Chronic Disease Risk Reduction Research Articles

Role of Mediterranean Diet and Physical Activity in the Prevention and Treatment of Depression

The Mediterranean diet, characterized by an abundance of whole grains, plant foods, olive oil and moderate intake of fish has been associated with a variety of disease outcomes. The Mediterranean diet is recognised as a healthful dietary pattern and has been extensively associated with chronic disease risk reduction. Consumption of food groups in the Mediterranean-based diet has anti-inflammatory and antioxidant properties which improves endothelial function and neuronal membrane composition. Engagement in physical activity, on the other hand, has anti-inflammatory and neuro-chemical effects that sustains cerebral blood flow, improves aerobic capacity and cerebral nutrient supply, and improves secretion of enkephalins and endorphins secreted during exercise.

Sodium Intake and Sodium to Potassium Ratio among New York City Adults in the 2018 Heart Follow-Up Study

BackgroundHigh sodium and low potassium intake are positively associated with blood pressure, a significant risk factor for cardiovascular disease. The mean intake of sodium among United States adults exceeds the chronic disease risk reduction level of 2300 mg/d, whereas potassium intake remains lower than the recommended levels. From 2008 through 2019, there were several local and national initiatives to reduce sodium in New York City (NYC). ObjectivesWe aimed to update and compare estimates of sodium intake among NYC adults overall and by covariates from the 2010 Heart Follow-Up Study (HFUS) with the 2018 HFUS. We also estimated the 2018 sodium-to-potassium ratio to understand overall diet quality among demographic groups. MethodsThis cross-sectional study used sodium and potassium measurements from 24-h urine collection and self-reported data from 2509 and 1656 participants in the 2018 and 2010 HFUS, respectively. The weighted mean daily intake of sodium and the sodium-to-potassium ratio were estimated. T-tests and multivariable linear regression models with tests for interactions were used to compare changes in sodium intake. ResultsThe mean sodium intake of adult New Yorkers in 2018 was 3292 mg/d. Sodium intake did not change from 2010 (3234 mg/d, P = 0.45) to 2018 in the overall population, although there was a decrease in sodium intake among adults 18–24 y old (3445 mg/d to 2957 mg/d, P = 0.05). The daily mean sodium-to-potassium ratio was 1.7 mg/mg. The highest sodium-to-potassium ratios were among Black females 18–44 y old (2.0) and 45–64 y old (2.2) and Black (2.1) and Latino (2.1) males between 18 and 44 y old. ConclusionsThe lack of population-level changes in sodium intake and the high sodium-to-potassium ratios among Black females and younger Black and Latino males suggest that further efforts to reduce sodium in the food supply and address persistent inequities are needed.

Multiprofessional Approach for Chronic Kidney Disease (CKD) Risk Reduction and Prophylaxis in the Kushiro Medical Area

Chronic kidney disease (CKD) is closely related to disorders of various organs of the body and is also a factor in increasing social security costs such as medical costs for dialysis. Multiprofessional public health associations in Kushiro City jointly manage CKD-targeted action as "Kushiro CKD network" composed of medical/dental physicians, nurses, nutritionists and pharmacists. Pharmacists have played a central role in affixing a CKD sticker to a patient's medicine notebook when the patient's estimated glomerular filtration rate (eGFR) <45 mL/min/1.73 m2, in order to highlight the risk of CKD for those patients and related medical staff. There are many drugs that require dose reduction considering for renal function, but we had found cases where renal function was not monitored and pharmaceutical dispensation adjusted before the CKD network started. Therefore, we took this opportunity to investigate the impact of CKD stickers on pharmacists' work. During the period from August 2018 to August 2021, about 3200 CKD stickers were affixed by pharmacists, and about 4500 cases of decreased renal function were detected at pharmacies. In addition, there were 334 cases in which renal function deterioration was identified by the CKD stickers and led to further inquiries, of which 265 cases, or about 80%, resulted in prescription changes. Based on these results, it is considered that CKD stickers are effective method for pharmacies understand renal function deterioration and conduct appropriate prescription reviews. Finally, and perhaps most importantly, the use of CKD stickers can help assure that patients with renal impairment care treated with appropriate medication doses.

