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Given the prevalence and consequences of childhood obesity, efforts are being made to identify risk factors and design evidence-based interventions to reduce its impact. Food and beverage consumption habits are established early in life, making preschool-age children an important group to focus on. This cross-sectional study explored beverage intake and its association with body weight status among low-income preschool-age children enrolled in the Special Supplementation Nutrition Program for Women, Infants, and Children (WIC). Authorized representatives for children between the ages of 3 and 4.9 years were interviewed at WIC clinics in Broward County, Florida. Anthropometric data were collected from the WIC data system. The intake of sugar-sweetened beverages (SSB), particularly fruit drinks, was significantly higher in overweight/obese children when compared with their under/normal weight counterparts. Independent of body weight status, the preschool-age children were consuming on average over twice as much as the recommended intake of 100% fruit juice per day for that age group. Close to 80% of the overweight/obese children consumed low-fat or fat-free milk most often than any other type of milk. The intake of SSB was positively correlated with both the intakes of 100% fruit juice and milk, and negatively correlated with the intake of water. When body weight status, race/ethnicity, and intake of other beverages were held constant, SSB intake was positively associated with milk intake and negatively associated with water intake. Results from this study support the need to encourage water intake and discourage SSB intake in an effort to reduce the risk for overweight and obesity in WIC-participating preschool-age children. Emphasizing the need to follow the recommendation to limit 100% fruit juice intake to 4 to 6 oz. per day is important when counseling families with young children. Efforts to increase awareness of the health consequences associated with consuming high-fat milk should continue. [ABSTRACT FROM AUTHOR]

Background. Approximately 17% of children aged 6–11 years were classified as obese in the United States. Obesity adversely affects physical functioning and leads to reduced quality of life. Heart function for overweight and obese children has not been reported. Methods. Data for this study were from NHANES National Youth Fitness Survey (NNYFS) conducted in conjunction with the National Health and Nutrition Examination Survey (NHANES) in 2012. This study used data from children aged 6–12 (N=732) that had the cardiorespiratory endurance measure, body mass index for age and sex, and dietary data (N=682). Cardiovascular endurance was estimated by heart rate reserve. Results. Compared to the highest percentile of heart rate reserve, those in the first percentile had 3.52 (2.36, 5.24) odds and those in the second percentile had 3.61 (1.84, 7.06) odds of being in the overweight/obese as compared to the under/normal weight category. Considering the highest percentile, boys had a heart rate reserve of 35%, whereas girls had a heart rate reserve of 13% (less than half that of boys). Conclusion. Having an overweight or obese classification for children in this study demonstrated a compromise in cardiovascular endurance. Parental awareness should be raised as to the detrimental consequence of overweight and heart health. [ABSTRACT FROM AUTHOR]

This study examined associations of language preference and length of stay in the United States and diet among 132 Haitian Americans aged ≥35, born in Haiti. Two dietary indices, Healthy Eating Index (HEI) and Alternative Healthy Eating Index (AHEI), were used to assess dietary quality. Years in the United States (>15 years;B = 0.063,p= .012) and female gender (B = 5.63,p= .028) were positively associated with AHEI. Lower HEI scores were associated with speaking no English (B= −6.11,p= .026). Participants reporting an income under 20,000/yr had lower AHEI scores (B= −7.63,p= .014). Concurrent use of these indices would provide a screening tool for nutrition intervention. Public health programs targeting low-cost resources, such as community gardening, are recommended to reduce health disparities among this population. [ABSTRACT FROM AUTHOR]

BACKGROUND: Blacks have a higher incidence of diabetes and its related complications. Self-rated health (SRH) and perceived stress indicators are associated with chronic diseases. The aim of this study was to examine the associations between SRH, perceived stress and diabetes status among two Black ethnicities. MATERIALS AND METHODS: The cross-sectional study included 258 Haitian Americans and 249 African Americans with (n = 240) and without type 2 diabetes (n = 267) (n = 507). Recruitment was performed by community outreach. RESULTS: Haitian-Americans were less likely to report 'fair to poor' health as compared to African Americans [OR = 0.58 (95% CI: 0.35, 0.95), P = 0.032]; yet, Haitian Americans had greater perceived stress than African Americans (P = 0.002). Having diabetes was associated with 'fair to poor' SRH [OR = 3.14 (95% CI: 2.09, 4.72), P < 0.001] but not perceived stress (P = 0.072). Haitian-Americans (P = 0.023), females (P = 0.003) and those participants having 'poor or fair' SRH (P < 0.001) were positively associated with perceived stress (Nagelkerke R(2) = 0.151). CONCLUSION: Perceived stress associated with 'poor or fair' SRH suggests that screening for perceived stress should be considered part of routine medical care; albeit, further studies are required to confirm our results. The findings support the need for treatment plans that are patient-centered and culturally relevant and that address psychosocial issues. [ABSTRACT FROM AUTHOR]

Race/ethnicity-, gender- and age-specific differences in dietary micronutrient intakes of US adults ≥  21 years were assessed from National Health and Nutrition Examination Survey, 2007-2008. The participants included Black non-Hispanics, Mexican-American and White non-Hispanics who signed an informed consent form for the interview and who completed the in-person 24-h recall. Micronutrient intakes were based on the Institute of Medicines' classifications of recommended dietary allowances specific for age and gender. Likelihood of many micronutrient insufficiencies was associated with being female, over 65 years, having diabetes and minority status. Younger and female adults had a greater likelihood of iron insufficiency than male and older adults. These findings demonstrate the importance of considering the intersection of age, gender and race in setting policies for micronutrient deficiency screening, particularly in young female adults and minorities. [ABSTRACT FROM AUTHOR]

Migration to the United States has been linked to obesity and poor diet quality. We investigated the relationship among diabetes self-management, diet, age and acculturation factors for 182 Cuban-Americans (Females = 110, Males = 72) with type 2 diabetes recruited from a randomized mailing list in South Florida. Inadequate glycemic control ( β = 0.257), BMI ( β = 0.251), total fat intake ( β = 0.251), and smoking ( β = 0.200), were positively associated, while understanding of overall diabetes care ( β = -0.165), was negatively associated with migration ( N = 162, adj.R = 0.286, F = 14.65, p < 0.001). These associations suggest that effective diabetes education targeting acculturation issues is lacking. [ABSTRACT FROM AUTHOR]

