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OBJECTIVE: To evaluate whether micronutrients (vitamins/minerals) benefit attention-deficit/hyperactivity disorder (ADHD) and irritability in a North American pediatric sample. METHOD: A three-site 8-week placebo-controlled randomized clinical trial of micronutrients was conducted in unmedicated children ages 6-12 with ADHD and at least one impairing irritability symptom by parent report on the Child and Adolescent Symptom Inventory-5 (CASI-5). A priori-defined primary outcomes were Clinical Global Impression-Improvement (CGI-I) (CGI-I of 1 or 2 = treatment responder) and parent-rated CASI-5 composite score of ADHD, oppositional defiant, disruptive mood dysregulation, and peer conflict symptoms, including impairment scores. RESULTS: Of 135 randomized (mean age 9.8 years), 126 (93%) comprised the modified intention-to-treat population. Blinding was maintained. For the CGI-I, 54% of the micronutrient and 18% of the placebo group were responders (Risk Ratio=2.97, 97.5% CI: 1.50, 5.90, p

BACKGROUND: Parents’ lived experiences of having a child with ADHD may shape their decision making regarding ADHD treatment options for their child. The aim of this study was to explore parents’ experiences of living with a child with ADHD in the family and how their experiences influence their perspectives on treatment preferences and priorities. METHODS: A phenomenological qualitative design was used. Semistructured interviews were conducted with parents of children with ADHD who were enrolled in a multisite randomized controlled trial. Interviews were transcribed verbatim, and transcripts at each site were double coded. Initial codes were derived directly from the text. Qualitative data were analysed with an inductive approach. RESULTS: Twenty-three parents were interviewed: eight from Alberta, Canada; eight from Portland, Oregon, USA; and seven from Columbus, Ohio, USA. Among the parents, 69% were married, 86% completed college education and 52% reported household income over $80,000. Among the children, the mean age was 9.6 years (SD = 1.8 years), 78% were boys and 48% were never medicated for their ADHD. Two major themes emerged from the analysis. Theme 1 was ‘impact of ADHD on families within and outside the home’ with the following subthemes: ‘reconfiguring the home life’, ‘trial-and-error of accommodations at school’ and ‘responding to social pressures to fit in’. Theme 2 was ‘enabling appropriate and accessible treatments for families’ with the following subthemes: ‘finding the “right fit” with professionals and treatments’ and ‘factors influencing inequitable access to treatments’. CONCLUSIONS: Parents described shared experiences and identified similar barriers, preferences and priorities for ADHD treatments regardless of demographic differences by site. Families desired access to family-centred, multimodal approaches to ADHD treatment. Further research is needed to identify the specific structural changes to healthcare, services and policies that will better support this approach.

AIM: To investigate the association between dietary patterns and total and obesity-related cancers risk. Additionally, to examine if acculturation modifies this relationship. SUBJECT AND METHODS: Dietary intake of postmenopausal Hispanic women (N=5,482) enrolled in the Women’s Health Initiative was estimated from a Food Frequency Questionnaire and used to calculate dietary pattern scores; Healthy Eating Index-2015 (HEI-2015), Mexican Diet (MexD) score, alternate Mediterranean Diet Score (aMED), and the energy adjusted-Dietary Inflammatory Index (E-DII™). Associations were evaluated using Cox proportional hazards regression models. RESULTS: 631 cancers and 396 obesity-related cancers were diagnosed over a mean-follow up of 12 years. Across dietary scores, there were no significant associations with cancer risk or mortality. Trend analysis suggest a potentially lower risk for total cancer related to the highest MexD score (HR 0.68, 95% CI 0.45–1.04, P-trend=0.03), and lower risk for obesity-related cancer mortality related to the highest score category for MexD (HR 0.65, 95% CI 0.37–1.16, P-trend=0.02), and aMED (HR 0.87, 95% CI 0.45–1.67, P-trend=0.04). Further analysis suggests less acculturated women with higher MexD scores had 56% lower risk for any cancer (HR 0.44, 95% CI 0.22–0.88, P-trend=0.03) and 83% lower risk for cancer mortality (HR 0.17, 95% CI 0.04–0.76, P-trend=0.01) compared to more acculturated Hispanic women. CONCLUSIONS: Dietary patterns were not associated with cancer risk and mortality in postmenopausal Hispanic women. Less-acculturated, Spanish-preferred speakers, who reported consuming a more traditional Mexican diet may experience a lower risk for cancer and cancer mortality.

