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Background: The National School Lunch Program (NSLP) provides >30 million meals to children daily; however, the specific nutrient composition of NSLP-selected and consumed meals for students from lower income and racial/ethnic minoritized backgrounds is unknown. Aims: To quantify the nutrients in school lunch selection and consumption among students participating in the NSLP and compare these values to nutrient recommendations. Method: Students (1st-5th graders; 98.6% from racial/ethnic minoritized backgrounds; 92.5% NSLP participation) from six Title I elementary schools serving universal free meals participated. Digital images of students' lunch meal selection and consumption were obtained (n = 1,102 image pairs). Plate waste analyses quantified portions consumed. Nutrient composition of students' lunch selection and consumption were calculated and compared with the 2010 Healthy Hunger-Free Kids Act and 2009 Institute of Medicine recommendations. Results: Most lunches selected (59%-97%) met recommendations for all nutrients except for total calories (23%), vitamin C (46%), and dietary fiber (48%). Based on lunch consumption, most students' lunches met recommendations for sodium (98%), protein (55%), calories from fat (82%), and saturated fat (89%); however, few met recommendations for total calories (5%), calcium (8%), iron (11%), vitamin A (18%), vitamin C (16%), and fiber (7%). Discussion: Meals selected met most nutrient recommendations for the majority of children; yet overall consumption patterns reflect suboptimal nutrient intake. Conclusion: Meals served under the NSLP policy mandates align with recommended nutrient patterns, highlighting the importance of maintaining these standards. Strategies to optimize children's intake of nutrient-rich portions of these meals are needed to optimize policy impact.

Social media has negative effects on adolescent body image and disordered eating behaviors, yet adolescents are unlikely to discontinue engaging with these platforms. Thus, it is important to identify strategies that can reduce the harms of social media on adolescent mental health. This article reviews research on social media and adolescent body image, and discusses strategies to reduce risks associated with social media use. Topics covered include interventions aimed at mitigating social media's negative impacts, the body-positivity movement, and policies regulating adolescents' social media use. Overall, this review highlights specific factors (such as staffing, duration, modality, facilitator training, and cultural sensitivity) to consider when designing and implementing social media interventions targeting adolescents. This review also discusses psychosocial outcomes associated with body positivity on social media. Finally, policy efforts to reduce the negative impact of social media on adolescents' body image and eating behaviors are described. In sum, there is a strong need to conduct further research identifying optimal approaches to reduce the harms of social media for adolescent body image and eating behavior. [ABSTRACT FROM AUTHOR]

Binge eating is increasingly prevalent in college students (White, Reynolds-Malear, & Cordero, 2011). Binge episodes involve eating an objectively large quantity of food in a discrete amount of time and a perceived lost control over eating (American Psychiatric Association [APA], 2013). Strong negative affect commonly precedes and follows each episode. Binge eating is associated with severe obesogenic consequences such as diabetes, impaired heart function, and intestinal problems (Thompson, Roehrig, & Kinder, 2007). Individuals who binge eat report impaired functioning in personal, occupational, and social domains (Hudson, Hiripi, Pope, & Kessler, 2007). Addressing behaviors antecedent to a binge, such as food selection and acquisition, is an important part of understanding and creating interventions for this maladaptive behavior. The emotion regulation theory of binge eating (Chen, Matthews, Allen, Kuo, & Linehan, 2008) views disordered eating as a maladaptive attempt to cope with intense emotions, rather than a response to physiological hunger (Napolitano & Himes, 2011). Eating carries an expectation of escape from negative affect through the transfer of attention from the negative affect to a concrete object (i.e., food; Heatherton & Baumeister, 1991). Binge eating is a maladaptive coping strategy because it provides initial momentary relief, but ultimately negative affect (e.g., guilt and disgust) follows (APA, 2013). Before emotional eating can occur, students must (consciously or nonconsciously) decide what foods they will emotionally eat and must acquire the food. Awareness of food selection behavior can help college health providers assist students in identifying trigger foods and locations. This study contributes to existing research by assessing whether food selection differs in the presence of an emotion within the unique context of a college campus.

Objective: To examine social cognitive factors associated with physical activity (PA) among preadolescent girls. Method: Social cognitive theory was used to examine PA in girls (N = 90; 71% African American) participating in Girls on the Run. Multiple regressions explored factors associated with PA at posttesting and 3-month follow-up. Results: Significant increases in PA, social influences, and self-efficacy were found, which were sustained at 3-month follow-up. Self-efficacy and social influences had the strongest relations to PA at posttest; self-efficacy remained the strongest predictor of PA at 3-month follow-up. Conclusions: Social support and self-efficacy are important targets of PA interventions in preadolescent girls.

This study evaluated a structural equation model of objectification theory among European American (EA; n = 408) and African American women (AA; n = 233). Modeling results indicated a particularly strong association between thin-ideal internalization/body monitoring and eating disorder symptoms, with weaker relationships among body dissatisfaction, depression, anxiety, and eating disorder symptoms. The measurement model was not equivalent for EAs and AAs; however, the structural model was invariant, suggesting that the relationships among these variables may be similar for both groups. Thus, objectification theory does appear to be applicable to AA women, although specification of relevant constructs and refinement of assessment instruments is warranted.

