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The purpose of this study was to compare activPAL algorithm-estimated values for time in bed (TIB), wake time (WT) and bedtime (BT) against self-report and an algorithm developed by van der Berg and colleagues. Secondary analyses of baseline data from the Community Activity for Prevention Study (CAPs) were used in which adults [greater than or equal to] 18 years wore the activPAL for seven days. Mixed-effects models compared differences between TIB, WT, and BT for all three methods. Bland-Altman plots examined agreement and the two-one-sided test examined equivalence. activPAL was not equivalent to self-report or van der Berg in estimating TIB, but was equivalent to self-report for estimating BT, and was equivalent to van der Berg for estimating WT. The activPAL algorithm requires adjustments before researchers can use it to estimate TIB. However, researchers can use activPAL's option to manually enter self-reported BT and WT to estimate TIB and better understand 24-hour movement patterns.

Alaimo, K., Olson, C.M., Frongillo Jr., E.A., and Briefel, R.R. 2001. Food insufficiency, family income, and health in US preschool and school-aged children. American Journal of Public Health 91(5): 781-786. [...]

Insufficient attention has been devoted to an examination of the factors that predict the level of satisfaction that community residents have with the neighborhoods in which they live. In this paper, we describe a program of research to examine the predictors of neighborhood satisfaction. Data on neighborhoods and individuals in Flint, Michigan were obtained from the 2000 Census and a citywide survey of neighborhood residents. Multilevel models were used to predict the effect of individual and neighborhood-level characteristics. Findings suggested that many factors from the survey predicted residents' satisfaction from their neighborhoods. While neighborhood characteristics derived fromthe census were statistically related to levels of neighborhood satisfaction, census variables did not add information to a model of neighborhood satisfaction already containing survey variables. [ABSTRACT FROM AUTHOR]

Approximately 13 million American children and 23 million adults live in food-insecure households-households where there is 'limited or uncertain availability of nutritionally adequate or safe foods'; and almost 10 million Americans experience hunger. During the past several decades, much progress has been made in our understanding of the prevalence, experience, and detrimental consequences of food insecurity and hunger for US families, adults, and children. This article reviews the latest research, offers a broad summary of the phenomena of food insecurity and hunger as they are experienced in the US, and proposes a policy-based research agenda for the future. [ABSTRACT FROM AUTHOR]

Objective. This study investigates associations between food insufficiency and cognitive, academic, and psychosocial outcomes for US children and teenagers ages 6 to 11 and 12 to 16 years. Methods. Data from the Third National Health and Nutrition Examination Survey (NHANES III) were analyzed. Children were classified as food-insufficient if the family respondent reported that his or her family sometimes or often did not get enough food to eat. Regression analyses were conducted to test for associations between food insufficiency and cognitive, academic, and psychosocial measures in general and then within lower-risk and higher-risk groups. Regression coefficients and odds ratios for food insufficiency are reported, adjusted for poverty status and other potential confounding factors. Results. After adjusting for confounding variables, 6- to 11-year-old food-insufficient children had significantly lower arithmetic scores and were more likely to have repeated a grade, have seen a psychologist, and have had difficulty getting along with other children. Food-insufficient teenagers were more likely to have seen a psychologist, have been suspended from school, and have had difficulty getting along with other children. Further analyses divided children into lower-risk and higher-risk groups. The associations between food insufficiency and children's outcomes varied by level of risk. Conclusions. The results demonstrate that negative academic and psychosocial outcomes are associated with family-level food insufficiency and provide support for public health efforts to increase the food security of American families. [ABSTRACT FROM AUTHOR]

OBJECTIVES: This study investigated associations between family income, food insufficiency, and health among US preschool and school-aged children. METHODS: Data from the third National Health and Nutrition Examination Survey were analyzed. Children were classified as food insufficient if the family respondent reported that the family sometimes or often did not get enough food to eat. Regression analyses were conducted with health measures as the outcome variables. Prevalence rates of health variables were compared by family income category, with control for age and gender. Odds ratios for food insufficiency were calculated with control for family income and other potential confounding factors. RESULTS: Low-income children had a higher prevalence of poor/fair health status and iron deficiency than high-income children. After confounding factors, including poverty status, had been controlled, food-insufficient children were significantly more likely to have poorer health status and to experience more frequent stomachaches and headaches than food-sufficient children; preschool food-insufficient children had more frequent colds. CONCLUSIONS: Food insufficiency and low family income are health concerns for US preschool and school-aged children. [ABSTRACT FROM AUTHOR]

