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OBJECTIVES: This study's purpose is to determine changes in household food security status and nutrition-related anthropometrics and pulmonary function of children with Cystic Fibrosis during the COVID-19 pandemic. METHODS: This retrospective study includede caregivers of children ages 2–18 years old with Cystic Fibrosis who had Ohio residency, a Forced Expiratory Volume in 1 second (FEV(1)) above 30% and consumed at least half of nutrient needs by mouth. After contacting all eligible households by phone, 30 subjects (50% response) enrolled. The validated 18 item Food Security survey module along with several supplemental questions was used to assess household food security status before and after the onset of the COVID-19 pandemic. A medical chart review collected demographics as well as weight (kg) and FEV(1)(%) for the visit closest to the start of the pandemic (Jan-Mar 2020) and the most current visit (July-Dec 2020). Change in weight was categorized as desirable/undesirable based on clinic standards for using the fiftieth percentile as desirable. A paired t-test was used to determine change in FEV(1) since the pandemic. Changes in food security status in relation to change in weight and change in FEV(1) were determined using Fisher's test and Welch's t-test, respectively. RESULTS: Participants were caregivers of children who were 9.96 ± 5.02 years old, 56% female, and 83% Caucasian. Ten % of participants (n = 3) reported household food insecurity before the pandemic, which increased to thirty % (n = 9) after the pandemic. Fifty percent of participants (n = 15) experienced an undesirable weight gain (2.71 kg ± 6.32 kg; mean ± std dev). There was no change in FEV(1) during the pandemic (−0.6% ± 9.02; P = .74). Changes in weight and FEV(1) were not related to change in household food security status (P = 0.287 and P = .088 respectively). CONCLUSIONS: Food insecurity increased during the COVID-19 pandemic; however, it was not related to undesirable weight change or decrease in FEV(1). The second part of this study will use semi-structured interviews to elucidate how families with children with cystic fibrosis coped with food insecurity during the pandemic. FUNDING SOURCES: Pulmonary Division, Nationwide Children's Hospital, Columbus OH

Objective We utilized a validated food inventory questionnaire to assess the types and quality of food available at a homeless youth drop-in center. Methods Scores for 13 food categories were computed; higher scores indicated a greater availability of foods found in that category. A summative score was computed to assess the presence of obesogenic foods. Results Dry cereal, vegetables, and meat, were the most available foods; 83.3%, 60.9%, and 56.3% of food items in each category, respectively, were available. The food categories with least available items included candy and dairy: 26.6% and 25.4% of items in those categories, respectively. Mean obesogenic food availability score was 31 ± 4.2 (range 23–34), out of a possible score of 71. Conclusions and Implications It is possible for a drop-in center to provide healthful foods to homeless youth. Further studies examining the extent to which drop-in centers contribute to the homeless youth food environment are warranted.

Food insecurity is a major public health concern characterized by an individual or household lacking access to adequate food to support a healthy lifestyle. Food insecurity has been associated with predisposing or exacerbating mental health symptoms in children. However, the evidence is scarce with regards to Attention-Deficit Hyperactivity Disorder (ADHD) symptoms in children. The purpose of this review is to summarize and identify gaps in the existing literature, as well as to explore associations between food insecurity and symptoms of childhood ADHD. Literature for this review was pulled from Ovid MEDLINE and PubMed library databases, with a focus on food insecurity, food insufficiency, hunger, and ADHD symptoms such as inattention, hyperactivity, and impulsivity in children. The limited evidence to date shows a predictive and inverse relationship between childhood experience of food insecurity and symptoms of ADHD, with lasting impacts into adulthood. Evidence exists to hypothesize that childhood food insecurity is associated with predisposing or exacerbating ADHD symptoms in children, yet the literature needed to confirm this relationship is scarce and utilizes inconsistent methodology. Future research is needed to further characterize this complex relationship and inspire community or public health interventions addressing food insecurity in children with ADHD. Additionally, it may be clinically useful to routinely screen for food insecurity when assessing pediatric ADHD symptoms.