Objective: to examine the relationships among reported medical advice, diabetes education, health insurance and health behavior of individuals with diabetes by race/ethnicity and gender. Method: Secondary analysis of data (N = 654) for adults ages ≥ 21 years with diabetes acquired through the National Health and Nutrition Examination Survey (NHANES) for the years 2007-2008 comparing Black, non-Hispanics (BNH) and Mexican-Americans (MA) with White, non-Hispanics (WNH). The NHANES survey design is a stratified, multistage probability sample of the civilian non-institutionalized U.S. population. Sample weights were applied in accordance with NHANES specifications using the complex sample module of IBM SPSS version 18. Results: The findings revealed statistical significant differences in reported medical advice given. BNH [OR = 1.83 (1.16, 2.88), p = 0.013] were more likely than WNH to report being told to reduce fat or calories. Similarly, BNH [OR = 2.84 (1.45, 5.59), p = 0.005] were more likely than WNH to report that they were told to increase their physical activity. Mexican-Americans were less likely to self-monitor their blood glucose than WNH [OR = 2.70 (1.66, 4.38), p < 0.001]. There were differences by race/ethnicity for reporting receiving recent diabetes education. Black, non-Hispanics were twice as likely to report receiving diabetes education than WNH [OR = 2.29 (1.36, 3.85), p = 0.004]. Having recent diabetes education increased the likelihood of performing several diabetes self-management behaviors independent of race. Conclusions: There were significant differences in reported medical advice received for diabetes care by race/ethnicity. The results suggest ethnic variations in patient-provider communication and may be a consequence of their health beliefs, patient-provider communication as well as length of visit and access to healthcare. These findings clearly demonstrate the need for government sponsored programs, with a patient-centered approach, augmenting usual medical care for diabetes. Moreover, the results suggest that public policy is needed to require the provision of diabetes education at least every two years by public health insurance programs and recommend this provision for all private insurance companies. [ABSTRACT FROM AUTHOR]

Objective. The main purpose of this study was to evaluate the associations of lifestyle medical advice and non-HDL cholesterol control of a nationally representative US sample of adults with hypercholesterolemia by race/ethnicity. Methods. Data were collected by appending sociodemographic, anthropometric, and laboratory data from two cycles of the National Health and Nutrition Survey (2007-2008 and 2009-2010). This study acquired data from male and female adults aged ⩾20 years (N = 11,577), classified as either Mexican American (MA), (n = 2173), other Hispanic (OH) (n = 1298), Black non-Hispanic (BNH) (n = 2349), or White non-Hispanic (WNH) (n = 5737). Results. Minorities were more likely to report having received dietary, weight management, and exercise recommendations by healthcare professionals than WNH, adjusting for confounders. Approximately 80% of those receiving medical advice followed the recommendation, regardless of race/ethnicity. Of those who received medical advice, reporting "currently controlling or losing weight" was associated with lower non-HDL cholesterol. BNH who reported "currently controlling or losing weight" had higher non-HDL cholesterol than WNH who reported following the advice. Conclusion. The results suggest that current methods of communicating lifestyle advice may not be adequate across race/ethnicity and that a change in perspective and delivery of medical recommendations for persons with hypercholesterolemia is needed [ABSTRACT FROM AUTHOR]

Diabetes is a world-wide epidemic associated with multiple environmental factors. Prolonged television viewing (TV) time has been related to increased risk of obesity and type 2 diabetes in several studies. TV viewing has been positively associated with cardiovascular disease risk factors, lower energy expenditure, over-eating high-calorie and high-fat foods. The objective of this study was to assess the associations of hours of TV viewing with dietary quality, obesity and physical activity for three ethnic minorities with and without type 2 diabetes. Diet quality and physical activity were inversely related to prolonged TV viewing. African Americans and participants with type 2 diabetes were more likely to watch more than 4 hours of TV per day as compared to their counterparts. Diet quality was inversely associated with physical activity level. Future studies are needed to establish the risk factors of prolonged TV watching in adult populations for the development of diabetes or diabetes-related complications. Although strategies to reduce TV watching have been proven effective among children, few trials have been conducted in adults. Intervention trials aimed at reducing TV viewing targeting people with type 2 diabetesmay be beneficial to improve dietary quality and physical activity, which may reduce diabetes complications. [ABSTRACT FROM AUTHOR]

ObjectiveTo examine the relationship between dietary patterns, as measured by the Healthy Eating Index (HEI) and the Alternate Healthy Eating Index (AHEI), and 10-year predicted CHD risk in Cuban Americans with and without type 2 diabetes (T2D).DesignIn a cross-sectional study participants were selected from two randomly generated mailing lists of individuals with and without T2D. HEI and AHEI scores were calculated from a self-reported FFQ. CHD risk was determined using the 10-year CHD risk calculator of the Adult Treatment Panel III.SettingMiami Dade and Broward Counties, FL, USA.SubjectsCuban Americans (n 358) aged ≥30 years.ResultsParticipants with T2D had a higher waist circumference (P = 0·001) and 10-year CHD risk score (P = 0·008) compared with those without T2D. Participants without T2D had a higher energy intake (P = 0·034), total blood cholesterol (P = 0·007), HDL cholesterol (P = 0·001) and HEI score (P = 0·006) compared with participants with T2D. AHEI score was a significant predictor of 10-year CHD risk (F(1,351) = 4·44, P = 0·036). An association between AHEI and 10-year CHD risk was found only for participants with T2D (β = −0·244, se = 0·049, P = 0·001).ConclusionThe present study showed that only participants with T2D with significantly higher AHEI scores had lower scores for 10-year predicted CHD risk. No association was found between HEI score and CHD risk among Cuban Americans. Individuals with T2D are advised to follow the AHEI dietary pattern. [ABSTRACT FROM PUBLISHER]

This study evaluated the use of HbA as a screening tool for undiagnosed type 2 diabetes (fasting plasma glucose ≥7.0 mmol/l) in a sample of Cuban-Americans aged ≥ 30 years old. Subjects were randomly recruited from Miami-Dade and Broward counties, FL. Fasting plasma glucose was measured by hexokinase enzymatic method. HbA was measured by the DCA2000 + system using the monoclonal antibody method. HbA demonstrated a high predictive value in detecting undiagnosed diabetes. The area under the receiver operating characteristics (ROC) curve was 0.87. Also, HbA had high sensitivity and specificity when using a cut off value of 6.37 (71 and 86%, respectively). Moderate sensitivity and very high specificity were shown with a cut off value of 6.84 (57 and 96%, respectively). HbA is a reliable alternative to fasting plasma glucose in screening for undiagnosed diabetes in Cuban-Americans. [ABSTRACT FROM AUTHOR]

