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Adaptations to interventions for specific settings or communities are critical for facilitating successful implementation. The Dynamic Adaptation Process model was applied to systematically assess the adaptation process made to an in-person parenting intervention (FPNG+) prior to its implementation online. This qualitative case study design included meeting notes and interviews completed with project team members. Meeting notes were analyzed using content analysis. Semi-structured interviews regarding project team members' roles on FPNG+ and processes and activities they identified as critical for the adaptation of FPNG+ to an online intervention were analyzed using a deductive-inductive approach. In the formative phase, three primary processes were identified: information gathering to determine if the environment existed for the implementation of an online program; considerations to support the facilitation process of FPNG+ to an online environment, and decision-making to support modifications to FPNG+. The pre-implementation phase consisted of three processes: information shared by the instructional designer to facilitate the delivery of the FPNG+ content online; modifications made to the format of the intervention to meet the cultural needs of Hispanic families and address contextual issues; and iterative efforts to tailor the intervention by the project team. This study used implementation science to distinguish the dynamic processes that occurred across different systems and multiple levels in the project team's effort to modify FPNG+ to an online intervention. The contribution of this study underscores the importance of identifying the processes that facilitate the modifications made to an intervention and the capacity to implement the modified intervention with Hispanic families.Adaptations to interventions for specific settings or communities are critical for facilitating successful implementation. The Dynamic Adaptation Process model was used to systematically assess the adaptation process made to an in-person parenting intervention (FPNG+) prior to its implementation online. Using a qualitative case study design, meeting notes were analyzed using content analysis; and semi-structured interviews were analyzed using a deductive-inductive approach. In the formative phase, three processes were identified: information gathering to determine if the environment existed for the implementation of an online program; considerations to support the facilitation process of FPNG+ to an online environment, and decision-making to support modifications to FPNG+. The pre-implementation phase consisted of three processes: information shared by the instructional designer to facilitate the delivery of the FPNG+ content online; modifications made to the format of the intervention to meet the cultural needs of Hispanic families and address contextual issues; and iterative efforts to tailor the intervention by the project team. The contribution of this study underscores the importance of identifying the processes that facilitate the changes made to an intervention and the capacity to implement the modified intervention with Hispanic families.

Low moderate-to-vigorous physical activity (MVPA) levels and obesity are associated with increased cardiometabolic disease risk.The aim of this study was to describe MVPA and cardiometabolic risk characteristics of insufficiently active African American women with obesity (N = 60) enrolled in a culturally tailored MVPA intervention.We assessed accelerometer-measured and self-reported MVPA, blood pressure, serum lipid profiles, cardiorespiratory fitness (VO2 peak), and aortic pulse wave velocity.Participants (mean age, 38.4; mean body mass index, 40.6 kg/m2) averaged 15 min/d of accelerometer-measured MVPA and 30 min/wk of self-reported MVPA. Systolic and diastolic blood pressure levels were elevated (135.4 and 84.0 mm Hg, respectively). With the exception of low-density lipoprotein cholesterol (121.4 mg/dL) and high-density lipoprotein cholesterol (47.6 mg/dL), lipid profiles were within reference ranges. Compared with normative reference values, average VO2 peak was low (18.7 mL/kg/min), and pulse wave velocity was high (7.4 m/s).Our sample of insufficiently active African American women with obesity was at an elevated risk for cardiometabolic disease.

Obesity is associated with chronic inflammation that may contribute to T2D among youth. We examined the association between inflammatory biomarkers and insulin sensitivity and β-cell function and response to lifestyle intervention among Latino youth with obesity. Latino youth (n = 64) were randomized to six months of lifestyle intervention (INT, n = 40) or usual care (UC, n = 24). INT included nutrition education and physical activity. UC involved meeting with a pediatric endocrinologist and registered dietitian to discuss healthy lifestyles. At baseline, multiple linear regression assessed fasting serum interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), monocyte chemoattractant protein-1 (MCP-1), high-molecular weight adiponectin (HMW Adpn), IL-10, IL-1 receptor antagonist (IL-1ra) as predictors of insulin sensitivity (whole-body insulin sensitivity index, WBISI) and β-cell function (oral disposition index, oDI). Changes in outcomes between groups were assessed using covariance pattern models. At baseline, MCP-1 (β ± SE, −0.12 ± 0.05, p = 0.027) and IL-1ra (−0.03 ± 0.01, p = 0.005) were negatively associated with WBISI. Treatment effects were not observed for inflammatory markers. WBISI was significantly increased among both INT (from 1.8 ± 0.2 to 2.6 ± 0.4, p = 0.005) and UC (from 1.6 ± 0.2 to 2.8 ± 0.5, p = 0.002) with no significant differences between the groups. Obesity-related inflammatory mediators were associated with T2D risk factors but were unaffected by lifestyle intervention among Latino youth.

We examined individual and parental demographics and home environment factors associated with locomotor skills in predominantly Hispanic preschool-aged children. We used questionnaires to survey parents, included inquiries regarding parenting practices, parents’ physical activity levels, and home-based physical activity resources; and we administered the Progressive Aerobic Cardiovascular Endurance Run (PACER) and the CHAMPS Motor Skills Protocol (CMSP) to children to measure the quantity and quality of their locomotor skills. Participants were 144 parents and their children (78.9% Hispanic, 49.3% girls) recruited from urban, community-based childcare and education centers. We examined the relationship between survey measures and PACER and CMSP scores with forward-selection stepwise linear regression models. Overall, 142 children completed the PACER, and 91 completed the CMSP. At the individual level, a child’s age was positively associated with both PACER and CMSP scores, and girls had lower PACER scores than boys. In the home environment, parental promotion of more screen time was associated with a higher children’s PACER score. In addition, higher parent concern for children’s safety was associated with a lower PACER score. We identified several physical activity promoting parent practices as new home environment factors related to the preschool-aged children’s locomotor development. Additional studies are needed to test new hypotheses generated from these data. ClinicalTrials.gov Identifier: NCT03261492 (date of registration 8/25/17)

BACKGROUND: Experiencing acculturative stress burdens Latinx families in a variety of negative and deleterious ways. Using the Family Stress Model, this study aims to explore the patterns and experiences of acculturative stress in Latinx families, and how these experiences related to Latinx adolescent internalizing and externalizing behaviors. METHOD: Data came from baseline reports of three cohorts of parent-youth dyads (n = 532) participating in a longitudinal randomized control effectiveness trial testing a parenting intervention in southwestern U.S. area. RESULTS: Findings indicate that youth exhibited more depressive symptomology when both parent and child reported higher acculturative stress. While youths’ anti-social behaviors were only associated with their own acculturative stress and not their parents’ acculturative stress levels. DISCUSSION: This study advances new knowledge about the relationship between acculturative stress and youth behaviors, and provides recommendations for developing future interventions with Latinx youth to prevent the onset of internalizing and externalizing behaviors.