Homeless mothers with young children in their care contend with high rates of substance use and low self-efficacy. However, a limited number of studies have examined these outcomes associated with housing and supportive services.Participants were randomly assigned to: (1) housing + support services (n = 80), (2) housing-only (n = 80), or (3) services as usual (SAU) (n = 80) and were re-assessed at 3-, 6-, 9- and 12-months postbaseline.The study recruited a community-based sample from homeless service agencies and advertisements in a large Midwestern city.The study recruited two hundred forty (N = 240) women between the ages of 18 to 24 years, experiencing homelessness and with a substance use disorder (SUD) who also had a biological child under the age of 6 years in their care.We measured frequency of alcohol and drug use using the Form 90 semi-structured interview, and self-efficacy using Pearlin and Schooler's (1978) 7-item Mastery Scale.Overall, mothers showed significant improvement in substance use and self-efficacy over time in each condition. However, as expected, patterns of change differentiated intervention groups with more mothers showing better substance use and self-efficacy outcomes in housing + supportive services than in SAU. Unexpectedly, more mothers in SAU showed better outcomes than those in housing-only.Substance use decreased and self-efficacy increased over time, but patterns of change characterized the intervention groups. In particular, findings suggest that when providing housing to this population, supportive services should also be offered.

A lack of in-depth assessment of the nutritional status of homeless youth precludes interventions that achieve nutritional adequacy. We enrolled 118 unaccompanied homeless youth to obtain sociodemographic and health data along with dietary, anthropometric, biochemical, and clinical assessments. As a reference, homeless youth data were compared to a convenience sample of 145 college students. Obesity was prevalent among homeless youth than among college students (29% vs. 8% respectively (CI: 11.2, 29.9). Among homeless youth, 74% of females versus 41% of males were overweight/obese (CI: 14.9, 51.2). Homeless youth also had poor diet quality (44.37 (SD: 12.64)). Over 70% of homeless youth had inadequate intakes of vitamins A, C, D3 and E, as well as calcium and magnesium. Our findings show increased weight, adiposity, and suboptimal intakes of essential nutrients among unaccompanied homeless youth. Further studies are needed to inform evidence-based nutrition interventions that will aid in improving their nutritional health.

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

IntroductionAttention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders of childhood. Up to 50% of children with ADHD may also experience symptoms of emotional dysregulation, such as anger, irritability, and aggression. Emotional dysregulation contributes to adverse health outcomes such as depression and peer problems, yet it is poorly understood, and effective treatment options are lacking. Emerging evidence suggests that sensory processing may play a role in emotional dysregulation. Forty to 50% of children with ADHD may also experience sensory modulation dysfunction, or SMD. SMD is characterized by hypo- or hyperreactivity to pain and sensation. Only one study investigated the relationship of SMD and emotional dysregulation in ADHD; they found a correlation of r=0.45. If SMD drives emotional dysregulation in ADHD, treating SMD has the potential to improve emotional regulation. Further evaluating the relationship between SMD and emotional dysregulation in ADHD is the crucial first step in developing effective treatment options.MethodsData for this analysis are derived from the baseline assessment of a multi-site, randomized, controlled trial: The Micronutrients for ADHD in Youth (MADDY) Study. The study enrolled children aged 6-12 with a diagnosis of ADHD and symptoms of emotional dysregulation. Using a cross-sectional study design, we will measure the association between emotional dysregulation and SMD at baseline. Emotional dysregulation was measured using the Strengths and Difficulties Questionnaire (SDQ) and a composite score from the Child and Adolescent Symptom Inventory, Version-5 (CASI-5). SMD will be assessed using two subscales from the Temperament in Middle Childhood Questionnaire (TMCQ). To test our hypothesis, we will use simple linear regression. Models will be adjusted for potential confounding variables.ConclusionOur results will serve to better characterize the relationship between SMD and emotional dysregulation in children with ADHD, which may inform treatment options and diminish adverse health outcomes.

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.