Objective To examine whether dietary glycemic index (GI) or glycemic load (GL) had an effect on the cardiovascular disease (CVD) risk factors and whether the effects were dependent on the diabetes status in the Cuban American population. Design A case-control, single-time-point study. Methods A total of 324 middle-aged Cuban American adults had completed data on fasting blood lipids, physical activity level and usual dietary intake using a validated food frequency questionnaire. Published GI values were assigned to food items and average dietary GI and GL were calculated per participant. Results Subjects without type 2 diabetes (T2D) were 3.3 times more likely to be in the recommended, highest high-density lipoprotein-cholesterol category if they were in the second dietary GL tertile as compared with those in the first dietary GL tertile ( P = 0.042, 95% confidence interval = 1.94, 10.78). Conclusions The results of the present study suggest that in this sample of Cuban Americans a high GI or GL diet do not adversely affects blood lipids, especially among subjects without T2D. [ABSTRACT FROM AUTHOR]

Objectives: We investigated the relationship among factors predicting inadequate glucose control among 182 Cuban-American adults (Females=110, Males=72) with type 2 diabetes mellitus (CAA). Study Design: Cross-sectional study of CAA from a randomized mailing list in two counties of South Florida. Methods: Fasted blood parameters and anthropometric measures were collected during the study. BMI was calculated (kg/ m2). Characteristics and diabetes care of CAA were self-reported Participants were screened by trained interviewers for heritage and diabetes status (inclusion criteria: self-reported having type 2 diabetes; age ? 35 years, male and female; not pregnant or lactating; no thyroid disorders; no major psychiatric disorders). Participants signed informed consent form. Statistical analyses used SPSS and included descriptive statistic, multiple logistic and ordinal logistic regression models, where all CI 95%. Results: Eighty-eight percent of CAA had BMI of ≥ 25 kg/ m2. Only 54% reported having a diet prescribed/told to schedule meals. We found CAA told to schedule meals were 3.62 more likely to plan meals (1.81, 7.26), p<0.001) and given a prescribed diet, controlling for age, corresponded with following a meal plan OR 4.43 (2.52, 7.79, p<0.001). The overall relationship for HbA1c < 8.5 to following a meal plan was OR 9.34 (2.84, 30.7. p<0.001). Conclusions: The advantage of having a medical professional prescribe a diet seems to be an important environmental support factor in this sample's diabetes care, since obesity rates are well above the national average. Nearly half CAA are not given dietary guidance, yet our results indicate CAA may improve glycemic control by receiving dietary instructions. [ABSTRACT FROM AUTHOR]

This study investigated the practices, attitudes, and beliefs of Florida's nurses and dietitians regarding dietary supplements (DS). Eighty-nine dietitians and 64 nurses responded to a self-reported online survey about nutrient-based supplements, defined as nutrients taken to supplement the diet for enhancing health, and herbal supplements, defined as plants used for enhancing health rather than food seasoning. Personal use of nutrient-based supplements for treatment of a health condition was higher among nurses (67%) than dietitians (42%) (p < .05). However, dietitians recommended nutrient-based supplements more often than nurses (p < .05). Both groups used fewer herbal than nutrient-based supplements (p < .001). More nurses than dietitians believed herbal supplements to be effective (p < .05). Practice trends regarding DS identified among Florida's dietitians and nurses can be a reference for states and countries in which the number of older adults is growing. [ABSTRACT FROM AUTHOR]

To assess the validity of a 131-item semiquantative food frequency questionnaire (FFQ) by comparison with multiple food records in Cuban Americans. The Willet FFQ was administered and food consumptions of three random days (two weekdays and one weekend day) were collected. Cuban Americans residing in Miami. Twenty adult Cuban American volunteers who participated in a larger epidemiological study to evaluate the dietary risk of type 2 diabetes and cardiovascular disease. There were no significant differences in the mean intakes of energy, macronutrients, cholesterol and alcohol estimated by the Willett FFQ and the 3-day food records. For most of the macronutrients the correlation coefficients ranged from 0.14 to 0.71. The correlation coefficient was highest for polyunsaturated fatty acid ( r = 0.71, P <0.001) and lowest for protein ( r = 0.14, P =0.56). Correlation coefficients for carbohydrate ( r = 0.42) and monounsaturated fatty acid ( r = 0.43) were only marginally significant ( P =0.06). Compared with 3-day food records, the Willett FFQ is a reasonable instrument to assess the intakes of most macronutrients and alcohol among Cuban Americans. Further studies should be conducted to validate the usefulness of the Willett FFQ in Cuban Americans for other nutrients. [ABSTRACT FROM AUTHOR]

Kuwait, one of the wealthiest countries in the Arabian Gulf and the world, has nutritional problems that vary from undernourishment-related anemia to overnourishment (overweight), associated with health complications such as diabetes, hypertension, and heart diseases (Ministry of Health, 1996). Previous studies reported the prevalence of obesity among Kuwaiti school children as 18 per cent and 27 per cent for boys and girls, respectively (Eid et al., 1986), and anemia in about 75 per cent of children aged 1-24 months and 40.7 per cent for those aged 25-60 months (Mostafa and Nuwayhed, 1979). The purpose of this study was to evaluate the influence of infant feeding practices and mothers' education and occupation on hemoglobin (Hb) levels and obesity among young children in Kuwait. Data previously collected (January through November 2000) by the Department of Food and Nutrition Administration of the Ministry of Health from 254 apparently healthy mothers and their infants (127 boys, 127 girls) aged 2-23 months, in all five Governates was used. The lengths, weights, and Hb levels of infants were measured and mothers were asked about their infant feeding practices, number of pregnancies, educational level, and occupation. The prevalence of anemia among Kuwaiti infants in this study was significantly (p = 0.004) higher (29.5%) than that reported for American infants, 18.4 per cent (DHHS 1997). Formula-fed Kuwaiti infants were significantly (P < 0.001) heavier (9.38 ± 2.35) than the breast and mixed-fed group (7.98 ± 1.75). Our findings suggest that programs for the prevention and control of obesity and anemia in Kuwait should be a priority on the national nutrition and health agenda. [ABSTRACT FROM AUTHOR]