Abstract Background This paper describes Project FIT, a collaboration between the public school system, local health systems, physicians, neighborhood associations, businesses, faith-based leaders, community agencies and university researchers to develop a multi-faceted approach to promote physical activity and healthy eating toward the general goal of preventing and reducing childhood obesity among children in Grand Rapids, MI, USA. Methods/design There are four overall components to Project FIT: school, community, social marketing, and school staff wellness - all that focus on: 1) increasing access to safe and affordable physical activity and nutrition education opportunities in the schools and surrounding neighborhoods; 2) improving the affordability and availability of nutritious food in the neighborhoods surrounding the schools; 3) improving the knowledge, self-efficacy, attitudes and behaviors regarding nutrition and physical activity among school staff, parents and students; 4) impacting the 'culture' of the schools and neighborhoods to incorporate healthful values; and 5) encouraging dialogue among all community partners to leverage existing programs and introduce new ones. Discussion At baseline, there was generally low physical activity (70% do not meet recommendation of 60 minutes per day), excessive screen time (75% do not meet recommendation of < 2 hours per day), and low intake of vegetables and whole grains and high intake of sugar-sweetened beverages, French fries and chips and desserts as well as a high prevalence of overweight and obesity (48.5% including 6% with severe obesity) among low income, primarily Hispanic and African American 3rd-5th grade children (n = 403). Trial registration ClinicalTrials.gov NCT01385046

Background : Wernicke's encephalopathy can occur in oncology patients independent of alcohol use, likely resulting from poor dietary thiamine intake. High metabolic demands, such as those in acute illnesses seen in the emergency department (ED), can exacerbate thiamine deficiency. In this study, our objective was to assess the incidence of thiamine deficiency in ED oncology patients, which could lead to Wernicke's encephalopathy or other thiamine deficiency disorders if left untreated. Methods : This was a single-center prospective cohort study. We included patients with acute illness and a history of active cancer management in the ED of a large, urban hospital. We also included age and sex-matched control patients with no history of cancer who sought ED care. We excluded patients with a history of alcohol use or parenteral thiamine administration before enrollment. We recorded whole blood thiamine levels to measure total body thiamine stores and collected data on clinical variables, thiamine treatment, and adverse events. Results : In total, 87 oncology and 71 control patients were included in the study. The mean age was 62.1 ± 13.7 and 58.9 ± 12.6 years, respectively, and 48% of oncology vs. 55% of control participants were female. The most common cancers represented were colon (23%), lung (25%), prostate (10%), and breast (9%). Thiamine deficiency was significantly higher in ED oncology patients (25, 28.7%) compared to controls (6, 8.5%), odds ratio 4.4 (95% CI 1.7-11.4). None of the oncology patients with deficiency received thiamine treatment in the ED. Conclusions : Our findings suggest that thiamine deficiency is prevalent in acutely ill oncology patients, yet rarely treated in the ED.

As part of the Community Activation for Prevention (CAPS) randomized controlled trial (RCT) of community gardening, we conducted a process evaluation to assess the implementation of a community gardening intervention over nine months, as measured by reach, fidelity (delivery, receipt, enactment), and acceptability. Evaluation instruments included repeated semi-structured interviews with study participants, direct observation of community garden sites, and an exit survey of participants. Primary outcomes were diet, physical activity, and anthropometry; secondary outcomes were stress and anxiety. The CAPS trial included 291 participants (19% non-white; 34% Hispanic/Latino; 35% without a college degree; 58% with income < $50,000 per year). Intervention delivery and receipt were high for environmental supports. Garden social events were offered by 73% of gardens, although only 48% of intervention participants reported attending these events. Of the 145 participants assigned to the gardening intervention, 97 (67%) reported gardening the entire season and reported visiting the community garden a median of 90 min per week (range: 0-840). Of the participants who completed the exit survey (48%), 89% were highly satisfied with the overall garden experience. The CAPS trial was favorably received and implemented with high fidelity, supporting the validity of the trial outcomes. These findings suggest that community gardens are a viable health promotion strategy that can be successfully implemented among new gardeners from diverse backgrounds. Strategies that engage new gardeners in the social aspects of the garden environment and connect gardeners with garden "mentors" or "buddies" to ensure new gardeners achieve success in their first years of gardening are recommended.Trial registration: NCT03089177. Registered 24 March 2017, https://clinicaltrials.gov/study/NCT03089177 ., (© 2024. The Author(s).)

