Impacts of the Farm to Keiki Program: An Anthropological Evaluation.

BackgroundAfrican Americans continue to have suboptimal cardiovascular health (CVH) related to diet and physical activity (PA) behaviors compared with White people. Mobile health (mHealth) interventions are innovative platforms to improve diet and PA and have the potential to mitigate these disparities. However, these are understudied among African Americans.ObjectiveThis study aims to examine whether an mHealth lifestyle intervention is associated with improved diet and PA-related psychosocial factors in African Americans and whether these changes correlate with diet and PA behavioral change.MethodsThis study is a retrospective analysis evaluating changes in diet and PA-related self-regulation, social support, perceived barriers, and CVH behaviors (daily fruit and vegetable intake and moderate-intensity PA [MPA] per week) in 45 African American adults (mean age 48.7 years, SD 12.9 years; 33/45, 73% women) enrolled in the FAITH! (Fostering African American Improvement in Total Health) app pilot study. The intervention is a 10-week, behavioral theory–informed, community-based mHealth lifestyle intervention delivered through a mobile app platform. Participants engaged with 3 core FAITH! app features: multimedia education modules focused on CVH with self-assessments of CVH knowledge, self-monitoring of daily fruit and vegetable intake and PA, and a sharing board for social networking. Changes in self-reported diet and PA-related self-regulation, social support, perceived barriers, and CVH behaviors were assessed by electronic surveys collected at baseline and 28 weeks postintervention. Changes in diet and PA-related psychosocial factors from pre- to postintervention were assessed using paired 2-tailed t tests. The association of changes in diet and PA-related psychosocial variables with daily fruit and vegetable intake and MPA per week was assessed using Spearman correlation. Associations between baseline and 28-week postintervention changes in diet and PA-related psychosocial measures and CVH behaviors with covariates were assessed by multivariable linear regression.ResultsParticipants reported improvements in 2 subscales of diet self-regulation (decrease fat and calorie intake, P=.01 and nutrition tracking, P<.001), one subscale of social support for healthy diet (friend discouragement, P=.001), perceived barriers to healthy diet (P<.001), and daily fruit and vegetable intake (P<.001). Improvements in diet self-regulation (increase fruit, vegetable, and grain intake, and nutrition tracking) and social support for healthy diet (friend encouragement) had moderate positive correlations with daily fruit and vegetable intake (r=0.46, r=0.34, and r=0.43, respectively). A moderate negative correlation was observed between perceived barriers to healthy diet and daily fruit and vegetable intake (r=−0.25). Participants reported increases in PA self-regulation (P<.001). Increase in social support subscales for PA (family and friend participation) had a moderate positive correlation with MPA per week (r=0.51 and r=0.61, respectively).ConclusionsOur findings highlight key diet and PA-related psychosocial factors to target in future mHealth lifestyle interventions aimed at promoting CVH in African Americans.

The purpose of this study is to explore the influence of the social environment, including family and community relationships, on diabetes-related dietary change behaviors in a low-income, predominantly African American community with limited access to healthy foods. Study methods included interviews and focus groups with adults with diabetes and family members of individuals with diabetes in a low-income African American community. In this analysis, interview participants included 11 participants with diabetes, one with prediabetes, and 8 family members or close friends with diabetes. Information from 4 participants with diabetes and 6 with family members with diabetes was included from 6 focus groups. Transcripts were analyzed via thematic iterative coding influenced by social cognitive theory to understand the influence of family and community relationships on dietary change. Participants' social environments strongly influenced diet-related behavioral change. Family members without diabetes provided reinforcements for dietary change for those with diabetes by preparing healthy food and monitoring intake, as well as by adopting dietary changes made by those with diabetes. Family and community members served as sources of observational learning about the potential impacts of diabetes and enhanced behavioral capability for dietary change among people with diabetes by providing dietary advice and strategies for making healthy choices. This study demonstrates the ways in which family and community members can influence dietary change in people with diabetes. Interventions targeting diabetes management should incorporate families and communities as sources of information, learning, and support.