Carrageenans appear on the FDA's GRAS list for food additives, however reports of adverse gastrointestinal and immunological consequences related to the consumption of food products containing carrageenan have been increasing. The goals of this study were to obtain current information on food industry use of carrageenans, the variety of foods into which they are incorporated, and estimate the level of human intake of carrageenans from these food products. Supermarkets, health food stores, and food manufacturers were surveyed to identify carrageenan-containing foods for the purpose of surveying consumers about their use of these products. One hundred ninety-eight carrageenan-containing food products were identified. A questionnaire was developed and used to collect demographic and food frequency data. These data when analyzed by demographic grouping revealed that the over 30-year-old, college-educated, female subject with normal to low body mass indices embodies the consumers most likely to have a high carrageenan intake. [ABSTRACT FROM AUTHOR]

AbstractObjectiveParticipantsMethodsResultsConclusionsTo determine if using the Snackability app improves snack intake among college students.US college students with overweight/obesity were recruited in June 2020-April 2021.A randomized controlled trial was conducted to test the Snackability app use for 12 wk on snack scores (calculated from the app) compared to controls. We also explored the effect on diet quality (Healthy Eating Index-2015) and weight. Outcomes were compared between the intervention and the control groups at 4, 8, and 12 wk using repeated measures ANOVA.Participants in the app group significantly increased snack score at week 4 (p < 0.001) and week 8 (p = 0.015) and increased HEI-2020 score (p < 0.001) at week 4 compared to controls. The first 4 wk had the highest app usage. No significant differences were seen in body weight.The Snackability app can be used as a tool to help improve snack and diet quality in this group. [ABSTRACT FROM AUTHOR]

Food borne diseases continue to be a public health risk affecting millions of individuals each year especially the immuno-compromised. The purpose of this study was to evaluate the most effective method to train consumers about food safety. Culturally appropriate food safety tools in English, Creole and Spanish were used to educate a convenience sample (n=379) of hard-to-reach population in South Florida. Three groups were involved in the study. Group 1 (n=263) received food safety education using lectures and videotapes. Group 2 (n=20), in addition to the lectures and videotapes received hands-on demonstrations, including correct hand washing technique. Group 3 (Control, n=96) received training unrelated to food safety. Knowledge was measured using a 17 item questionnaire in a pre-test/ post test/ 3-month follow-up test design. Most of the participants were older Hispanic females and had only a 12th grade/GED education with no previous food safety training. Means and SEM for pre-test/post test/follow up for Group 1 were 56.9±16.3, 71.3±6.9 and 64.1±16.5, respectively. Group 2 showed the greatest increase, for which the results were 62.8 ± 14.1, 85.6±13.8 and 75.31±16.3, respectively. For Group 3, the results were 58.1±15.3, 58.6± 15.9 and 61.6±17.1. Food safety knowledge was not significantly different between groups at pre-test. However at post test, all 3 groups differed significantly (p<0.001). Based on these findings, training for hard-to-reach populations should include hands-on demonstrations. [ABSTRACT FROM AUTHOR]

In this paper, factors associated with poverty among refugees were explored using a nationally representative sample in the United States. Relying on the social exclusion theory,) a refugee integration framework was selected as a conceptual framework of the study. Poverty was calculated based on households' income (income poverty) and deprivation in three domains of education, health, and housing (multidimensional poverty). Multivariate models of the study identified limited English language proficiency as the strongest predictor of both income and multidimensional poverty among refugees. The findings call for more attention to English language training among refugees in the United States. [ABSTRACT FROM AUTHOR]

In the present scoping review, we explore whether existing evidence supports the premise that social determinants of health (SDoH) affect immigrant health outcomes through their effects on the microbiome. We adapt the National Institute on Minority Health and Health Disparities' research framework to propose a conceptual model that considers the intersection of SDoH, the microbiome, and health outcomes in immigrants. We use this conceptual model as a lens through which to explore recent research about SDoH, biological factors associated with changes to immigrants' microbiomes, and long‐term health outcomes. In the 17 articles reviewed, dietary acculturation, physical activity, ethnicity, birthplace, age at migration and length of time in the host country, socioeconomic status, and social/linguistic acculturation were important determinants of postmigration microbiome‐related transformations. These factors are associated with progressive shifts in microbiome profile with time in host country, increasing the risks for cardiometabolic, mental, immune, and inflammatory disorders and antibiotic resistance. The evidence thus supports the premise that SDoH influence immigrants' health postmigration, at least in part, through their effects on the microbiome. Omission of important postmigration social‐ecological variables (e.g., stress, racism, social/family relationships, and environment), limited research among minoritized subgroups of immigrants, complexity and inter‐ and intra‐individual differences in the microbiome, and limited interdisciplinary and biosocial collaboration restrict our understanding of this area of study. To identify potential microbiome‐based interventions and promote immigrants' well‐being, more research is necessary to understand the intersections of immigrant health with factors from the biological, behavioral/psychosocial, physical/built environment, and sociocultural environment domains at all social‐ecological levels. [ABSTRACT FROM AUTHOR]

Environmental factors, preventive medical care, and behaviors play a role in childhood obesity. This study used the National Survey of Children's Health, 2011-2012, for 42,828 children, ages 10-17 years. Greater percent of children in the overweight/obese category performed no moderate-to-vigorous physical activity: 11.9 (10.6, 13.3) as compared to children in the underweight/normal weight category: 9.7 (8.9 10.6). No moderate-to-vigorous physical activity was associated with no preventive medical care, inadequate or no health care, parents reporting higher percent of no parks or playgrounds, and unsafe and unsupportive neighborhoods. Odds ratios of overweight/obesity were higher for males [OR = 2.06 (1.64, 2.60)], Hispanics [OR = 1.49 (1.17, 1.90)], non-Hispanic Black females [OR = 1.59 (1.20, 2.08)], younger females [OR10-12 yrs. = 1.35 (1.03, 1.79) and OR13-15 yrs. = 1.4. (1.06, 1.89) vs. OR = 1.0016-17 yrs.], children with high television viewing [OR0-1 hr./day = 0.72 (0.61, 0.86); OR>1 to <4 hrs./day 0.84 (0.72, 0.99) = vs. OR = 1.00≥ 4 hrs./day,] and lower categories of physical activity [OR 0 days/wk. = 1.38 (1.13, 1.62); OR1-3 days/wk. = 1.14 (1.22, 1.62) vs. OR7 days/wk. = 1.00], higher poverty, smoke exposure, and parental perception of their neighborhood as unsupportive. Promoting preventive medical care and neighborhood cooperation may have potential to lower childhood obesity. [ABSTRACT FROM AUTHOR]

