Dietary Behavior Change Research Articles

Multilevel Influences on Fat, Sugar, Salt, Fruit, and Vegetable Consumption Behaviors Among Urban Indians: Application of the Social Ecological Model

Designing effective interventions for achieving desired dietary behavior changes requires an in-depth study of people’s behaviors situated in sociocultural and interpersonal contexts. Guided by the Social Ecological Model, we explored the individual, family, and social-structural-level influences on dietary behaviors related to consumption of fat, sugar, salt, fruits, and vegetables among urban adults in India. We conducted 10 focus groups with a sample of men and women in diverse socioeconomic groups. Data were explored using framework analysis. Social Ecological Model helped in identifying multilevel influences that facilitated or hindered healthy dietary behaviors: Individual-level influences—awareness of dietary recommendations, self-efficacy, risk perception, and perceived benefits and costs; Family-level influences—family members’ preferences, family norms, family support, and the home environment; and Social-structural influences—societal norms, culture, media, cost, availability and accessibility of fruits and vegetables, and government policies. Overall, the findings indicated the need for a range of multilevel interventions that are more likely to promote and sustain healthy dietary behaviors—for example, improving awareness about dietary recommendations (individual level), promoting positive family norms through involvement of family members (family level), and restricting the use of fat, sugar, and salt in packaged food, and supportive policies for promoting consumption of fruits and vegetables (structural level).

Personalised nutrition technologies: a new paradigm for dietetic practice and training in a digital transformation era

Personalised nutrition technologies: a new paradigm for dietetic practice and training in a digital transformation era

The Mediating Effect of Body Dissatisfaction in Association between Obesity and Dietary Behavior Changes for Weight Loss in Chinese Children

ObjectiveThe aim of this study was to analyze the mediating effect of body dissatisfaction in correlation between obesity and dietary behavior changes for weight loss (DBCWL). MethodsA total of 680 primary and middle school students were included in this study. Their body height, weight, and waistline were effectively measured, and they were also evaluated to assess their body dissatisfaction, perception of dietary behaviors, and DBCWL. The correlation among these factors was analyzed using mediating effect models. ResultsThe prevalence of overweight/obesity and abdominal obesity was significantly higher in males than in females (P < 0.05). Overweight/obesity, abdominal obesity, and body dissatisfaction significantly increased the risk for DBCWL (OR = 2.57, 2.77, and 1.95, respectively). Overweight/obesity and abdominal obesity significantly increased the risk for body dissatisfaction (OR = 6.00 and 4.70, respectively). Significant mediating effects of body dissatisfaction were observed in correlation between overweight/obesity and DBCWL and between abdominal obesity and DBCWL (OR = 2.20 and 1.92, respectively; P < 0.05), and the proportions of mediating effects among the total effects were 48.89% and 46.60%, respectively. ConclusionBody dissatisfaction might play an important mediating effect in association between DBCWL and obesity, which indicates that guiding children to correctly recognize their body might be more conducive than promoting obese children toward weight loss through dietary behavior changes.

Drivers and barriers toward reducing meat consumption

The purpose of this paper is to explore the consumers' attitude and intention toward reducing meat consumption. In exploring such, the influence of social norm, perceived benefits, perceived barrier and environmental concern are examined. A self-administered online survey was employed for data collection. A sample of 298 Australians was analysed through structural equation modelling with SPSS AMOS 25. Social norm, perceived benefits and barriers as well as environmental concerns had significant impact on the consumers’ attitude toward reducing meat consumption. The findings of this paper validate and extend the theoretical framework on dietary behaviour change in particular one that involves reducing the consumption of meat. The findings provide valuable insights to food producers and the food industry, as well as health professionals as it highlights the linkages between meat consumption reduction and a broad array of motivations such as health and care for the environment. The study provides insights into the motivations of individuals to limit their meat consumption. More importantly, it also systematically examines the perceived benefits and barriers of meat consumption thus shedding insights on the opportunities for dietary behaviour change and public health.