This study evaluated structural equation models of the associations among family functioning, childhood abuse, depression, anxiety, alexithymia, and eating disorder symptomatology in a sample of 412 European American and 192 African American female undergraduates. Additionally, the specific roles of anxiety, depression, and alexithymia as mediators were assessed. Each of these variables was a significant mediator of the association between childhood abuse and disordered eating. Finally, a test of invariance between the African American and European American subsamples was significant, highlighting the need for additional cross-cultural eating disorder research.

Objective: The goals of this study were to examine the role of dissociation and depression as possible mediators of the relationship between several forms of childhood trauma and bulimic symptomatology and to explore potential ethnic differences in these relationships. Method: Four hundred seventeen female undergraduates participated in this cross-sectional study. They completed measures of dissociative, depressive, and bulimic symptoms, and childhood trauma. Experiences of multiple forms of childhood trauma were measured, including physical abuse, sexual abuse, emotional abuse, physical neglect, and emotional neglect. However, only emotional abuse was correlated with bulimic symptoms at p less than 0.01. Therefore, other forms of trauma were excluded from the analyses to control for Type I error. Results: Dissociation was not associated with emotional abuse after controlling for depression; therefore, tests of dissociation as a mediator were discontinued. Depression was significantly associated with emotional abuse after controlling for dissociation. Emotional abuse was significantly associated with bulimia. Finally, emotional abuse and depression together were significantly associated with bulimia after controlling for dissociation. However, emotional abuse became nonsignificant when entered with depression, indicating that depression mediated the relationship between emotional abuse and bulimic symptoms. There were no ethnic differences in this relationship. Conclusions: It appears that among women who have experienced childhood emotional abuse, depression is more strongly associated with unhealthy eating behaviors than is dissociation. Results also suggest that emotional abuse is a form of childhood trauma particularly relevant to bulimia.

Objective: To evaluate the feasibility, acceptability, and preliminary efficacy of a multisystem transition preparation intervention, SHIFT, for young adults (YAs) with type 1 diabetes (T1D).Methods: A single-arm, clinic-based pilot was conducted with 25 YAs with T1D (M age = 18.9 ± 1.0 years; 80% female), their parents (n = 25), and their providers (n = 10). Young adults and parents participated in a 6-month intervention designed to enhance transition readiness and independent diabetes management. Providers viewed a video module highlighting their role preparing YAs for transition and received individualized reports of YA's goals and transition readiness. Intervention feasibility (i.e., recruitment, retention, and engagement) and acceptability (e.g., program satisfaction) were assessed. Assessments of transition readiness, diabetes engagement, hemoglobin A1c (HbA1c), and related psychosocial variables were conducted at baseline, post-intervention (6 m), and follow-up (9 m). Paired t-tests examined 0-6 m and 0-9 m changes in study constructs.Results: SHIFT was feasible, evidenced by recruitment (100% of sample recruited in 4 m), retention (100% at 6 m), and YA session attendance (100%). Program satisfaction was high for YAs, parents, and providers (9.12 ± 1.40, 8.79 ± 1.56, 8.20 ± 1.30, respectively, [out of 10]). Significant improvements (with effect sizes ranging from small to medium) were observed in parent and YA-reported transition readiness at 6 and 9 m (ps<.05) and diabetes engagement at 9 m (ps<.05). Although based on limited data due to COVID-19-related disruptions, a potential reduction in HbA1c was also observed.Conclusion: Findings support the feasibility, acceptability, and preliminary efficacy of SHIFT (although limited by the single arm design and homogeneous sample), and suggest a larger randomized controlled trial is warranted. [ABSTRACT FROM AUTHOR]

Although the COVID-19 pandemic has increased the importance of digital technology in clinical trial implementation, there is a dearth of literature reporting on challenges and strategies related to multi-site randomized controlled trials (RCTs) among pediatric cancer survivors during the pandemic. This paper discusses challenges faced in the implementation of the NOURISH-T+ trial so far (December 2019–March 2022) and describes adaptations made as a result of these disruptions in the areas of recruitment, data collection, and overall engagement. This reflection is based on a multisite cluster-RCT that aims to examine whether an intervention targeting parents as agents of change to promote healthy eating and physical activity in pediatric cancer survivors, NOURISH-T+ (Nourishing Our Understanding of Role modeling to Improve Support and Health for Healthy Transitions), reduces body mass and improves health behaviors compared to Brief NOURISH-T (Enhanced Usual Care/EUC). The COVID-19 pandemic has created and exacerbated challenges for our trial related to participant recruitment and engagement, technology access and literacy, and data collection and management, as well as COVID-related challenges (e.g. Zoom fatigue). Strategies used to address these challenges might prove helpful in future virtual or hybrid RCTs, including developing trust and rapport with participants, providing support through multiple routes of dissemination, and using data management applications (e.g. REDCap™) for automation and project management. Extra efforts to build families' trust and rapport, offering multiple routes of support, and automating as many tasks as possible are critical to ensuring the continuation of high-quality clinical trials during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]