Hispanic women are at high risk for type 2 diabetes (T2D), with obesity and unhealthy eating being important contributing factors. A cross-sectional design was used in this study to identify dietary patterns and their associations with diabetes risk factors. Participants completed a culturally adapted Food Frequency Questionnaire capturing intake over the prior 3 months. Overweight/obese Hispanic women (n = 191) with or at risk for T2D were recruited from a community clinic into a weight loss intervention. Only baseline data was used for this analysis. Dietary patterns and their association with diabetes risk factors (age, body mass index, abdominal obesity, elevated fasting blood glucose [FBG], and hemoglobin A1c). An exploratory factor analysis of dietary data adjusted for energy intake was used to identify eating patterns, and Pearson correlation coefficient (r) to assess the association of the eating patterns with the diabetes risk factors. Six meaningful patterns with healthful and unhealthful traits emerged: (1) sugar and fat-laden, (2) plant foods and fish, (3) soups and starchy dishes, (4) meats and snacks, (5) beans and grains, and (6) eggs and dairy. Scores for the “sugar and fat-laden” and “meats and snacks” patterns were negatively associated with age (r = − 0.230, p = 0.001 and r = − 0.298, p

Environmental characteristics of early care and education centers (ECECs) are an important context for preschool-aged children’s development, but few studies have examined their relationship with children’s locomotor skills. We examined the association between characteristics of the ECEC environment with quantitatively (i.e., product-based) and qualitatively (i.e., process-based) measured locomotor skills, using the Progressive Aerobic Cardiovascular Endurance Run (PACER) and the locomotor portion of the Children’s Activity and Movement in Preschool Study (CHAMPS) motor skills protocol (CMSP), respectively. ECEC characteristics included outdoor and indoor play environment quality, outdoor and indoor play equipment, screen-time environment quality, and policy environment quality. Mean (SD) scores for the PACER (n = 142) and CSMP (n = 91) were 3.7 ± 2.3 laps and 19.0 ± 5.5 criteria, respectively, which were moderately correlated with each other (Pearson r = 0.5; p < 0.001). Linear regression models revelated that a better policy environment score was associated with fewer PACER laps. Better outdoor play and screen-time environment quality scores and more outdoor play equipment were positively associated with higher CMSP scores. ECEC environments that reflect best practice guidelines may be opportunities for locomotor skills development in preschool-aged children. ClinicalTrials.gov Identifier: NCT03261492 (8/25/17).

This article reports the results of Smart Walk: a randomized pilot trial of an 8-month culturally tailored, smartphone-delivered physical activity (PA) intervention for African American women with obesity. Sixty participants (age range = 24–49 years; BMI range = 30–58 kg/m2) were randomized to the Smart Walk intervention (n = 30) or a wellness comparison intervention (n = 30). Results supported the acceptability and feasibility of the intervention, as demonstrated by participant retention (85% at 4 months and 78% at 8 months), Smart Walk app use, and intervention satisfaction (i.e., 100% of PA participants completing the intervention [n = 24] reported they would recommend it to friend). Smart Walk participants also reported greater increases in moderate-to-vigorous PA (4-month between-arm difference in change [b] = 43.3 min/week; p = 0.018; Cohen’s d = 0.69; 8-month b = 56.6 min/week; p = 0.046; d = 0.63) and demonstrated clinically relevant, although not statistically significant (p-values > 0.05), baseline to 4 months improvements in cardiorespiratory fitness (b = 1.67 mL/kg/min; d = 0.40), systolic blood pressure (b = −3.33 mmHg; d = 0.22), diastolic blood pressure (b = −4.28 mmHg; d = 0.37), and pulse wave velocity (b = −0.46 m/s; d = 0.33). Eight-month cardiometabolic outcomes followed similar trends, but had high rates of missing data (45–53%) due to COVID-19 restrictions. Collectively, findings demonstrated favorable outcomes for acceptability and feasibility, while also highlighting key areas for refinement in future research.

BACKGROUND: Overweight Hispanic women are at high risk for type 2 diabetes. A clinical diagnosis of hyperglycemia is often necessary to access interventions. We examined the prevalence of undiagnosed hyperglycemia among a group of low-income overweight or obese Hispanic women, who were receiving care at a Federally Qualified Health Center (FQHC). METHODS: Among 196 overweight or obese Hispanic women (mean age 44 ± 10 years, mean weight 86.8 ±16.5 kg, mean Body Mass Index [BMI] 36.5 ± 6.4 kg/m(2)) enrolled in a randomized clinical weight loss trial, we compared A1C and fasting blood glucose (FBG) obtained at baseline with women’s existing diabetes and prediabetes diagnoses in the medical record. RESULTS: According to the information in participants’ medical records, 36% (70/196) had diagnosed diabetes, 20% (39/196) had a diagnosis of prediabetes, and the remaining 44% (87/196) had neither diagnosis. Among participants without a diagnosis of diabetes or prediabetes during the baseline screening for our study, 63% (55/87) had a least one test in the pre-diabetes range (baseline A1C and FBG were in pre-diabetes range for 39 and 55 participants, respectively), and 13% (11/87) had at least one test in the diabetic range (baseline A1C and FBG values in diabetes range for 3 and 11 participants, respectively). DISCUSSION: We found substantial prevalence of undiagnosed hyperglycemia among a sample of overweight and obese Hispanic women. It is possible that limited awareness of diabetes risk may be a barrier to patient compliance with screening recommendations.

Background African American (AA) women perform low levels of physical activity (PA) and are disproportionally burdened by cardiometabolic disease conditions when compared to White women and the U.S. population as a whole. These disparities emphasize the need for innovative and effective interventions to increase PA and reduce cardiometabolic disease risk among AA women. Recent evidence suggests that mobile health (mHealth) interventions have the potential to increase PA and reduce cardiometabolic disease risk factors. Few studies have examined the efficacy of mHealth PA interventions among racial/ethnic minorities, including AA women. This represents a missed opportunity given the reported success of technology-delivered PA interventions in predominately White populations and the high use of technology among AA women. Objective To describe the design, theoretical rationale, and cultural relevance of Smart Walk, a culturally sensitive smartphone-delivered PA intervention for AA women. Design and methods Smart Walk is an 8-month, randomized controlled pilot trial designed to increase PA and reduce cardiometabolic disease risk among AA women. Sixty physically inactive AA women with obesity will be assigned to receive either a culturally relevant intervention designed to increase PA (by targeting leisure-time, household chore/task-related, and occupational PA) or a culturally relevant wellness attention-matched control condition. Outcomes will be assessed at baseline, 4 months, and 8 months, and include feasibility and acceptability of the PA intervention and evaluation of effects on PA and cardiometabolic risk factors. Summary Smart Walk represents a culturally relevant, theory-based approach to promote PA and reduce cardiometabolic disease risk in AA women.

BACKGROUND: Obese youth with prediabetes are at increased risk for premature morbidity and mortality through multiple mechanisms, including increased systemic inflammation. GlycA is a novel measure of systemic inflammation that predicts type 2 diabetes, cardiovascular events, and all-cause mortality in adults. OBJECTIVE: The purpose of the current study is to examine changes in GlycA following lifestyle intervention among obese, prediabetic Latino youth. METHODS: Obese, prediabetic Latino youth (n=27; 15.5±1.1 years, 13 male/14 female) completed a 12week lifestyle intervention that included weekly nutrition education and three days/week of moderate to vigorous physical activity. Prediabetes was characterized by an expanded definition of impaired glucose tolerance, using 2-hour glucose ≥ 120 mg/dL after an oral glucose tolerance test. GlycA was assessed at baseline and 12 weeks using nuclear magnetic resonance spectroscopy. RESULTS: Following the lifestyle intervention GlycA was significantly reduced (445.3±51.3 μmol/L to 419.0±50.0 μmol/L, p=0.01) (mean±SD). Additional improvements were observed in multiple cardiovascular risk factors, including body mass index (BMI) (34.8±5.0 kg/m(2) to 34.0±5.1 kg/m(2), p

