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The role of early probiotic supplementation in infants for the prevention of respiratory viral illnesses is unclear. We examined the association of Lactobacillus rhamnosus GG (LGG) supplementation during the first 6 months of life with the frequency and severity of viral illnesses during the first 24 months of life. We conducted a secondary analysis of data from the randomized controlled Trial of Infant Probiotic Supplementation ( n = 184). Parents reported the number of respiratory viral illnesses, and a composite severity score was created based on symptoms. A negative binomial regression model and a mixed-effects linear regression model assessed for differences in the number of episodes and severity of episodes between treatment groups, respectively. There was no significant difference in the incidence rate of viral illness episodes or symptom severity between treatment groups. Daily supplementation with LGG in early infancy does not decrease the number or severity of viral illnesses during the first 2 years of life.

Introduction: Latinx and Asian American communities in the U.S. face unique yet similar structural barriers to maintaining adequate diet quality, contributing to an increased burden of diabetes and non-alcoholic fatty liver disease in these groups. These inequities have been exacerbated in recent years due to overt anti-immigrant and anti-Asian sentiment during the COVID-19 pandemic, invoking fear and cultural shame for these groups, and amplifying challenges towards accessing food and economic stability. Hypothesis: Herein we describe a community-centered, multi-level approach aligned with the National Institute of Minority Health and Health Disparities Framework. We hypothesize our study will result in increased fruit and vegetable intake (self-report, measured via skin carotenoids), social cohesion and ethnic pride at the individual level and improved socioeconomic outcomes at the neighborhood level. Methods: Working collaboratively with 8 community-based and farm partners, the goal of the Building Access to Food through Systems and Solidarity (BASIS) Study is to improve diet and economic stability in Sunset Park—a neighborhood of Mexican and Chinese American families in Brooklyn, NY. This neighborhood has been hard-hit during the COVID-19 pandemic and lagged in economic recovery, and its residents are disconnected from government support. BASIS addresses food access, nutrition education, policy change, and hands-on learning (e.g., gardening, cooking) incorporating culturally appropriate values, foods, and taste preferences throughout each of these activities. Results: To date, we have held four group model-building workshops with partners to identify common priorities/goals towards improving nutrition in immigrant communities; co-developed Mexican and Chinese American-specific nutrition education materials; held eight virtual and in-person sessions with community members (n=291); conducted qualitative interviews (n=19) and quantitative data collection (n=175) amongst community residents to inform program development; and implemented a subsidized, community-supported agriculture pilot program for 20 weeks in 2022 (n=38). BASIS resources have been well-received by community members, with high engagement (90% attend weekly produce box pick-up events) and acceptance (100% indicated they would recommend the program to others). Conclusions: Planned evaluation will include mixed methods and administrative data analyses for assessment of multi-level outcomes. BASIS will expand to more participants (n=150), and will include additional program components (e.g., food policy assessment; workforce development; small business owner education). BASIS presents a powerful model to improve diet in immigrant communities applying systems thinking and community-centered best practices, lessons which may be gleaned for other immigrant communities.

Introduction: Among 2-19-year-olds in the United States (US), 26.2% of Hispanic/Latino youth vs. 16.6% of non-Hispanic White youth experience obesity (body mass index [BMI] percentile ≥age- and sex-specific 95 th BMI percentile). While health behaviors are important, psychological and sociocultural measures vary across racial/ethnic groups and may underpin obesity disparities. Machine learning is one statistical approach that can be used to identify determinants of obesity. However, few studies have applied these methods to childhood obesity research, with most studies only examining traditional risk factors and creating a single model across all racial/ethnic groups. Our objective was to identify key predictors of BMI percentile in Hispanic/Latino youth to help design childhood obesity interventions that reduce health disparities. Hypothesis: We hypothesized that a BMI percentile prediction model developed for Hispanic/Latino youth would identify both traditional and novel risk factors as important determinants. Methods: Hispanic/Latino 8-16-year-olds from the 4 US sites of the Hispanic Community Children’s Health Study/Study of Latino Youth (SOL Youth) were examined ( n =1,466). BMI percentiles were determined via measured height and weight and CDC growth charts. A supervised machine learning approach, Least Absolute Shrinkage and Selection Operator (LASSO) regression, was used with BMI percentile as the outcome. There were 98 predictor variables examined spanning demographics; health behaviors; and environmental, psychological, and sociocultural measures. LASSO-selected variables were entered into a multivariable linear regression model to obtain effect estimates. P-values were adjusted for both multiple testing and the variable selection process and assessed with α Results: A LASSO model with 30 variables yielded the optimum mean squared error (MSE; R 2 =0.37), but a 12-variable solution was selected based on MSE and parsimony. Four associations were statistically significant. Perception of being larger than the “ideal” body weight (β=8.75 [95% CI: 8.21, 12.13]), reporting disordered eating (β=12.61 [95% CI: 10.64, 14.91]), and having a parent with obesity (β=4.90 [95% CI: 3.49, 17.75]) were associated with a higher BMI percentile. Spending >$5 weekly on snacks/beverages/fast food (β=-4.62 [95% CI: -19.18, -2.09]) was associated with a lower BMI percentile. Conclusions: Psychological and parental factors predicted higher BMI percentile and greater money spent on snacks/beverages/fast food predicted lower BMI percentile among Hispanic/Latino youth in the US. Addressing Hispanic/Latino youth’s relationships with food, body weight, and parents may be important in obesity interventions. Longitudinal research is needed to clarify directionality and replicate novel findings.