Objective: Study goals were to (1) provide a rationale for developing a composite primary outcome score that includes symptom severity for attention-deficit/hyperactivity disorder (ADHD) and emotional dysregulation, plus symptom-induced impairment; (2) demonstrate weighting methods to calculate the composite score using a sample of children diagnosed with ADHD and aggression; and (3) identify the optimal weighting method most sensitive to change, as measured by effect sizes. Methods: We conducted secondary data analyses from the previously conducted Treatment of Severe Childhood Aggression (TOSCA) study. Children aged 6-12 years were recruited through academic medical centers or community referrals. The composite primary outcome comprised the ADHD, oppositional defiant disorder, disruptive mood dysregulation disorder, and peer conflict subscales from the Child and Adolescent Symptom Inventory (CASI), a DSM (Diagnostic and Statistical Manual)-referenced rating scale of symptom severity and symptom-induced impairment. Five weighting methods were tested based on input from senior statisticians. Results: The composite score demonstrated a larger (Cohen's d) effect size than the individual CASI subscales, irrespective of the weighting method (10%-55% larger). Across all weighting methods, effect sizes were similar and substantial: approximately a two-standard deviation symptom reduction (range: -1.97 to -2.04), highest for equal item and equal subscale weighting, was demonstrated, from baseline to week 9, among all TOSCA participants. The composite score showed a medium positive correlation with the Clinical Global Impressions-Severity scores, 0.46-0.47 for all weighting methods. Conclusions: A composite score that included severity and impairment ratings of ADHD and emotional dysregulation demonstrated a more robust pre-post change than individual subscales. This composite may be a more useful indicator of clinically relevant improvement in heterogeneous samples with ADHD than single subscales, avoiding some of the statistical limitations associated with multiple comparisons. Among the five similar weighting methods, the two best appear to be the equal item and equal subscale weighting methods.

These comments include established behavioral treatment preceding and augmenting stimulant use to prevent or reduce dosing, nutritional approaches with placebo-controlled evidence, and possible effects of stimulant on micronutrient levels.

Older adults have physical and social barriers to eating but whether this affects functional status is unknown. We examined associations between eating barriers and physical function in the Women’s Health Initiative (WHI). In 2012-14, a subset of alive and participating women (n=5910) completed an in-home examination including the Short Physical Performance Battery (SPPB) (grip strength, balance, timed walking speed, chair stand). WHI participants complete annual mailed questionnaires; the 2013-14 questionnaire included items on eating alone, eating < two meals/day, dentition problems affecting eating, physical difficulties with cooking/shopping and monetary resources for food. Linear regression tested associations of these eating barriers with SPPB, adjusting for BMI, age, race/ethnicity, and medical multimorbidities. Over half (56.8%) of participants were ≥ 75 years, 98.8% had a BMI ≥ 25.0 kg/m(2) and 66% had multimorbidities. Eating barriers, excluding eating alone, were associated with significantly lower total (all p

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.

Aims: Nutritional status can be compromised by food insecurity which is common among HIV infected persons. Providing food assistance is expected to improve food insecurity and nutritional status among persons infected with HIV. This study aimed at examining the relationship of participating in the Supplemental Nutrition Assistance Program (SNAP), the largest food assistance program in the United States, with food security and nutritional status among HIV infected adults. Study Design : A cross - sectional study de sign was used in this study. Place and Duration of Study: This study was conducted in Miami, FL, USA, between April 2011 and August 2012. Methodology: We included 159 HIV infected individuals in this study, 113 participants were SNAP recipients while 46 w ere not. All study participants were, however, eligible to participate in SNAP. Each participant completed demographic and food security surveys as well as dietary and nutrition status assessment. Statistical analyses were conducted using univariate and mu ltivariate analyses.

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.

This study evaluated the association between health related quality of life and food security among persons living with HIV (PLHIV). We studied 167 PLHIV who completed questionnaires assessing food security, disease symptomatology, and several domains of the SF-36 health related quality of life survey. HIV disease state was assessed from medical records. Associations between independent and outcome variables were determined through linear regression models. Compared to food security, very low food security was significantly associated with lower mental component summary scores, [average difference −4.98 (95 % CI −9.85, −0.10)]; mental health, [average difference −5.44 (95 % CI −10.08, −0.81)]; and general health, [average difference −5.13 (95 % CI −9.65, −0.65)] after adjusting for covariates. About a fourth of participants experienced severe food insecurity, which negatively influenced their mental health and general wellbeing. The inclusion of resources for food assistance in HIV treatment programs may help ameliorate mental health challenges faced by PLHIV.

