items related to teacher observations of students’ behaviors. Teachers that participated in the teacher questionnaire may or may not have received a SNAP‐Ed intervention in their classroom, during the 2014–15 school year.The youth survey analysis found a significant increase in whole grain consumption (17%, p<0.05) and total PA minutes per day (11% p<0.05). The teacher questionnaire analysis showed that 42% of teachers observed an increase in students’ whole grain consumption and 67% observed students being more physically active.The low sample size for the teacher questionnaire and the unmatched teachers with classrooms were limitations to interpreting the results; however, teacher observations identified trends related to the significant findings of the youth survey. The surveys given to the students and teachers both supported the finding of increased consumption of whole grains and PA among youth in SNAP‐Ed participating schools. Using multiple surveys to assess perceived and observed behavior changes, can strengthen the interpretation of the results and identify trends.
Prevalence of Excess Sodium Intake in the United States, NHANES 2009–2012
Authors: Jackson Sandra L , King Sallyann Coleman , Zhao Lixia , Cogswell Mary E 
Published: November 2023

ObjectiveTo inform the 2015 Dietary Guidelines for Americans, the Dietary Guidelines Advisory Committee (DGAC) reviewed the scientific evidence and recommended consuming a healthy dietary pattern including less than 2300 mg dietary sodium/day or the “age‐appropriate Dietary Reference Intake (DRI) amount” in relation to calories. The objective of the present study was to examine the prevalence of excess sodium intake among Americans ages 2 and older, and among hypertensive adults.DesignData were analyzed from 14,728 participants aged 2 years and older in the 2009–2012 National Health and Nutrition Examination Survey(NHANES).ResultsA majority of US children (81%) and adults (89%) consumed >2300 mg sodium/day. More than 90% of US children exceeded the DRI upper intake level for their age. Among adults, 80% of women and 98% of men exceeded 2300 mg sodium per day, and among hypertensive adults, 86%. Total sodium intake was higher among males than females (p<0.001), but sodium density did not differ significantly by sex (p=0.50).ConclusionsThe DGAC emphasized expanding efforts to reduce the amount of sodium added to foods during commercial processing and preparation. Given the high prevalence of excess sodium in take in the US, population‐wide strategies such as these are needed.