Hispanic/Latino youth are less physically active than non-Hispanic/Latino youth. We assessed whether activity-specific parenting practices relate to moderate-to-vigorous physical activity (MVPA) and sedentary behavior among Hispanic/Latino youth, and whether cultural (acculturation) and neighborhood characteristics (perceived barriers to activity) relate to the use of parenting practice patterns. Using the Hispanic Community Children’s Health Study/Study of Latino Youth (SOL Youth, n = 976 8–16-year-olds), we modeled linear regression associations between parenting practices and mean daily MVPA and sedentary behavior. Parenting practice patterns were then developed using k-means cluster analysis, and regressed on parental acculturation and neighborhood characteristics. Discipline predicted higher MVPA in females (β 1.89 [95% CI 0.11–3.67]), while Monitoring/Reinforcement predicted higher MVPA in males (β 4.71 [95% CI 0.68–8.74]). Three patterns were then identified: Negative Reinforcement (high Limit Setting and Discipline use), Positive Reinforcement (high Limit Setting and Monitoring/Reinforcement use), and Permissive Parenting (low parenting practice use). Higher acculturation predicted use of Positive Reinforcement. Activity-specific parenting practices are associated with activity in sex-specific ways among Hispanic/Latino youth, and cultural factors predict the use of parenting practices.

We examined links among dietary patterns (DPs) , insulin resistance (IR) , and diabetes risk by heritage (Cuban, Dominican, Mexican, Puerto Rican, and Central and South American) in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) . HCHS/SOL is a population-based cohort of 16,415 Hispanics/Latinos aged 18-74 y living in 4 US cities. At both visits, questionnaires and clinical examinations were administered, including two 24-hr diet recalls conducted at baseline only (2008-11) . Among 7,774 participants with 2nd-visit data (2014-17) and without diabetes at baseline, we performed heritage-specific principal factor analyses and characterized overarching DPs based on high-loading foods shared by ≥ 2 heritage groups. We classified 6-yr IR status (improved, unchanged, worsened) using a SD-change in fasting insulin. We defined incident diabetes using self-report, self-reported diabetes medication, or labs (fasting glucose (≥126 mg/dL) , post-OGTT (≥200 mg/dL) , or HbA1C (≥6.5%)) . We identified 5 overarching DPs: Burger, Fries, & Soft Drinks; White Rice, Beans, & Red Meats; Fish & Whole Grains; Cheese & Sweets; and Stew & Corn. Comparing highest to lowest quintiles, the Burger, Fries, & Soft Drinks DP in Dominicans (log-odds: 2.35, 95% CI: 1.02, 3.68, P trend=0.037) and White Rice, Beans, & Red Meats DP in Cubans (log-odds: 1.27, 95% CI: 0.49, 2.06, P trend =0.009) were associated with worsened (vs. unchanged) 6-year IR status. The Burger, Fries, & Soft Drinks DP in Puerto Ricans (OR: 3.00, 95% CI:1.50, 5.99, P trend=0.003) and the White Rice, Beans, & Red Meats DP in Central Americans (OR: 2.41, 95% CI: 1.05, 5.50, P trend=0.032) were associated with greater diabetes risk. In sum, dietary interventions for diabetes prevention should be tailored by Hispanic/Latino heritage. Disclosure L.E.Maldonado: None. L.Gallo: None. S.Albrecht: None. D.Sotres-alvarez: None. J.Mattei: None. M.L.Daviglus: None. G.A.Talavera: None. K.M.Perreira: None. L.Van horn: None. Y.Mossavar-rahmani: None. M.N.Lecroy: None. Funding The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) was carried out as a collaborative study supported by contracts from the National Heart, Lung, and Blood Institute (NHLBI) to the University of North Carolina (N01-HC65233) , University of Miami (N01-HC65234) , Albert Einstein College of Medicine (N01-HC65235) , Northwestern University (N01-HC65236) , and San Diego State University (N01-HC65237) . The following Institutes/Centers/Offices contribute to the HCHS/SOL through a transfer of funds to the NHLBI: National Center on Minority Health and Health Disparities, the National Institute of Deafness and Other Communications Disorders, the National Institute of Dental and Craniofacial Research, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute of Neurological Disorders and Stroke, and the Office of Dietary Supplements. This research received support from the National Heart, Lung, and Blood Institute Global Cardiometabolic Disease Training Grant (1T32HL129969-01A1) , the National Institute of Diabetes and Digestive and Kidney Diseases (K01DK107791) ,and from the Population Research Infrastructure Program (R24 HD050924) awarded to the Carolina Population Center at The University of North Carolina at Chapel Hill by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

