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Purpose/Objectives: The purpose of this study was to identify key drivers of students' breakfast habits, including eating breakfast at home or at school, to inform strategies that school nutrition professionals might use to increase participation in School Breakfast Programs (SBPs). Methods: A convenience sample of students in grades 1-12 from two public school districts in Connecticut participated in focus groups. Each of the 13 focus groups included students from two or three grade levels and was facilitated by a lead moderator and note-taker. Recorded discussions were transcribed with students' comments coded to identify common themes. Within each theme, the grade levels of participants were identified to determine whether the theme represented comments by elementary school (grades 1-6), middle school (grades 7-8), and/or high school (grades 9-12) participants. Results: A total of 105 students (57% female, 43% male) participated. Across all grade levels, hunger, or a desire to avoid its adverse effects (e.g., grumpiness, headache), was identified as a consistently mentioned reason for eating breakfast. Other reasons included parental influence (elementary students), desire to improve energy (elementary students), and desire to improve school performance (elementary and middle school students). Breakfast skipping was often reported by middle and high school students, who cited inadequate time and lack of hunger as reasons. Across all grade levels, reasons for not participating in the SBP included distaste for, distrust of, and/or cost of school foods. Inconvenience of eating at school and perception of school foods as unhealthy or "junk" were cited by elementary and middle school students. Suggestions to improve school breakfast included more choices (all grades), improved freshness or quality of foods (all grades), and healthier options (elementary and middle school students). Application to Child Nutrition Professionals: Emphasizing food quality and increasing convenience of school breakfast may help to increase SBP participation.

Objective: To determine the reliability and validity of a 10-item questionnaire, the Food Label Literacy for Applied Nutrition Knowledge questionnaire. Methods: Participants were elementary school children exposed to a 90-minute school-based nutrition program. Reliability was assessed via Cronbach alpha and intraclass correlation coefficient (ICC). Validity was assessed comparing the questionnaire's food choices using an objective metric of nutrition quality, the Overall Nutritional Quality Index (ONQI), via t test. Statistical significance was set at 0.05. Results: Four hundred ninety-nine children participated, 51% were female, and the average age was 8.6 (plus or minus 0.9) years. Cronbach alpha = 0.77 and ICC = 0.68 (between administrations) were observed. ONQI scores of correct responses were significantly higher when compared to the ONQI scores of incorrect responses (27.4 plus or minus 9.4 vs 16.2 plus or minus 9.4; P = 0.01). Conclusions and Implications: The Food Label Literacy for Applied Nutrition Knowledge questionnaire was found to be both reliable and a valid measure of food label literacy in children taught the Nutrition Detectives program. (Contains 1 table.)

Background: The purpose of this study was to evaluate the effects of a nutrition education program designed to teach elementary school students and their parents, and to distinguish between more healthful and less healthful choices in diverse food categories. Methods: Three schools were assigned to receive the Nutrition Detectives[TM] program and 2 comparable schools served as controls. A total of 1180 second, third, and fourth grade elementary school students were included, with 628 students in the intervention and 552 in the control group. The program, delivered by physical education instructors over several sessions totaling less than 2 hours, taught the children how to read food labels and detect marketing deceptions, while learning to identify and choose healthful foods. Parents were introduced to the program through written materials sent home and at school functions. Assessments included a food label quiz, dietary pattern, and body mass index (BMI). Results: Students in intervention schools showed a significant increase in nutrition label literacy (p less than 0.01). Third grade students showed the most improvement, 23% (p less than 0.01). The parents of intervention group students also showed a significant increase in nutrition label literacy by 8% (p less than 0.01). Total caloric, sodium, and total sugar intake decreased nonsignificantly among students in the intervention group (p greater than 0.05). BMI did not change over the short duration of the study. Conclusions: Nutrition Detectives effectively enhances the ability of students and their parents to identify more nutritious food choices. Further evaluation of the program and its potential to influence dietary pattern, BMI, and health outcomes in students and their families is warranted. (Contains 3 tables and 1 figure.)