Overview of international naturopathic practice and patient characteristics: results from a cross-sectional study in 14 countries

BackgroundNaturopathy is a distinct system of traditional and complementary medicine recognized by the World Health Organization and defined by its philosophic approach to patient care, rather than the treatments used by practitioners. Worldwide, over 98 countries have practicing naturopaths, representing 36% of all countries and every world region. The contributions of naturopaths to healthcare delivery services internationally has not been previously examined. Thus, the primary intention of this research was to conduct an international survey of naturopathic practice and patient characteristics in order to gain insight to the breadth of their practices and the type of clinical conditions routinely encountered.MethodsThe cross-sectional study was conducted in naturopathic clinics in 14 countries within 4 world regions including the European (Portugal, United Kingdom, Switzerland, Spain), Americas (Canada, United States, Chile, Brazil), Western Pacific (Hong Kong, Australia, New Zealand) and African (South Africa). Naturopathic practitioners in each country were invited to prospectively complete an online survey for 20 consecutive cases. The survey was administered in four languages.ResultsA total of 56 naturopaths from 14 countries participated in the study, providing a mean of 15.1 cases each (SD 7.6) and 851 cases in total. Most patients were female (72.6%) and all age categories were represented with a similar proportion for 36–45 years (20.2%), 46–55 years (19.5%), and 56–65 years (19.3%). A substantial majority (75%) of patients were considered by the participant to be presenting with chronic health conditions. The most prevalent category of health conditions were musculoskeletal (18.5%), gastrointestinal (12.2%), and mental illness (11.0%). The most common treatment categories prescribed or recommended to patients by the participants were dietary changes (60.5%), lifestyle and behaviour changes (56.9%), herbal medicines (54.2%) and nutritional supplements (52.1%). Many patients were known by participants to be receiving care from a general practitioner (43.2%) or a specialist medical practitioner (27.8%).ConclusionsNaturopathic practitioners provide health care for diverse health conditions in patients in different age groups. The global population would benefit from researchers and policy makers paying closer attention to the potential risks, benefits, challenges and opportunities of the provision of naturopathic care within the community.

Understanding the association between mother's education level and effectiveness of a child obesity prevention intervention: a secondary analysis of an RCT.

to explain differences in effectiveness of paediatrician-led motivational interviewing (MI) in decreasing body mass index (BMI) between children of mothers with low or high education level. secondary analysis of a randomised control trial. individually randomized controlled trial previously conducted from 2011 to 2013 in the province of Reggio Emilia (Emilia-Romagna Region, Northern Italy). Eligible participants included in the trial were 372 (187 in the MI group and 185 in the control group) overweight children (BMI percentile >= 85th and < 95th) aged between 4 and 7 years, residing in the province of Reggio Emilia and under the care of paediatrician for >= 12 months. The intervention included 5 MI sessions based on the transtheoretical model of addiction and behavioural change delivered at 1, 4, 7, and 12 months after the baseline visit, when families had to define specific goals in changing physical activity (PA) and diet behaviours. primary: BMI score variation (ΔBMI) from baseline to 12 months; secondary: percentage of changes in parent-reported PA and dietary behaviours. a significant effect of MI on ΔBMI in children whose mothers had high education level (ΔBMI = -0.62; 95%CI -0.92;-0.32) were observed. Children of women with high education level in MI group had more improvements in set unstructured PA, decreasing screen time and sweet snacks consumption, while children with less educated mothers had improvements in consuming more vegetable soup and less desserts, sweet snacks, and sugary beverages. Highly educated mothers chose for their children to drink fewer sugary beverages and to increase PA. Less educated mothers most frequently chose as goals having breakfast, eating more fruit and vegetables, eating fewer snacks, and having less screen time. Overall achievement was similar in the two strata for diet goals, but higher for PA goals in the high education level stratum. MI intervention was not effective in reducing BMI in children of mothers with low education level. This does appear to be weakly or not associated with goal choices and achievement within MI, it is rather an effect of unmeasured behaviours which possibly mediate association between MI and BMI reduction.