Background Metabolic diseases, including obesity and type 2 diabetes, are a major health concern for Latina immigrants. Performing regular aerobic physical activity (PA) is a lifestyle behavior associated with the prevention and control of these conditions. However, PA levels of most Latina immigrants are below national guidelines. Neighborhood environmental factors may influence the PA levels of adults, but limited research has explored associations between the neighborhood environment and PA levels among Latina immigrants. Objective The objective of this study was to explore the PA patterns of first-generation US Latina immigrants and how neighborhood environmental factors are related to those PA patterns. Methods Using a cross-sectional study design, 50 first-generation Latina immigrants completed the International Physical Activity Questionnaire (IPAQ) and the Neighborhood Scales Questionnaire, which assessed 6 perceived neighborhood factors: (1) walking environment, (2) aesthetic quality, (3) safety, (4) violence, (5) social cohesion, and (6) activities with neighbors. Median self-reported metabolic equivalent (MET)-minutes/week of PA were used to summarize domain-specific (ie, work, domestic/household, leisure, and transportation) and intensity-specific (ie, walking, moderate, vigorous, moderate to vigorous) PA patterns. Logistic regression examined associations between neighborhood factors and engaging in leisure-time PA (ie, dichotomous outcome of some versus no leisure-time PA), transportation PA (ie, dichotomous outcome of some versus no transportation PA), and meeting national PA guidelines (ie, dichotomous outcome of meeting versus not meeting guidelines). Results Preliminary analyses showed that 10 participants reported excessively high PA levels and 1 participant had incomplete PA data; these women were excluded from analyses based on IPAQ scoring guidelines. The remaining 39 participants (mean age 40.5 years; mean length of US residency 4.6 years) reported a median of 4512 MET-minutes/week of total PA. The majority of PA was acquired through domestic activities (median 2160 MET-minutes/week), followed by leisure-time PA (median 396 MET-minutes/week), transportation PA (median 198 MET-minutes/week), and work PA (0 MET-minutes/week). Intensity-specific PA patterns showed a median of 594 MET-minutes/week of walking activity and 3500 MET-minutes/week of moderate-to-vigorous PA. Logistic regression models indicated that the neighborhood factors of walking environment, aesthetic quality, and safety were positively associated with engaging in leisure-time PA (odds ratios of 5.95, 95% CI 1.49-23.74; 2.45, 95% CI 1.01-5.93; and 3.30, 95% CI 1.26-8.67, respectively) and meeting national PA guidelines (odds ratios of 4.15, 95% CI 1.13-15.18; 6.43, 95% CI 1.45-28.39; and 2.53, 95% CI 1.00-6.36, respectively). The neighborhood factors of violence, social cohesion, and activities with neighbors were not significantly associated with PA outcomes. Conclusions Although most participants met national PA guidelines (ie, ≥500 MET-minutes/week of moderate-to-vigorous PA), the majority of their PA was achieved through domestic activities, with limited leisure, transportation, and work PA. Given that leisure-time PA in particular plays a significant role in improving health outcomes, findings suggest that many Latina immigrants could benefit from a leisure-time PA intervention. Such interventions should consider neighborhood environmental influences, as these factors may serve as determinants of PA.

In Mexican Americans, metabolic conditions, such as obesity and type 2 diabetes (T2DM), are not necessarily associated with an increase in mortality; this is the so-called Hispanic paradox. In this cross-sectional analysis, we used a metabolomic analysis to look at the mechanisms behind the Hispanic paradox. To do this, we examined dietary intake and body mass index (BMI; kg/m2) in men and women and their effects on serum metabolomic fingerprints in 70 Mexican Americans (26 men, 44 women). Although having different BMI values, the participants had many similar anthropometric and biochemical parameters, such as systolic and diastolic blood pressure, total cholesterol, and LDL cholesterol, which supported the paradox in these subjects. Plasma metabolomic phenotypes were measured using liquid chromatography tandem mass spectrometry (LC-MS/MS). A two-way ANOVA assessing sex, BMI, and the metabolome revealed 23 significant metabolites, such as 2-pyrrolidinone (p = 0.007), TMAO (p = 0.014), 2-aminoadipic acid (p = 0.019), and kynurenine (p = 0.032). Pathway and enrichment analyses discovered several significant metabolic pathways between men and women, including lysine degradation, tyrosine metabolism, and branch-chained amino acid (BCAA) degradation and biosynthesis. A log-transformed OPLS-DA model was employed and demonstrated a difference due to BMI in the metabolomes of both sexes. When stratified for caloric intake ( 2200 kcal/d), a separate OPLS-DA model showed clear separation in men, while females remained relatively unchanged. After accounting for caloric intake and BMI status, the female metabolome showed substantial resistance to alteration. Therefore, we provide a better understanding of the Mexican-American metabolome, which may help demonstrate how this population—particularly women—possesses a longer life expectancy despite several comorbidities, and reveal the underlying mechanisms of the Hispanic paradox.

BackgroundThe Diabetes Prevention Program (DPP) and Look AHEAD studies demonstrated that modest weight loss and increased physical activity can significantly reduce the incidence of diabetes among overweight individuals with prediabetes. However, these studies involved costly interventions, all of which are beyond the reach of most real-world settings serving high-risk, low-income populations. Our project, De Por Vida, implemented a diabetes risk-reduction intervention for Hispanic women in a Federally Qualified Health Center and assessed the program’s efficacy. This report describes the methodology used to develop and implement De Por Vida, the cultural adaptations made, the community–academic partnership formed to carry out this program, and the barriers and challenges encountered through the implementation process.MethodsOur goal was to translate the DPP and Look AHEAD programs into an intervention to prevent diabetes and reduce diabetes complications among high-risk Hispanic women at a federally qualified health center in Hillsboro, Oregon, where more than half of clinic patients are Spanish-speaking, and nearly all live in poverty. This randomized clinical trial targeted overweight Spanish-speaking women at risk for, or diagnosed with, type 2 diabetes. We developed a 12-month behavioral diabetes risk-reduction intervention that was responsive to the cultural practices of the Hispanic population and that could be implemented in low-income clinical settings. Study planning and implementation involved close collaboration among the clinic leadership, a research team from the Kaiser Permanente Center for Health Research, and Arizona State University.DiscussionCreating a fully informed partnership between research and clinical institutions is the first step in successful cooperative research projects. The adoption of a bidirectional, rather than a top-down, approach to communication between researchers and health-care providers, and between clinic management and the clinic frontline staff, gave the research study team crucial information about barriers, constraints, and needs that clinic staff experienced in implementing the program. This allowed clinic management and front-line clinic staff to play an active role in study implementation, identifying problem areas, and collaborating in finding practical solutions.Clinical Trial Registrationwww.clinicaltrials.gov, NCT03113916.

Type 2 Diabetes (T2D) has reached epidemic levels among the pediatric population. Furthermore, disparities in T2D among youth are distributed in a manner that reflects the social inequality between population sub-groups. Here, we investigated the neighborhood determinants of T2D risk among a sample of Latino adolescents with obesity residing in Phoenix, Arizona (n = 133). In doing so we linked together four separate contextual data sources: the American Community Survey, the United States Department of Agriculture Food Access Research Atlas, the Arizona Healthy Community Map, and the National Neighborhood Data Archive to systematically analyze how and which neighborhood characteristics were associated with T2D risk factors as measured by fasting and 2-h glucose following a 75 g oral glucose tolerance test. Using linear regression models with and without individual/household covariates, we investigated how twenty-two housing and transportation sociodemographic and built and food environment characteristics were independently and jointly associated with T2D risk. The main finding from these analyses was the strong association between the density of fast food restaurants and 2-h glucose values (b = 2.42, p < 0.01). This association was independent of individual, household, and other neighborhood characteristics. Our results contribute to an increasingly robust literature demonstrating the deleterious influence of the neighborhood food environment, especially fast food, for T2D risk among Latino youth.

