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Health Equity 2023To examine racial/ethnic differences in dietary behaviors, diet quality, body mass, and the perceived availability of healthful foods in one's neighborhood among mothers...
Disparities in Perceived Availability of Healthful Foods, Dietary Behaviors, Diet Quality, and Obesity Among Mothers from Low-Income Households: Additional Evidence in the Call for Broader Approaches to Obesity Prevention.
PURPOSE
To examine racial/ethnic differences in dietary behaviors, diet quality, body mass, and the perceived availability of healthful foods in one's neighborhood among mothers from low-income California households.
METHODS
Cross-sectional telephone surveys of mothers from randomly sampled households with incomes ≤185% federal poverty level in 2018 and 2019 using a validated 24-h dietary recall assessment. Dietary outcomes were cups of fruits and vegetables, ounces of sugar-sweetened beverages, teaspoons of added sugars, and kilocalories consumed the previous day. Diet quality was assessed by calculating Health Eating Index-2015 scores. Supplemental survey items assessed mothers' weight and height. Body mass index (BMI) was calculated with a BMI of 30 or higher considered obese. Perceived availability of fresh fruits and vegetables and healthy foods in general within one's neighborhood was recorded.
RESULTS
The analytic sample of 9200 mothers was 66.3% Latina, 17.3% white, 12.6% African American, and 3.8% Asian American, Native Hawaiian, or Pacific Islander (AANHPI). African American mothers consumed the fewest cups of fruits and vegetables and the most teaspoons of added sugars, reported poor diet quality, and had the highest obesity rate, 54.7% versus 46.9% for Latinas, 39.9% for whites, and 23.5% for AANHPIs. Accordingly, a greater proportion of African Americans reported limited availability of fresh fruits and vegetables and healthy foods in general in their neighborhood.
CONCLUSION
Findings are interpreted in light of recent calls for broader approaches to address health disparities, including strategies that focus on inequalities in racial/ethnic socioeconomic status and systemic racism.
PubMed: 37096054
DOI: 10.1089/heq.2022.0127 -
PLOS Global Public Health 2023Sugar sweetened beverage (SSB) taxes are a promising strategy to decrease SSB consumption, and their inequitable health impacts, while raising revenue to meet social...
BACKGROUND
Sugar sweetened beverage (SSB) taxes are a promising strategy to decrease SSB consumption, and their inequitable health impacts, while raising revenue to meet social objectives. In 2016, San Francisco passed a one cent per ounce tax on SSBs. This study compared SSB consumption in San Francisco to that in San José, before and after tax implementation in 2018.
METHODS & FINDINGS
A longitudinal panel of adults (n = 1,443) was surveyed from zip codes in San Francisco and San José, CA with higher densities of Black and Latino residents, racial/ethnic groups with higher SSB consumption in California. SSB consumption was measured at baseline (11/17-1/18), one- (11/18-1/19), and two-years (11/19-1/20) after the SSB tax was implemented in January 2018. Average daily SSB consumption (in ounces) was ascertained using the BevQ-15 instrument and modeled as both continuous and binary (high consumption: ≥6 oz (178 ml) versus low consumption: <6 oz) daily beverage intake measures. Weighted generalized linear models (GLMs) estimated difference-in-differences of SSB consumption between cities by including variables for year, city, and their interaction, adjusting for demographics and sampling source. In San Francisco, average SSB consumption in the sample declined by 34.1% (-3.68 oz, p = 0.004) from baseline to 2 years post-tax, versus San José which declined 16.5% by 2 years post-tax (-1.29 oz, p = 0.157), a non-significant difference-in-differences (-17.6%, adjusted AMR = 0.79, p = 0.224). The probability of high SSB intake in San Francisco declined significantly more than in San José from baseline to 2-years post-tax (AOR[interaction] = 0.49, p = 0.031). The difference-in-differences of odds of high consumption, examining the interaction between cities, time and poverty, was far greater (AOR[city*year 2*federal poverty level] = 0.12, p = 0.010) among those living below 200% of the federal poverty level 2-years post-tax.
CONCLUSIONS
Average SSB intake declined significantly in San Francisco post-tax, but the difference in differences between cities over time did not vary significantly. Likelihood of high SSB intake declined significantly more in San Francisco by year 2 and more so among low-income respondents.
