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Background: The burden of obesity and chronic disease is increasing in the older US Hispanic/Latino adult population. There is limited evidence on successful weight management strategies as perceived by this population. Assessing barriers and opportunities for weight management using mixed methods is a robust approach to collect in‐depth information that can be applied to the development of well‐tailored weight management interventions for this population. Objective: The objective of this study was to assess perceived individual, interpersonal, and environmental factors that influence weight management in older Hispanic/Latino adults. Methods: This community‐based cross‐sectional study included 23 Hispanic/Latino older (>50y) adults with obesity (BMI >30 kg/m2). Perceived barriers and opportunities for weight management were assessed through validated questionnaires and focus groups. Prospectively registered on ClinicalTrials.gov (NCT03978416) on 7 June 2019. Results: In this demographically heterogeneous population, language acculturation was generally low, and the frequency of poor dietary behaviors was high. Participants linked financial strain to lower diet quality, as well as anxiety to uncontrolled eating and food cravings. Social support and trust in healthcare professionals were perceived as priorities for healthy eating. Structural and environmental barriers such as affordability and availability of culturally preferred foods were also identified as influences on food choices and eating behavior. Conclusions: This study revealed opportunities for culturally tailored weight management interventions in older Hispanic/Latino adults with obesity. Clinical Trial Registry Number: NCT03978416 (ClinicalTrials.gov) [ABSTRACT FROM AUTHOR]

Objective: Restaurants may be important settings for interventions to reduce children's energy intake. The objective of this study was to test the impact of a parent-focused social marketing campaign to promote healthy children's meals on calories ordered and consumed by children at quick-service restaurants (QSR). Design: Using a repeated cross-sectional study design, two urban communities were randomised to intervention (IN) v. control (C) condition. A community-wide social marketing campaign was implemented in the IN community to empower Black and Latinx mothers who frequent QSR (priority population) to select healthier options for their child. Setting: Data were collected in 2016 at QSR located within the communities pre- and post-IN and analysed in 2017. Participants: Parents (n 1686; n 819 and n 867 for I and C conditions, respectively) were recruited after placing their QSR order; a survey, receipt and their child's leftovers were collected. Results: Calories ordered did not differ significantly between the IN and C conditions (changeadj = –146·4 kJ (–35·0 kcal); 95 % CI –428·0 kJ (–102·3 kcal), 134·6 kJ (32·2 kcal)). In a sub-analysis of only the priority audience, children in the IN community ordered significantly fewer calories compared to C children in unadjusted models (changeunadj = –510·4 kJ (–122·0 kcal); 95 % CI –1013·4 kJ (–242·2 kcal), –7·5 kJ (–1·8 kcal)), but the trend did not persist after adjusting for covariates (changeadj = –437·2 kJ (–104·5 kcal); 95 % CI –925·5 kJ (–221·2 kcal), 50·6 kJ (12·1 kcal)). Calories consumed followed similar trends. Conclusion: The campaign did not significantly reduce children's QSR calories ordered or consumed. However, a quantitatively important mean reduction in calories was suggested among the priority audience, indicating potential for community-wide promotion of healthful children's meals. [ABSTRACT FROM AUTHOR]

Purpose: Socioeconomic status (SES) may impact children's physical activity (PA) behaviors and confidence to participate in PA. We examined how SES modifies the relationship between children's perceived athletic competence (PAC) and moderate to vigorous PA (MVPA).Methods: Children (N = 1157; 45% male; grades 3--4) were recruited for the Fueling Learning through Exercise study. Free/reduced price lunch eligibility was used as an indicator of SES. Seven-day accelerometry (ActiGraph GT3X+) was used to measure daily MVPA, out-of-school MVPA (O-MVPA), and school-time MVPA. PAC was assessed using the Harter's Self-Perception Profile for Children (6 items, scored 1--4; median split: high and low PAC). Results: MVPA and PAC differed between low-SES [n = 556; 41.6 (17.1) min/d; high PAC = 45%] and middle-SES children [n = 412; 49.6 (22.7) min/d; high PAC = 62%]. There was an interaction between SES and PAC for MVPA (P < .001) and O-MVPA (P < .001), but not for school-time MVPA (P > .05). Middle- SES children with high PAC were more likely to engage in MVPA (β = 6.6 min/d; 95% confidence interval, 3.9 to 9.3; P < .001) and O-MVPA (β = 4.8min/d; 95% confidence interval, 2.8 to 6.8; P < .001), associations that did not exist for low-SES children (P > .05). Conclusions: PAC was positively associated with daily MVPA and O-MVPA, but not among low-SES children. Research is needed to elucidate the factors that shape the relationship between PAC and MVPA. [ABSTRACT FROM AUTHOR]