The purpose of this study was to assess the effects of a pilot community-based behavioral intervention on the home food environment in U.S. households. Parents (21 females, 2 males, age = 36 &plusmn, 5.5 years, 78% Hispanic) of elementary school-aged children attended a 10-week dietary improvement behavioral intervention targeting an increase in fruit and vegetable consumption and a reduction in sugar intake. Home food availability of fruit, vegetables, and sugar-laden foods and beverages were assessed before and after the intervention using a modified version of the Home Food Inventory. Relative to baseline, the intervention resulted in significant increases in fruit availability (7.7 &plusmn, 3.2 items vs. 9.4 &plusmn, 3.1 items, p = 0.004) and low sugar cereal (2.3 &plusmn, 1.4 types vs. 2.7 &plusmn, 1.4 types, p = 0.033). There was a significant reduction in sugar-sweetened beverage availability (3.2 &plusmn, 1.9 types vs. 1.7 &plusmn, 1.3 types, p = 0.004). There was a significant increase in the number of households with accessible ready-to-eat vegetables and fruit, and a significant reduction in available prepared desserts, and candy (p &lt, 0.01). There were no significant changes in the availability of vegetables and sugar-laden cereals. The current intervention resulted in positive changes in the home food environment. Further research to confirm these results in a randomized controlled trial is warranted.

BACKGROUND Metabolic diseases, including obesity and type 2 diabetes, are a major health concern for Latina immigrants. Performing regular aerobic physical activity (PA) is a lifestyle behavior associated with the prevention and control of these conditions. However, PA levels of most Latina immigrants are below national guidelines. Neighborhood environmental factors may influence the PA levels of adults, but limited research has explored associations between the neighborhood environment and PA levels among Latina immigrants. OBJECTIVE The objective of this study was to explore the PA patterns of first-generation US Latina immigrants and how neighborhood environmental factors are related to those PA patterns. METHODS Using a cross-sectional study design, 50 first-generation Latina immigrants completed the International Physical Activity Questionnaire (IPAQ) and the Neighborhood Scales Questionnaire, which assessed 6 perceived neighborhood factors: (1) walking environment, (2) aesthetic quality, (3) safety, (4) violence, (5) social cohesion, and (6) activities with neighbors. Median self-reported metabolic equivalent (MET)-minutes/week of PA were used to summarize domain-specific (ie, work, domestic/household, leisure, and transportation) and intensity-specific (ie, walking, moderate, vigorous, moderate to vigorous) PA patterns. Logistic regression examined associations between neighborhood factors and engaging in leisure-time PA (ie, dichotomous outcome of some versus no leisure-time PA), transportation PA (ie, dichotomous outcome of some versus no transportation PA), and meeting national PA guidelines (ie, dichotomous outcome of meeting versus not meeting guidelines). RESULTS Preliminary analyses showed that 10 participants reported excessively high PA levels and 1 participant had incomplete PA data; these women were excluded from analyses based on IPAQ scoring guidelines. The remaining 39 participants (mean age 40.5 years; mean length of US residency 4.6 years) reported a median of 4512 MET-minutes/week of total PA. The majority of PA was acquired through domestic activities (median 2160 MET-minutes/week), followed by leisure-time PA (median 396 MET-minutes/week), transportation PA (median 198 MET-minutes/week), and work PA (0 MET-minutes/week). Intensity-specific PA patterns showed a median of 594 MET-minutes/week of walking activity and 3500 MET-minutes/week of moderate-to-vigorous PA. Logistic regression models indicated that the neighborhood factors of walking environment, aesthetic quality, and safety were positively associated with engaging in leisure-time PA (odds ratios of 5.95, 95% CI 1.49-23.74; 2.45, 95% CI 1.01-5.93; and 3.30, 95% CI 1.26-8.67, respectively) and meeting national PA guidelines (odds ratios of 4.15, 95% CI 1.13-15.18; 6.43, 95% CI 1.45-28.39; and 2.53, 95% CI 1.00-6.36, respectively). The neighborhood factors of violence, social cohesion, and activities with neighbors were not significantly associated with PA outcomes. CONCLUSIONS Although most participants met national PA guidelines (ie, ≥500 MET-minutes/week of moderate-to-vigorous PA), the majority of their PA was achieved through domestic activities, with limited leisure, transportation, and work PA. Given that leisure-time PA in particular plays a significant role in improving health outcomes, findings suggest that many Latina immigrants could benefit from a leisure-time PA intervention. Such interventions should consider neighborhood environmental influences, as these factors may serve as determinants of PA.

OBJECTIVES: The purpose of this study was to determine how closely parents and their adolescent children self-report family meal habits specific to types of food served and technology use. METHODS: Dyads (n = 100) of one parent (40.0 ± 7.1 years; 92.1% female) and one 6(th)-8(th) grade adolescent child (12.5 ± 0.9 years; 41.3% female) from primarily Hispanic families were recruited through middle schools in a Southwestern US metropolitan area. Parents and adolescents each completed surveys to self-report types of foods typically served at dinner (vegetables, 100% fruit juice, other fruit, milk, and sugar-sweetened beverages) and technology use allowed (television watching, use of hand-held games, talking on the phone, texting, listening to music with headphones) during family meals using identical questions. Answer choices were Never = 1, Sometimes = 2, Usually = 3, or Always = 4. Parents’ responses were compared to those of adolescents using paired samples T-tests. RESULTS: Relative to adolescent responses, parents reported greater family mealtime offering of vegetables (2.5 ± 0.9 vs. 1.8 ± 0.7), 100% fruit juice (2.0 ± 0.9 vs. 1.3 ± 1.0), other fruit (2.4 ± 1.0 vs. 1.3 ± 1.0), milk (2.9 ± 1.0 vs. 1.0 ± 1.0), and sugar-sweetened beverages (2.1 ± 0.8 vs 1.2 ± 0.9; P

OBJECTIVES: Migration to the US has been associated with food insecurity and detrimental changes in diet quality. How these changes affect women in context of their neighborhood food environment has not been thoroughly explored. This study aimed to assess if food insecurity is associated with diet quality and to explore if perceived food availability moderates this purported association in a sample of Mexican immigrant women. METHODS: Mexican-born women (n = 57, 41 ± 7 y) residing in a southwestern US metropolitan area for >1 y self-reported food security status, monthly fast-food frequency, and their perception of fruit, vegetables, and low-fat product availability within their neighborhood via survey. Diet was assessed using the Southwest Food Frequency Questionnaire to estimate intake of fruit, vegetables, salty snacks, sugar, and healthy eating index (HEI)-2015 score. Independent samples t-tests compared dietary outcomes between women classified as food secure (n = 41; high or marginal food security) and food insecure (n = 16; low or very low food security). A moderation analysis assessed the effect of the perception of the neighborhood food environment on the relationship between food security and HEI-2015 score. RESULTS: Fifty four % of participants worked full time and 42% had a monthly household income