Salt consumption and the risk of chronic diseases among Chinese adults in Ningbo city

BackgroundChronic diseases have become one of essential public health concerns, leading causes of mortality in China. It is related to the changes in dietary pattern and dietary behavior. The objectives are to assess daily salt intake in Chinese people living in Ningbo and to examine its relationship with health outcomes.MethodsOur study used data from health and nutrition survey in 2017. This study included 2811 adults aged 18–79 years (48% males) from urban and rural areas in Ningbo. A food frequency questionnaire together with demographic, physical and medical questionnaires was used to collect dietary intake, demographic, lifestyle and medical information. Ordinal logistic regression was used in the statistical analysis.ResultsThe mean daily salt intake (13.0 g/day) of the participants was higher than the Chinese dietary reference intake (DRI, 6 g/d), which was related to higher risk of pre-hypertension and hypertension. Stratified by gender, education and lifestyle factors, daily salt intake was only significant in the blood pressure category (male: P = 0.048; less education: P = 0.003; urban: P = 0.006; no regular physical activity: P = 0.005, no regular smoking: P = 0.006). Ordinal logistic regression model shows that daily salt intake was significantly associated with higher odds of developing hypertension.ConclusionThe daily salt intake of the majority of citizens living in Ningbo exceeded Chinese DRI and may increase the risk of hypertension. Moreover, public health intervention of salt restriction is necessarily needed for the prevention and control the ongoing epidemic of chronic diseases.

δ13C and δ15N variation on guanacos in Tierra del Fuego: references for terrestrial foodwebs in a high-latitude island

The guanaco (Lama guanicoe) was a key staple hunted by foragers throughout the Holocene in southern South America. Stable isotope analyses provide insights about guanaco long-term ecology. Particularly, the characterization of prey habitat and feeding behavior in the past is of the utmost interest for zooarchaeological models. Therefore, we evaluate δ13C and δ15N variation in guanacos inhabiting different C3 plant communities in Tierra del Fuego (Argentina). δ13C and δ15N values derived from bone collagen samples (n = 60), both archeological and modern, serve as geographical markers of forest-steppe environments during the late Holocene. Increased isotopic variation in the middle Holocene could be related either to variations in the terrestrial baseline or to changing dietary behavior of guanacos in a fluctuating environment. Measures of isotopic variability did not clearly correlate to hunting strategies, since areas with similar patterns in the exploitation of guanacos show differences in their isotopic niche size and distribution. Among the samples from the southern coast, there is a strong negative correlation between δ13C and δ15N. This is a trend not observed in herbivores from the forests of continental Patagonia, suggesting that different factors structure natural isotopic variation in guanacos from the Fuegian forest. δ13C and δ15N variation on bone assemblages probably reflect that guanacos fed in confined home-ranges, as it is observed in modern populations, and that hunting activities were developed at patches relatively close to the sites.

A Cluster Randomized Trial of a Community-Based Intervention Among African-American Adults: Effects on Dietary and Physical Activity Outcomes.

Evidence of the effectiveness of community-based lifestyle behavior change interventions among African-American adults is mixed. We implemented a behavioral lifestyle change intervention, Heart Matters, in two rural counties in North Carolina with African-American adults. Our aim was to evaluate the effect of Heart Matters on dietary and physical activity behaviors, self-efficacy, and social support. We used a cluster randomized controlled trial to compare Heart Matters to a delayed intervention control group after 6 months. A total of 143 African-American participants were recruited and 108 completed 6-month follow-up assessments (75.5%). We used mixed regression models to evaluate changes in outcomes from baseline to 6-month follow-up. The intervention had a significant positive effect on self-reported scores of encouragement of healthy eating, resulting in an increase in social support from family of 6.11 units (95% CI [1.99, 10.22]) (p < .01). However, intervention participants also had an increase in discouragement of healthy eating compared to controls of 5.59 units (95% CI [1.46, 9.73]) among family (p < .01). There were no significant differences in changes in dietary behaviors. Intervention participants had increased odds (OR = 2.86, 95% CI [1.18, 6.93]) of increased frequency of vigorous activity for at least 20 min per week compared to control participants (p < .05). Individual and group lifestyle behavior counseling can have a role in promoting physical activity levels among rural African-American adults, but more research is needed to identify the best strategies to bolster effectiveness and influence dietary change. Trial Registration: Clinical Trials, NCT02707432. Registered 13 March 2016.