Young adulthood is an influential life stage for developing lifelong eating patterns, yet limited research characterizes dietary intake among young adults. This cross-sectional study assessed dietary intake and characteristics associated with nutrition knowledge and healthy food consumption among college students. We hypothesized that healthy food intake would be lower than United States (U.S.) dietary guidelines and that perceived healthy eating barriers would be negatively associated with diet quality. Participants were undergraduate college students enrolled in an introductory human nutrition course (N = 762), with surveys administered during the first week of class. Survey instruments included the Dietary Screener Questionnaire developed by the National Cancer Institute and the Jones Nutrition Knowledge questionnaire. Perceived encouragement, cost, taste, and ease of eating healthier foods were assessed with questions from the National Health Interview Survey. College student daily mean intakes of fiber (15.46 ± 3.06 grams), whole grains (0.63 ± 0.29 ounce equivalents), combined fruits and vegetables (2.38 ± 0.73 cup equivalents), and dairy (1.49 ± 0.53 cup equivalents) were lower than U.S. recommended dietary guidelines, while mean intakes of added sugars (14.65 ± 4.01 teaspoon equivalents) were greater than recommendations. As hypothesized, dietary intakes of young adult college students were sub-optimal, not meeting the U.S. dietary guidelines for fiber, whole grains, fruits, vegetables, dairy, and added sugars. Additionally, perceived ease of eating healthier foods, cost, and nutrition knowledge were significantly associated with increased consumption of healthier foods. Results highlight the need to reduce barriers to improve healthy eating among young adults., Competing Interests: Author declarations None., (Copyright © 2024 Elsevier Inc. All rights reserved.)

To measure associations between gardening with different compost amendments and the human gut microbiota composition, gardeners (n = 25) were provided with one of three types of compost: chicken manure (CM), dairy manure and plant material (DMP), or plant-based (P). Stool samples were collected before gardening (T1), after compost amendment (T2), and at peak garden harvest (T3). Compost and soil samples were collected. DNA was extracted, 16S rRNA libraries were established, and libraries were sequenced by Illumina MiSeq. Sequences were processed using mothur, and data were analyzed in R software version 4.2.2. Fast expectation-maximization microbial source tracking analysis was used to determine stool bacteria sources. At T2/T3, the gut microbiotas of P participants had the lowest Shannon alpha diversity, which was also the trend at T1. In stool from T2, Ruminococcus 1 were less abundant in the microbiotas of those using P compost as compared to those using CM or DMP. At T2, Prevotella 9 had the highest abundance in the microbiotas of those using CM compost. In participants who used CM compost to amend their gardening plots, a larger proportion of the human stool bacteria were sourced from CM compared to soil. Soil exposure through gardening was associated with a small but detectable change in the gardeners' gut microbiota composition. These results suggest that human interactions with soil through gardening could potentially impact health through alterations to the gut microbiota.