Introduction: Adherence to dietary recommendations among Latinx adolescents is low, contributing to an increased risk for obesity and cardiometabolic disease. Parents play a crucial role in adolescents’ disease risk and diet quality due to their role in modeling healthful behaviors and providing food. However, information about how parental monitoring and eating-related parenting practices are associated to cardiovascular risk is scarce. Hypothesis: We hypothesized that unhealthful parenting practices would be associated with higher cardiometabolic risk factors among Latinx adolescents. Methods: We included 61 parent-adolescent (6 th -8 th grade) Latinx dyads. Parents self-reported information about parental monitoring, family eating habits (use of media during meals, inclusion of specific foods during dinner, fast food intake), parental feeding style, and parental energy index (whether parents have had conversations with their children regarding weight and healthful diet and physical activity behaviors). Adolescent cardiometabolic risk factors measured include blood pressure (BP), total cholesterol, and HbA1c. Age- and sex-adjusted BMI percentile (BMI%) and z-scores (BMIz) were calculated from weight and height measurements. Associations between parental practices and cardiometabolic risk factors were analyzed using linear regression (B) and correlation (r). Results: Adolescents’ measured risk factors were as follows: SBP=106±11 mm Hg, DBP=62±7 mm Hg, weight=61±15 kg, BMI%=83±20, BMIz=1.2±0.9, HbA1c=5.1±0.4 %, and total cholesterol=164±12 mg/dL. Use of media during meals (e.g., TV, electronic devices) was associated with higher adolescent weight (B=7.97; r=.31; p=.02) and BMIz (B=.37; r=.27, p=.05). Parental restrictive feeding style was associated with higher adolescent weight (B=5.54; r=.22; p=.03), BMI% (B=13.19; r=.52, p=.001) and diastolic BP (B=2.50; r=.27, p=.04). Adolescent children of parents reporting a greater parental energy index had a greater body weight (B=6.90; r=.46; p=.001) and BMI % (B=6.28; r=.33, p=.01). Parent-reported frequency of consuming family meals, frequency of fast food meals, importance of consuming family meals, and inclusion of vegetables, fruit and 100% juice, milk, and sugar-sweetened beverages during family meals were not associated with adolescents’ BMI or BP. Associations with other risk factors were not significant. Conclusions: Results suggest that unhealthful parenting practices such as restrictive feeding and allowing the use of media during meals may negatively influence cardiometabolic risk factors among Latinx adolescents. Parents of children with a greater BMI reported having more conversations about weight and healthful behaviors with their children. Future family-based behavioral interventions for this population should incorporate more parenting strategies as part of their curricula.

Hispanic women are at high risk for type 2 diabetes (T2D), with obesity and unhealthy eating being important contributing factors. A cross-sectional design was used in this study to identify dietary patterns and their associations with diabetes risk factors. Participants completed a culturally adapted Food Frequency Questionnaire capturing intake over the prior 3 months. Overweight/obese Hispanic women (n = 191) with or at risk for T2D were recruited from a community clinic into a weight loss intervention. Only baseline data was used for this analysis. Dietary patterns and their association with diabetes risk factors (age, body mass index, abdominal obesity, elevated fasting blood glucose [FBG], and hemoglobin A1c). An exploratory factor analysis of dietary data adjusted for energy intake was used to identify eating patterns, and Pearson correlation coefficient (r) to assess the association of the eating patterns with the diabetes risk factors. Six meaningful patterns with healthful and unhealthful traits emerged: (1) sugar and fat-laden, (2) plant foods and fish, (3) soups and starchy dishes, (4) meats and snacks, (5) beans and grains, and (6) eggs and dairy. Scores for the "sugar and fat-laden" and "meats and snacks" patterns were negatively associated with age (r = - 0.230, p = 0.001 and r = - 0.298, p 0.001, respectively). Scores for "plant foods and fish" were positively associated with FBG (r = 0.152, p = 0.037). Being younger may be an important risk factor for a diet rich in sugar and fat; this highlights the need to assess dietary patterns among younger Hispanic women to identify traits potentially detrimental for their health.

ObjectiveTo examine if first-year roommates made similar meal plan decisions.MethodsResidence information for 1186 first-year students (N = 593 roommate pairs) and 559 floormates was obtained for the 2015-2016 academic year. Linear generalized estimating equations (GEEs) were used to examine if the number of meals students used over the semester was higher if their roommate used their meal plan more frequently. A logistic GEE examined joint meal plan usage between students and roommates for each month of the semester. To determine if residence, rather than roommate, explained the results, a simulation was conducted by randomly assigning the floormates to a same-sex roommate.ResultsThe number of meals students used in spring was higher if the students' roommate had used more meals in spring, even after controlling for the number of meals students used in fall (Female: β = 0.07, 99% CI = 0.00, 0.13; Male: β = 0.10, 99% CI = 0.02, 0.18). Students were more likely to use a meal with their roommate if they were on the same meal plan (Female: OR = 1.61, 99% CI = 1.27, 2.04; Male: OR = 1.57, 99% CI = 1.09, 2.25), and less likely after the first month of being roommates (Female: OR = 0.57-0.25; Male: OR = 0.50-0.22; p

ObjectiveObesity and hyperglycaemia contribute to the atherosclerotic process in part through oxidative modifications to lipoprotein particles. The present study aimed to evaluate the effects of a lifestyle intervention on markers of oxidized lipoproteins in obese Latino adolescents with prediabetes.DesignPre–post design.SettingParticipants were enrolled into a 12-week lifestyle intervention. Measurements pre- and post-intervention included anthropometrics and body composition, lipid panel, oxidized LDL (oxLDL), oxidized HDL (oxHDL), intake of fresh fruits and vegetables, and cardiorespiratory fitness.ParticipantsThirty-five obese Latino adolescents (seventeen females, eighteen males; mean age 15·5 (sd1·0) years; mean BMI percentile 98·5 (sd1·2)) with prediabetes.ResultsIntervention participation resulted in significant reductions in weight (−1·2 %,P= 0·042), BMI and BMI percentile (−2·0 and −0·4 %, respectively,P< 0·001), body fat (−7·0 %,P= 0·025), TAG (−11·8 %,P= 0·032), total cholesterol (−5·0 %,P= 0·002), VLDL-cholesterol (−12·5 %,P= 0·029), and non-HDL-cholesterol (−6·7 %,P= 0·007). Additionally, fitness (6·4 %,P< 0·001) and intake of fruits and vegetables (42·4 %,P= 0·025) increased significantly. OxLDL decreased significantly after the intervention (51·0 (sd14·0)v. 48·7 (sd12·8) U/l,P= 0·022), while oxHDL trended towards a significant increase (395·2 (sd94·6)v. 416·1 (sd98·4) ng/ml,P= 0·056).ConclusionsThese data support the utility of lifestyle intervention to improve the atherogenic phenotype of Latino adolescents who are at high risk for developing premature CVD and type 2 diabetes.

Background: The association between acculturation and physical activity (PA) among Mexican American (MA) adults is not understood. This study assessed potential mediating factors that may explain these associations among 75 healthy MA adults [age: 37.5 (9.3) y; 65.3% female].Methods: Secondary data analysis using hierarchical logistic regression examined whether perceived environmental barriers, social support, and intention to exercise potentially mediated relationships between acculturation level, and total and leisure-time moderate to vigorous PA (MVPA). Data were collected via questionnaire.Results: Most participants (67%) reported lower average household monthly incomes ($0–$3000), completed some college or obtained a college degree (64.4%), and were first generation immigrants (59%). Acculturation was associated with greater odds of engaging in total MVPA [odds ratio (OR) = 1.7; 95% confidence interval (CI), 1.2–2.4] and leisure-time MVPA (OR = 1.6; 95% CI, 1.1–1.2). Perceived environmental barriers were associated with greater odds of engaging in both total and leisure-time MVPA (OR = 4.3; 95% CI, 2.1–5.8 and OR = 5.5; 95% CI, 2.0–7.0, respectively), and social support was associated with greater odds for total MVPA (OR = 3.7; 95% CI, 1.1–6.4).Conclusions: Results provide preliminary evidence for mediating factors that may explain the relationship between acculturation level and PA among MA adults. Contradicting prior evidence, results suggest that PA engagement, despite perceived environmental barriers, is possible among MA adults having stronger social support.