Precision Nutrition: The Hype Is Exceeding the Science and Evidentiary Standards Needed to Inform Public Health Recommendations for Prevention of Chronic Disease.

As dietary guidance for populations shifts from preventing deficiency disorders to chronic disease risk reduction, the biology supporting such guidance becomes more complex due to the multifactorial risk profile of disease and inherent population heterogeneity in the diet-disease relationship. Diet is a primary driver of chronic disease risk, and population-based guidance should account for individual responses. Cascading effects on evidentiary standards for population-based guidance are not straightforward. Precision remains a consideration for dietary guidance to prevent deficiency through the identification of population subgroups with unique nutritional needs. Reducing chronic disease through diet requires greater precision in (a) establishing essential nutrient needs throughout the life cycle in both health and disease; (b) considering effects of nutrients and other food substances on metabolic, immunological, inflammatory, and other physiological responses supporting healthy aging; and (c) considering healthy eating behaviors. Herein we provide a template for guiding population-based eating recommendations for reducing chronic diseases in heterogenous populations.

Modelling population-level and targeted interventions of weight loss on chronic disease prevention in the Canadian population

Obesity is a known risk factor for major chronic diseases. Prevention of chronic disease is a top global priority. The study aimed to model scenarios of population-level and targeted weight loss interventions on 10-year projected risk of chronic disease in Canada using a population-level risk prediction algorithm. The validated Chronic Disease Population Risk Tool (CDPoRT) forecasts 10-year risk of chronic disease in the adult population. We applied CDPoRT to the 2013/14 Canadian Community Health Survey to generate prospective chronic disease estimates for adults 20 years and older in Canada (n = 83,220). CDPoRT was used to model the following scenarios: British Columbia's (BC) and Quebec's (QC) provincial population-level weight reduction targets, a population-level intervention that could achieve weight loss, targeted weight loss interventions for overweight and obese groups, and the combination of a population-level and targeted weight loss intervention. We estimated chronic disease risk reductions and number of cases prevented in each scenario compared with the baseline. At baseline, we predicted an 18.4% risk and 4,151,929 new cases of chronic disease in Canada over the 10-year period. Provincial weight loss targets applied to the Canadian population estimated chronic disease reductions of 0.6% (BC) and 0.1% (QC). The population-level intervention estimated a greater reduction in risk (0.2%), compared to the targeted interventions (0.1%). The combined approach estimated a 0.3% reduction in chronic disease risk. Our modelling predicted that population-level approaches that achieve weight loss in combination with targeted weight loss interventions can substantially decrease the chronic disease burden in Canada.

Firmly Establishing Lifestyle Medicine Within the Value Framework.

The rapid growth of Lifestyle Medicine (LM) and Value-Based Care (VBC) are occurring simultaneously yet are not fully aligned in the minds of key stakeholders. Both focus on bending the healthcare cost curve by improving patient outcomes, providing greater access to chronic disease risk reduction services and in the case of LM, driving toward chronic disease remission and reversal. Both require strong physician engagement to be effective and will greatly benefit from thoughtful use of digital health technologies. In this review, key focus areas will be highlighted as foundational aspects in which LM is synonymous with high-value care. Continued efforts in these key areas will ensure that LM becomes the foundation for VBC.

Sodium intake trend and current intake level by meal provision place among the citizens of Seoul.