Background: Gardening has been associated with greater fruit and vegetable intake, but few randomized trials have been conducted., Objectives: We sought: 1 ) to determine changes in fruits and vegetable intake combined and separately from baseline (spring) to harvest time (fall), as well as from baseline to winter follow-up, and 2 ) to identify the mediators (both quantitatively and qualitatively) between gardening and vegetable intake., Methods: A randomized controlled trial of community gardening was conducted in Denver, Colorado, USA. Post hoc quantitative difference score analysis and mediation analysis were conducted by comparing intervention group participants who were randomized to receive a community garden plot, plants and seeds, and a gardening class with control group participants who were randomized to remain on a waitlist for a community garden plot ( n = 243). Qualitative interviews were completed with a subset of participants ( n = 34) and analyzed to explore the influences of gardening on diets., Results: The average age of participants was 41 y, 82% of them were female, and 34% of them were Hispanic. Compared with control participants, from baseline to harvest, community gardeners significantly increased their intake of total vegetables by 0.63 servings ( P = 0.047) and garden vegetables by 0.67 servings ( P = 0.02) but not combined fruit/vegetable or fruit intake. There were no differences between the groups from baseline to winter follow-up. Community gardening was positively associated with eating seasonally ( P = 0.02), which had a significant indirect effect on the association between community gardening and garden vegetable intake (bootstrap 95% CI: 0.002, 0.284). Reasons qualitative participants gave for eating garden vegetables and making dietary changes included the availability of garden produce; emotional attachment with the plants; feelings of pride, accomplishment, and self-reliance; taste and quality of garden produce; trying new foods; cooking and sharing food; and increased seasonal eating., Conclusions: Community gardening increased vegetable intake through increased seasonal eating. Community gardening should be recognized as an important setting for improving diets.This trial was registered in ClinicalTrials.gov as NCT03089177 (https://clinicaltrials.gov/ct2/show/NCT03089177)., (© 2023 The Author(s).)

Background: Unhealthy diet, physical inactivity, and social disconnection are important modifiable risk factors for non-communicable and other chronic diseases, which might be alleviated through nature-based community interventions. We tested whether a community gardening intervention could reduce these common health risks in an adult population that is diverse in terms of age, ethnicity, and socioeconomic status., Methods: In this observer-blind, randomised, controlled trial, we recruited individuals who were on Denver Urban Garden waiting lists for community gardens in Denver and Aurora (CO, USA), aged 18 years or older, and had not gardened in the past 2 years. Participants were randomly assigned (1:1), using a randomised block design in block sizes of two, four, or six, to receive a community garden plot (intervention group) or remain on a waiting list and not garden (control group). Researchers were masked to group allocation. Primary outcomes were diet, physical activity, and anthropometry; secondary outcomes were perceived stress and anxiety. During spring (April to early June, before randomisation; timepoint 1 [T1]), autumn (late August to October; timepoint 2 [T2]), and winter (January to March, after the intervention; timepoint 3 [T3]), participants completed three diet recalls, 7-day accelerometry, surveys, and anthropometry. Analyses were done using the intention-to-treat principle (ie, including all participants randomly assigned to groups, and assessed as randomised). We used mixed models to test time-by-intervention hypotheses at an α level of 0·04, with T2 and T3 intervention effects at an α level of 0·005 (99·5% CI). Due to potential effects of the COVID-19 pandemic on outcomes, we excluded all participant data collected after Feb 1, 2020. This study is registered with ClinicalTrials.gov, NCT03089177, and data collection is now complete., Findings: Between Jan 1, 2017, and June 15, 2019, 493 adults were screened and 291 completed baseline measures and were randomly assigned to the intervention (n=145) or control (n=146) groups. Mean age was 41·5 years (SD 13·5), 238 (82%) of 291 participants were female, 52 (18%) were male, 99 (34%) identified as Hispanic, and 191 (66%) identified as non-Hispanic. 237 (81%) completed measurements before the beginning of the COVID-19 pandemic. One (<1%) participant in the intervention group had an adverse allergic event in the garden. Significant time-by-intervention effects were observed for fibre intake (p=0·034), with mean between-group difference (intervention minus control) at T2 of 1·41 g per day (99·5% CI -2·09 to 4·92), and for moderate-to-vigorous physical activity (p=0·012), with mean between-group difference of 5·80 min per day (99·5% CI -4·44 to 16·05). We found no significant time-by-intervention interactions for combined fruit and vegetable intake, Healthy Eating Index (measured using Healthy Eating Index-2010), sedentary time, BMI, and waist circumference (all p>0·04). Difference score models showed greater reductions between T1 and T2 in perceived stress and anxiety among participants in the intervention group than among those in the control group., Interpretation: Community gardening can provide a nature-based solution, accessible to a diverse population including new gardeners, to improve wellbeing and important behavioural risk factors for non-communicable and chronic diseases., Funding: American Cancer Society, University of Colorado Cancer Centre, University of Colorado Boulder, National Institutes of Health, US Department of Agriculture National Institute of Food and Agriculture, Michigan AgBioResearch Hatch projects., Competing Interests: Declaration of interests JRH owns controlling interest in Connecting Health Innovations (CHI), a company that has licensed the right to his invention of the dietary inflammatory index (DII) and for which JRH and the University of South Carolina have secured a federally registered trademark for the DII. The CHI aims to develop computer and smartphone applications for patient counselling and dietary intervention in clinical settings. CHI owns all derivative products, including the energy-adjusted DII (E-DII). All CHI-related activity occurred outside the submitted work, which includes royalties paid to CHI. JRH confirms that the subject matter of this manuscript did not have any direct bearing on that work, nor has that activity exerted any influence on this project. All other authors declare no competing interests., (Copyright © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Gardening has the potential to improve health by providing access to nature, vegetables, and physical activity. However, scarce research exists on the health impacts of gardening on racial and ethnic minority urban populations in the United States. This study used qualitative interviews to examine the perceived physical and mental health effects of gardening in a primarily African American sample of 28 gardeners. Prominent physical health impacts attributed to gardening included providing an enjoyable source of activity, management of chronic diseases, and improved physical functioning. Participants also reported that gardening improved their mood, relieved stress, was an important part of their spirituality, contributed to their personal growth, and provided an opportunity for helping others. These findings suggest that gardening may improve physical and mental health among diverse groups.

