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Background: Type 2 diabetes mellitus (T2DM) disproportionately affects African American (AA) populations. Despite the importance of diet in diabetes management, the association of diet quality and/or the degree of food processing with glycemic control in AA adults with T2DM remains unclear., Objective: This study aimed to examine associations between diet quality scores and the degree of processing in the diet with glycosylated hemoglobin (HbA1c) level in AA adults with T2DM., Design: This cross-sectional study used baseline data from participants in Texas Strength Through Resilience in Diabetes Education, an ongoing clinical trial., Participants/setting: Participants involved in this analysis (N = 273) were AA adults with T2DM recruited through local churches in Austin, TX, and the surrounding areas from August 2020 through April 2023., Main Outcome Measures: Participants provided 2 24-hour dietary recalls (1 weekend and 1 weekday) and a blood sample to measure HbA1c level. Healthy Eating Index 2015, Alternative Healthy Eating Index 2010, and Alternate Mediterranean Diet scores were calculated. The NOVA method was used to calculate the percentage of grams and calories that came from ultraprocessed foods and unprocessed or minimally processed foods., Statistical Analyses Performed: Linear regression and analysis of variance models tested associations between the diet quality scores and degree of food processing with HbA1c level, adjusting for demographic covariates. Models were stratified by insulin use after finding a significant interaction with ultraprocessed foods and unprocessed or minimally processed foods., Results: Regression analyses revealed that the percentage of grams in the total diet from ultraprocessed foods was positively associated with HbA1c level (β adj  = .015; P adj  = .032), whereas unprocessed or minimally processed foods were inversely associated with HbA1c level (β adj  = -.014; P adj  = .043). There was no significant association between any diet quality score and HbA1c level., Conclusions: In AA adults with T2DM, only the degree of food processing was associated with HbA1c level. Future research should explore whether a causal relationship exists between food processing and HbA1c level and investigate mechanisms by which ultraprocessed foods may affect glycemic control., (Copyright © 2024 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Background: Numerous school-based interventions have used cooking and gardening approaches to improve dietary intake; however, research is limited on the mediation effect of dietary psychosocial factors on the link between the intervention and increased vegetable intake, particularly in children from low-income and racial and ethnic minority US families., Objective: Our aim was to examine the effects of the Texas Sprouts intervention on dietary psychosocial factors related to intake of vegetables, and whether these psychosocial factors mediate the link between the intervention and increased intake of vegetables in schoolchildren from low-income and racial and ethnic minority US families., Design: This was an analysis of data on secondary outcomes from the Texas Sprouts program, a 1-year school-based gardening, nutrition, and cooking cluster randomized controlled trial consisting of elementary schools that were randomly assigned to either the Texas Sprouts intervention or to control., Participants/setting: Participants were 2,414 third- through fifth-grade students from low-income and racial and ethnic minority US families from 16 schools (8 intervention and 8 control) in Austin, TX., Intervention: The intervention group received eighteen 60-minute gardening, nutrition, and cooking student lessons in an outdoor teaching garden and 9 monthly parent lessons throughout the academic year., Main Outcome Measures: Child psychosocial and dietary measures were collected at baseline and post intervention via validated questionnaires., Statistical Analyses Performed: Generalized linear mixed models assessed the intervention effects on dietary psychosocial factors. Mediation analyses examined whether these psychosocial factors mediated the link between the intervention and increased child vegetable intake., Results: Children in Texas Sprouts, compared with controls, showed significant increases in the mean scores of gardening attitudes, cooking self-efficacy, gardening self-efficacy, nutrition and gardening knowledge, and preferences for fruit and vegetables (all, P < .001). Each of the dietary psychosocial factors mediated the association between the Texas Sprouts intervention and child vegetable intake., Conclusions: Besides targeting dietary behaviors, future school-based interventions should also focus on understanding the mechanisms through which teaching children to cook and garden influence dietary psychosocial factors as mediators of change in healthy eating behaviors., (Copyright © 2023 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Background: School gardening programs have consistently been found to improve dietary behaviors in children. Although several quasi-experimental studies have also reported that school gardens can enhance academic performance, to date, no randomized controlled trial has been conducted to substantiate this., Objective: The objective of the study was to examine the effects of Texas Sprouts (TX Sprouts), a gardening, nutrition, and cooking program vs control on academic performance in primarily low-income, Hispanic children., Design: This is a secondary analysis of the grade-level academic scores from schools that participated in the TX Sprouts program, a school-based cluster randomized controlled trial, consisting of 16 elementary schools that were randomly assigned to either the TX Sprouts intervention (n = 8 schools) or control (delayed intervention; n = 8 schools)., Participants/setting: Analysis included 16 schools with students in fourth