The diversity of meal provision places has increased in recent years and sodium intake can vary depending on where meals are eaten, particularly in large cities. In this study, an analysis of the recent trends in sodium intake was performed and a comparison of sodium intake level according to meal provision place among citizens of Seoul was performed. Data from a 24-h recall dietary intake survey from the 2010-2019 Korea National Health and Nutrition Examination Survey (KNHANES) were used in order to determine the trends in sodium intake among citizens of Seoul, aged 3-74 years old. (n = 11,811). The trend of daily sodium intake was presented in absolute amount and proportion compared to the chronic disease risk reduction intake (CDRR) for each selected characteristic. A comparison of sodium intake level according to meal provision place by sex and age groups as a total amount per meal (mg), density per meal (mg/1,000 kcal), and proportion of the daily sodium intake was performed using the 2016-2019 KNHANES. Sodium intake levels showed a downward trend from 2010-2019. The highest level of sodium intake was observed for subjects aged 30-49, and the level for males aged 30-49 was 202.8% higher than the CDRR. Results of the analysis of sodium intake per meal according to meal provision place showed that the highest sodium intake was in the order of restaurant meal (RM) > institutional foodservice (IF) > home meal (HM) > convenience food (CF). A higher sodium density (mg/1,000 kcal) was observed for IF compared with RM in most adults. Adults aged over 50 years old consumed more than half of the daily sodium in HM. Significant variation in the level of sodium intake was observed according to sex and age groups, therefore, different approaches and nutrition policies based on meal provision place are needed.

The Nutritarian Women’s Health Study (NWHS): Cohort 1

Plant-based dietary patterns are associated with chronic disease risk reduction, prevention, and reversal. As such, the Nutritarian diet is a dietary plan grounded in the daily consumption of micronutrient-dense, plant-rich foods that satisfy nutrient needs with a corresponding improvement in overall health. The Nutritarian Women’s Health Study was a fully-online intervention that included supportive, automated email messages, with participants self-reporting dietary adherence and anthropometric measurements quarterly. Changes in Body Mass Index (BMI) were not significant. The groups with the lowest baseline Waist-to-Height-Ratio (WHtR) showed an initial increase followed by a decrease. Responses related to dietary adherence showed that most participants easily consumed greens, beans, onions/garlic, berries, and seeds, avoided animal products, alcohol, and refined foods, but had difficulty with regularly consuming mushrooms and tomatoes. A midpoint questionnaire revealed participants consumed an overwhelming amount of their meals/snacks according to the dietary plan and about half found it easy/very easy to eat strictly Nutritarian. A large majority reported a positive change in health from participating in the study. The barriers to following the dietary plan include a busy lifestyle and the opposing views/pressures from friends, family, co-workers, and/or spouse/partner. It is important to evaluate this fully-online approach when considering future interventions.

Prevalence of Excess Sodium Intake and Their Corresponding Food Sources in Adults from the 2017–2018 Brazilian National Dietary Survey

Excessive sodium intake has been related to high blood pressure, a central risk factor for cardiovascular disease. In the present work, updated estimates of sodium intake, the main food sources, and the prevalence of excessive intakes in a nationwide multi-ethnic sample of Brazilian adults (2017–2018 Brazilian National Dietary Survey) were presented. Based on two 24-h recalls adjusted for the within-person variation, the overall median of sodium intake was 2432 mg. The prevalence of adults exceeding the recommended limits (tolerable upper limit, UL, and the chronic disease risk reduction cut-off point, CDRR) was 61% and 56%, respectively. The median sodium intake and proportion of individuals above the limits varied according to the subgroups evaluated. Males and adults (20–29 years) presented the highest excessive sodium intakes, and consequently, lowest adherence rates to UL and CDRR recommendations. The top food sources of sodium were white bread and toast (12.3%), beans (11.6%), white rice (10.6%), beef (7.7%), and poultry meat (5.5%). Given the health benefits of dietary sodium reduction, it would be advisable to enhance the current national initiatives of awareness and educational campaigns’ combined efforts to reduce sodium in processed foods to effectively decrease this micronutrient intake across the Brazilian population.

Dietary Reference Intakes of sodium for Koreans: focusing on a new DRI component for chronic disease risk reduction.