Aim: We explored the feasibility of collecting and analyzing human microbiome data in a longitudinal randomized controlled trial of community gardening. Methods & materials: Participants were randomly assigned to gardening (N = 8) or control (N = 8). Participants provided stool, mouth, hand and forehead microbiome samples at six timepoints. Analyses combined mixed models with Qiita output. Results: Participant satisfaction was high, with 75% of participants completing evaluations. While no microbial effects were statistically significant due to small sample size, the analysis pipeline utility was tested. Conclusion: Longitudinal collection and analysis of microbiome data in a community gardening randomized controlled trial is feasible. The analysis pipeline will be useful in larger studies for assessment of the pathway between microbiota, gardening and health outcomes.

The article presents a framework for understanding the relationship between community garden participation, and the myriad ways gardens and participation lead to emotional, social, and health impacts. Existing empirical research relating community gardens to health behaviors, such as physical activity and diet, and longer-term chronic disease-related outcomes is summarized. The research areas discussed include the effects of community garden participation on individual, social, emotional, and environmental processes; health behaviors including diet and physical activity; and health outcomes such as self-rated health, obesity, and mental health. Other mechanisms through which community gardens may affect population health are described. Applying a multitheoretical lens to explore associations between community garden participation and health enables us to delineate key aspects of gardening that elicit positive health behaviors and multifactorial health assets that could be applied to designing other types of health interventions.

Project FIT was a two-year multi-component nutrition and physical activity intervention delivered in ethnically-diverse low-income elementary schools in Grand Rapids, MI. This paper reports effects on children's nutrition outcomes and process evaluation of the school component. A quasi-experimental design was utilized. 3rd, 4th and 5th-grade students (Yr 1 baseline: N = 410; Yr 2 baseline: N = 405; age range: 7.5-12.6 years) were measured in the fall and spring over the two-year intervention. Ordinal logistic, mixed effect models and generalized estimating equations were fitted, and the robust standard errors were utilized. Primary outcomes favoring the intervention students were found regarding consumption of fruits, vegetables and whole grain bread during year 2. Process evaluation revealed that implementation of most intervention components increased during year 2. Project FIT resulted in small but beneficial effects on consumption of fruits, vegetables, and whole grain bread in ethnically diverse low-income elementary school children.