Malaysian adolescents' perceptions of healthy eating: a qualitative study.

To explore the concepts of healthy eating and to identify the barriers and facilitating factors for dietary behaviour change in adolescents. A qualitative study involving twelve focus groups. Two secondary schools in the district of Hulu Langat in Selangor, Malaysia. Seventy-two adolescents aged 13-14 years. Adolescents had some understanding regarding healthy eating and were able to relate healthy eating with the concepts of balance and moderation. The adolescents' perceptions of healthy and unhealthy eating were based on food types and characteristics, cooking methods and eating behaviours. Facilitators for healthy eating were parents' control on adolescents' food choices, feeling concern about own health and body, being influenced by other's health condition, and knowledge of healthy or unhealthy eating. On the other hand, barriers for healthy eating were the availability of food at home and school, taste and characteristics of foods, and lack of knowledge on healthy or unhealthy foods. The findings contribute to a better understanding of the adolescents' concept of healthy eating, as well as the facilitators and barriers to practising healthy eating. Future interventions should include a method of promoting the immediate benefits of healthy eating, the way to cope with environmental barriers for healthy eating, and increasing the availability of healthy food choices at home and in the school environment. The health and nutrition education programmes should also focus on educating parents, as they can be role models for adolescents to practise more healthful behaviours.

A catalogue of UK household datasets to monitor transitions to sustainable diets

There is growing international consensus that current patterns of food consumption are not sustainable and global change is needed. Understanding the mechanisms for a transition towards more sustainable diets requires systematic temporal monitoring at the individual or household level. Whilst many countries collect panel data on food expenditure and dietary intake, these datasets are often not designed to monitor progress towards dietary sustainability, therefore using them to understand how or why diets are becoming more or less sustainable can prove challenging. What is also lacking is a curated dataset catalogue or a library where all relevant data could be easily accessible to enable such evaluation. Our aim was to identify, classify and describe existing food expenditure and diet datasets available in the UK and to assess the extent to which they can be used to monitor transitions to sustainable diets. We found that despite the large number of datasets tracking UK individual or household food purchases and consumption over time, these datasets are not suited to understand how and why individuals are transitioning to sustainable diets. With the exception of proprietary datasets, most datasets only collect data annually, making it challenging to understand fine-scale behavioural change over shorter timeframes. There is an opportunity to design and implement an open-access UK sustainable diets data collection effort at the individual and household level. These efforts can be complemented with recent innovations in data science methods and digital technologies – such as dietary intake trackers – that, along with supporting individuals in their dietary behaviour change, may enable the collection of high-quality datasets.

The effects of if-then plans on weight loss: results of the 24-month follow-up of the McGill CHIP Healthy Weight Program randomized controlled trial

BackgroundCurrent evidence suggests that some of the most effective weight loss approaches are changes in dietary and physical activity behaviors through lifestyle modification programs. The Group Lifestyle Balance (GLB) program is a group-based behavior modification program aimed at changing diet and physical activity for weight loss. It was developed to be more cost-effective and easier to disseminate than its individually administered parent program, the Diabetes Prevention Program (DPP). However, the average weight loss following participation in the GLB is only approximately 3.5%, with low long-term weight loss maintenance.PurposeWe aimed to optimize the weight loss outcomes of the GLB to increase the efficacy already afforded by its cost-effectiveness and ease of dissemination. We did this by integrating the habit formation tool of if-then plans into the program. This program is called the enriched GLB or the McGill Comprehensive Health Improvement (CHIP) Healthy Weight Program. Results at 3 and 12 months of participation have already been published elsewhere. They showed no between-group differences between the standard and enriched GLB but higher weight loss in both groups compared to the DPP. This paper reports the long-term weight loss maintenance data following participation in the program.MethodsOf the 172 participants enrolled at the beginning of the study, data from 110 participants were available and analyzed at 24 months, i.e., 12 months after the end of the 12-month intervention.ResultsNo between-group difference in weight loss maintenance was observed. Pooled results showed a significant weight regain from 12 to 24 months, i.e., an average of 7.85 lbs. of the 20.36 lbs. lost. However, participants from both groups were still 12.51lbs or 6.13% lighter at 24 months than at baseline.ConclusionIf-then plans did not result in a higher percentage of weight loss at 24-month follow-up compared to the standard GLB. However, at 24 months, both groups did show a maintenance of a significant portion of the weight lost at the end of intervention.Trial registrationClinicalTrials.gov Identifier: NCT02008435, registered 6 December 2013.