Sodium is a physiologically essential nutrient, but excessive intake is linked to the increased risk of various chronic diseases, particularly cardiovascular. It is, therefore, necessary to accomplish an evidence-based approach and establish the Korean Dietary Reference Intakes (KDRIs) index, to identify both the nutritional adequacy and health effects of sodium. This review presents the rationale for and the process of revising the KDRIs for sodium and, more importantly, establishing the sodium Chronic Disease Risk Reduction Intake (CDRR) level, which is a new specific set of values for chronic disease risk reduction. To establish the 2020 KDRIs for dietary sodium, the committee conducted a systematic literature review of the intake–response relationships between the selected indicators for sodium levels and human chronic diseases. In this review, 43 studies published from January 2014 to December 2018, using databases of PubMed and Web of Science, were finally included for evaluating the risk of bias and strength of evidence (SoE). We determined that SoE of the relationship between dietary sodium and cardiovascular diseases, cerebrovascular disease, and hypertension, was moderate to strong. However, due to insufficient scientific evidence, we were unable to establish the estimated average requirement and the recommended nutrient intake for dietary sodium. Therefore, the adequate intake of sodium for adults was established to be 1,500 mg/day, whereas the CDRR for dietary sodium was established at 2,300 mg/day for adults. Intake goal for dietary sodium established in the 2015 KDRIs instead of the tolerable upper intake level was not presented in the 2020 KDRIs. For the next revision of the KDRIs, there is a requirement to pursue further studies on nutritional adequacy and toxicity of dietary sodium, and their associations with chronic disease endpoint in the Korean population.

Temporal Trends in Dietary Sodium Intake Among Adults Aged ≥19 Years - United States, 2003-2016.

Hypertension, which can be brought on by excess sodium intake, affects nearly one half of U.S. adults and is a major risk factor for heart disease, the leading cause of death in the United States (1). In 2019, the National Academies of Sciences, Engineering, and Medicine (NASEM) established the Chronic Disease Risk Reduction (CDRR) intake, a chronic-disease-specific recommendation for dietary sodium of 2,300 mg/day. Reducing daily sodium to CDRR intake is expected to reduce chronic disease risk among healthy persons, primarily by lowering blood pressure (2). Although the 2019 sodium CDRR intake is equivalent in number to the 2005 Tolerable Upper Limit (UL) released by NASEM (then known as the Institute of Medicine), the UL was intended to provide guidance on safe intake levels, not to serve as an intake goal (2). To describe excess sodium intake in the context of the CDRR intake goal, this report analyzed National Health and Nutrition Examination Survey (NHANES) data from 2003 to 2016 to yield temporal trends in usual sodium intake >2,300 mg/day and in mean sodium intake, unadjusted and adjusted for total energy intake, among U.S. adults aged ≥19 years. The percentage of U.S. adults with sodium intake above CDRR intake was 87.0% during 2003-2004 and 86.7% during 2015-2016. Among U.S. adults overall, no significant linear trend was noted from 2003 to 2016 in unadjusted or energy intake-adjusted mean sodium intake. Small, significant declines were observed in mean usual sodium intake among some groups (adults aged 19-50 years, non-Hispanic White adults, adults experiencing obesity, and adults without hypertension). However, after energy adjustment, only adults aged ≥71 years and Mexican American adults demonstrated significant change in usual sodium intake. Many U.S. adults might be at risk for chronic disease associated with sodium intake above CDRR intake, and efforts to lower sodium intake could improve population cardiovascular health. The results of this report support enhanced efforts to reduce population sodium intake and cardiovascular disease risk, including the Food and Drug Administration's (FDA's) recently released guidance for the reduction of sodium in the commercially processed, packaged, and prepared food supply.

Risk of Micronutrient Inadequacy among Hispanic, Lactating Mothers: Preliminary Evidence from the Southern California Mother's Milk Study.