The Michigan Healthy School Action Tools (HSAT) is an online self-assessment and action planning process for schools seeking to improve their health policies and practices. The School Nutrition Advances Kids study, a 2-year quasi-experimental intervention with low-income middle schools, evaluated whether completing the HSAT with a facilitator assistance and small grant funding resulted in (1) improvements in school nutrition practices and policies and (2) improvements in student dietary intake. A total of 65 low-income Michigan middle schools participated in the study. The Block Youth Food Frequency Questionnaire was completed by 1,176 seventh-grade students at baseline and in eighth grade (during intervention). Schools reported nutrition-related policies and practices/education using the School Environment and Policy Survey. Schools completing the HSAT were compared to schools that did not complete the HSAT with regard to number of policy and practice changes and student dietary intake. Schools that completed the HSAT made significantly more nutrition practice/education changes than schools that did not complete the HSAT, and students in those schools made dietary improvements in fruit, fiber, and cholesterol intake. The Michigan HSAT process is an effective strategy to initiate improvements in nutrition policies and practices within schools, and to improve student dietary intake., (© 2015 Society for Public Health Education.)

Background: The Child Nutrition and WIC Reauthorization Act of 2004 mandated written school wellness policies. Little evidence exists to evaluate the impact of such policies. This study assessed the quality (comprehensiveness of topics addressed and strength of wording) of wellness policies and the agreement between written district-level policies and school-reported nutrition policies and practices in 48 low-income Michigan school districts participating in the School Nutrition Advances Kids study., Method: Written wellness policy quality was assessed using the School Wellness Policy Evaluation Tool. School nutrition policies and practices were assessed using the School Environment and Policy Survey. Analysis of variance determined differences in policy quality, and Fisher's exact test examined agreement between written policies and school-reported practices., Results: Written wellness policies contained ambiguous language and addressed few practices, indicating low comprehensiveness and strength. Most districts adopted model wellness policy templates without modification, and the template used was the primary determinant of policy quality. Written wellness policies often did not reflect school-reported nutrition policies and practices., Conclusions: School health advocates should avoid assumptions that written wellness policies accurately reflect school practices. Encouraging policy template customization and stronger, more specific language may enhance wellness policy quality, ensure consistency between policy and practice, and enhance implementation of school nutrition initiatives., (© 2014 Society for Public Health Education.)

Background: Schools can promote healthy eating in adolescents. This study used a qualitative approach to examine barriers and facilitators to healthy eating in schools., Methods: Case studies were conducted with 8 low-income Michigan middle schools. Interviews were conducted with 1 administrator, the food service director, and 1 member of the coordinated school health team at each school., Results: Barriers included budgetary constraints leading to low prioritization of health initiatives; availability of unhealthy competitive foods; and perceptions that students would not eat healthy foods. Schools had made improvements to foods and increased nutrition education. Support from administrators, teamwork among staff, and acknowledging student preferences facilitated positive changes. Schools with a key set of characteristics, (presence of a coordinated school health team, nutrition policies, and a school health champion) made more improvements., Conclusions: The set of key characteristics identified in successful schools may represent a school's health climate. While models of school climate have been utilized in the educational field in relation to academic outcomes, a health-specific model of school climate would be useful in guiding school health practitioners and researchers and may improve the effectiveness of interventions aimed at improving student dietary intake and other health behaviors., (© 2014, American School Health Association.)

This study evaluated a community-based and social marketing healthy corner store program (FIT store) to improve the affordability and availability of healthy foods in low-income, urban, and ethnically diverse neighborhoods in Michigan. The Nutrition Environment Measures Survey in Stores data were analyzed for the FIT (N = 4) stores. Two cross-sectional surveys were conducted among the FIT store customers before (N = 401) and after (N = 318) the intervention. Three FIT stores improved their total Nutrition Environment Measures Survey in Stores availability score from before to after the intervention. A significantly higher level of FIT awareness and monthly bean and nut consumption was reported in the postintervention.