The Food Compass is a nutrient profiling system (NPS) to characterize the healthfulness of diverse foods, beverages and meals. In a nationally representative cohort of 47,999 U.S. adults, we validated a person's individual Food Compass Score (i.FCS), ranging from 1 (least healthful) to 100 (most healthful) based on cumulative scores of items consumed, against: (a) the Healthy Eating Index (HEI) 2015; (b) clinical risk factors and health conditions; and (c) all-cause mortality. Nationally, the mean (SD) of i.FCS was 35.5 (10.9). i.FCS correlated highly with HEI-2015 (R = 0.81). After multivariable-adjustment, each one SD (10.9 point) higher i.FCS associated with more favorable BMI (−0.60 kg/m2 [−0.70,−0.51]), systolic blood pressure (−0.69 mmHg [−0.91,−0.48]), diastolic blood pressure (−0.49 mmHg [−0.66,−0.32]), LDL-C (−2.01 mg/dl [−2.63,−1.40]), HDL-C (1.65 mg/d [1.44,1.85]), HbA1c (−0.02% [−0.03,−0.01]), and fasting plasma glucose (−0.44 mg/dL [−0.74,−0.15]); lower prevalence of metabolic syndrome (OR = 0.85 [0.82,0.88]), CVD (0.92 [0.88,0.96]), cancer (0.95 [0.91,0.99]), and lung disease (0.92 [0.88,0.96]); and higher prevalence of optimal cardiometabolic health (1.24 [1.16,1.32]). i.FCS also associated with lower all-cause mortality (HR = 0.93 [0.89,0.96]). Findings were similar by age, sex, race/ethnicity, education, income, and BMI. These findings support validity of Food Compass as a tool to guide public health and private sector strategies to identify and encourage healthier eating. The Food Compass is a nutrient profiling system to characterize the healthfulness of diverse foods, beverages and meals. In a nationally representative cohort of 47,999 U.S. adults, the authors validate a person's individual Food Compass Score against health outcomes. [ABSTRACT FROM AUTHOR]

We examined the cross-sectional association between plasma 25-hydroxyvitamin D [25(OH)D] and markers of the insulin resistant phenotype. Plasma 25(OH)D concentrations were measured in 808 nondiabetic participants of the Framingham Offspring Study. Outcome measures included fasting and 2-h post 75-g oral glucose tolerance test (OGTT) glucose and insulin; these were used to calculate the homeostatic model assessment-insulin resistance (HOMA IR) and insulin sensitivity index ([ISI.sub.0,120]). We also measured plasma adiponectin, triacylglycerol, and HDL cholesterol concentrations as markers of the insulin-resistant phenotype. After adjusting for age, sex, BMI, waist circumference, and current smoking status, plasma 25(OH)D concentration was inversely associated with fasting plasma glucose and insulin concentrations, and HOMA-IR. Compared with the participants in the lowest tertile category of plasma 25(OH)D, those in the highest tertile category had a 1.6% lower concentration of fasting plasma glucose (P-trend = 0.007), 98% lower concentration of fasting plasma insulin (P-trend = 0.001), and 12.7% lower HOMA-I R score (P-trend < 0.001). After adjusting for age and sex, plasma 25(OH)D was positively associated with [ISI.sub.0,120], plasma adiponectin, and HDL cholesterol and inversely associated with plasma triacylglycerol, but these associations were no longer significant after further adjustment for BMI, waist circumference, and current smoking status. 25(OH)D and 2-h post-OGTT glucose were not associated. Among adults without diabetes, vitamin D status was inversely associated with surrogate fasting measures of insulin resistance. These results suggest that vitamin D status may be an important determinant for type 2 diabetes mellitus.

Objective: To determine whether the contents of food and beverage advertisements are associated with physical activity and athletic ability more often than those for toys and games, and to describe persuasive techniques used in advertising food and beverages to children. Design: A content analysis of advertisements during 31 hours of school-age children's television programming. Analysis: Chi-square tests were used to examine differences in depictions of physical activity. Types of persuasive techniques were tabulated and, within each advertisement, categorized as implicit or explicit. Results: Food and beverage ads depicted children engaged in physical activity and associated the advertised product with athletic ability significantly more than toy and game ads. Food was most often associated with fun and good times (75%), pleasant taste (54.1%), being hip or cool (43.2%), and feelings of happiness (43.2%). Implications for Research and Practice: These findings raise concern that greater levels of physical activity and athletic ability in food advertising, in which the product is frequently associated with fun, may promote overconsumption, especially of calorie-dense, nutrient-poor foods. Further research would elucidate whether this concern is warranted. On the other hand, since food advertisements are presumably effective, health educators can use these techniques to formulate messages for nutritious foods. This concept should be tested with well-designed interventions. Key Words: childhood obesity, food, advertising