Micronutrients are dietary components important for health and physiological function, and inadequate intake of these nutrients can contribute to poor health outcomes. The risk of inadequate micronutrient intake has been shown to be greater among low-income Hispanics and postpartum and lactating women. Therefore, we aimed to determine the risk of nutrient inadequacies based on preliminary evidence among postpartum, Hispanic women. Risk of micronutrient inadequacy for Hispanic women (29–45 years of age) from the Southern California Mother’s Milk Study (n = 188) was assessed using 24 h dietary recalls at 1 and 6 months postpartum and the estimated average requirement (EAR) fixed cut-point approach. Women were considered at risk of inadequate intake for a nutrient if more than 50% of women were consuming below the EAR. The Chronic Disease Risk Reduction (CDRR) value was also used to assess sodium intake. These women were at risk of inadequate intake for folate and vitamins A, D, and E, with 87.0%, 93.4%, 43.8%, and 95% of women consuming less than the EAR for these nutrients, respectively. Lastly, 71.7% of women consumed excess sodium. Results from this preliminary analysis indicate that Hispanic women are at risk of inadequate intake of important micronutrients for maternal and child health.

Preexisting Executive Function Deficits and Change in Health Behaviors During the COVID-19 Pandemic.

BackgroundExecutive functions (EF) support engagement in goal-directed behaviors, including several health behaviors. Stressful and cognitively demanding events can disrupt EFs and interfere with health behavior, possibly to a greater extent in those with preexisting EF deficits. This study examined the association between preexisting EF deficits and subsequent negative changes in eating patterns, physical activity, sedentariness, and alcohol/substance use during the COVID-19 pandemic.MethodParticipants were 374 young adults in a follow-up study of the longitudinal, multisite Study of Early Child Care and Youth Development (SECCYD). Preexisting EF deficits were assessed with the Barkley Deficits in Executive Function Scales-Short Form, and personally impactful negative changes in four health behaviors (physical activity, unhealthy eating, sedentary time, alcohol/substance use) during the COVID-19 pandemic were subsequently assessed with the Epidemic-Pandemic Impacts Inventory.ResultsIn ordered logistic regression models, higher preexisting total EF deficits were associated with greater negative impactful changes in physical activity and unhealthy eating, independent of sociodemographic variables, obesity, and (as relevant) accelerometer-based physical activity and pre-COVID-19 diet quality. Socioeconomic status moderated the association between total EF deficits and impactful change in alcohol/substance use, with EF deficits linked to greater impactful change in alcohol/substance use only in higher socioeconomic strata.ConclusionIndividuals with preexisting EF deficits appear more vulnerable to the negative impact of the COVID-19 pandemic on several key health behaviors. As the pandemic unfolds, strategies may be needed to identify those with EF deficits (e.g., screening tools) and provide them with tailored support for chronic disease risk reduction.

The Equity and Effectiveness of Achieving Canada's Voluntary Sodium Reduction Guidance Targets: A Modelling Study Using the 2015 Canadian Community Health Survey-Nutrition.

Background: High sodium intake is a leading modifiable risk factor for cardiovascular diseases. This study estimated full compliance to Canada’s voluntary sodium reduction guidance (SRG) targets on social inequities and population sodium intake. Methods: We conducted a modeling study using n = 19,645, 24 h dietary recalls (Canadians ≥ 2 years) from the 2015 Canadian Community Health Survey—Nutrition (2015 CCHS-N). Multivariable linear regressions were used to estimate mean sodium intake in measured (in the 2015 CCHS-N) and modelled (achieving SRG targets) scenarios across education, income and food security. The percentage of Canadians with sodium intakes above chronic disease risk reduction (CDRR) thresholds was estimated using the US National Cancer Institute (NCI) method. Results: In children aged 2–8, achieving SRG targets reduced mean sodium intake differences between food secure and insecure households from 271 mg/day (95%CI: 75,468) to 83 mg/day (95%CI: −45,212); a finding consistent across education and income. Mean sodium intake inequities between low and high education households were eliminated for females aged 9–18 (96 mg/day, 95%CI: −149,341) and adults aged 19 and older (males: 148 mg/day, 95%CI: −30,327; female: −45 mg/day, 95%CI: −141,51). Despite these declines (after achieving the SRG targets) the majority of Canadians’ are above the CDRR thresholds. Conclusion: Achieving SRG targets would eliminate social inequities in sodium intake and reduce population sodium intake overall; however, additional interventions are required to reach recommended sodium levels.