OBJECTIVE Determine the association between key dental outcomes and added sugar intake using a survey instrument to assess added sugars, which was specifically tailored to immigrant and US-born adults of Mexican origin. METHODS Hispanic adults of Mexican origin (n = 326; 36.2 ± 12.1 years) completed a self-administered survey to gather acculturation, self-reported dental experiences and self-care practices (eg brushing, flossing, pain, bleeding gums), and socio-demographic information. The survey included a culturally tailored 22-item Added Sugar Intake Estimate (ASIE) that assessed added sugar intake from processed foods and sugar-sweetened beverages in a semiquantitative food frequency questionnaire format. Linear regression, 2-sample t test, and ANOVA were used to evaluate associations of demographic and dental outcomes with daily added sugar intake. RESULTS Of the mean total daily added sugar intake (99.6 ± 94.6 g), 36.5 ± 44.4 g was derived from sugar-containing foods and snacks, and 63.1 ± 68.2 g from beverages. Participants who reported greater added sugar intake were more likely to have reported the presence of a toothache in the preceding 12 months, having been prescribed antibiotics for dental reasons, being less likely to floss daily, have reported eating or drinking within 1 hour before bed and have lower psychological acculturation (P

In Mexican Americans, metabolic conditions, such as obesity and type 2 diabetes (T2DM), are not necessarily associated with an increase in mortality, this is the so-called Hispanic paradox. In this cross-sectional analysis, we used a metabolomic analysis to look at the mechanisms behind the Hispanic paradox. To do this, we examined dietary intake and body mass index (BMI, kg/m2) in men and women and their effects on serum metabolomic fingerprints in 70 Mexican Americans (26 men, 44 women). Although having different BMI values, the participants had many similar anthropometric and biochemical parameters, such as systolic and diastolic blood pressure, total cholesterol, and LDL cholesterol, which supported the paradox in these subjects. Plasma metabolomic phenotypes were measured using liquid chromatography tandem mass spectrometry (LC-MS/MS). A two-way ANOVA assessing sex, BMI, and the metabolome revealed 23 significant metabolites, such as 2-pyrrolidinone (p = 0.007), TMAO (p = 0.014), 2-aminoadipic acid (p = 0.019), and kynurenine (p = 0.032). Pathway and enrichment analyses discovered several significant metabolic pathways between men and women, including lysine degradation, tyrosine metabolism, and branch-chained amino acid (BCAA) degradation and biosynthesis. A log-transformed OPLS-DA model was employed and demonstrated a difference due to BMI in the metabolomes of both sexes. When stratified for caloric intake (&lt, 2200 kcal/d vs. &gt, 2200 kcal/d), a separate OPLS-DA model showed clear separation in men, while females remained relatively unchanged. After accounting for caloric intake and BMI status, the female metabolome showed substantial resistance to alteration. Therefore, we provide a better understanding of the Mexican-American metabolome, which may help demonstrate how this population—particularly women—possesses a longer life expectancy despite several comorbidities, and reveal the underlying mechanisms of the Hispanic paradox.

ObjectiveThe study aims were to (i) identify determinants of Nutrition Facts Panel (NFP) use and (ii) describe the association between NFP use and dietary intake among Latinos with type 2 diabetes.DesignBaseline cross-sectional data from a clinical trial were used to assess the association between NFP use and dietary intake. Diet was measured using two methods: (i) a diet quality score (the Healthy Eating Index-2010) derived from a single 24 h recall and (ii) dietary pattern (exploratory factor analyses) from an FFQ. Multivariable logistic and non-parametric quantile regressions were conducted, as appropriate.SettingsHartford County, Connecticut, USA.SubjectsLatino adults (n 203), ≥21 years of age, with diagnosed type 2 diabetes, glycosylated Hb≥7 %, and without medical conditions limiting physical activity.ResultsParticipants’ education level, diabetes-related knowledge and English speaking were positively associated with NFP use. At the higher percentiles of diet quality score, NFP use was significantly associated with higher diet quality. Similarly, NFP users were more likely to consume a ‘healthy’ dietary pattern (P=0·003) and less likely to consume a ‘fried snack’ pattern (P=0·048) compared with NFP non-users.ConclusionsThe association between reported NFP use and diet quality was positive and significantly stronger among participants who reported consuming a healthier diet. While NFP use was associated with a healthier dietary pattern, not using NFP was associated with a less-healthy, fried snack pattern. Longitudinal studies are needed to understand whether improving NFP use could be an effective intervention to improve diet quality among Latinos with type 2 diabetes.

There is growing interest on the effects of mindfulness techniques, particularly mindful eating (ME), on eating behaviors and weight status. This study aimed to (1) evaluate whether the ME practices of adult parents and adolescents were associated to their respective weight status and (2) assess the relationship between a parent’s ME behaviors and those of their adolescent child. Data was collected as part of a secondary data analysis from a cross-sectional observational study conducted with primarily Hispanic parent and youth dyads (n = 57) from public housing sites in Phoenix, Arizona. Participants completed the Mindful Eating Questionnaire (MEQ) and research staff collected anthropometric data. Adjusted multivariate linear regressions were used in data analysis. No associations were observed between ME and weight status for either parents or youth. However, parent overall MEQ scores were associated with adolescent overall MEQ scores (r = 0.47, p

This systematic review and meta-analysis examined the literature on early care and education center (ECEC)-based physical activity interventions to identify ecologic environmental factors that improve cardiovascular fitness (CVF) in preschool-aged children. Data sources included PubMed, Web of Science, Cochrane Library Trials, CINHAL, Science Direct, PsychINFO and SPORTDiscus. Peer-reviewed publications of studies that met the following criteria were eligible for inclusion: (1) mean age of participants between two and a half and five and a half years old enrolled in a pre-primary school; (2) randomized controlled trials or quasi-experimental interventions with a control group; (3) interventions occurring before, during, or immediately after school; (4) use of an objective measure or field-based estimate of CVF; (5) enrolled apparently healthy children. In June of 2018, titles (n = 1197) were reviewed for inclusion into the study and 74 abstracts/full texts were assessed for eligibility. Ten articles met all eligibility criteria and were included in the final review. A random effects meta-analysis suggested a moderate-to-large effect size for ECEC-based interventions to increase CVF (g = 0.75; 95%CI [0.40–1.11]). Interventions that included three or more ecologic environments (g = 0.79 [0.34–1.25]) were more effective than interventions occurring at the individual level (g = 0.67 [0.12–1.22]). Study quality was moderate, and (mean ± SD) 17.9 ± 4.3 (63.9%) of 28 checklist items were reported. Preliminary evidence suggests that ECEC-based interventions to increase CVF are highly effective at improving preschool children's exercise test scores. Although ECEC-based interventions show promise, the small number of studies included in this review limits confidence in these findings. Review registered at PROSPERO CRD42018099115. Keywords: Child, Preschool, Cardiorespiratory fitness, Systematic review, Physical activity, Social ecology

Latinx adolescents are at higher risk for chronic diseases relative to adolescents of other ethnic groups, in part because of their lack of adherence to diet recommendations and their higher rates of substance use. Given the proximal influence of family factors during the developmental stage of adolescence, parenting interventions may be an effective way to promote healthy nutrition and substance use prevention simultaneously. This article describes the design and theoretical rationale of a study assessing the effects of Families Preparing the New Generation Plus (FPNG Plus), a 10-week culturally-tailored nutrition and substance use prevention parenting program, on diet and substance use outcomes among Latinx middle school students (6th–8th grade). The 3-arm cluster randomized controlled trial compares FPNG Plus (substance use prevention and healthy nutrition), FPNG (substance use prevention only), and a comparison condition (focusing on academic success) in 1494 parent-child dyads from 18 schools, randomized at the school level. Adolescents and parents will complete surveys pre- and post-intervention, and 16-weeks after program participation, regarding diet behaviors, substance use, and parenting practices. A random subsample of 126 dyads (42 from each program), will participate in additional data collection to assess the home food environment, detailed dietary intake (via two 24-h recalls), and provide biomarkers of cardiometabolic risk (blood pressure, total cholesterol and HbA1c). If successful, this study will provide evidence contributing to helping Latinx parents assist their adolescent children develop and maintain long-lasting positive lifestyle behaviors in order to prevent concurrent substance use and diet-related chronic diseases.