Background: The School Nutrition Advances Kids project tested the effectiveness of school-initiated and state-recommended school nutrition practice and policy changes on student dietary intake in low-income middle schools., Methods: Schools recruited by an application for grant funding were randomly assigned to (1) complete an assessment of nutrition education, policies, and environments using the Healthy School Action Tools (HSAT) and implement an action plan, (2) complete the HSAT, implement an action plan, and convene a student nutrition action team, (3) complete the HSAT and implement an action plan and a Michigan State Board of Education nutrition policy in their cafeteria à la carte, or (4) a control group. All intervention schools were provided with funding and assistance to make self-selected nutrition practice, policy, or education changes. Block Youth Food Frequency Questionnaires were completed by 1176 seventh-grade students from 55 schools at baseline and during eighth-grade follow-up. Nutrient density and food group changes for the intervention groups were compared to the control group, controlling for baseline dietary intake values, gender, race/ethnicity, school kitchen type, urbanization, and percent of students eligible for free or reduced-price meals. Analyses were conducted by randomization and based on changes the schools self-selected., Results: Improvements in students' nutrient density and food group intake were found when schools implemented at least three new nutrition practice changes and established at least three new nutrition policies. Students in schools that introduced mostly healthful foods in competitive venues at lunch demonstrated the most dietary improvements., Conclusions: New USDA nutrition standards for à la carte and vending will likely increase the healthfulness of middle school children's diets.

Objectives: To determine the joint association of junk food consumption (JFC) and screen time (ST) with adiposity in children., Methods: Two hundred fourteen (121 girls, 93 boys) third-to-fifth-grade students (54% Hispanic, 35% African American, 8% white) completed a lifestyle behavior survey, which included self-reported JFC and ST, as part of a school-based lifestyle intervention program., Results: Neither JFC nor ST, independently or jointly, was associated with adiposity measures. JFC and ST were significantly correlated (r = .375)., Conclusions: The low achievement of physical activity and screen time recommendations and high prevalence of overweight/obesity in this mostly minority, low socioeconomic status population indicates a potential focus for intervention.

Objective: This qualitative study used a case study approach to explore the potential of farm-to-school programs to simultaneously improve children's diets and provide farmers with viable market opportunities., Design: Semistructured interviews were the primary data collection strategy., Setting: Seven farm-to-school programs in the Upper Midwest and Northeast regions of the United States., Participants: Seven school food service professionals, 7 farmers, and 4 food distributors recruited from 7 farm-to-school programs., Phenomenon of Interest: Interviews probed why farmers, school food service professionals, and food distributors participate in farm-to-school programs and how they characterize the opportunities and challenges to local school food procurement., Analysis: Data were analyzed using thematic coding and data displays., Results: School food service professionals described 3 motivators for buying locally grown food for their cafeterias: (1) "The students like it," (2) "The price is right," and (3) "We're helping our local farmer." Students' preference for locally grown food was related to food quality, influence of school staff, and relationships with farmers. Buying food directly from farmers and wholesalers was associated with lower prices and flexible specifications, and the "local feel.", Conclusions and Implications: Understanding school food service professionals' motivations for buying locally grown food is critical to the sustainability of farm-to-school programs., (Copyright 2010 Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.)

Objective: To determine the association between household participation in a community garden and fruit and vegetable consumption among urban adults., Design: Data were analyzed from a cross-sectional random phone survey conducted in 2003. A quota sampling strategy was used to ensure that all census tracts within the city were represented., Setting: Flint, Michigan., Participants: 766 adults., Variables Measured: Fruit and vegetable intake was measured using questionnaire items from the Behavioral Risk Factor Surveillance System. Household participation in a community garden was assessed by asking the respondent if he or she, or any member of the household, had participated in a community garden project in the last year., Analysis: Generalized linear models and logistic regression models assessed the association between household participation in a community garden and fruit and vegetable intake, controlling for demographic, neighborhood participation, and health variables., Results: Adults with a household member who participated in a community garden consumed fruits and vegetables 1.4 more times per day than those who did not participate, and they were 3.5 times more likely to consume fruits and vegetables at least 5 times daily., Conclusions and Implications: Household participation in a community garden may improve fruit and vegetable intake among urban adults.

Background: This project updated and improved the Promoting Active Communities Program (PAC), a Web-based assessment that enables communities to scrutinize their programs, policies, and environments related to physical activity, generating ideas and community commitment for improvements., Methods: A literature review, focus groups, and expert review guided PAC improvements., Results: Over 150 articles and audit measures in the fields of transportation, public health, and urban planning were reviewed. Indicators were identified, categorized, and evaluated for use in the PAC. Focus-group participants communicated motivations, processes, and obstacles for completing the PAC and developing an action plan. Participants requested technical information to guide them in achieving active-living environments., Conclusions: Information gathered was used to improve the PAC Web site. A technical assistance document, Design Guidelines for Active Michigan Communities, was created to aid communities in creating active-living environments. The new PAC and Design Guidelines are available for public use at www.mihealthtools.org/communities.