Caregiver involvement in interventions for improving children's dietary intake and physical activity behaviors.

CITATION: Morgan, E. H., et al. 2017. Caregiver involvement in interventions for improving children’s dietary intake and physical activity behaviors. Cochrane Database of Systematic Reviews, 2:1-19, Art. CD012547, doi:10.1002/14651858.CD012547.

Recursos terapêuticos e motivação para mudança de comportamento em adultos encaminhados para cirurgia bariátrica

Bariatric surgery is considered an important strategy to control obesity, however it must be indicated only after the failureof clinical treatments. The aim of this study was to investigate the degree of obesity, the presence of comorbidities andtherapeutic resources used in the treatment of obesity in patients referred for bariatric surgery, as well as to identify thestage of motivation for changing their dietary behavior. This was a cross-sectional study that investigated 44 patientsreferred for bariatric surgery in the municipality of Diadema-SP. The electronic medical records were consulted to collectanthropometric data, biochemical tests, presence of comorbidities and previous treatments for obesity. Face-to-faceinterviews were conducted with a sub-sample (n=16) for a more detailed investigation of the therapeutic resources: dieting,physical exercise and use of drugs. The motivational stage for changing behavior was assessed by a questionnaire based onthe trans-theoretical model, containing 5 closed questions about changes in eating habits within the previous six months.It was found that 91% of individuals had grade II and III obesity, 43% arterial hypertension and 34% diabetes mellitus.Among the interviewees, 88% reported monitoring with SUS for more than 2 years, 81% underwent pharmacologicaltreatment, 38% practiced physical exercise, 88% followed some diet and 19% reported monitoring with a nutritionist.The most observed motivational stage for changing dietary behavior was action (56%). It is concluded that the individualsreferred for bariatric surgery had a high degree of obesity and risk of comorbidities, and that several therapeutic strategies,mainly pharmacological treatments and trending diets, had already been adopted.

Factors Associated with Tendency for Weight Loss in a Representative Sample of Children and Adolescents: The CASPIAN-V Study.

Background:This study aims to determine the factors affecting the tendency to lose weight (TLW) and its methods in Iranian children and adolescents.Methods:In this cross-sectional nationwide study 14800 students, aged 7–18 years, living in 30 provinces of Iran were selected via multistage cluster random sampling method. The dietary and physical activity habits and TLW as well as psychosocial health status, anxiety, self-satisfaction, and change in dietary behaviors were assessed by the global school-based student health survey (WHO-GSHS) questionnaire. Multivariate logistic regression model was used to identify factors influencing TLW.Results:Overall, 14274 students (participation rate of 99%), consisting of 51% boys and 71.4% urban residents, completed the study. Of them, 37.7% (51.4% Girls and 48.6% boys) tended to lose weight. In multivariate model, the odds for TLW was 12% higher in students aged 13–18 years than those aged 6–12 years (OR = 1.12, 95% CI: 1.02 to 1.23; P < 0.001). Students with high anxiety level were 43% more likely to have TLW (OR = 1.43, 95% CI: 1.28–1.59; P < 0.001). The odds of increasing physical activity for weight loss was 22% lower in obese than in normal weight students (OR = 0.78, 95% CI: 0.66 to 0.93; P < 0.001).Conclusions:TLW was significantly higher in girls, as well as in those with higher anxiety level. In addition to dietary change, increasing physical activity should be encouraged among children and adolescents with excess weight. Public education regarding proper lifestyle change for reaching healthy weight should be underscored.