Lifestyle changes that emphasis on plant-based diets (PBD) are typically recommended for those at risk for type 2 diabetes mellitus (T2DM) to mitigate their cardo-metabolic risk. We examined the impact of the inclusion of eggs compared with their exclusion from PBD on diet quality among adults at risk for T2DM. This was a randomized, controlled, single-blind, crossover trial of 35 adults (mean age 60.7 years; 25 women, 10 men; 34 Caucasians, 1 African-American) at risk for T2DM (i.e., pre- diabetes or metabolic syndrome) assigned to one of two possible sequence permutations of two treatments (PBD with eggs and exclusively PBD), with a 4-week washout period. Participants received dietary counseling from a dietitian to exclude or to include 2 eggs daily in the context of PBD for a 6-week period. Diet quality was assessed using the Healthy Eating Index 2015 (HEI-2015) at baseline and 6 weeks. Compared with the exclusion of eggs, the inclusion of eggs in the context of PBD improved the diet quality score for intake of total protein foods (1.0 ± 1.1 vs. −0.4 ± 1.0; p <.0001); seafood and plant proteins (0.2 ± 1.2 vs. −0.4 ± 1.1; p = 0.0338); and fatty acids (0.8 ± 2.5 vs. −0.7 ± 2.7; p = 0.0260). Overall diet quality score depreciated with the adoption of exclusively PBD without eggs (−3.1 ± 8.3; p = 0.0411), while it was unaffected with the adoption of a PBD with the inclusion of eggs (−0.6 ± 7.9; p = 0.6892). Eggs could be used as an adjuvant to enhance the diet quality among those at risk for T2DM who adopt plant-based dietary patterns. [ABSTRACT FROM AUTHOR]

PURPOSE/OBJECTIVES The purpose of this study was to identify key drivers of students' breakfast habits, including eating breakfast at home or at school, to inform strategies that school nutrition professionals might use to increase participation in School Breakfast Programs (SBPs). METHODS A convenience sample of students in grades 1-12 from two public school districts in Connecticut participated in focus groups. Each of the 13 focus groups included students from two or three grade levels and was facilitated by a lead moderator and note-taker. Recorded discussions were transcribed with students' comments coded to identify common themes. Within each theme, the grade levels of participants were identified to determine whether the theme represented comments by elementary school (grades 1-6), middle school (grades 7-8), and/or high school (grades 9-12) participants. RESULTS A total of 105 students (57% female, 43% male) participated. Across all grade levels, hunger, or a desire to avoid its adverse effects (e.g., grumpiness, headache), was identified as a consistently mentioned reason for eating breakfast. Other reasons included parental influence (elementary students), desire to improve energy (elementary students), and desire to improve school performance (elementary and middle school students). Breakfast skipping was often reported by middle and high school students, who cited inadequate time and lack of hunger as reasons. Across all grade levels, reasons for not participating in the SBP included distaste for, distrust of, and/or cost of school foods. Inconvenience of eating at school and perception of school foods as unhealthy or "junk" were cited by elementary and middle school students. Suggestions to improve school breakfast included more choices (all grades), improved freshness or quality of foods (all grades), and healthier options (elementary and middle school students). APPLICATION TO CHILD NUTRITION PROFESSIONALS Emphasizing food quality and increasing convenience of school breakfast may help to increase SBP participation. [ABSTRACT FROM AUTHOR]