BackgroundHispanic/Latino youth are disproportionately burdened by obesity and have a high prevalence of prediabetes and dyslipidemia. Differences in parent and child acculturation related to language use and preference (i.e., language acculturation) are associated with adverse cardiometabolic health behaviors, but no study has examined associations with cardiometabolic markers.PurposeTo determine whether discordance in parent–child language acculturation (parent–child acculturation gap) was associated with poor youth cardiometabolic health.MethodsHispanic/Latino 8–16-year-olds (n = 1,466) and parents from the Hispanic Community Children’s Health Study/Study of Latino Youth (SOL Youth) were examined. Mean scores for the Brief ARSMA-II’s Anglo (AOS) and Latino (LOS) Orientation Scales represented language acculturation. Cardiometabolic markers included youth body mass index (BMI) percentile, blood pressure percentiles, and dysglycemia and hyperlipidemia measures. Missing data were imputed. Survey-weighted multivariable linear regression examined the association of youth, parent, and youth × parent (the acculturation gap) AOS and LOS scores separately with each cardiometabolic marker.ResultsYouth reported greater English and lower Spanish use than parents. Greater discordance in AOS scores was associated with elevated BMI percentile only (p-for-interaction < .01). The LOS acculturation gap was not associated with any outcome. Adjustment for acculturative stress, family functioning and closeness, parenting style, and youth’s diet and physical activity did not alter findings. Removal of nonsignificant acculturation gaps did not indicate an association between individual youth or parent AOS or LOS scores and any cardiometabolic marker.ConclusionsDiscordance in Hispanic/Latino parent–child dyads’ English use may relate to increased risk for childhood obesity. Future studies should identify mediators of this association.

Background: Hispanic/Latino youth in the United States are at an elevated risk for not meeting national guidelines for physical activity (PA). Siblings have the potential to influence each other’s PA and sedentary behavior (SB) through means such as role modeling and co-participation. However, to our knowledge, no study has examined correlations in Hispanic/Latino siblings’ PA and SB behavior using objective measures. Objective: To examine correlations in siblings’ total PA, moderate-to-vigorous physical activity (MVPA), and SB, and to explore whether social and environmental measures explain differences in siblings’ PA and SB. Methods: Hispanic/Latino 8-16-year-olds from the cross-sectional Hispanic Community Children’s Health Study/Study of Latino Youth (SOL Youth) with at least one sibling enrolled in the study were examined ( n =537). Frequency, duration, and intensity of PA were assessed using the ActiCal TM accelerometer. PA-related social and environmental measures were assessed using validated, interviewer-administered questionnaires. Mixed effects linear regression models were used with total PA, MVPA, or SB as the outcome, individual and family-level socio-demographic variables as fixed effects, and family as a random effect. Correlations between siblings’ PA and SB were assessed with intraclass correlation coefficients (ICCs). All models were examined stratified by siblings’ sex concordance and age difference. PA-related social and environmental measures were subsequently added as fixed effects. Results: Mean total PA was 257.4 counts/minutes. On average, youth spent 35.9 minutes in MVPA and 599.4 minutes (10.0 hours) in SB per day. Overall correlations in siblings’ PA and SB were slight to fair, with ICCs of 0.28 (95% CI: 0.18, 0.38), 0.31 (95% CI: 0.22, 0.39), and 0.46 (95% CI: 0.38, 0.54) for total PA, MVPA, and SB, respectively. Siblings who were all brothers had the strongest correlations in total PA (0.61 [95% CI: 0.47, 0.74]) and MVPA (0.62 [95% CI: 0.48, 0.75]) compared to siblings who were all sisters (total PA only) or of differing sexes (total PA and MVPA). Correlations in SB did not differ according to siblings’ sex concordance. Correlations in PA and SB did not differ by siblings’ age difference. Friend support for PA, the after-school PA environment, and workout equipment use at home did not explain differences in siblings’ PA or SB. Conclusions: Correlations in Hispanic/Latino siblings’ PA and SB were slight to fair, with siblings who were all brothers having the strongest correlations in PA. Future research should examine how role-modeling, caregiving responsibilities, and sibling-specific familial support contribute to similarities in siblings’ PA and SB and sex-specific differences in PA correlations.