Aim: The purpose of the present study was to determine the association of unhealthy dietary food items with cardiometabolic risk factors with and without sociodemographic factors. Methods: This cross‐sectional study used data available to the public from the National Health and Nutrition Survey (NHANES) 2009–2010 where unhealthy food consumption was based on responses to the Dietary Screener Questionnaire (unique to this NHANES cycle), and cardiometabolic risk factors were based on laboratory results, anthropometric measures, interview and examination questions for 2045 adults aged 20–69 and belonging to four racial/ethnic groups: 473 Mexican Americans (MA); 267 Other Hispanics (OH); 389, non‐Hispanic Blacks (NHB) and 916 non‐Hispanic Whites (NHW) (characterised by NHANES). Results: A higher percent of MA, followed by OH and NHB, consumed soft drinks as compared to NHW. Consumption of fried potatoes was over 75% across groups and was associated with higher odds dyslipidaemia (high non‐HDL cholesterol) in the reduced model: OR = 1.38 (1.10, 1.73), P = 0.009 and full model: OR = 1.50 (1.15, 1.96), P = 0.005. All unhealthy foods measured were consumed more often by males as compared to females. Conclusions: Dyslipidaemia was associated with fried potato consumption and marginally with processed meats. Dietary interventions, tailored to specific populations, are needed to determine if substituting healthy foods in place of unhealthy ones will improve cardiometabolic outcomes. [ABSTRACT FROM AUTHOR]

Snacking behavior may affect snack quality, overall diet quality, and body weight; however, the associations between these variables have not been studied among college students. The objective of this study was to associate snacking behaviors with snack quality, diet quality, and weight status among college students with overweight and obesity. We hypothesized that a higher snacking frequency, accessibility and availability of unhealthy snacks, and lack of knowledge would be associated with lower snack and diet quality, and higher weight. Participants (n = 140) completed a snack behavior questionnaire, three 24-hour dietary recalls to assess diet quality using Healthy Eating Index 2015 (HEI-2015), and snack score using an algorithm based on the US DA Smart Snack guidelines and reported weight and height to calculate body mass index (BMI). Analysis of variance and Pearson correlation was used in the analyses. After adjusting for confounders, snack frequency was not associated with snack score, HEI-2015 score, or BMI, but evening snacks had a significantly lower snack score compared with late afternoon snacks (P =.017). Also, those with more accessibility and availability of unhealthy snacks had a lower snack score (P =.001), lower HEI-2015 score (P =.006), and higher BMI (P =.019). Snacking for pleasure was significantly associated with a lower snack score (P =.037). Snack score was positively correlated with HEI-2015 score but not with BMI. In conclusion, late snacking, unhealthy snack environment, and snacking for pleasure were associated with lower snack and diet quality. These findings could be used in future intervention strategies to improve snacking behaviors and the food environment. This study examined the association between snacking behavior with snack and diet quality and body mass index (BMI) in college students with overweight and obesity. Evening snacks and snacking for pleasure were significantly associated with a lower snack quality. Accessibility and availability of unhealthy snacks were significantly associated with lower snack and diet quality and higher BMI. Also, snack quality was positively associated with diet quality, which was inversely associated with BMI. [Display omitted] [ABSTRACT FROM AUTHOR]

Objective. The main purpose of this study was to evaluate the associations of lifestyle medical advice and non-HDL cholesterol control of a nationally representative US sample of adults with hypercholesterolemia by race/ethnicity. Methods. Data were collected by appending sociodemographic, anthropometric, and laboratory data from two cycles of the National Health and Nutrition Survey (2007-2008 and 2009-2010). This study acquired data from male and female adults aged ≥ 20 years (N = 11,577), classified as either Mexican American (MA), (n = 2173), other Hispanic (OH) (n = 1298), Black non-Hispanic (BNH) (n = 2349), or White non-Hispanic (WNH) (n = 5737). Results. Minorities were more likely to report having received dietary, weight management, and exercise recommendations by healthcare professionals than WNH, adjusting for confounders. Approximately 80% of those receiving medical advice followed the recommendation, regardless of race/ethnicity. Of those who received medical advice, reporting "currently controlling or losing weight" was associated with lower non-HDL cholesterol. BNH who reported "currently controlling or losing weight" had higher non-HDL cholesterol than WNH who reported following the advice. Conclusion. The results suggest that current methods of communicating lifestyle advice may not be adequate across race/ethnicity and that a change in perspective and delivery of medical recommendations for persons with hypercholesterolemia is needed. [ABSTRACT FROM AUTHOR]

Background: Diabetes is a global epidemic. Cardiovascular disease (CVD) is one of the most prevalent consequences of diabetes. Nutrition is considered a modifiable risk factor for CVD, particularly for individuals with diabetes; albeit, there is little consensus on the role of carbohydrates, proteins and fats for arterial health for persons with or without diabetes. In this study, we examined the association of macronutrients with arterial pulse pressure (APP), a surrogate measure of arterial health by diabetes status and race.Methods: Participants were 892 Mexican Americans (MA), 1059 Black, non-Hispanics (BNH) and 2473 White, non-Hispanics (WNH) with and without diabetes of a weighted sample from the National Nutrition and Health Examination Survey (NHANES) 2007-2008. The cross-sectional analysis was performed with IBM-SPSS version 18 with the complex sample analysis module. The two-year sample weight for the sub-sample with laboratory values was applied to reduce bias and approximate a nationally, representative sample. Arterial stiffness was assessed by arterial pulse pressure (APP).Results: APP was higher for MA [B = 0.063 (95% CI 0.015 to 0.111), p = 0.013] and BNH [B = 0.044 (95% CI 0.006 to 0.082), p = 0.018] than WNH, controlling for diabetes, age, gender, body mass index (BMI), fiber intake, energy intake (Kcal) and smoking. A two-way interaction of diabetes by carbohydrate intake (grams) was inversely associated with APP [B = -1.18 (95% CI -0.178 to -0.058), p = 0.001], controlling for race, age, gender, BMI, Kcal and smoking. BNH with diabetes who consumed more mono-unsaturated fatty acids (MUFA) than WNH with diabetes had lower APP [B = -0.112 (95%CI-0.179 to -0.045), p = 0.003] adjusting for saturated fatty acids, Kcal, age, gender, BMI and smoking.Conclusion: Higher MUFA and carbohydrate intake for persons with diabetes reflecting lower APP may be due to replacement of saturated fats with CHO and MUFA. The associations of APP with diabetes, race and dietary intake need to be confirmed with intervention and prospective studies. Confirmation of these results would suggest that dietary interventions for minorities with diabetes may improve arterial health. [ABSTRACT FROM AUTHOR]