The Case for a Health at Every Size Approach for Chronic Disease Risk Reduction in Women of Color

The conventional approach to chronic disease management in women of color is a dieting-for-weight-loss approach, which has not been proven to be effective. The purpose of this article is to highlight the shortcomings of the dieting-for-weight-loss approach and demonstrate the potential efficacy of the Health at Every Size approach when working with women of color to prevent and address chronic diseases. The article's areas of focus are weight stigma, bias, and size discrimination; the implications of differing weight perceptions and motivations for change; and weight as the primary determinant of health and biological factors affecting weight.

Reduction in Chronic Disease Risk and Burden in a 70-Individual Cohort Through Modification of Health Behaviors.

IntroductionHealth risk factors, including lifestyle risks and health literacy, are known to contribute to the chronic disease epidemic. According to the Centers for Disease Control and Prevention (CDC), chronic diseases account for 90% of healthcare costs, morbidity, and mortality. In the United States, healthcare providers attempt to modulate a limited set of risks. However, chronic diseases continue to proliferate despite expansion of wellness programs and drugs to manage and prevent chronic conditions. Pandemics, exemplified by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), show that people in good health suffer mortality rates at 10% the rate compared to those with pre-existing chronic conditions. Healthcare costs and morbidity rates often parallel mortality rates. New root-cause risk and health tools that accommodate low health literacy and are linked to personalized health improvement care plans are needed to reverse the chronic disease epidemic. Reported here is a study on 70 manufacturing employees in the Midwest US using a personalized and group approach to chronic disease reversal and prevention which may also find utility in pandemic severity and policy decisions.MethodsHealth, lifestyle, behavior, and motivation data were collected on 70 individuals at the beginning of a nine-month disease reversal and prevention program. The data were updated every two to six months over the period. Inputs included information from a novel health risk assessment, serum biomarkers specific for chronic disease, and traditional medical information. Using all these data we generated robust, personalized, and modifiable care plans that were implemented by the participant and guided by a care team including health coaches and medical providers. Periodic renewal of profile data and biomarkers facilitated adjustment of care plans to optimize the path toward health goals set mutually by the participant and the care team.ResultsNinety percent of participants experienced a favorable reduction in chronic disease biomarkers. The reduction in serum biomarkers coincided with a reduction in disease and risk attributes based on medical chart data and before and after interviews. Hemoglobin A1C, for example, lowered in all but one participant concomitant with reported improved energy and reduced need for medications in the majority of participants. Markers of inflammation lowered across the population. Most importantly each individual reported improvement in their overall health.ConclusionsThis simple, inexpensive, root-cause based risk and health approach generates a “do no harm” action plan that guides a care team, including the participant, on a path to improved health. The data demonstrate that changes in a novel risk calculator score coincide with changes in sensitive biomarkers for chronic disease. When the risks of an individual are reduced, the biomarkers reflect that change with self-reported wellbeing also improved. This program and process may be of value to society plagued with escalating levels of chronic disease and merits further study and implementation.

Eating Pattern and Nutritional Risks among People with Multiple Sclerosis Following a Modified Paleolithic Diet.