Few studies have derived data-driven dietary patterns in youth in the USA. This study examined data-driven dietary patterns and their associations with BMI measures in predominantly low-income, racial/ethnic minority US youth. Data were from baseline assessments of the four Childhood Obesity Prevention and Treatment Research (COPTR) Consortium trials: NET-Works (534 2–4-year-olds), GROW (610 3–5-year-olds), GOALS (241 7–11-year-olds) and IMPACT (360 10–13-year-olds). Weight and height were measured. Children/adult proxies completed three 24-h dietary recalls. Dietary patterns were derived for each site from twenty-four food/beverage groups using k-means cluster analysis. Multivariable linear regression models examined associations of dietary patterns with BMI and percentage of the 95th BMI percentile. Healthy (produce and whole grains) and Unhealthy (fried food, savoury snacks and desserts) patterns were found in NET-Works and GROW. GROW additionally had a dairy- and sugar-sweetened beverage-based pattern. GOALS had a similar Healthy pattern and a pattern resembling a traditional Mexican diet. Associations between dietary patterns and BMI were only observed in IMPACT. In IMPACT, youth in the Sandwich (cold cuts, refined grains, cheese and miscellaneous) compared with Mixed (whole grains and desserts) cluster had significantly higher BMI (β= 0·99 (95 % CI 0·01, 1·97)) and percentage of the 95th BMI percentile (β= 4·17 (95 % CI 0·11, 8·24)). Healthy and Unhealthy patterns were the most common dietary patterns in COPTR youth, but diets may differ according to age, race/ethnicity or geographic location. Public health messages focused on healthy dietary substitutions may help youth mimic a dietary pattern associated with lower BMI.

Objective We examined links among dietary patterns (DPs), insulin resistance (IR), and diabetes risk by heritage in the Hispanic Community Health Study/Study of Latinos. Methods Hispanics/Latinos of Cuban, Dominican, Mexican, Puerto Rican, Central American, and South American heritage aged 18–74 years and diabetes-free completed two 24 h dietary recalls at baseline (2008–2011) and provided 6-year follow-up data (2014–2017; n = 7774). We classified 6-year IR status [improved, unchanged (referent), worsened] using a 1-SD change in fasting insulin between visits and defined incident diabetes based on American Diabetes Association criteria. We derived heritage-specific DPs via principal factor analysis and estimated their associations with 6-year IR status (multinomial) and incident diabetes (binary) using complex survey-based logistic regression. Results Five overarching DPs based on high-loading foods were shared by two or more heritage groups: “Burger, Fries, & Soft Drinks”; “White Rice, Beans, & Red Meats”; “Fish & Whole Grains”; “Cheese & Sweets”; and “Stew & Corn”. Comparing highest-to-lowest DP quintiles, the Dominican “Burger, Fries, & Soft Drinks” and Cuban “White Rice, Beans, & Red Meats” DPs were associated with worsened 6-year IR status (log-odds: 2.35, 95% CI: 1.02, 3.68, Ptrend = 0.037 and log-odds: 1.27, 95% CI: 0.49, 2.06, Ptrend = 0.009, respectively). The Puerto Rican “Burger, Fries, & Soft Drinks” and the Central American “White Rice, Beans, & Red Meats” DPs were associated with greater diabetes incidence (OR: 3.00, 95% CI:1.50, 5.99 and OR: 2.41, 95% CI: 1.05, 5.50, respectively). Conclusions A diet characterized by higher intakes of burgers, fries, and soft drinks and another characterized by higher intakes of white rice, beans, and red meats may be adversely associated with IR and diabetes risk in some Hispanic/Latino heritage groups. Future work is needed to offer more heritage-specific dietary guidance for diabetes prevention in this population.

The objective of this study was to determine how well Hispanic/Latino siblings' diet quality correlate with each other and whether social and environmental factors explained potential differences. Hispanic/Latino 8-16-year-olds from the cross-sectional Hispanic Community Children's Health Study/Study of Latino Youth (SOL Youth) with at least one sibling enrolled in the study were examined (n = 740). Diet quality was assessed with the Healthy Eating Index 2010 (HEI-2010), calculated from two 24-h recalls. Mixed effects models were used with HEI-2010 score as the outcome, and correlations in siblings' diet quality were assessed with intraclass correlation coefficients (ICCs). All models were examined stratified by age and sex. Diet-related social and environmental measures were added as fixed effects in a secondary analysis. Mean (standard deviation) overall HEI-2010 score was 53.8 (13.0). The ICC for siblings' HEI-2010 score was 0.31 (95% CI: 0.25, 0.38). Siblings who were born