PubMed: 36963015
DOI: 10.1371/journal.pgph.0001219 -
The Journal of Nutrition May 2023Limited research evidence exists on the effects of red meat on gut microbiota in human adults. (Randomized Controlled Trial)
Randomized Controlled Trial
Effects of Adding Lean Red Meat to a U.S.-Style Healthy Vegetarian Dietary Pattern on Gut Microbiota and Cardiovascular Risk Factors in Young Adults: a Crossover Randomized Controlled Trial.
BACKGROUND
Limited research evidence exists on the effects of red meat on gut microbiota in human adults.
OBJECTIVE
We aim to assess the effects of consuming a Healthy U.S.-Style Dietary Pattern (HDP), without or with unprocessed or processed lean red meats, on gut microbiota and fecal short-chain fatty acid (SCFA) levels in healthy young adults. Secondary outcomes are cardiovascular disease risk factors.
METHODS
We conducted a randomized, controlled, crossover trial with 3 3-wk dietary interventions, each separated by a 5-wk washout period with habitual dietary intake. Nineteen participants (8 females, age 26 ± 4 y old, BMI 23 ± 3 kg/m) consumed 3 study diets in random order: 1) healthy lacto-ovo vegetarian diet (LOV); 2) LOV plus 3 ounces/d of cooked unprocessed lean red meat (URM); and 3) LOV plus 3 ounces/d of cooked processed lean red meat (PRM). Fecal and fasting blood samples were collected before and during the last 2 wk of each intervention. We measured fecal bacterial community structure using 16S rRNA amplicon sequencing (V4 region, primers 515F-806R). Community diversity, structure, and taxonomic composition were computed using Mothur v.1.44.3.
RESULTS
The addition of unprocessed or processed lean red meats to a LOV HDP did not influence short-term changes in bacterial taxonomic composition. Independent of red meat intake, the HDP led to changes in 23 bacteria; reductions in serum total cholesterol (TC) and LDL-C concentrations; but no changes in fecal SCFA, serum triglycerides, HDL-C concentrations, TC/HDL-C ratio, or blood pressures. With data from all 3 diet interventions combined, changes in some bacteria were associated with improvements in TC, LDL-C, triglycerides, and HDL-C concentrations, and TC/HDL-C ratio.
CONCLUSIONS
Healthy young adults who adopt an HDP that may be vegetarian or omnivorous, including lean red meat, experience short-term changes in gut microbial composition, which associate with improvements in multiple lipid-related cardiovascular risk factors. NCT03885544, https://clinicaltrials.gov/ct2/show/NCT03885544?cond=NCT03885544&draw=2&rank=1.
Topics: Female; Humans; Young Adult; Adult; Cardiovascular Diseases; Gastrointestinal Microbiome; Cholesterol, LDL; RNA, Ribosomal, 16S; Risk Factors; Diet; Red Meat; Triglycerides; Heart Disease Risk Factors; Vegetarians; Cross-Over Studies
PubMed: 36921804
DOI: 10.1016/j.tjnut.2023.03.013 -
Clinical Pharmacokinetics Apr 2023Cilofexor is a selective farnesoid X receptor (FXR) agonist in development for the treatment of nonalcoholic steatohepatitis and primary sclerosing cholangitis. Our...
Evaluation of the Potential for Cytochrome P450 and Transporter-Mediated Drug-Drug Interactions for Cilofexor, a Selective Nonsteroidal Farnesoid X Receptor (FXR) Agonist.
BACKGROUND AND OBJECTIVE
Cilofexor is a selective farnesoid X receptor (FXR) agonist in development for the treatment of nonalcoholic steatohepatitis and primary sclerosing cholangitis. Our objective was to evaluate potential drug-drug interactions of cilofexor as a victim and as a perpetrator.
METHODS
In this Phase 1 study, healthy adult participants (n = 18-24 per each of the 6 cohorts) were administered cilofexor in combination with either perpetrators or substrates of cytochrome P-450 (CYP) enzymes and drug transporters.