Preliminary studies suggest that a modified Paleolithic diet may benefit symptoms of fatigue in progressive multiple sclerosis (MS). However, this diet restricts the consumption of eggs, dairy, and gluten-containing grains, which may increase the risk of micronutrient deficiencies. Therefore, we evaluated the nutritional safety of this diet among people with progressive MS. Three nonconsecutive 24-h dietary recalls were collected from (n = 19) progressive MS participants in the final months of a diet intervention study and analyzed using Nutrition Data System for Research (NDSR) software. Food group intake was calculated, and intake of micronutrients was evaluated and compared to individual recommendations using Nutrient Adequacy Ratios (NARs). Blood was drawn at baseline and the end of the study to evaluate biomarker changes. Mean intake of fruits and vegetables exceeded nine servings/day and most participants excluded food groups. The intake of all micronutrients from food were above 100% NAR except for vitamin D (29.6 ± 34.6%), choline (73.2 ± 27.2%), and calcium (60.3 ± 22.8%), and one participant (1/19) exceeded the Tolerable Upper Limit (UL) for zinc, one (1/19) for vitamin A, and 37% (7/19) exceeded the chronic disease risk reduction (CDRR) for sodium. When intake from supplements was included in the analysis, several individuals exceeded ULs for magnesium (5/19), zinc (2/19), sodium (7/19), and vitamins A (2/19), D (9/19), C (1/19), B6 (3/19), and niacin (10/19). Serum values of vitamins D, B12, K1, K2, and folate significantly increased compared to respective baseline values, while homocysteine and magnesium values were significantly lower at 12 months. Calcium and vitamin A serum levels did not change. This modified Paleolithic diet is associated with minimal nutritional risks. However, excessive intake from supplements may be of concern.

Abstract B095: Eat, Move, Live: An intervention strategy for the reduction of cancer and chronic diseases tailored to the Latina population

Abstract Chronic diseases such as diabetes and obesity have been linked with an increased occurrence of various malignancies. Given that 1 in 3 Latina women will be diagnosed with cancer in their lifetime, it is critical that chronic diseases be targeted. In order to reduce the incidence of cancer and chronic disease among the Latina population, the Eat, Move, Live (EML) program was created. EML is a community-based intervention strategy aimed at reducing the prevalence of chronic disease risk through tailored modifications in lifestyle, nutrition and physical activity. Recruitment for the study occurred through collaboration with community organizations and with the use of flyers, social media, and word of mouth. Through recruitment a total of 48 participants enrolled and 28 completed follow-up data. Participants of the program attended a 5-week series of courses that included a one-hour interactive nutritional education segment aimed at chronic disease risk reduction, a 30-minute food preparation followed by a demonstration, and 30-minute physical activity session. Each of the courses was conducted at a community partner site as a way to increase participation and adherence. Health behaviors, beliefs, demographics, body measurements and biomarkers were taken at baseline and at follow-up. The mean weight at baseline was 174.8 lb and at follow-up was 171.4 lb (p-value &amp;lt;0.001), with a mean weight loss of 3.4 lbs. The mean waist-to-hip (WHR) at baseline was 0.86 and 0.85 at follow-up. Although WHR mean ratio was not statistically significant, there was a reduction in the WHR to 0.85, and according to the World Health Organization a WHR of 0.85 and below is viewed as healthy for women. Mean BMI at baseline was 32.2 and at follow-up was 30.4. BMI data were approaching significance with a p-value &amp;lt; 0.06. Our findings suggest that a tailored community-based intervention strategy can significantly reduce weight loss among the Latina population. This has important implications because weight loss has been linked to a reduction in the risk for cancer and other chronic diseases (1). Following completion of the program, participants shared that before the intervention views of chronic diseases were viewed as irreversible, but after education an improved understanding that modifiable behaviors could result in the prevention/delay of the onset of chronic diseases was observed. Future implications of this program are focused on increasing the retention rate and sustainability of results. Citation Format: Cristal Resto, Mayra Serrano, Katty Nerio, Marisela Garcia, Alejandro Fernandez, Victoria L. Seewaldt. Eat, Move, Live: An intervention strategy for the reduction of cancer and chronic diseases tailored to the Latina population [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B095.