Some food parenting practices (FPPs) are associated with obesogenic dietary intake in non-Hispanic youth, but studies in Hispanics/Latinos are limited. We examined how FPPs relate to obesogenic dietary intake using cross-sectional data from 1214 Hispanic/Latino 8–16-year-olds and their parents/caregivers in the Hispanic Community Children’s Health Study/Study of Latino Youth (SOL Youth). Diet was assessed with 2 24-hour dietary recalls. Obesogenic items were snack foods, sweets, and high-sugar beverages. Three FPPs (Rules and Limits, Monitoring, and Pressure to Eat) derived from the Parenting strategies for Eating and Activity Scale (PEAS) were assessed. K-means cluster analysis identified 5 groups of parents with similar FPP scores. Survey-weighted multiple logistic regression examined associations of cluster membership with diet. Parents in the controlling (high scores for all FPPs) vs. indulgent (low scores for all FPPs) cluster had a 1.75 (95% CI: 1.02, 3.03) times higher odds of having children with high obesogenic dietary intake. Among parents of 12–16-year-olds, membership in the pressuring (high Pressure to Eat, low Rules and Limits and Monitoring scores) vs. indulgent cluster was associated with a 2.96 (95% CI: 1.51, 5.80) times greater odds of high obesogenic dietary intake. All other associations were null. Future longitudinal examinations of FPPs are needed to determine temporal associations with obesogenic dietary intake in Hispanic/Latino youth.

Introduction: Hispanic/Latino youth in the United States are disproportionately burdened by obesity. Siblings are important determinants of each other’s health behaviors, particularly in Hispanic/Latino families whose cultural values are distinctive for stressing close and supportive family relationships. However, no study in Hispanic/Latino youth has examined how overall diet quality correlates between siblings. Objective: To determine how well Hispanic/Latino siblings’ diet quality correlates with each other and whether social and environmental factors explain potential differences. Methods: Hispanic/Latino 8-16-year-olds from the Hispanic Community Children’s Health Study/Study of Latino Youth (SOL Youth) with at least one sibling enrolled in the study were examined ( n =749). The Healthy Eating Index 2010 (HEI-2010) was calculated from two 24-hour recalls to assess overall diet quality. All analyses used mixed effect models with HEI-2010 score as the outcome. Individual and family-level socio-demographic variables were fixed effects, and family and intercept were random effects. Correlations between siblings’ diet quality were assessed with intraclass correlation coefficients (ICCs). All models were examined stratified by age and sex, and the ICCs were compared across groups using Fisher’s z-transformation. Diet-related social and environmental measures were added as fixed effects in a secondary analysis. Results: Overall HEI-2010 score was 53.7. The ICC for siblings’ HEI-2010 score was 0.31, indicating slight correlation. Separate examination of the twelve HEI-2010 components showed that siblings’ intake of empty calories and sodium had the highest correlation (ICC=0.31), while intake of total protein foods had the lowest correlation (ICC=0.13). Siblings who were born Conclusions: Overall diet quality scores of Hispanic/Latino siblings in this study were modestly correlated, with stronger correlations among siblings closer in age and of concordant sex. Differences in peer support and foods consumed outside the home may explain differences in siblings’ diet quality. Future studies should examine additional psychosocial determinants of siblings’ diets.

Background: Hispanic youth are less physically active and more sedentary than non-Hispanic youth, contributing to relatively high rates of obesity among the nation’s largest ethnic minority group. Though parents can influence children’s behavior, it is unclear whether parenting practices related to the child’s physical activity are associated with activity in Hispanic/Latino youth, and whether cultural and environmental contexts predict the use of these parenting practices. Objective: We assessed 1) whether activity-specific parenting practices (ASPPs) are associated with moderate-to-vigorous physical activity (MVPA) and sedentary activity among Hispanic/Latino youth, and 2) if higher parental acculturation and greater perceived neighborhood-level socioeconomic challenges are associated with the use of less effective ASPP patterns. Methods: Youth from the Hispanic Community Children’s Health Study/Study of Latino Youth (SOL Youth; n=976) were examined. Activity was assessed using 7-day accelerometer data. ASPPs were identified from the Parenting strategies for Eating and Activity Scale (PEAS) using exploratory and confirmatory factor analysis of the ten items on activity. We used survey-weighted linear regression models to assess whether derived ASPPs predicted mean daily MVPA and sedentary time. K-means cluster analysis was used to group individuals based on ASPP use. Finally, we used survey-weighted multinomial logistic regression models to examine the association of parent acculturation-related measures and perceived neighborhood socioeconomic status and barriers to activity with ASPP cluster membership. Results: Factor analysis of the activity-specific PEAS items identified three ASPPs: Limit Setting, Discipline, and Monitoring/Reinforcement. Discipline predicted higher MVPA in females only (β 1.89 [95% CI 0.11-3.67]), and Monitoring/Reinforcement predicted higher MVPA in males only (β 4.71 [95% CI 0.68-8.74]). There was no association between Limit Setting and MVPA or any ASPPs and sedentary activity. K-cluster analysis revealed three ASPP patterns: Restrictive (high scores for Limit Setting and Discipline), Supportive (high scores for Limit Setting and Monitoring/Reinforcement) and Permissive (low score across ASPPs). Higher Anglo-orientation on the Brief ARSMA-II acculturation measure predicted membership in the Supportive compared to Permissive cluster (p= 0.03), while perceived neighborhood characteristics did not predict ASPP cluster membership. Conclusions: ASPPs are associated with MVPA in sex-specific ways but have no association with sedentary activity in Hispanic/Latino youth. Among acculturation and neighborhood characteristics, only Anglo-orientation predicted ASPPs patterns. More research is needed to understand how acculturation is influencing ASPPs and if ASPPs can be leveraged to change children’s activity.