The goal of this study was to evaluate dietary patterns among South Floridian Latino women with Type 2 diabetes against American Diabetes Association (ADA) dietary recommendations, and ascertain the issues that interfere with adoption of diet prescriptions. Free-living, adult Latino females (N= 128), diagnosed with type 2 diabetes and living in Miami-Dade, South Florida participated in the study. Diet recalls were assessed for caloric and macronutrient composition, and patients were asked about reinforcing and detracting influences on their compliance with dietary recommendations, understanding of diet prescriptions including medication and sick-day guidelines. Estimated daily caloric intake ranged from 571 to 4405 Kcal and the mean (±SD)was 1837.26 (±673.93). Macronutrient intake patterns compared with ADA guidelines were 90.9% of recommended percent caloric contribution from carbohydrate, 120% for protein, and 107% for fat. Only 46.9% of subjects consumed a combined carbohydrate and monounsaturated fat intake of 60-70% of calories per ADA guidelines. Most participants reported eating a typically South Floridian Latino diet; that the most significant change made to their diets was not to its quality, but rather quantity; and that it was inconvenient to cook differently for 'the rest of the family' so their own diet composition remained unaltered. [ABSTRACT FROM AUTHOR]

African-Americans are on the top of the list of the population at risk of diabetes. A total of 161,000 Haitian-Americans live in Miami-Dade County which is 60% of the Haitians living in Florida. They form the 2"d largest immigrant community. Research has lumped Haitians with other African populations which makes it difficult to address health care problems of Haitian. They are a distinct group with food choices & lifestyles different from other African decent populations. Dietary intakes, physical activity level, anthropometric measures and CVD knowledge of Haitian-American adults (N=122; 29 males and 93 females) who live in Miami-Dade County was studied. Standardized questionnaires were used. BMI (mean ±SD) of the study population was 29 ±7.2 for subjects ≤40 and, 30±6.1 for subjects >40 years of age. Thirty three percent (33%) of the males and 27.0% of the females had 31.5 ± 6.0 percent of their calories provided by fat. Coronary Heart Disease knowledge (CHDK) was considered as fair (68.5% correct answer). Physical activity level was less than (6.6±1.1) points which is considered low. Servings of fruits (1.2±0.9) and vegetables (2.5±3.1) and total fiber intake (16±8.4g/day) was lower than the recommended. High correlations were found between CV risk factors and both education (r=.888, p<0.05) and annual income (r=.843, p<0.05). Based on these findings we concluded that Haitian population may be at high risk for obesity, type 2 diabetes and CVD. Further studies with randomized population selection are needed. [ABSTRACT FROM AUTHOR]

Psychosocial and CVD risk factors among Cuban Americans with (n=175) and without (n=125) type 2 diabetes mellitus (T2DM) were studied. Subjects were recruited by randomly selected mailing list responders. Of the subjects with T2DM, 61 were males and 114 were females. Of the non diabetics 42 were males and 83 were females. Beck Depression Inventory and Stress Scale were used along with Socio Demographic Questionnaire. Fasting blood was collected for glucose, Lipid panel and HbHA1c determinations. Independent-Samples T test was used to compare means between diabetics and non-diabetics. Anthropometric measures and blood pressures were taken on the day of blood draw. Diabetic subjects were older (65.4±12.2 years) (p<.002) had greater waist circumference (p<.009) (105±14.6 cm) than non diabetics (61.0±11.9) (101±12.1) respectively. However BMI was not significantly different between the groups. Systolic blood pressure was significantly higher (p<.001) among the diabetics (133±16) than non diabetics (126±17). Beck Depression inventory score indicated that diabetics were significantly (p<.001) more depressed (10.8±10.6) than non diabetics (7.3±6) but both groups were equally stressed. HbA1c level was higher (p<.000) for diabetics (7.2±3) than non diabetics (5.6±2) corresponding to the blood glucose levels (mg/dl) (143±71 and 94±27 respectively at p<.000). HDL cholesterol (mg/dl) was lower (p<.023) (49.5±14.5) in diabetics than non diabetics (53.6±16.3). Gender and age differences regarding psychosocial and biochemical differences need to be further explored. [ABSTRACT FROM AUTHOR]

In a cross-sectional study we examined fasting blood lipids, glucose (BG) and high-sensitivity C-reactive protein (hs-CRP) levels of Foreign-born Afro Caribbean American (FBCA, n=31) living in the US for less than 10 years, US-born Afro Caribbean American (USBCA, n=30), and African American (AA, n=30) men, ages 18-40 years. Socio-demographic data was collected. Total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), BG and hs-CRP were analyzed by standard procedures. There were no significant differences between the male ethnic groups for mean (± SD) of TC, LDL-C, HDL-C and BG levels. However, more USBCA (36.7%; 43.3%) and AA (26.7%; 26.7%) than FBCA (19.4%; 22.6%) had elevated TC (≥ 200 mg/dL) and LDL-C (≥ 130 mg/dL), respectively. Significantly (p<0.01) more FBCA (48.4%) had low HDL-C (< 40 mg/dL) compared to USBCA (20.0%) but not AA (36.7%) males. Elevated BG (≥110 mg/dL) was observed in 6.5% FBCA, 6.7% USBCA and 6.7% AA, whereas more AA (23.3%) had elevated hs-CRP (> 3.0 mg/L) levels than FBCA (10.7%) and USBCA (10.0%) males. We have demonstrated differences in CHD risk factors between different ethnic subgroups of the same racial group. The understanding of these differences will help healthcare professionals in the development of culturally sensitive programs and strategies for the improvement of health outcomes in this population. [ABSTRACT FROM AUTHOR]