and fifth grade in Austin, TX from 2016 to 2019 that had a majority Hispanic population and a majority of children participating in the free and reduced lunch program., Intervention: The intervention consisted of 18 one-hour gardening, nutrition, and cooking lessons taught in an outdoor teaching garden by trained educators throughout the academic year., Main Outcome Measures: Texas Education Agency grade-level data for the State of Texas Assessments of Academic Readiness were obtained via the Texas Education Agency website for the corresponding year of the intervention or control condition., Statistical Analysis Performed: Repeated measures general linear models with pre- and post-intervention State of Texas Assessments of Academic Readiness scores as the dependent variable were run, adjusting for the percent of free and reduced lunch and school district as covariates., Results: Schools that received the TX Sprouts intervention had a 6.5-percentage-point increase in fourth-grade reading State of Texas Assessments of Academic Readiness scores compared with control schools (P = .047). There were no significant differences in reading scores for fifth grade students or math scores for either fourth- or fifth-grade students between groups., Conclusions: Study findings provide evidence that school gardening programs may have some modest effects on academic achievement., (Copyright © 2023 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Background: Breakfast consumption is often associated with improving cardiometabolic parameters and diet quality. However, literature evaluating breakfast consumption with these outcomes between the school and home environments is limited., Objective: This study examined relationships between breakfast consumption locations (school vs home) and cardiometabolic parameters, breakfast dietary intake, and daily dietary intake., Design: This cross-sectional study used baseline data from TX Sprouts, a 1-year school-based gardening, nutrition, and cooking cluster-randomized trial, implemented in 16 elementary schools in Austin, TX, during 2016 to 2019., Participants/setting: Analyses included 383 low-income, multiracial/ethnic elementary school-aged children (mean age = 9.2 years; 60.6% Hispanic; 70.5% free/reduced lunch; 58.5% home breakfast consumers)., Main Outcome Measures: Cardiometabolic parameters were obtained via fasting blood draws, and dietary intake was assessed using one 24-hour dietary recall conducted on a random, unannounced weekday. Cardiometabolic and dietary parameters (ie, energy intake, macronutrients, and food group servings) for breakfast and for the day were evaluated., Statistical Analyses Performed: Multivariate analysis of covariance was performed to examine cardiometabolic parameters and dietary intake between school and home breakfasts., Results: School breakfast consumers (SBC) had lower fasting triglyceride levels than home breakfast consumers (HBC) (89.0 mg/dL vs 95.7 mg/dL; P = 0.03) (to convert to mmol/L, multiply by 0.0113). SBC had lower total fat for the day (P = 0.02) and lower total and saturated fat, sodium, and refined grains at breakfast (P ≤ 0.01) than HBC. However, SBC had lower protein at breakfast (P = 0.01) and higher carbohydrates, total sugar, and added sugar for the day and at breakfast (P ≤ 0.03) than HBC., Conclusions: SBC compared with HBC had lower fat intake, which may have contributed to the lower triglyceride level observed in SBC, but also had lower protein intake at breakfast and higher added sugar intake for the day and at breakfast. These results suggest dietary intake differed between HBC and SBC; that is, the home and school environments, but more research is needed to evaluate if such differences are due to School Breakfast Program guidelines., (Copyright © 2022 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Background: No studies have assessed the relationship between diet quality, using the Healthy Eating Index (HEI), and adiposity, physical activity, and metabolic disease risk factors in a Hispanic college population., Objective: To assess associations between diet quality and adiposity, metabolic health, and physical activity levels in a Hispanic college freshman population., Design: This was a cross-sectional study. Measurements were obtained during a 4-hour in-person visit and included demographic information via questionnaire, height, weight, waist circumference, body mass index, body fat via BodPod, hepatic fat, visceral adipose tissue (VAT) and subcutaneous adipose tissue via magnetic resonance imaging, glucose, insulin, homeostatic model assessment of insulin resistance (HOMA-IR), and lipids via blood draw from fasting subjects, physical activity (ie, step counts per day and time spent in different intensity levels) via 7-day accelerometry, and dietary intake via three to four 24-hour dietary recalls. Dietary quality was calculated using the HEI-2015., Participants/setting: Hispanic college freshmen (n=92), 18 to 19 years, 49% male, who were enrolled at University of Texas at Austin from 2014 to 2015., Main Outcome Measures: Main outcome measures were diet quality and adiposity, metabolic health, and physical activity levels., Statistical Analyses Performed: Linear regressions determined if dietary quality is related to adiposity, metabolic, and physical activity outcomes. A priori covariates included sex, body fat, and body mass index percentile (for metabolic models), and moderate and vigorous physical activity (MVPA, for adiposity and metabolic models)., Results: The average HEI-2015 total score was 54.9±13.4. A 1-point increase in HEI score was associated with 1.5 mL lower VAT (P=0.013); 8 minutes per day higher light activity (P=0.008), and 107 more step counts per day (P=0.002); and 0.10 μg/mL lower insulin (P=0.046) and 0.5 U lower HOMA-IR (P<0.001)., Conclusion: Results suggest that small improvements in diet quality may be positively associated with a reduction in metabolic