Role the awareness of healthy nutrition and lifestyle for improving dietary behavior and the bodily status of employees agri-food industry

AbstractIntroduction:Awareness and education Nutritional contribute to the voluntary improvement of dietary behaviour and adopting healthy lifestyle. In a work environment, nutrition education falls under the social responsibility of the employer to promote healthier dietary choices. This study aims to assess the impact of nutrition education on dietary behaviour, lifestyle and body composition on a group of industry workers.Materials and Methods:A group of 44 workers have volunteered to participate to this 6 months’ trial. Participants were aged between 28 and 58 years old (43% women and 57% men). All participants have completed a cap-score questionnaire at the beginning and end of the study, the questionnaire was organised into 3 sections: food groups, dietary behaviour, and lifestyle. Anthropometric measurements (height, weight, BMI, muscle mass, fat mass, hip circumference and waist circumference) were monitored during the study. Nutrition education sessions addressed 4 topics including healthy lifestyle. Participants were free to attend to any of the workshops.Results:Only fifteen participants attended all sessions. Data showed that obesity lowered by 28.6% and overweight increased by 32.6%, body composition changes were not significant. Changes in dietary behaviour were not significant, while scores of food groups and lifestyle changed significantly (p = 0.053 and p = 0.042 respectively).Discussion:This study reveals the commitment of workers to nutrition education which could be a part in improving their dietary choices, their health and their productivity.

Change in disparities of dietary quality score (FSAm-NPS) in adolescents and young adults between 2004 and 2014 in Belgium

AbstractIntroductionThe transition from adolescence toward adulthood is a critical period regarding changes in dietary behaviours. Moreover at these ages, socio-economic and regional disparities in food group consumption are observed. The aim of our study was to determine how the nutritional quality of diet, measured by the modified Nutrient Profiling System of the British Food Standards Agency (FSAm-NPS), evolved between 2004 and 2014, according to socio-economic and regional characteristics of adolescents and young adults living in Belgium.Material and methodsTwo non-consecutive 24-hour dietary recalls were carried out in two nationally-representative samples of 15-to-39-year-old respondents included in the Belgian Food Consumption Surveys in 2004 (n = 1,186) and 2014 (n = 952). Weighting factor (according to age, gender, day of recall, season and province) and sample design were considered. The weighted mean individual FSAm-NPS was computed from all foods and beverages consumed and converted into a scale from 0 (less favourable diet) to 100 (more favourable diet). Slope (SII) and Relative (RII) Index of Inequality were compared between 2004 and 2014 in three age groups (15–18 y, 19–25 y and 26–39 y), adjusting for gender, energy intake, and other socio-economic and regional characteristics.ResultsIn the three age groups, the weighted mean FSAm-NPS significantly increased between 2004 and 2014 (2004: 55.2 (SEM: 0.2) vs. 2014: 57.3 (0.5), p &lt; 0.001 in 15–18-year-olds; 54.9 (0.6) vs. 58.0 (0.4), p &lt; 0.001 in 19–25-year-olds; 56.9 (0.3) vs 58.3 (0.3), p &lt; 0.01 in 26–39-year-olds). While a significant FSAm-NPS gradient was observed according to household education among 15–18- and 26–39-year-olds in 2004 (adjusted SII: 2.56 (95% CI: 1.08–4.04) and 2.73 (0.34–5.12), respectively; RII: 1.05 (1.02–1.08) and 1.05 (1.01–1.09)), no significant difference was found in 2014. Conversely, no significant score disparity was observed according to household type in 2004, but disparities appeared in 2014: index of inequality were significant among subjects aged 19–25 y (SII: 3.89 (0.62–7.17); RII: 1.07 (1.01–1.13)) and 26–39 y (SII: 2.74 (0.31–5.17); RII: 1.05 (1.01–1.09)), the FSAm-NPS being more favourable for those living in two-parent families. The FSAm-NPS was generally higher for subjects living in Flanders than those in Wallonia (significant SII and RII only among 26–39-year-olds), the magnitude of regional disparities remaining stable over time.DiscussionOverall FSAm-NPS improved during this 10-year period, but differentially according to family structure and household education. However, statistical power was weakened by the limited sample size. Additional investigations of changes in food group consumption disparities will complement our interpretations.