Risk factors for type 2 diabetes (T2DM) and cardiovascular diseases (CVD) were studied in 28 overweight (BMI≥95th P) and 32 nonoverweight (BMI<85th P) Hispanic adolescents aged 12-16 years. The risk factors were fasting plasma glucose (FPG), insulin sensitivity (IS), total cholesterol (TC), HDL, LDL, triglycerides (TG), presence of acanthosis nigricans (AN), and blood pressure (BP) ≥ 95th P. Independent-Samples T test was used to compare means between overweight and non-overweight. IS (%) was significantly (p<0.001) lower for overweight (72.3±37.8) than non-overweight (163.7±65.3). TC (mg/dL) was significantly (p<0.001) higher for overweight (171.5±32.6) than non-overweight (141.7±20.2). TG (mg/dL) was significantly (p<0.01) higher (110.5±51.0) for overweight than non-overweight (71.0±34.2). LDL (mg/dL) was higher (p<0.001) for overweight (113.2±28.0) than non-overweight (90.2±19.1). Overweight was significantly associated with AN (χ²=22.86, p<0.001) and BP (χ²=18.97, p<0.001). Multinomial Logistic Regressign was used to test the association of overweight with clustering of risk factors (2 or more risk factors). Overweight adolescents were more likely to have 2 or more risk factors as compared to having 0 (OR=76.80, p<0.001) or 1 (OR=17.60, p<0.001) risk factor. The study shows that overweight Hispanic adolescents are at greater risk for T2DM and CVD than their non-overweight counterparts. [ABSTRACT FROM AUTHOR]

Asthma is a chronic disease increasing in prevalence in Western cultures. Sedentary behaviors, such as television viewing, video game and computer use, have been associated with poor diet and being overweight. The extent to which these factors were associated with asthma was investigated in a representative sample of U.S. children ages 2–11 years (N = 4133). Results showed low dietary fiber, reported being told your child was overweight by a healthcare provider, and race/ethnicity were associated with asthma; whereas, screen time, fat intake, and meals out were not associated with asthma. Implications for clinical practice and research were discussed. [ABSTRACT FROM AUTHOR]

Purpose: This study examined the association of microalbuminuria (MAU), as determined by albumin-to-creatinine ratio (ACR), with hypertension (HTN) among Turkish immigrants with type 2 diabetes (T2D) living in deprived neighborhoods of The Hague, Netherlands. Methods: A total of 110 participants, physician-diagnosed with T2D, aged ≥ 30 years were recruited from multiple sources from The Hague, Netherlands in a cross-sectional design. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured using automated office blood pressure equipment. Urine albumin was measured by immunoturbidimetric assay. Urine creatinine was determined using the Jaffe method. MAU was defined as ACR ≥ 3.5 mg/mmol for females and/or ACR ≥ 2.5 mg/mmol for males. Results: MAU was present in 21% of Turkish immigrants with T2D. Adjusted logistic regression analysis indicated that the odds of having MAU were 6.6 times higher in hypertensive than those that were normotensive (p = 0.007; 95% confidence interval [CI]: 1.19, 36.4). Conclusion: These findings suggest that HTN and MAU may be assessed as a standard of care for T2D management for this population. Prospective studies of diabetes outcomes are recommended to further verify these findings. [ABSTRACT FROM AUTHOR]

Objective: To assess acceptability of food safety education delivered by interactive multimedia (IMM) in a Supplemental Nutrition Program for Women, Infants and Children Program (WIC) clinic. Methods: Female clients or caregivers (n=176) completed the food-handling survey; then an 1MM food safety education program on a computer kiosk. Satisfaction with program, participant demographics, and change in food-handling behavior were assessed by univariate analyses. Results: Over 90% of the participants enjoyed the kiosk, and most (87.5%) reported using computers a lot. Compared with participants with education beyond high school, participants with less education were more likely to report enjoying the kiosk (98.2% vs 88.1%, P = .007), preferred learning with the kiosk (91.7% vs 79.1%, P = .02), and would like to learn about other topics using 1MM (95.4% vs 86.6%, P = .04). Conclusions and Implications: Food safety education delivered by 1MM was well accepted by innercity WIC clinic clients, including those with less education. [ABSTRACT FROM AUTHOR]

The objective of the study was to evaluate 169 Kuwaiti mother–daughter dyads and their associations with health behaviors for eating healthy, engaging in physical activity, daughters perceived body weight, time spent with computer/video, and time viewing television. Female students aged 10–14 years were selected from private and public schools in the State of Kuwait. Results demonstrated that daughters exhibited similar behaviors to their mothers in their perceived eating behavior, physical activity, computer/video game use, and TV screen time. Future research is essential to determine the role of mothers in effective health behavior intervention strategies for female Kuwaiti adolescents. [ABSTRACT FROM PUBLISHER]

Background. The Older Americans Act (OAA) requires that nutrition programs provide meals and related nutrition services that promote health and help manage chronic diseases. The purpose of this study was to compare health status, food security, functional limitations, and chronic diseases of older adults who received or did not receive OAA meals using data from a representative sample of US adults. Methods. Data were from the National Health and Nutrition Surveys 2011–2014 for 2,392 older adults ≥ 65 years of age, including 187 Mexican Americans, 212 other Hispanics, 521 non-Hispanic Blacks, 219 non-Hispanic Asians, and 1253 non-Hispanic Whites. Results. Those receiving OAA meals had higher percent of food insecurity and functional disabilities. Adjusting for potential confounders, adults who received OAA meals had higher odds of emphysema (OR = 2.02; 1.05, 3.89) and lower odds of good-to-excellent health (OR = 0.52; 0.36, 0.77). Women and minorities had poorer health status compared to non-Hispanic Whites. Conclusion. A higher proportion of older adults who received nutritional services reported poorer health as compared to older adults who do not participate in these services. Future studies should assess nutritional adequacy for older adults who participate in nutritional programs comparing sex and race/ethnicity. [ABSTRACT FROM AUTHOR]