Region-specific nutritious, environmentally friendly, and affordable diets in India

The obesity epidemic in adolescents from Middle Eastern (ME) backgrounds necessitates co-designed and culturally-responsive interventions. This study’s objective was to gather the opinions, attitudes, capabilities, opportunities and motivations of ME adolescents residing in Australia on healthy eating and physical activity (PA) behaviours to inform a future prevention program. Five focus groups were conducted, with 32 ME participants, aged 13–18 years, recruited via purposive and snowball sampling. More participants were female (n = 19) and from lower socioeconomic areas (n = 25). A reflexive thematic analysis was performed using the Capability, Opportunity, Motivation-Behaviour (COM-B) model as the coding framework. Limited nutritional knowledge and cooking skills accompanied by a desire to make dietary changes were reported. Local and school facilities provided adolescents with PA opportunities, but participants declared safety concerns and limited opportunities for females and older grade students. Social support from family and friends were enablers for both healthy eating and PA. Cravings and desire for cultural foods influenced food choices. Individual and/or group approaches using social media and face-to-face format were recommended for future programs. To enable PA and dietary behaviour changes, interventions should be specifically tailored for ME adolescents to improve their nutrition literacy and skills, along with providing safe environments for sport in conjunction with social support.

BackgroundThe diagnosis of prostate cancer (PC) can provide a trigger for dietary change, and there is evidence that healthier diets may improve quality of life and clinical outcomes. However, men’s views about dietary change in PC survivorship are largely unknown. This multi-centre qualitative interview study explored men’s views about dietary change in PC survivorship, to better understand motivations for, and barriers to, achieving desired changes. The role of radical and active surveillance treatments on dietary change and the influence of men’s partners were examined. Focus groups also evaluated stakeholder opinion, including healthcare professionals, about the provision of dietary advice to PC patients.MethodsA multi-centre interview study explored views about diet and motivations for, and barriers to, dietary change in men at elevated risk or diagnosed with PC following prostate specific antigen (PSA) testing. 58 men and 11 partners were interviewed. Interviews and focus groups were undertaken with 11 healthcare professionals, 5 patients and 4 partners to evaluate stakeholders’ opinions about the feasibility and acceptability of providing dietary advice to PC patients. Data were analysed using methods of constant comparison and thematic analysis.ResultsOver half of diagnosed men reported making dietary changes, primarily to promote general or prostate health or facilitate coping, despite their uncertainty about diet-PC links. Interest in dietary advice was high. Information needs varied depending on treatment received, with men on active surveillance more frequently modifying their diet and regarding this as an adjunct therapy. Men considered their partners integral to implementing changes. Provision of dietary advice to men diagnosed with PC was considered by healthcare professionals and men to be feasible and appropriate in the context of a holistic ‘care package’.ConclusionsMany men make positive dietary changes after PC diagnosis, which are perceived by men and their partners to bring psychological and general health benefits and could help future dietary intervention trials. Men and their partners desire more and better dietary information that may support PC survivorship, particularly among those embarking on active surveillance/monitoring programmes. There are opportunities for healthcare professionals to support PC patients both clinically and psychologically by the routine integration of healthy eating advice into survivorship care plans.

The Health Risks of Obesity Have Been Exaggerated.

Certificates of Distinction at USA medical schools are given to students who have shown additional commitment and effort in areas such as global health and social justice. In 2014, the Dean's Certificate of Distinction in Native Hawaiian Health (COD-NHH), at the John A. Burns School of Medicine (JABSOM), was designed to offer more experience and knowledge in Native Hawaiian health, as well as directly benefiting Native Hawaiian communities through personal and cultural growth, service learning and scholarly projects. The COD-NHH utilises the Department of Native Hawaiian Health 'na pou kihi' framework represented by a hale (house). This framework embodies the Native Hawaiian holistic view of health and incorporates traditional values and cultural strengths, critical to ensure that students can work comfortably and effectively in our communities. Activities focus on four 'pou kihi' (pillars): (1) cultural knowledge and space; (2) community/environmental stewardship; (3) knowledge advancement and dissemination; and (4) social justice. The first cohort received their COD-NHH in May 2017. Interest among JABSOM students is expanding. The COD-NHH, though well received, has required some modification including new technology for data collection of requirements. Feedback from the community is positive and continued community partnerships allow for opportunities of engagement with the student.

The relevance of ancient dna to contemporary disease

Prevention of Covid-19 transmission by increasing immunity of the body with protein intake results in changes in people's dietary behavior. Pressure due to changing environment and loss of work leads to the tendency to eat sweet foods, preserved, high in fat and salt. This study aims to determine changes in food consumption patterns in Indonesia during the Covid-19 pandemic. Use a quick assessment of empirical facts about Indonesia's ongoing impact on Covid-19. The research approach framework conceptualizes Covid-19 as a 'Cause', and its effect on changes in food consumption patterns is "Consequent". The data used in this study from study literature uses references from national and international literature. Literature materials in the form of journals, articles, books, and news that discuss the impact of the Covid-19 pandemic on people's behavior, especially food consumption behavior, which can be accessed in electronic media. Pandemic covid-19 in Indonesian society affects food consumption patterns, namely, in adults, consumption of vegetables, fruits, and spices increases. While in adolescence, consumption of sweets and fast food increases. This change in the diet affects immunity. A healthy diet increases immunity and reduces the potential for contracting covid-19. Changes in different diets require a tailored approach to community nutrition fulfillment programs. It is necessary to create a program to raise awareness among young people to implement a healthy diet, and a program to support the consistency of healthy diets that have been formed in the community due to the covid-19 pandemic.