Abstract P356: Modeling the Impact of Flexibility in Fat Levels of Dairy Foods Consumed to Meet Recommendations From the 2015 Dietary Guidelines for Americans Healthy U.S.-style Eating Pattern

Introduction: The 2015 Dietary Guidelines for Americans (DGA) recommends consuming low-fat or fat-free dairy foods due to concerns about excess intake of energy, which can lead to overweight or obesity, and saturated fat, a type of fat that can increase blood levels of low-density lipoprotein cholesterol, a blood biomarker used to predict cardiovascular disease risk. The 2015 DGA recommends limiting intake of saturated fats to less than 10% of calories per day and balancing energy intake. Hypothesis: The objective of this study was to assess the impact of replacing one serving of fat-free dairy foods provided in current models of the 2000-calorie Healthy U.S.-Style Eating Pattern (HUSEP) with one serving of whole- or reduced-fat dairy foods. We hypothesized that this replacement would still result in an eating pattern within calorie, saturated fat, and sodium limits. Methods: Utilizing the same food pattern modeling procedures used for the 2015 DGA, we assessed the energy and nutrient composition of six alternative models of the 2000-calorie HUSEP. In each pattern, we replaced 1 of the 3 servings of the USDA’s fat-free dairy food composite with whole- or reduced-fat dairy products or whole-/reduced-fat dairy composites. The 6 replacement models included replacements with: 1) a whole-fat dairy food composite, 2) a reduced-fat dairy food composite, 3) whole milk, 4) reduced-fat milk, 5) whole-fat cheese, and 6) reduced-fat cheese. Results: In all 6 models, the amount of saturated fat did not exceed 10% of total calories. In models 2, 3, and 4, saturated fat was 9% of total calories. The amount of energy increased slightly in all models. The original HUSEP provided 2003 calories, and the 6 models in this study provided an additional 45 (Model 4) to 94 (Model 5) additional calories. The amount of sodium also increased. The original HUSEP provides 1787 mg of sodium, and these models provided between 2082 and 2683 mg of sodium. While still lower than the current average sodium intake (3,440 mg/d), the amount of sodium in Models 1, 2, 5, and 6 exceeds 2,300 mg/d, the Chronic Disease Risk Reduction Intake level for sodium. Conclusions: Results of this study indicate that some reduced- and whole-fat dairy foods, especially milk, can fit into calorie-balanced healthy eating patterns that also align with saturated fat and sodium recommendations. Allowing some flexibility in fat level of dairy food servings aligns with the 2010 DGA recommendation that calories from solid fats and added sugars are best used to increase the palatability of nutrient-dense foods, which includes milk, cheese, and yogurt.

Moving the Needle on Hypertension: What Knowledge Is Needed?

This review highlights the gaps in knowledge and methodological challenges discussed during the Experimental Biology 2019 expert panel session titled "Moving the Needle on Hypertension: What Knowledge Is Needed?" Hypertension is a critical public health burden. Despite a demonstrated benefit of blood pressure reduction on measures of hypertension-related morbidity and mortality, rates for successful blood pressure control remain low. Dietary sodium reduction has been shown to reduce both systolic blood pressure by approximately 3.2 mm Hg and diastolic blood pressure by 2.3 mm Hg, depending on baseline blood pressure and degree of sodium reduction. The updated Dietary Reference Intakes for adults released by the National Academies of Sciences, Engineering, and Medicine include a Chronic Disease Risk Reduction sodium intake level of 2300 mg/d, highlighting the importance of dietary sodium intake in reducing elevated blood pressure and indicating that reducing intakes to this level is expected to reduce blood pressure and risk of cardiovascular disease. The average US daily sodium intake of 3400 mg/d is well above the Chronic Disease Risk Reduction of 2300 mg/d, suggesting that dietary sodium reduction has the potential to significantly improve public health. Although the National Academies of Sciences, Engineering, and Medicine report presents intake recommendations based on a systematic, comprehensive, and thorough evaluation of the evidence, several challenges to moving the needle on hypertension remain. Success will require a more advanced understanding of sodium and potassium physiology, as well as development of the tools needed to effectively address existing research gaps and reduce barriers to sodium intake reduction.