Machine learning is a class of algorithms able to handle a large number of predictors with potentially nonlinear relationships. By applying machine learning to obesity, researchers can examine how risk factors across multiple settings (e.g., school and home) interact to best predict childhood obesity risk. In this narrative review, we provide an overview of studies that have applied machine learning to predict childhood obesity using a combination of sociodemographic and behavioral risk factors. The objective is to summarize the key determinants of obesity identified in existing machine learning studies and highlight opportunities for future machine learning applications in the field. Of 15 peer-reviewed studies, approximately half examined early childhood (0-24 months of age) determinants. These studies identified child's weight history (e.g., history of overweight/obesity or large increases in weight-related measures between birth and 24 months of age) and parental overweight/obesity (current or prior) as key risk factors, whereas the remaining studies indicated that social factors and physical inactivity were important in middle childhood and late childhood/adolescence. Across age groups, findings suggested that race/ethnic-specific models may be needed to accurately predict obesity from middle childhood onward. Future studies should consider using existing large data sets to take advantage of the benefits of machine learning and should collect a wider range of novel risk factors (e.g., psychosocial and sociocultural determinants of health) to better predict childhood obesity. Ultimately, such research can aid in the development of effective obesity prevention interventions, particularly ones that address the disproportionate burden of obesity experienced by racial/ethnic minorities.

Individuals of South Asian ethnicity have an increased risk for obesity and related diseases. Foods available in the home during the first 1000 days (conception to 24 months old) are an important determinant of diet, yet no study has examined the association of early‐life home food availability (HFA) with later diet and obesity risk in South Asian households. We examined whether obesogenic HFA at 18 months of age is associated with dietary intake and body mass index (BMI) at 36 months of age in low‐income Pakistani and White households in the United Kingdom. In this prospective birth cohort study (Born in Bradford 1000), follow‐up assessments occurred at 18 (n = 1032) and 36 (n = 986) months of age. Variety and quantity of snack foods and sugar‐sweetened beverages (SSBs) in the home and consumed were measured using the HFA Inventory Checklist and food frequency questionnaires, respectively. BMI was calculated using measured length/height and weight. Multinomial logistic regression models examined associations between HFA and tertiles of dietary intake, and multivariable linear regression models assessed associations between HFA and BMI. Pakistani households had a greater variety and quantity of snack foods and SSBs available compared with White households. Variety and quantity of snack foods and SSBs in the home at 18 months were positively associated with children's intake of these items at 36 months, but associations between HFA and BMI were null. Reducing obesogenic HFA during the first 1000 days may promote the development of more healthful diets, though this may not be associated with lower obesity risk during toddlerhood.

Background: Loss of muscle mass may increase risk for type 2 diabetes (T2D), but few prospective studies have examined this association. The objective of this study was to determine whether loss of muscle mass (approximated with fat free mass [FFM]) is associated with risk for prediabetes and T2D in a population disproportionately burdened by T2D. Methods: Participants were Hispanic/Latino adults (aged 18-74 years) in the Hispanic Community Health Study/Study of Latinos (6.1-year follow-up), a multi-site, community-based cohort in the United States. Eligible participants were free of T2D at baseline (2008-2011; n=6264). Fasting glucose, HbA1c, and fasting insulin were measured. Diabetes was defined according to American Diabetes Association criteria. Analysis: Survey-weighted Poisson regression models examined the association of percent change in relative FFM (FFM/total body weight; %∆FFM) with incident prediabetes and T2D. Survey-weighted linear regression models examined associations of %∆FFM with changes in glucose and insulin measures. Models were adjusted for age, sex, Hispanic/Latino background, site, nativity, education, income, physical activity, years between visits, and diabetic medication use (for lab values only). Results: Relative FFM declined by 2.1% between visits. %∆FFM was inversely associated with incident prediabetes (p-for-trend=0.001) but not T2D. %∆FFM was inversely associated with changes in glucose and insulin measures (p-for-trend Conclusions: Findings suggest that muscle mass maintenance/accumulation during adulthood may reduce T2D risk (primarily insulin resistance), particularly among individuals who are overweight/obese. Disclosure M.N. LeCroy: None. S. Hua: None. R. Kaplan: None. D. Sotres-Alvarez: None. Q. Qi: None. B. Thyagarajan: None. L. Gallo: None. A. Pirzada: None. M.L. Daviglus: None. G.A. Talavera: None. C.R. Isasi: None. Funding National Heart, Lung, and Blood Institute (N01HC65233, N01HC65234, N01HC65235, HHSN268201300003I, N01HC65236, N01HC65237, T32HL144456)