RESULTS
In total, 131 participants completed the study. As a victim, cilofexor area under the curve (AUC) was 651%, 795%, and 175% when administered following single-dose cyclosporine (600 mg; organic anion transporting polypeptide [OATP]/P-glycoprotein [P-gp]/CYP3A inhibitor), single-dose rifampin (600 mg; OATP1B1/1B3 inhibitor), and multiple-dose gemfibrozil (600 mg twice daily [BID]; CYP2C8 inhibitor), respectively, compared with the administration of cilofexor alone. Cilofexor AUC was 33% when administered following multiple-dose rifampin (600 mg; OATP/CYP/P-gp inducer). Multiple-dose voriconazole (200 mg BID; CYP3A4 inhibitor) and grapefruit juice (16 ounces; intestinal OATP inhibitor) did not affect cilofexor exposure. As a perpetrator, multiple-dose cilofexor did not affect the exposure of midazolam (2 mg; CYP3A substrate), pravastatin (40 mg; OATP substrate), or dabigatran etexilate (75 mg; intestinal P-gp substrate), but atorvastatin (10 mg; OATP/CYP3A4 substrate) AUC was 139% compared with atorvastatin administered alone.
CONCLUSION
Cilofexor may be coadministered with inhibitors of P-gp, CYP3A4, or CYP2C8 without the need for dose modification. Cilofexor may be coadministered with OATP, BCRP, P-gp, and/or CYP3A4 substrates-including statins-without dose modification. However, coadministration of cilofexor with strong hepatic OATP inhibitors, or with strong or moderate inducers of OATP/CYP2C8, is not recommended.
Topics: Adult; Humans; Rifampin; Cytochrome P-450 CYP2C8; Cytochrome P-450 CYP3A; Atorvastatin; ATP Binding Cassette Transporter, Subfamily G, Member 2; Neoplasm Proteins; Pharmaceutical Preparations; Drug Interactions; Cytochrome P-450 Enzyme System; Membrane Transport Proteins; Cytochrome P-450 CYP3A Inhibitors; Organic Anion Transporters
PubMed: 36906733
DOI: 10.1007/s40262-023-01214-w -
Frontiers in Nutrition 2023The 2020-2025 Dietary Guidelines for Americans (DGA) includes a Healthy Vegetarian Dietary Pattern (HVDP) with dairy foods and eggs as one of its three recommended...
INTRODUCTION
The 2020-2025 Dietary Guidelines for Americans (DGA) includes a Healthy Vegetarian Dietary Pattern (HVDP) with dairy foods and eggs as one of its three recommended dietary patterns for non-pregnant, non-lactating healthy adults. This study evaluates whether pescatarian, lacto-vegetarian, and "pescavegan" adaptations of the HVDP can be nutritionally adequate if modeled with foods recommended by the DGA.
METHODS
The nutrient composition of these three alternative models of the HVDP were assessed at 1, 800-, 2, 000-, 2, 200-, and 2,400- kcal/day using similar food pattern modeling procedures as the 2020 DGA. For the pescatarian and pescavegan models, 0.5 ounce-equivalent of refined grains per day was replaced with seafood. For the lacto-vegetarian and pescavegan models, eggs were replaced with equal proportions of the other vegetarian protein foods. In the pescavegan model, dairy foods were replaced by a dairy alternative group comprised of fortified soy milk and soy yogurt.
RESULTS
All models at all energy levels were within Acceptable Macronutrient Distribution Ranges (AMDRs) for all macronutrients, contained ≤5% of total kcal from saturated fat, and met recommendations for most micronutrients. Nutrients provided below the Dietary Reference Intakes (DRIs) in these models included iron, sodium, vitamin D, vitamin E, and choline. Micronutrients provided at less than 50% of their respective DRIs included vitamin D and choline.
DISCUSSION
Adapting the HVDP for lactovegetarian, pescatarian, and pescavegan dietary patterns provided adequate amounts of macronutrients and most micronutrients.
PubMed: 36824178
DOI: 10.3389/fnut.2023.1113792 -
JMIR Research Protocols Feb 2023Social and behavioral determinants of health are increasingly recognized as central to effective person-centered intervention in clinical practice, disease management,...
BACKGROUND
Social and behavioral determinants of health are increasingly recognized as central to effective person-centered intervention in clinical practice, disease management, and public health. Accordingly, social prescribing (SP) has received increased attention in recent times. The rampant global prevalence of obesity indicates that the customary, reductionistic, and disease-oriented biomedical approach to health service delivery is inadequate/ineffective at arresting the spread and mitigating the damaging consequences of the condition. There is an urgent need to shift the focus from reactive downstream disease-based treatments to more proactive, upstream, preventive action. In essence, this requires more effort to affect the paradigm shift from the traditional "biomedical approach of care" to a "biopsychosocial model" required to arrest the increasing prevalence of obesity. To this end, an SP approach, anchored in systems thinking, could be an effective means of moderating prevalence and consequences of obesity at a community level.