disease risk, during a critical time period in a young person's life., (Copyright © 2019 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Background: The impact of sugar restriction on subsequent sugar intake by overweight adolescents is unknown., Objective: Our aim was to examine the effect of sugar restriction on subsequent ad libitum sugar intake by overweight adolescents and whether habitual sugar intake and impulsivity influence the effect of sugar restriction on subsequent sugar intake., Design: This was an in-laboratory crossover feeding trial with sugar-exposure and sugar-restriction conditions., Participants/setting: Eighty-seven overweight Latino and African-American adolescents underwent both meal conditions in two separate 8-hour in-laboratory visits., Intervention: Participants had access to ad libitum snack trays for 3 hours after the condition-specific meals., Main Outcome Measures: Ad libitum sugar intake during the snack period was measured at each visit. Habitual sugar intake and impulsivity were assessed at baseline., Statistical Analyses Performed: Repeated measures analysis of covariance was used to examine the within-person effect of meal condition on ad libitum sugar intake. Mixed models were used to examine the moderating effects of habitual sugar intake and impulsivity on the meal condition-ad libitum sugar intake relationship., Results: Participants consumed more ad libitum sugar during the snack period in the sugar-restriction condition than in the sugar-exposure condition (sugar restriction=78.63±38.84 g, sugar exposure=70.86±37.73 g; F=9.64, P=0.002). There was no relationship between habitual sugar intake and how much ad libitum sugar participants consumed during either condition. Higher impulsivity was associated with greater ad libitum sugar intake during both conditions (sugar restriction: b=.029, standard error=.01, P<0.05; sugar exposure: b=.034, standard error=.01, P<0.05)., Conclusions: Findings suggest that overweight adolescents restricted from sugar intake consume greater amounts of sugar when they are later given access to high-sugar foods. Overweight adolescents with higher impulsivity appear to consume greater amounts of sugar regardless of previous levels of sugar consumption. Compensatory sugar intake and trait impulsivity may have implications for dietary interventions in this population., (Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

There are limited data on the influence of vegetable consumption on adiposity and metabolic health, specifically nonstarchy vegetables and vegetables that are dark green and deep orange/yellow (also known as nutrient-rich vegetables). Our study examines the relationship between vegetable intake and adiposity, liver fat, and insulin dynamics in overweight Latino youth. This cross-sectional study of 175 overweight (body mass index ≥85th percentile) Latino youth (aged 8 to 18 years), with data collected during 2006-2011, included the following: dietary intake via multiple 24-hour recalls, total body fat via dual-energy x-ray absorptiometry, adipose tissue distribution and liver fat via magnetic resonance imaging, and insulin dynamics via frequently sampled intravenous glucose tolerance test. Linear regression and analysis of covariance were used for analysis, with the following a priori covariates: age, sex, energy intake, and total body fat. Participants who consumed the most nonstarchy vegetables (mean intake=1.7±1.0 servings/day) compared with the least (mean intake=0.1±0.1 servings/day) had 44% less liver fat (10.0%±8.5% vs 5.6%±8.7%; P=0.01). Nutrient-rich vegetable intake was positively correlated with insulin sensitivity (r=0.19; P=0.03). Consumers of nutrient-rich vegetables (mean intake=0.3±0.4 servings/day [n=107]), compared with nonconsumers (n=68), had 31% increased insulin sensitivity (1.6±1.6 vs 2.1±1.3×10(⁻⁴)/min/μU/mL; P=0.03) and 17% less visceral adipose tissue (2.3±0.9 vs 1.9±0.7 L; P=0.01). Consumption of specific vegetable types by overweight Latino youth is associated with positive metabolic outcomes, including reduced visceral and liver fat and risk factors for type 2 diabetes, even when consumed in small quantities. These may be relevant targets for interventions., (Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Garden-based approaches to nutrition education may be effective for improving nutrition habits in adolescents. A quasi-experimental, garden-based intervention for Latino youth (LA Sprouts) was piloted and assessed for its influence on behavior associated with dietary intake and psychosocial factors. Study participants were 104 predominately Latino fourth and fifth grade students in Los Angeles (mean age, 9.8±0.7 years; n=70 control subjects, n=34 LA Sprouts participants); more than half (n=61, 59.8%) were overweight or obese (body mass index ≥85th percentile). LA Sprouts participants received an intervention of weekly 90-minute culturally tailored, interactive classes for 12 consecutive weeks at a community garden during the spring of 2010; control participants received an abbreviated delayed intervention. Questionnaire data were obtained before and after the intervention. Compared with control subjects, LA Sprouts participants had an increased preference for vegetables overall, increased preferences for three target fruits and vegetables, as well as improved perceptions that "vegetables from the garden taste better than vegetables from the store." In the overweight/obese subgroup (n=61), LA Sprouts participants had a 16% greater increase in their preference for vegetables compared with control subjects (P=0.009). Results from this pilot study suggest that a cooking, nutrition, and gardening after-school program in a garden-based setting can improve attitudes and preferences for fruits and vegetables in Latino youth, which may lead to improved nutritional habits and dietary intake and reduced health disparities., (Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)