Background. The State of Kuwait has a growing obesity epidemic in both genders and all age groups; however, obesity rates in the young seem to be rising. Methods. We conducted a cross-sectional survey in 169 Kuwaiti female adolescents attending both private and public schools spanning the six governorates in the State of Kuwait in order to explore female adolescents’ self-image, body dissatisfaction, type of school (private versus public), TV viewing, and computer games and their relationship to body mass index. Results. Approximately half the students classified as obese perceived their body image to lie in the normal range. Females in the obese category were the most dissatisfied with their body image, followed by those in the overweight category. Eating behavior, level of physical activity, school type, television viewing, computer/video usage, and desired BMI were not significantly associated with level of obesity. Conclusion. This study was one of the few studies to assess adolescent females’ body image dissatisfaction in relation to obesity in the State of Kuwait. The results suggest that including body image dissatisfaction awareness into obesity prevention programs would be of value. [ABSTRACT FROM AUTHOR]

To validate a sun exposure questionnaire against objective measures of change in skin color and to assess its validity in predicting 25(OH)D in a sample of African Americans and Hispanics with type 2 diabetes. Ninety subjects 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 25(OH)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 25(OH)D. This relationship remained significant only for stomach skin color ( P = 0.020) after controlling for covariates. It may be possible that the color of the skin is a better predictor of 25(OH)D in this particular population than sun exposure behaviors. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the differences in correlation of PPARGC1A polymorphisms with type 2 diabetes (T2D) risk in adults of African origins: African Americans and Haitian Americans. The case-control study consisted of >30 years old, self-identified Haitian Americans (n=110 cases and n=116 controls) and African Americans (n=124 cases and n=122 controls) living in South Florida with and without T2D. Adjusted logistic regression indicated that both SNP rs7656250 (OR = 0.22, P=0.005) and rs4235308 (OR = 0.42, P=0.026) showed protective association with T2D in Haitian Americans. In African Americans, however, rs4235308 showed significant risk association with T2D (OR = 2.53, P=0.028). After stratification with sex, in Haitian Americans, both rs4235308 (OR = 0.38, P=0.026) and rs7656250 (OR = 0.23, P=0.006) showed protective association with T2D in females whereas in African American males rs7656250 had statistically significant protective effect on T2D (OR = 0.37, P=0.043). The trends observed for genetic association of PPARGC1A SNPs, rs4235308, and rs7656250 for T2D between Haitian Americans and African Americans point out differences in Black race and warrant replicative study with larger sample size. [ABSTRACT FROM AUTHOR]

The study examined the associations of anthropometric measures of obesity with high sensitivity C-reactive protein (hs-CRP) levels in Turkish immigrants with type 2 diabetes (T2D) living in the Netherlands. A total of 110 participants, physician-diagnosed with T2D, aged 30 years and older were recruited from multiple sources from The Hague, Netherlands. Serum hs-CRP levels were measured with immunoturbidimetric assay. Glycated hemoglobin (A1C) was determined by high-pressure liquid chromatography. Measures of obesity: body weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were determined. Statistical analysis included descriptive statistics, Pearson's correlations and multiple linear regressions (MLR) stratified by gender. Hs-CRP was log transformed to achieve normality. Subjects with hs-CRP levels >10 mg/L ( n = 17) were excluded from the analysis. Females had a higher BMI ( p = 0.007), HC ( p < 0.001), and WHtR ( p = 0.011) as compared to males. Conversely, males had a higher weight ( p = 0.007), and WHR ( p < 0.001) than females. MLR showed that after controlling for covariates, log hs-CRP was positively associated with BMI (B = 0.039, SE = 0.019, β = 0.287, p < 0.05), WC (B = 0.025, SE = 0.011, β = 0.332, p < 0.05) and WHtR (B = 4.015, SE = 1.464, β = 0.376, p < 0.01) in females only. Gender-specific associations between obesity measures and hs-CRP level need to be further investigated in the Turkish immigrant population. Hs-CRP assessment may be added as a standard of care for T2D treatment within this population. [ABSTRACT FROM AUTHOR]

Background. Lack of adherence to dietary and physical activity guidelines has been linked to an increase in chronic diseases in the United States (US).The aim of this study was to assess the association of lifestyle behaviors with self-rated health (SRH). Methods. This cross-sectional study used self-reported data from Living for Health Program (N =1,701) which was conducted from 2008 to 2012 in 190 health fair events in South Florida, US. Results. Significantly higher percent of females as compared to males were classified as obese (35.4% versus 27.0%), reported poor/fair SRH (23.4% versus 15.0%), and were less physically active (33.9% versus 25.4%). Adjusted logistic regression models indicated that both females and males were more likely to report poor/fair SRH if they consumed ≤2 servings of fruits and vegetables per day (OR = 2.14, 95% CI 1.30-3.54; OR = 2.86, 95% CI 1.12-7.35, resp.) and consumed mostly high fat foods (OR = 1.58, 95% CI 1.03-2.43; OR = 3.37, 95% CI 1.67-2.43, resp.).The association of SRH with less physical activity was only significant in females (OR = 1.66, 95% CI 1.17-2.35). Conclusion. Gender differences in health behaviors should be considered in designing and monitoring lifestyle interventions to prevent cardiovascular diseases [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the association between 25-hydroxyvitamin D [25(OH)D] levels and diabetes status in three ethnicities. This cross sectional study included Cuban Americans ( n = 199), Haitian Americans ( n = 253) and African Americans ( n = 248) with and without type 2 diabetes (T2D) from Florida, U.S. Recruitment of participants was through mailing lists (Cuban Americans and African Americans) and community based sources (Haitian Americans). Adjusted logistic regression analysis indicated significant differences in the odds of having insufficient 25(OH)D levels by ethnicity [ P < 0.001], diabetes status [ P < 0.001], and their interaction [ P < 0.001]. Holm's modified Bonferroni method showed that only Cuban Americans without T2D had significantly lower odds of having insufficient 25(OH)D compared to all other groups. Haitian American and African American participants and participants having T2D had the greatest risk of 25(OH)D insufficiency. Future studies should focus on the role of vitamin D supplementation and diabetes outcomes across ethnic groups. [ABSTRACT FROM AUTHOR]