Introduction: Hispanic/Latino youth are disproportionately burdened by obesity and have a high prevalence of pre-diabetes and dyslipidemia. Acculturation may help explain this elevated cardiometabolic risk. Within immigrant families, parents and children acculturate at different rates. A difference in the degree of acculturation, known as the “acculturation gap”, between parents and their children has been associated with behaviors that may increase cardiometabolic risk in youth. However, no previous studies have investigated the association between the parent-child acculturation gap and cardiometabolic health. Hypothesis: We tested whether greater gaps in parent-child acculturation were associated with worse cardiometabolic health in Hispanic/Latino youth. Methods: Hispanic/Latino youth ( n =1466, 8-16-year-olds) and parents from the Hispanic Community Children’s Health Study/Study of Latino Youth (SOL Youth) were examined. Mean scores on the Brief Acculturation Rating Scale for Mexican Americans-II (ARSMA-II) Anglo and Latino Orientation Scales (AOS and LOS, respectively) were used to represent parent and youth acculturation. The Brief ARSMA-II primarily assesses language use patterns on a 5-point Likert-type scale, with higher scores on the AOS indicating a preference for English and higher scores on the LOS indicating a preference for Spanish. Cardiometabolic markers included youth body mass index (BMI) percentile, blood pressure percentiles, fasting glucose, HOMA-IR, HbA1c, cholesterol, triglycerides, and hsCRP. Missing data were addressed using multiple imputation. Survey-weighted multivariable linear regression examined associations of youth, parent, and youth x parent (the acculturation gap) scores for the AOS and LOS scales separately with each cardiometabolic marker. Results: On average, compared to their parents, youth reported a greater preference for English and a lower preference for Spanish (AOS=4.2 vs. 2.7; LOS=3.1 vs. 4.2, respectively). Greater discordance (i.e., an acculturation gap) in parent and youth AOS scores was associated with elevated BMI percentile only (p-for-interaction≤0.001). The LOS acculturation gap was not associated with any cardiometabolic measures. Adjustment for acculturative stress, family functioning and closeness, parenting style, and youth’s diet and physical activity did not alter the findings. Removal of non-significant acculturation gaps indicated an inverse association between parent AOS score and youth SBP percentile (β=-2.47, 95% CI: -4.73, -0.21) and between parent LOS score and youth total cholesterol (β=-2.87, 95% CI: -5.52, -0.21). Conclusions: Discrepancies in English language use in parent-child dyads may relate to increased obesity risk in Hispanic/Latino youth. Future studies are needed to identify mediators of this association, such as general stress and English language fluency.

Objective Examine cross-sectional and longitudinal associations of accelerometer measured step volume (steps/day) and cadence with adiposity and six-year changes in adiposity in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Methods HCHS/SOL’s target population was 60% female with a mean age of 41 years. Cross-sectional (n = 12,353) and longitudinal analyses (n = 9,077) leveraged adjusted complex survey regression models to examine associations between steps/day, and cadence with weight (kg), waist circumference (cm) and body mass index (kg/m2). Effect measure modification by covariates was examined. Results Lower steps/day and intensity was associated with higher adiposity at baseline. Compared to those in the highest quartile of steps/day those in the lowest quartile have 1.42 95% CI (1.19, 1.70) times the odds of obesity. Compared to those in the highest categories of cadence step-based metrics, those in the lowest categories had a 1.62 95% CI (1.36, 1.93), 2.12 95% CI (1.63, 2.75) and 1.41 95% CI (1.16, 1.70) odds of obesity for peak 30-minute cadence, brisk walking and faster ambulation and bouts of purposeful steps and faster ambulation, respectively. Compared to those with the highest stepping cadences, those with the slowest peak 30-minute cadence and fewest minutes in bouts of purposeful steps and faster ambulation had 0.72 95% CI (0.57, 0.89) and 0.82 95% CI (0.60, 1.14) times the odds of gaining weight, respectively. Conclusion Inverse cross-sectional relationships were found for steps/day and cadence and adiposity. Over a six-year period, higher step intensity but not volume was associated with higher odds of gaining weight.