A healthy diet is associated with lower risk of chronic disease. African Americans generally have poor diet quality and experience a higher burden of many chronic diseases. We examined the associations of demographic and psychosocial factors and barriers to diet quality among African American adults. This cross-sectional study included 100 African American adults in a southeastern metropolitan area. Psychosocial factors (social support, self-efficacy), and barriers to healthy eating were assessed with validated measures. Diet quality was assessed using the Healthy Eating Index (HEI-2010). Nested linear regressions were used to examine the association between the variables of interest and HEI scores. Participants reported having social support (M (mean) = 2.0, SD (standard deviation) = 0.6, range 0&ndash, 3), high levels of self-efficacy (M = 3.1, SD = 0.7, range 1&ndash, 4), and low barriers (M = 1.4, SD = 0.6, range 0&ndash, 4) to engage in healthy eating but total mean HEI scores needed improvement (M = 54.8, SD = 10.9, range 27.1&ndash, 70.0). Participants consumed significantly higher empty calories and lower whole fruits, dairy, and total protein foods than the national average. Barriers to healthy eating (b = &minus, 12.13, p = 0.01) and the interaction between age and barriers (b = 0.25, p = 0.02) were most strongly associated with lower HEI scores. Younger African Americans with the highest barriers to healthy eating had the lowest HEI scores. Culturally appropriate interventions targeting empty calories, barriers to healthy eating, and knowledge of the Dietary Guidelines for Americans are needed for African Americans.

OBJECTIVES: Attention-deficit/hyperactivity disorder (ADHD) is a neuropsychiatric disorder commonly diagnosed in childhood. Current pharmaceutical treatment options provide a poor long-term risk: benefit ratio with little knowledge of the long-term effects. A broad-spectrum multi-nutrient formula has shown promise in children, but its effects on nutrient status and the underlying metabolome interactions have not been characterized. METHODS: Blood samples from medication-free children (n = 74) with ADHD enrolled in a double–blind randomized placebo-controlled multinutrient trial (RCT) were collected at baseline and 8 weeks post-intervention. Following RCT is an 8-week open label phase during which all participants took the active supplement. Symptoms were assessed using the Child and Adolescent Symptom Inventory 5. Double-blinded plasma samples will be analyzed for tyrosine, phenylalanine, tryptophan, magnesium, and zinc. Untargeted LC-MS metabolomics using HILIC chromatography and a high resolution QTof will assess very polar analytes in plasma extracts. Linear modeling will elucidate the influence of treatment, sampling time, and ADHD symptom score on plasma nutrient and plasma metabolite concentration. RESULTS: Preliminary findings of the open label phase show a significant improvement in inattention (P = 0.0435), hyperactivity (P = 0.0068), ODD (P = 0.0108) and DMDD (P = 0.0119). We hypothesize that these improvements in ADHD symptoms will be correlated with increased circulating concentrations of tyrosine, phenylalanine, tryptophan, magnesium, zinc, and metabolites involved in neurotransmitter synthesis and/or branched chain amino acid metabolism. CONCLUSIONS: Preliminary findings indicate improvements of ADHD symptoms of inattention, hyperactivity, ODD and DMDD following 8 weeks of open label multi-nutrient supplementation. Results of the double-blinded phase are expected to mirror those observed in the open label phase, with increases in nutrients in those receiving the multinutrient. FUNDING SOURCES: The sample analyses were supported by NIH Award Number Grant P30 CA016058, OSU, and OSUCCC. Foundation for the Center of Excellence in Mental Health, Canada; The Ohio State University Department of Human Sciences, College of Education and Human Ecology; The Ohio State University Wexner Medical Center, Clinical Research Center.