Background: The objective of this research was to review reporting of ethical concerns and community involvement in peer-reviewed systematic reviews or meta-analyses concerning American Indian, Alaska Native, or Native Hawaiian (AI/AN/NH) health. Methods: Text words and indexed vocabulary terms were used to query PubMed, Embase, Cochrane Library, and the Native Health Database for systematic reviews or meta-analyses concerning AI/AN/NH health published in peer-reviewed journals, followed by a search through reference lists. Each article was abstracted by two independent reviewers; results were discussed until consensus was reached. Results: We identified 107 papers published from 1986 through 2012 that were primarily about AI/AN/NH health or presented findings separately for AI/AN/NH communities. Two reported seeking indigenous reviewer feedback; none reported seeking input from tribes and communities. Approximately 7% reported on institutional review board (IRB) approval of included studies, 5% reported on tribal approval, and 4% referenced the sovereignty of AI/AN tribes. Approximately 63% used evidence from more than one AI/AN/NH population study, and 28% discussed potential benefits to communities from the synthesis research. Conclusions: Reporting of ethics and community involvement are not prominent. Systematic reviews and meta-analyses making community-level inferences may pose risks to communities. Future systematic reviews and meta-analyses should consider ethical and participatory dimensions of research.

Long-term dietary intervention reveals resilience of the gut microbiota despite changes in diet and weight

Background By definition, messages in tailored approaches are built to reach a given person, based on her/his specific characteristics and needs. Tailored dietary behavior change interventions have a small but significant effect on dietary behavior change. The majority of these interventions target a few food groups or nutrients, without evaluating the overall diet. Diet optimization is a powerful mathematical method to translate nutrient recommendations into individual-specific food choices. This method is increasingly used in nutrition research, in the fields of public health and diet sustainability. Objective: The aim was to combine tailored approaches and diet optimization in a web application of tailored nutrition counselling. Method and results The web application, called MS-Diet, was developed based on behavior changes techniques, such as: self-monitoring, self-regulatory, tailored feedback and engaging communication techniques. In a first feature, based on user’s data collected online (including answers to a food frequency questionnaire), the user can obtain a picture of the nutritional quality of her/his diet, the diet cost and the level of physical activity. In a second feature, MS-Diet suggests to the user a list of tailored dietary advices to get a healthier diet (i.e., a nutritionally adequate diet), adapted to her/his specific needs and food preferences. With the application, the user is actor in her/his own dietary changes: she/he specifies her/his food preferences and; chooses dietary suggestions that she/he considers achievable. Conclusions This prototype could be a future online health promotion tool which could help individuals to improve their diet or serve as a decision-support tool for health professionals. The evaluation of the tool (e.g. whether the use of the tool results in changes of dietary habits) is warranted before use on health promotion. Key messages MS-Diet demonstrates how diet optimization can be used to design dietary advice adapted to user’s needs and food preferences. MS-Diet is a promising tool to help individuals improving their diet but requires qualitative and quantitative evaluation for further improvements.

Central to many considerations of health-related dietary change is the interpretation given to 'healthy' and 'unhealthy' eating. Results are reported from two studies which investigated people's understanding of these concepts. The first study involved structured interviews with 48 respondents: a wide range of interpretations of healthy and unhealthy eating was found using content analysis techniques. The second study (n = 242) used questionnaires to assess the extent to which different interpretations were endorsed. The extent to which different eating behaviours were perceived as healthy or unhealthy varied greatly. A principal components analysis of perceptions of healthy and unhealthy eating produced five separate factors. Some differences in perceptions were found for people of different age, gender and educational level. Objectively assessed dietary intake and perceived intake were found to be two distinct quantities. 'Healthy' eaters were found to perceive 'healthy eating' slightly differently to 'unhealthy' eaters. The results suggest that lay understanding of healthy eating does generally conform with dietary guidelines, and therefore health promotion priorities should focus on physical and psychological constraints to healthy eating, rather than attempting to increase the public's knowledge as a whole.

Modelling food demand in the 21st century

IntroductionObesity increases the risk of morbidity and mortality. A major driver has been the increased availability of ultra-processed food (UPF), now the main UK dietary energy source. The UK Eatwell...