Previous reviews have indicated that immigration from South Asian to Western countries leads to unhealthy changes in diet; however, these reviews have been limited by the methods used in some included studies. This critical narrative review summarizes findings from original research articles that performed appropriate statistical analyses on diet data obtained using culturally appropriate diet assessment measures. All studies quantitatively compared the diets of South Asian immigrants with those of residents of Western or South Asian countries or with those of South Asian immigrants who had varying periods of time since immigration. Most studies examined total energy and nutrient intake among adults. Total energy intake tended to decrease with increasing duration of residence and immigrant generation, and immigrants consumed less protein and monounsaturated fat compared with Westerners. However, findings for intakes of carbohydrate, total fat, saturated fat, polyunsaturated fat, and micronutrients were mixed. Studies that examine food group intake and include South Asians living in South Asia as a comparison population are needed.

Objective:To describe snacking characteristics and patterns in children and examine associations with diet quality and BMI.Design:Children’s weight and height were measured. Participants/adult proxies completed multiple 24 h dietary recalls. Snack occasions were self-identified. Snack patterns were derived for each sample using exploratory factor analysis. Associations of snacking characteristics and patterns with Healthy Eating Index-2010 (HEI-2010) score and BMI were examined using multivariable linear regression models.Setting:Childhood Obesity Prevention and Treatment Research (COPTR) Consortium, USA: NET-Works, GROW, GOALS and IMPACT studies.Participants:Predominantly low-income, racial/ethnic minorities: NET-Works (n534, 2–4-year-olds); GROW (n610, 3–5-year-olds); GOALS (n241, 7–11-year-olds); IMPACT (n360, 10–13-year-olds).Results:Two snack patterns were derived for three studies: a meal-like pattern and a beverage pattern. The IMPACT study had a similar meal-like pattern and a dairy/grains pattern. A positive association was observed between meal-like pattern adherence and HEI-2010 score (Pfor trend < 0⋅01) and snack occasion frequency and HEI-2010 score (βcoefficient (95 % CI): NET-Works, 0⋅14 (0⋅04, 0⋅23); GROW, 0⋅12 (0⋅02, 0⋅21)) among younger children. A preference for snacking while using a screen was inversely associated with HEI-2010 score in all studies except IMPACT (βcoefficient (95 % CI): NET-Works, −3⋅15 (−5⋅37, −0⋅92); GROW, −2⋅44 (−4⋅27, −0⋅61); GOALS, −5⋅80 (−8⋅74, −2⋅86)). Associations with BMI were almost all null.Conclusions:Meal-like and beverage patterns described most children’s snack intake, although patterns for non-Hispanic Blacks or adolescents may differ. Diets of 2–5-year-olds may benefit from frequent meal-like pattern snack consumption and diets of all children may benefit from decreasing screen use during eating occasions.

Background Despite interest in the importance of the home food environment and its potential influence on children’s diets and social norms, there remain few self-report checklist methods that have been validated against the gold standard of researcher-conducted inventories. This study aimed to assess the criterion validity and reliability of the ‘Home Food Availability Inventory Checklist’ (HFAI-C), a 39-item checklist including categories of fruit, vegetables, snacks and drinks. Methods The HFAI-C was completed by 97 participants of White and Pakistani origin in the UK. Validity was determined by comparing participant-reported HFAI-C responses to data from researcher observations of home food availability using PABAK and weighted kappa statistics. The validity of measuring the amount of items (in addition to presence/absence) available was also determined. Test-retest reliability compared repeated administrations of the HFAI-C using intra-class correlation coefficients. Results Validity and reliability was fair to moderate overall. For validity, the average category-level PABAK ranged from 0.31 (95 % CI: 0.25, 0.37) for vegetables to 0.44 (95 % CI: 0.40, 0.49) for fruits. Assessment of the presence/absence of items demonstrated higher validity compared to quantity measurements. Reliability was increased when the HFAI-C was repeated close to the time of the first administration. For example, ICCs for reliability of the measurement of fruits were 0.52 (95 %CI: 0.47, 0.56) if re-administered within 5 months, 0.58 (95 % CI: 0.51, 0.64) within 30 days and 0.97 (95 %CI: 0.94, 1.00) if re-administered on the same day. Conclusions Overall, the HFAI-C demonstrated fair to moderate validity and reliability in a population of White and South Asian participants. This evaluation is consistent with previous work on other checklists in less diverse, more affluent populations. Our research supports the use of the HFAI-C as a useful, albeit imperfect, representation of researcher-conducted inventories. The feasibility of collecting information using the HFAI-C in large, multi-ethnic samples can facilitate examination of home food availability in relation to exposures such as ethnicity and outcomes including behavioural, social and health outcomes. Future work using the HFAI-C could provide important insights into a modifiable influence with potential to impact health. Electronic supplementary material The online version of this article (doi:10.1186/s12966-016-0381-y) contains supplementary material, which is available to authorized users.