Purpose: To compare two intensity levels (standard vs. enhanced) of a nutrition and physical activity intervention vs. a control (usual programs) on nutrition knowledge, body mass index, fitness, academic performance, behavior, and medication use among elementary school students.Design: Quasi-experimental with three arms.Setting: Elementary schools, students' homes, and a supermarket.Subjects: A total of 1487 third-grade students.Intervention: The standard intervention (SI) provided daily physical activity in classrooms and a program on making healthful foods, using food labels. The enhanced intervention (EI) provided these plus additional components for students and their families.Measures: Body mass index (zBMI), food label literacy, physical fitness, academic performance, behavior, and medication use for asthma or attention-deficit hyperactivity disorder (ADHD).Analysis: Multivariable generalized linear model and logistic regression to assess change in outcome measures.Results: Both the SI and EI groups gained less weight than the control (p < .001), but zBMI did not differ between groups (p = 1.00). There were no apparent effects on physical fitness or academic performance. Both intervention groups improved significantly but similarly in food label literacy (p = .36). Asthma medication use was reduced significantly in the SI group, and nonsignificantly (p = .10) in the EI group. Use of ADHD medication remained unchanged (p = .34).Conclusion: The standard intervention may improve food label literacy and reduce asthma medication use in elementary school children, but an enhanced version provides no further benefit. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the effects of a nutrition education program designed to teach elementary school students and their parents, and to distinguish between more healthful and less healthful choices in diverse food categories. Three schools were assigned to receive the Nutrition Detectives™ program and 2 comparable schools served as controls. A total of 1180 second, third, and fourth grade elementary school students were included, with 628 students in the intervention and 552 in the control group. The program, delivered by physical education instructors over several sessions totaling less than 2 hours, taught the children how to read food labels and detect marketing deceptions, while learning to identify and choose healthful foods. Parents were introduced to the program through written materials sent home and at school functions. Assessments included a food label quiz, dietary pattern, and body mass index (BMI). Students in intervention schools showed a significant increase in nutrition label literacy (p < .01). Third grade students showed the most improvement, 23% (p < .01). The parents of intervention group students also showed a significant increase in nutrition label literacy by 8% (p < .01). Total caloric, sodium, and total sugar intake decreased nonsignificantly among students in the intervention group (p > .05). BMI did not change over the short duration of the study. Nutrition Detectives effectively enhances the ability of students and their parents to identify more nutritious food choices. Further evaluation of the program and its potential to influence dietary pattern, BMI, and health outcomes in students and their families is warranted. [ABSTRACT FROM AUTHOR]

Presents information on a study which evaluated a cardiovascular nutrition education package designed for African American adults with elevated cholesterol level or blood pressure. Rationale for Cardiovascular Dietary Education System (CARDES) approach; Results of the approach; Analysis on the study findings.

Purpose: To compare the effects of nut-based snack bars (NBSB) vs. prepackaged 200-kcal portions of typical conventional snack foods, when consumed over a 12-week period by a group of overweight adults.Design: Randomized, single-blind parallel design with two treatment groups.Setting: Clinical Trial: Subjects: Thirty-four overweight participants were enrolled.Intervention: Commercially available NBSB or conventional snack foods as part of an ad libitum diet for 12 weeks.Measures: Primary Outcome Measures: body mass index, body weight, body composition, waist circumference.Secondary Outcome Measures: blood pressure, lipid profile, nutrients intake, hunger/satiety, quality of life.Analysis: Generalized linear models with time as repeated measure were used to analyze these data.Results: Daily consumption of NBSB for 12 weeks, as compared to daily consumption of conventional snacks, significantly reduced percentage body fat (-1.7% ± 10.8% vs. 6.2% ± 9.3%; p = .04) and visceral fat (-1.3 ± 5.9 vs. 2.7 ± 4.0; p = .03). There were no between-group differences (p > .05) for blood pressure, lipid panel, satiety, or quality of life measures.Conclusion: Our data suggest that daily consumption of NBSB for 12 weeks reduced body fat and had no adverse effects on weight, blood pressure, lipid profile, satiety, or quality of life in this small sample of overweight adults. [ABSTRACT FROM AUTHOR]

Introduction: Despite well-documented evidence that physical activity is beneficial to children, average fitness levels of US children have declined. Lack of physical activity has been associated with childhood obesity. We evaluated the effects of a physical activity program in the elementary school classroom on health outcomes., Methods: Three schools in the Independence School District in Independence, Missouri, were assigned to receive the ABC (Activity Bursts in the Classroom) for Fitness program, and 2 comparable schools served as controls. The program, led by classroom teachers, provides multiple, brief, structured physical activity breaks throughout the day. Baseline data for the study were collected in September 2007, and follow-up data were collected in April 2008., Results: Physical fitness measures of upper-body strength, abdominal strength, and trunk extensor improved (P <.001). Medication use for asthma (P = .03), attention-deficit hyperactivity disorder (P = .07), or either medication combined (P = .005) decreased., Conclusion: The effects of the program on daily physical activity, fitness, and measures of health are beneficial.