OBJECTIVE
The proposed SP intervention has the following three key objectives: (1) build a sustainable program for Circular Head based on SP, peer education, and health screening to minimize the incidence of obesity and related lifestyle diseases; (2) increase service and workforce connectivity and collaboration and initiate the introduction of new services and activities for obesity prevention and community health promotion; and (3) enhance health and well-being and minimize preventable adverse health outcomes of obesity and related lifestyle diseases through enhancement of food literacy and better nutrition, enhancement of physical literacy and habitual personal activity levels, and improvement of mental health, community connectedness, and reduction of social isolation.
METHODS
This paper describes a prospective SP strategy aimed at obesity prevention in Circular Head, a local government area in Northwest (NW) Tasmania. SP is a prominent strategy used in the Critical Age Periods Impacting the Trajectory of Obesogenic Lifestyles Project, which is an initiative based in NW Tasmania focused on assessing obesity prevention capacity. A social prescription model that facilitates the linkage of primary health screening with essential health care, education, and community resources through a dedicated "navigator" will be implemented. Four interlinked work packages will be implemented as part of the initial plan with each either building on existing resources or developing new initiatives.
RESULTS
A multimethod approach to triangulate insights from quantitative and qualitative research that enables the assessment of impact on individuals, community groups, and the health care system will be implemented within the initial pilot phase of the project.
CONCLUSIONS
Literature is replete with rhetoric advocating complex system approaches to curtail obesity. However, real-life examples of whole-of-systems interventions operationalized in ways that generate relevant evidence or effective policies are rare. The diverse approach for primary prevention of obesity-related lifestyle diseases and strategies for improvement of health and well-being described in this instance will contribute toward closing this evidence gap.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)
PRR1-10.2196/41280.
PubMed: 36800232
DOI: 10.2196/41280 -
Journal of Nutrition Education and... Apr 2023To examine the dietary behaviors of mothers from very low food security (VLFS) households following the availability of coronavirus disease 2019 (COVID-19) unemployment...
OBJECTIVE
To examine the dietary behaviors of mothers from very low food security (VLFS) households following the availability of coronavirus disease 2019 (COVID-19) unemployment and Supplemental Nutrition Assistance Program benefits.
METHODS
Diet and food security status were obtained from 2,584 California mothers during Federal Fiscal Year 2020. Fruits, vegetables, and 100% fruit juice (FV100%FJ), sugar-sweetened beverages, and water intake, and Healthy Eating Index-2015 scores, were compared across 4 groups (before vs after COVID-19 benefits by VLFS vs non-VLFS households) with race/ethnicity and age as covariates.
RESULTS
Before COVID-19 benefits, VLFS was associated with fewer cups of FV100%FJ (P = 0.010), more fluid ounces of sugar-sweetened beverages (P = 0.004), and poorer diet quality (P = 0.003). After COVID-19 benefits, mothers from VLFS vs non-VLFS households reported similar dietary outcomes. VLFS mothers reported 0.96 (95% confidence interval, 0.53-1.38) more cups of FV100%FJ after COVID-19 benefits.
CONCLUSIONS AND IMPLICATIONS
Coronavirus disease 2019 benefits may have reduced dietary inequities among low-income families. Associations between increased Supplemental Nutrition Assistance Program and unemployment benefits and decreased costs associated with the negative health outcomes linked to food insecurity and poor diets would be of value.
Topics: Female; Humans; Feeding Behavior; Food Supply; COVID-19; Diet; Food Assistance; Food Insecurity
PubMed: 36739249
DOI: 10.1016/j.jneb.2022.10.009 -
BMC Research Notes Feb 2023This article presents the dataset titled "Nutrition habits amongst college students in the United States. [1]" The dataset contains the survey responses of 200 US...