Introduction: Middle-aged Hispanic women have the highest prevalence of overweight and lifetime risk for diabetes of all gender/racial groups. This study examines use of alternative medicine for weight loss and diabetes management among overweight and obese Mexican American women with or at risk for diabetes. Method: As part of a diabetes risk-reduction intervention targeting overweight and obese Hispanic women at a federally qualified health center in Hillsboro, Oregon, we administered a survey of different treatment modalities, including alternative medicine, traditional Mexican medicine, and home remedies to 85 Hispanic women. We also asked participants how often they disclosed their use of alternative methods to their providers. Results: Nearly all participants with diabetes (97%) reported using at least one alternative strategy for diabetes control, with home remedies, commercial weight-loss products, and herbal teas being the most endorsed. Most participants with diabetes and half of those without diabetes reported never telling their provider. Conclusion: This group of women reported a high prevalence of use of alternative methods for weight control and diabetes management. Yet most participants with diabetes never reported this use to a health care provider. To ensure patient safety, providers treating Hispanic women need to probe for complementary and alternative medicine practices.

OBJECTIVES: To better understand how Latinx middle school youth perceive the family- and environment-related factors that influence their diet and eating behaviors. METHODS: Five gender-stratified focus groups (3 with females, 2 with males) with 37 Latinx seventh grade students (54% female) were conducted. The guided discussion included questions about participants’ food choices, the role of their parents in their diet, the way diet and food are discussed at home, and healthy body-related concerns among their peers. Focus groups were audio recorded, transcribed verbatim, and coded in NVivo on the basis of specificity, extensiveness, frequency, and emotionality. Themes emerged from group dialogue; detailed conversations and predominant topics of discussion were noted. RESULTS: Youth identified several home- and family-level factors influencing their eating behaviors and food preferences, including parental/caregiver modeling, home food availability, and household budgetary constraints. Within the home, youth described a limited ability to participate in decisions regarding food choices, meal planning, meal preparation, and communicating with their caregivers about food preferences. Some youth expressed frustration due to perceiving that other family members were given alternative food options during meals. Youth were interested in eating healthier foods, but those options were not always available at home. Healthy foods at school were described as poorly prepared, and not always available. Youth reported experiencing peer pressure regarding healthy or unhealthy food selection, body image, and fitness level, and reported awareness of the use of unhealthful eating behaviors (e.g., restrictive eating, dieting, purging) as coping strategies. CONCLUSIONS: Family- and household-related factors emerged as important factors that influence youth dietary behaviors. Youth expressed they would eat more nutritious foods if they had more options, if the food was well prepared, and they were given more autonomy over their food and meal choices. Future diet interventions should incorporate strategies to address family-level and environmental factors that influence dietary intake in this vulnerable population. FUNDING SOURCES: Funded by NIMHD.

Introduction: Insulin resistance (IR) is associated with impaired lipid metabolism. The Lipoprotein Insulin Resistance Index (LP-IR) is a novel composite biomarker that estimates IR from lipoprotein particle size and concentration, and prospectively predicts type 2 diabetes (T2D) in adults. Less is known about LP-IR and T2D risk in youth. This study evaluated the effect of a lifestyle intervention on LP-IR scores in obese Latino youths with prediabetes. Methods: Obese Latino adolescents (n=27, 15.5±1.1 years, 13 male/14 female) with prediabetes (defined as a 2-hour, post-challenge glucose ≥120 mg/dL) completed a 12-week intervention including nutrition education (one hour/week) and moderate-to-vigorous physical activity (three hours/week). Measurements at baseline and 12 weeks included anthropometrics, total, large, medium, and small lipoprotein particle concentrations (VLDL and chylomicron, LDL, and HDL), mean lipoprotein particle sizes (VLDL, LDL, HDL), lipid concentrations (total triglyceride, VLDL and chylomicron triglyceride, and HDL cholesterol), and LP-IR scores using nuclear magnetic resonance spectroscopy. Results: After adjusting for body fat and sex, significant reductions in LP-IR scores (63.2±14.4 vs. 59.0±15.5 units, p=0.013), large VLDL and chylomicron particle concentration (9.1±7.8 vs. 7.3±6.2 nmol/L, p=0.004), total HDL particle concentration (30.2±4.3 vs. 28.3±3.9 μmol/L, p=0.013), total triglyceride concentration (144.5±91.9 vs. 122.9±77.9 mg/dL, p=0.002), as well as VLDL and chylomicron triglyceride concentration (117.5±66.7 vs. 102.0±55.7 mg/dL, p=0.020) were observed following lifestyle intervention. Conclusion: Lifestyle intervention significantly reduces LP-IR scores and lipoprotein particle parameters in obese adolescents with prediabetes and may decrease future risk of cardiometabolic disorders through improvements in insulin resistance and lipoprotein metabolism. Disclosure A.M. Renteria-Mexia: None. M. Olson: None. M.A. Connelly: Employee; Self; LabCorp. S. Vega-López: None. A. Williams: None. G.Q. Shaibi: None. Funding National Institute on Minority Health and Health Disparities (P20MD002316, U54MD002316); Programa para el Desarrollo Profesional Docente, para el Tipo Superior, México (to A.M.R-M.)

OBJECTIVES: To determine how health-related conversations between parents and their adolescent children is associated with mealtime media device use by adolescents. METHODS: A sample of primarily Hispanic parents (n = 347; 43 ± 6.5 years; 89.3% female) of 6th, 7th or 8th grade adolescents enrolled in a parenting intervention focusing on the promotion of healthy nutrition and substance use prevention. Parents completed baseline surveys to self-report the frequency with which they had health-related conversations with their adolescent child (healthy eating, being physically active, adolescent's weight, adolescent weighing too much, eating differently to lose weight, exercising to lose weight), and the frequency with which the adolescent used media devices during mealtimes (television and movie watching, cellphone use or texting, handheld gaming devices, listening to music with headphones). Spearman's rank correlations were used to assess the associations between health-related communication and mealtime media device use. RESULTS: Reported conversations about healthy eating, being physically active, and general weight of the adolescent were not associated with reported use of media devices by adolescents during mealtimes. Having conversations related to the adolescent weighing too much was positively and significantly correlated with television/movie watching (r = 0.219; P

This study evaluated the effect of nopales (prickly pear cactus pads) for improving cardiometabolic risk factors and oxidative stress, compared to control, in hypercholesterolemic adults. In a randomized crossover trial, participants were assigned to a 2-wk intervention with 2 cups/day of nopales or cucumbers (control), with a 2 to 3-wk washout period. The study included 16 adults (46 ± 14 y; BMI = 31.4 ± 5.7 kg/m2) with moderate hypercholesterolemia. There was no significant treatment-by-time effect for any dietary composition data, lipid profile, cardiometabolic outcomes, or oxidative stress markers. Both treatments significantly increased triglyceride concentrations (cucumber, 14.8%; nopales, 15.2%; pTime = 0.020). On average, LDL-c was decreased by 2.0 mg/dL (−1.4%) after the cucumber phase and 3.9 mg/dL (−2.9%) after the nopales phase (pTime = 0.176). In conclusion, these data do not support the purported benefits of nopales at doses of 2 cups/day for 2-wk on markers of lipoprotein profile, cardiometabolic risk, and oxidative stress in hypercholesterolemic adults.