Cancer patients receiving treatment are at a higher risk for the acquisition of foodborne illness than the general population. Despite this, few studies have assessed the food safety behaviors, attitudes, risk perceptions, and food acquisition behaviors of this population. Further, no studies have, yet, quantified the food safety knowledge of these patients. This study aims to fill these gaps in the literature by administering a thorough questionnaire to cancer patients seeking treatment in three hospitals in a Midwest, metropolitan area. Demographic, treatment, food security, and food safety knowledge, behaviors, attitudes, risk perceptions, and acquisition information was assessed for 288 patients. Specific unsafe attitudes, behaviors, and acquisition practices were identified. Most notable is that 49.4% (n = 139) of participants were not aware that they were at increased risk of foodborne infection, due to their disease and treatment. Additionally, though patients exhibited a general understanding of food safety, the participant average for correctly answering the food safety questions was 74.77% &plusmn, 12.24%. The section concerning food storage showed lowest participant knowledge, with an average score of 69.53% &plusmn, 17.47%. Finally, patients reporting low food security also reported a higher incidence of unsafe food acquisition practices (P &lt, 0.05). These findings will help healthcare providers to better educate patients in the food safety practices necessary to decrease risk of foodborne infection, and to provide targeted food safety education to low-food-security patients.

OBJECTIVES: Attention-deficit/hyperactivity disorder (ADHD) is a neuropsychiatric disorder with increasing global prevalence and high heritability commonly diagnosed in childhood. Current pharmaceutical treatment options provide a poor long-term risk: benefit ratio. Nutrition has significant effects on neurological functioning, and increasing evidence exists to support the use of multinutrients as alternative treatment for ADHD. The goal of this study is to assess the efficacy and tolerability of a multinutrient supplement as an alternative treatment for ADHD and co-occurring mood dysregulation symptoms. METHODS: The Multinutrients in ADHD Youth study is a fully-funded, multi-site, randomized double-blinded clinical trial for adolescents ages 6–12 years (n = 135). The study is 16 weeks in total, with an 8-week randomized controlled trial (RCT) followed by an 8-week open label (OL) phase. During the RCT phase, participants are assigned to either the treatment or placebo group at a 3:2 ratio. Study outcomes of ADHD symptoms include child's inattention, hyperactivity and mood dysregulation, which are assessed using validated questionnaires. Outcome data for the OL phase of the study were analyzed using end of RCT phase as baseline given that the RCT component of the study is still blinded. RESULTS: Preliminary findings based on the OL phase compared ADHD symptoms following 8 weeks of open label supplementation (n = 27 families). A significant decrease in symptom count was found for inattention (P ≤ 0.001), hyperactivity (P ≤ 0.001), ODD (P ≤ 0.001) and DMDD (P ≤ 0.001). CONCLUSIONS: This study is the first adequately powered RCT in North America to investigate the effects of multinutrients supplements on ADHD symptoms among children. Preliminary findings indicate a trend in the improvements of ADHD symptoms of inattention, hyperactivity, ODD and DMDD in the OL phase of the study. FUNDING SOURCES: Foundation for the Center of Excellence in Mental Health, Canada; The Ohio State University Department of Human Sciences, College of Education and Human Ecology; The Ohio State University Wexner Medical Center, Clinical Research Center.

A high diet quality is associated with a lower risk of cancer mortality. However, the predictive factors of diet quality among cancer patients are not well understood. This study determines the socio-demographic and disease-related factors that affect diet quality among cancer patients. Two hundred and forty-two cancer patients completed questionnaires assessing sociodemographic and disease-related characteristics. Diet quality was measured using the Healthy Eating Index 2010 (HEI). Independent sample t-tests and one-way ANOVA with post-hoc analysis using the Tukey HSD test were used to compare mean HEI scores across these characteristics. A regression model was used to determine factors that predicted diet quality. The overall HEI score among cancer patients was 61.59 (SD = 11.67). Patients with a high school degree or General Education Diploma (GED) or less had lower HEI scores (&beta, = &minus, 4.03, p = 0.04, &beta, 7.77, p = 0.001, respectively) compared to those with college degrees. Additionally, homemakers had significantly higher HEI scores (&beta, = 7.95, p = 0.008) compared to those who worked at least 40 hours per week. Also, individuals with some types of cancers (e.g., endometrial or uterine) had significantly higher HEI scores (&beta, = 12.56, p = 0.002) than those with other cancers (e.g., head and neck). Our findings will help oncology healthcare providers identify and target cancer patients with specific demographic characteristics who are at increased risk for consuming poor-quality diets with much needed food resource interventions.