OBJECTIVE
This article presents the dataset titled "Nutrition habits amongst college students in the United States. [1]" The dataset contains the survey responses of 200 US college students aged 18-24 years regarding their knowledge, attitudes, and challenges with regard to nutrition. The recommended USDA (US daily allowance) is 200 calories, comprised of 2 cups fruits, 2.5 cups vegetables, 5.5 ounces of protein, 6 ounces of grains, and 3 cups of dairy [2]. Adhering to these nutritional guidelines however can be complicated by rising tuition prices, food insecurity, and inability to make one's own food.
DATA DESCRIPTION
The data in the dataset attempt to estimate the incidence of these barriers. These data could be useful to understand the barriers to healthy eating amongst young adults, and design targeted solutions.
Topics: Young Adult; Humans; United States; Diet; Students; Fruit; Vegetables; Nutritional Status; Universities
PubMed: 36732844
DOI: 10.1186/s13104-023-06273-7 -
Nutrients Jan 2023The under-consumption of calcium, potassium, fiber, and vitamin D is considered a U.S. public health concern. Shifts in eating patterns that increase the consumption of...
BACKGROUND
The under-consumption of calcium, potassium, fiber, and vitamin D is considered a U.S. public health concern. Shifts in eating patterns that increase the consumption of vegetables, fruits, whole grains, nuts/seeds, and dairy products can help achieve the recommended intakes of these nutrients, leading to healthier diets.
OBJECTIVE
We assessed the impact of adding 1 ounce (28.35 g) of walnuts to usual diets on diet quality and nutrients of concern, including magnesium, fiber, and potassium.
METHODS
We utilized 24 h dietary recalls obtained from the What We Eat in America, National Health and Nutrition Examination Survey (NHANES) and modeled the addition of 1 ounce (28.35 g) of walnuts to the usual diets of no-nut consumers. No-nut consumers aged ≥4 years ( = 7757) from the 2015-2018 NHANES study were included. Population percentages with intakes below the estimated average requirement (EAR) values for calcium, magnesium, folate, and vitamin E and above the adequate intake (AI) values for potassium and fiber were examined. Diet quality was assessed using the Healthy Eating Index-2015 (HEI-2015). The National Cancer Institute method was used to estimate the usual and modeled intakes. Significant differences between usual (current) and modeled intakes were determined using non-overlapping 95% confidence intervals. All analyses included sample weights to account for the NHANES survey design.
RESULTS
Adding 1 ounce (28.35 g) of walnuts to the usual diet resulted in significant reductions in the percentages of adults with intakes below the EAR for magnesium and folate (69.6% vs. 52.0%; 49.2% vs. 40.6%, respectively), and increased the percentage of adults above the AI for potassium (22.8% vs. 26.5%). A similar trend was observed among children (4-18 years). HEI scores improved significantly from 49.1 (95% CI: 48.0-50.4) to 58.5 (95% CI: 57.5-59.6) in children and from 52.4 (95% CI: 51.0-53.8) to 59.2 (95% CI: 58.0-60.5) in adults.
CONCLUSIONS
Adding 1 ounce (28.35 g) of walnuts to the usual diet of no-nut consumers improved the diet quality and adequacy of some under-consumed nutrients.
Topics: Adult; Child; Humans; United States; Nutrition Surveys; Nuts; Juglans; Magnesium; Calcium; Diet; Calcium, Dietary; Folic Acid; Potassium
PubMed: 36678128
DOI: 10.3390/nu15020258 -
Annals of Operations Research Dec 2022This study used information theory and network theory to predict the fluctuations of currency values of the machine learning model. For experiments, we calculate the...
This study used information theory and network theory to predict the fluctuations of currency values of the machine learning model. For experiments, we calculate the causal relationships between currencies using loarithmic return (log-return) and entropic value-at-risk (EVaR) values of gold price per troy ounce in 48 currencies over 25 years. To quantify the causal relationships, we used the concept of transfer entropy. After quantifying their information flow, we modeled and analyzed those nonlinear causal relationships as a network. The network analysis results confirmed that information flow-based nonlinear causal relationships differed from the commonly-known key currency order. Then, we classified currencies using hierarchical clustering methods based on the configured networks. We predicted fluctuations in currency values using machine learning algorithms based on network topology-based information. As a result, we show that using the data columns in the same communities based on statistically significant nonlinear causal relationships can improve most machine-learning-based fluctuations of currency values for various countries from the perspective of data efficiency.
PubMed: 36533279
DOI: 10.1007/s10479-022-05101-8