This study aims to examine children&rsquo, s fruit, vegetable, and added sugar consumption relative to the Dietary Guidelines for Americans and the American Heart Association&rsquo, s recommendations, as well as to compare children&rsquo, s reported consumption with parental perception of the child&rsquo, s overall diet quality. Data were drawn from 2 independent, cross sectional panels (2009&ndash, 10 and 2014&ndash, 15) of the New Jersey Child Health Study. The analytical sample included 2229 households located in five New Jersey cities. Daily consumption of fruit (cups), vegetables (cups), and added sugars (teaspoons) for all children (3&ndash, 18 years old) were based on parent reports. Multivariate linear regression analyses estimated children&rsquo, s adjusted fruit, vegetable, and added sugar consumption across parents&rsquo, perception categories (Disagree, Somewhat Agree, and Strongly Agree that their child eats healthy). Although only a small proportion of children meet recommendations, the majority of parents strongly agreed that their child ate healthy. Nonetheless, significant differences, in the expected direction, were observed in vegetable and fruit consumption (but not sugar) across parental perceptional categories for most age/sex groups. Dietary interventions tailored to parents should include specific quantity and serving-size information for fruit and vegetable recommendations, based on their child&rsquo, s age/sex, and highlight sources of added sugar and their sugar content.

A cross-sectional, self-administered survey was used to gather information about dental outcomes, sugar-containing food behaviors and intake, and sociodemographic characteristics of adults of Mexican and Central-American (Guatemala, El Salvador, Honduras) origin (n = 517). Bivariate and multiple-variable logistic regressions were used to examine the associations of behaviors related to added sugar-containing foods/beverages (overall intake and consumption before bed) with dental outcomes. Outcome measures involved dental outcomes, dental self-care practices, and added sugar intake. Estimated daily added sugar intake among all participants was 98 (SD = 99) g, with no difference in consumption among participants from different countries. The majority of added sugar (63 (SD = 74) g) was provided by sugar-sweetened beverages. Participants who reported consuming sugar-containing foods or beverages within an hour before bed were more likely to report having a fair/poor/very poor condition of teeth and gums and having felt dental pain (p &lt, 0.05 for all). The amount of sugar intake was associated with being prescribed medication for oral or dental problems (p = 0.008) and dental pain (p = 0.003). Findings support the association between sugar containing food&ndash, related behaviors and dental problems among Hispanic immigrants to the U.S. Health promotion and preventive interventions for this population should consider these behaviors as modifiable contributors to adverse dental outcomes.

OBJECTIVES: Dietary acculturation consists of adopting food culture after migration to a host country. The purpose of this study was to describe how Mexican-born women perceive factors which contributed to their changes in dietary habits after migrating to the United States (US). METHODS: Fifteen self-identified Mexican women (41 ± 7 years old) residing in a Southwestern US metropolitan area and who had lived in the US for >1 year participated in semi-structured interviews conducted in Spanish. Interview guides, developed from a constructivist perspective, asked about the US food culture, changes in dietary habits, loss or maintenance of native food culture, and the incorporation of elements of the new food culture. Interview audio recordings were transcribed verbatim and analyzed based on pre-established theoretical categories using MAXQDA 2018. RESULTS: Half of the participants worked full time (53%) and had a household income of less than $2000/month (53%). When comparing the US food culture to that of Mexico, the majority of participants perceived greater availability and access to fast food (n = 9). Some participants identified feeling pressure for purchasing larger amounts of food to save money (n = 2). Only one participant associated high intake of fresh and nutritious food with the US food culture. Some participants perceived having more competing demands for time, resulting in not having enough time to prepare household meals (n = 3). Women referred to having maintained the consumption of meat, multiple ingredients (e.g., tortillas, limes, chili peppers), and products of Mexican traditional cuisine (n = 15), but having lost flavors (n = 11), commensality (n = 8), ways of preparation (n = 7), food freshness (n = 3) and smells (n = 1). Even though vegetables and trendy-health products were reported as newly incorporated elements in the diet (n = 7), participants also reported the incorporation of frozen (n = 2) and pre-cooked products (n = 2), which they considered are characteristic from the US diet. CONCLUSIONS: Findings suggest that dietary acculturation among Mexican immigrant women is a complex process. This points to the importance of considering the cultural aspects of diet when designing strategies to improve diet and health for this group. FUNDING SOURCES: CONACYT, Mexico and Program for Transborder Communities.

Background Community-based programs have had modest success in combating obesity in Latino populations. Latino families' norms and beliefs about weight often hold larger body sizes to be normal, leading to lower engagement in weight-focused programs. Because improvements in cardiorespiratory fitness confer health benefits, regardless of weight, they offer an alternative to obesity-focused approaches. We describe the rationale and design of Athletes for Life (AFL), a community- and family-based intervention for Latino families. Methods/Design This two-group randomized controlled trial will test the efficacy of AFL for improving cardiorespiratory fitness and diet in 6- to 11-year-old children (N = 160) and their parents, relative to a wait-list control group. Children will participate in 12 weeks of semiweekly sports skill programing and nutrition sessions. Concurrently, parents will participate in sports-focused activity and behavior change sessions that focus on nutrition, chronic disease prevention, and healthy eating. Cardiovascular fitness will be measured by the 1-mile run and 3-min step-test for both parents and children. Secondary outcomes include changes in objectively measured physical activity, dietary measures, body composition, and cardiometabolic risk (waist circumference, blood pressure, blood lipids, glucose, insulin, and C-reactive protein). Discussion AFL, implemented with a strong community partnership, will provide a test of the efficacy of culturally tailored intervention programming to promote positive health behaviors and improve health outcomes in Latino families. Intervention content, structure, and messaging will provide guidance for future methods to engage Latino families in health promotion programs that highlight their cultural norms, and beliefs. Trial registration Clinicaltrials.gov Identifier NCT03761589 (12/3/2018).

Background Smart Walk is a culturally relevant, social cognitive theory–based, smartphone-delivered intervention designed to increase physical activity (PA) and reduce cardiometabolic disease risk among African American (AA) women. Objective This study aimed to describe the development and initial usability testing results of Smart Walk. Methods Smart Walk was developed in 5 phases. Phases 1 to 3 focused on initial intervention development, phase 4 involved usability testing, and phase 5 included intervention refinement based on usability testing results. In phase 1, a series of 9 focus groups with 25 AA women (mean age 38.5 years, SD 7.8; mean BMI 39.4 kg/m2, SD 7.3) was used to identify cultural factors associated with PA and ascertain how constructs of social cognitive theory can be leveraged in the design of a PA intervention. Phase 2 included the analysis of phase 1 qualitative data and development of the structured PA intervention. Phase 3 focused on the technical development of the smartphone app used to deliver the intervention. Phase 4 consisted of a 1-month usability trial of Smart Walk (n=12 women; mean age 35.0 years, SD 8.5; mean BMI 40 kg/m2, SD 5.0). Phase 5 included refinement of the intervention based on the usability trial results. Results The 5-phase process resulted in the development of the Smart Walk smartphone-delivered PA intervention. This PA intervention was designed to target social cognitive theory constructs of behavioral capability, outcome expectations, social support, self-efficacy, and self-regulation and address deep structure sociocultural characteristics of collectivism, racial pride, and body appearance preferences of AA women. Key features of the smartphone app included (1) personal profile pages, (2) multimedia PA promotion modules (ie, electronic text and videos), (3) discussion boards, and (4) a PA self-monitoring tool. Participants also received 3 PA promotion text messages each week. Conclusions The development process of Smart Walk was designed to maximize the usability, cultural relevance, and impact of the smartphone-delivered PA intervention.