Food insufficiency has been shown to be associated with poor health, academic and psychosocial outcomes in American children, but the relationship between food insufficiency and depressive disorders in U.S. adolescents has not been studied. Further, there are no national estimates of the prevalence of depressive disorders for U.S. adolescents, nor investigation of associations with sociodemographic characteristics using national data. Therefore, we analyzed data for 15- and 16-y-old adolescents from the Third National Health and Nutrition Examination Survey (NHANES III). Depressive disorders and suicidal symptoms were assessed using the Diagnostic Interview Schedule. Adolescents were classified as "food insufficient" if a family respondent reported that the family sometimes or often did not have enough to eat. The prevalence of depression outcomes is reported by sociodemographic characteristics. Odds ratios for associations with food insufficiency are reported, adjusted for sociodemographic factors. Overall, lifetime prevalence of major depressive disorder was 6.3% and of dysthymia, 5.4%. Almost 5% of 15- to 16-y-old adolescents reported that they had ever attempted suicide and 38.8% reported at least one suicidal symptom. Female adolescents were significantly more likely than males to have had dysthymia, any depressive disorder and all symptoms of suicide. Low income adolescents were less likely to report suicide ideation than high income adolescents, but there were no other differences by family income. Food-insufficient adolescents were significantly more likely to have had dysthymia, thoughts of death, a desire to die and have attempted suicide. There is a strong association between food insufficiency and depressive disorder and suicidal symptoms in U.S. adolescents.

Objectives: To investigate associations between family income, food insufficiency, and being overweight in US children aged 2 to 7 and 8 to 16 years, to discuss mechanisms that may explain these associations, and to propose design and data requirements for further research that could effectively examine this issue., Methods: Data from the Third National Health and Nutrition Examination Survey were analyzed. Children were classified as food insufficient if the family respondents reported that their family sometimes or often did not get enough food to eat. The prevalence of overweight was compared by family income category and food sufficiency status within age-, sex-, and race-ethnic-specific groups. Odds ratios for food insufficiency are reported, adjusted for family income and other potential confounding factors., Results: Among older non-Hispanic white children, children in families with low income were significantly more likely to be overweight than children in families with high income. There were no significant differences by family income for younger non-Hispanic white children, non-Hispanic black children, or Mexican American children. After adjusting for confounding variables, there were no differences in overweight by food sufficiency status, except that younger food-insufficient girls were less likely to be overweight, and non-Hispanic white older food-insufficient girls were more likely to be overweight than food-sufficient girls (P<.10)., Conclusion: Further research to evaluate whether food insecurity causes overweight in American children requires longitudinal quantitative and in-depth qualitative methods.

Intervention strategies aimed at reducing the prevalence of nutrition-related diseases, including designing nutrition policies and nutrition education and assistance programs, require effective monitoring of what Americans are eating. Nutrient reference data from the third National Health and Nutrition Examination Survey provide essential information to achieve these goals. Mean and median iron intakes were adequate in males of all race-ethnic groups but were generally low in females and young children. Mean and median calcium intakes were also higher in males than in females and were lower than recommendations in adolescents and in women of all ages. Mean sodium intakes for all age, sex, and race-ethnic groups exceeded the minimum requirements of healthy persons and were higher in non-Hispanic black children and adolescents than in non-Hispanic white and Mexican American children and adolescents. Mean fiber intakes also did not meet recommendations in most subgroups and were higher in Mexican American adults followed by non-Hispanic white adults and non-Hispanic black adults. Further research is planned to compare the food sources of energy and nutrients consumed by different population groups in NHANES III to similar results from earlier nation surveys. NHANES III, Phase 2 (1991-94) recalls were collected using the same dietary method as those collected in Phase 1 (1988-91), and other analyses will compare findings from both phases of NHANES III.