Improvement of osteoporosis-related behaviors in female students based on trans theoretical model.

BACKGROUND:Osteoporosis is one of the major problems associated with aging and is more common among women than men. This study was designed to modify osteoporosis-related behaviors in female students based on the transtheoretical model (TTM).MATERIALS AND METHODS:This quasi-experimental study was conducted on female secondary school students. The sample size was determined 100 by using Altman's nomogram, including 50 cases and 50 controls. Participants were completed the Demographic Information and Osteoporosis-Related Behavior Questionnaire based on TTM. Evaluation of the data showed that each participant was at what stage of change in physical activity and preventive dietary behavior of osteoporosis. The content of the training package was designed, and for the intervention group, 2-h training sessions were held weekly by the instructor in accordance with the stage of change for 2 months, and the booklet was provided with the appropriate contents of the stage of change. Three months after the completion of training, the questionnaires were completed by intervention and control groups. Statistical analysis was performed using SPSS 23 software.RESULTS:Concerning the stages of change in physical activity and nutrition, a significant difference was before and after the intervention in the intervention group (P < 0.001), while no significant difference was observed in the control group. After the intervention, there was a significant difference in the self-efficacy and some subconstruct of processes of change, but there wasnot a significant difference in the decisional balance.CONCLUSION:Educational intervention based on TTM has been successful in achieving the goal of modifying osteoporosis-related behaviors in female students. The results of this study can be used by health planners to plan and implement health promotion interventions that will undoubtedly help reduce the burden of disease.

Effects of HuoxueJiangtang decoction alone or in combination with metformin on renal function and renal cortical mRNA expression in diabetic nephropathy rats

Context HuoxueJiangtang decoction (ZY) is a traditional Chinese medicine for the treatment of diabetes. Objective The protective effect of ZY on renal injury in diabetic nephropathy rats was investigated in this study. Materials and methods Fifty 4-week-old SPF Wistar male rats were selected to construct diabetic nephropathy model rats (DN) group by continuous high-fat feeding for 4 weeks, followed by a tail vein injection of 30 mg/kg streptozotocin for 1 week. The experimental rats were divided into six groups of 10 rats: normal (control), DN, DN + ZY, DN + metformin, DN + metformin + ZY, and DN + metformin + captopril (positive control) groups. Among the groups, 6.25 g/kg ZY, 250 mg/kg metformin, and 17.5 mg/kg captopril were given to the rats by gavage once a day for 16 weeks. Blood glucose, dietary behaviour, biochemical indicators, and gene expression changes were measured in each group. Results Metformin + ZY treatment significantly lowered blood glucose, water intake, urine total protein, urine albumin, urine volume, serum triglyceride, and serum cholesterol levels in the DN group. The pathological changes of kidney tissue showed that the DN + metformin + ZY group had a protective effect on kidney tissue damage. And ZY and metformin + ZY treatments repaired the expression of genes in the DN group. Discussion and conclusion The ZY and metformin combined treatment showed a clear therapeutic effect on kidney damage in DN. This study provides a potential mechanism for the treatment of diabetic nephropathy with ZY combined with metformin.

You are What You Think Your Social Network Eats: Public Housing, Social Networks, and Fast-Food Consumption.

High-sodium diets (e.g., fast-food intake, FF) may contribute to increased hyper-tension risk among low-income populations. We examined the association between FF intake and perceived social-network member FF intake among Baltimore public housing residents. We analyzed 2014-2015 cross-sectional data. Our dependent variable was FF intake (eating FF weekly versus not), and our independent variable was perceiving one or more network member eating FF weekly. We used multivariable Poisson regression with robust variance, adjusted for individual and network covariates. The 266 public housing residents had mean age 44.5 years: 86.1% women, 95.5% African American, 56.8% hypertension, and 42.8% who ate FF weekly. Residents were significantly more likely to eat FF weekly if they perceived that their network contained one or more members who consumed FF weekly (relative risk 1.50, 95%CI 1.05-2.14, p=.02). Given the association between personal and social network consumption of FF weekly, further investigation may be warranted of novel social network interventions for dietary behavior change.