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.

The literature on the potential clinical and non-clinical benefits of participation in food assistance programs for people living with HIV in developed countries is scarce. We conducted a cross-sectional study of 165 HIV infected adults to determine the impact of the Supplemental Nutrition Assistance Program (SNAP) on HIV disease status and health related quality of life (HQROL). There was no significant association between SNAP participation and disease status; CD4 cell count (β = 0.02, P = 0.837) and viral load (β = 0.02, P = 0.836). The mean scores for all the HRQOL domains were lower compared to the US population, but none were associated with SNAP participation. Higher scores on the general health domain, were marginally associated with SNAP participation (β = 0.16, P = 0.071). In this study, SNAP participation was not significantly associated with less disease progression, and only marginally associated with quality of life among this population of HIV infected individuals.

Objective: Botswana is an African country with one of the highest rates of HIV (24.1%) in the general population, in the world. The objective of this study was to determine the prevalence and chara...

Nutritional status during HIV infection is related to disease outcome and health status. While HIV disease continues to put infected individuals at nutritional risk, nutritional issues have shifted from undernutrition and weight loss to obesity and metabolic imbalances even though inadequacy in nutrient intake persists. Nutrition education targeted at improving dietary habits through improvements in nutrition knowledge, self-efficacy and readiness to change are critical to reduce nutritional risks in HIV infected patients. This pilot study, conducted between January 2012 and September 2012, evaluated the effect of a nutrition education on nutrition knowledge and behavior, dietary intake, and nutritional status of HIV infected adults. Forty-five individuals were randomized into intervention (30 participants) and control (15 participants) groups. They completed pretest, posttest, and 3 months follow-up assessments and surveys administered before and after the intervention program. Although there were no significant differences in some of the outcome measures between the groups, we observed a trend towards improved nutrition knowledge and self-efficacy scores in the intervention group compared to the control group. In addition, fewer individuals in the control group progressed in the stage of change continuum compared to the intervention group for all dietary habits assessed. This study serves as a platform for developing nutrition education tools to address the nutritional and health needs of this population.

BackgroundWomen gain total body weight and accrue body fat during pregnancy. Breastfeeding has been suggested as an efficient means of promoting postpartum weight loss due to its high energy cost. We investigated the effect of infant feeding mode on maternal body composition.MethodsThis study evaluated maternal weight and percent body fat changes in exclusively breastfeeding versus mixed feeding mothers during the first 12 weeks postpartum using the BOD POD. Twenty four mothers aged 19 – 42 years were studied. Participants were recruited from Athens-Clarke County and surrounding areas of the State of Georgia, USA. The study was conducted between November 2005 and December 2006.ResultsPrepregnancy weight was higher in mixed feeding mothers than in exclusively breastfeeding mothers (68.4 kg vs. 61.4 kg) but the difference was not statistically significant. At 12 weeks postpartum, exclusively breastfeeding mothers had lost more total body weight than mixed feeding mothers (4.41 ± 4.10 kg versus 2.79 ± 3.09 kg; p = 0.072). There was no significant difference in fat weight change between the two groups (4.38 ± 2.06 kg versus 4.17 ± 2.63 kg). However, mixed feeding mothers lost slightly more percent body fat than exclusively breastfeeding mothers (1.90 ± 4.18 kg versus 1.71 ± 3.48 kg), but the difference was not statistically significant. The trend in percent body fat loss was significant among exclusively breastfeeding mothers (p = 0.034) but not mixed feeding mothers (p = 0.081). Exclusively breastfeeding mothers consumed more calories than mixed feeding mothers (1980 ± 618 kcal versus 1541 ± 196 kcal p = 0.08). Physical activity levels were, however, higher in mixed feeding mothers than exclusively breastfeeding mothers.ConclusionOur results provide further evidence that exclusive breastfeeding promotes greater weight loss than mixed feeding among mothers even in the early postpartum period. This suggests that there is the need to encourage mothers to exclusively breastfeed as a means of overweight and obesity prevention.