Diet-related Chronic Diseases Research Articles

English

Healthy eating during adolescence is a fundamental prerequisite for optimal physical growth, psychosocial and cognitive development and prevention of diet-related chronic diseases. This study assessed the dietary habit, nutritional status and associated factors among adolescents in Tamale metropolis, Ghana. An analytical cross-sectional survey of 402 adolescents was used in this study. Semi structured questionnaire was used to solicit information on the adolescents’ socio-demographic characteristics and dietary practices. Descriptive statistics and regression analysis were used to summarize the data and to assess factors associated with the adolescent’s dietary habits and nutritional status. Meal skipping (87.8%), particularly breakfast was observed as the main unhealthy eating habit among adolescents in the Tamale metropolis. The prevalence of underweight, overweight and obesity as observed among adolescents were 26.1, 5.2, and 0.7%, respectively. Adolescents whose caregivers/parents are of low socio-economic status were 27% less likely to practice unhealthy dietary habits compared to those whose parents/caregivers are of high socio-economic status (OR=0.73; 95%CI: 0.54-0.99; P=0.04). The risk of adolescents being underweight as against normal in males was 2.46 times higher (RRR=2.46; 95% CI: 1.50-4.04; P=0.001) compared to the risk of being underweight in females whereas the risk of being overweight or obese as against normal was 57% lower (RRR=0.43; 95% CI: 0.14-1.36; P=<0.001) in males compared to the risk of being overweight or obese in females. More than quarter of the adolescents were underweight and factors such as unhealthy dietary habits, average socio-economic status, and adolescents whose mothers were unemployed were predictors of underweight.    Key words: Adolescents, dietary habit, nutritional status, overweight, underweight, obesity.

Nanostructured steady-state nanocarriers for nutrients preservation and delivery.

Food bioactives possess specific physiological benefits of preventing certain diet-related chronic diseases or maintain human health. However, the limitations of the bioactives are their poor stability, lower water solubility and unacceptable bioaccessibility. Structure damage or degradation is often found for the bioactives under certain environmental conditions like high temperature, strong light, extreme pH or high oxygen concentration during food processing, packaging, storage and absorption. Nanostructured steady-state nanocarriers have shown great potential in overcoming the drawbacks for food bioactives. Various delivery systems including solid form delivery system, liquid form delivery system and encapsulation technology have been developed. The embedded food nutrients can largely decrease the loss and degradation during food processing, packaging and storage. The design and application of stimulus and targeted delivery systems can improve the stability, bioavailability and efficacy of the food bioactives upon oral consumption due to enzymatic degradation in the gastrointestinal tract. The food nutrients encapsulated in the smart delivery system can be well protected against degradation during oral administration, thus improving the bioavailability and releazing controlled or targeted release for food nutrients. The encapsulated food bioactives show great potential in nutrition therapy for sub-health status and disease. Much effort is required to design and prepare more biocompatible nanostructured steady-state nanocarriers using food-grade protein or polysaccharides as wall materials, which can be used in food industry and maintain the human health.

Dietary habits among primary school students in Algadid Althora/Al gazira State: Sudan 2022

Background: Nutrition is essential element. For life. Result of. review showed that nutrition. Has remarkable effects on brain function, so. Protein, iron, iodine, and the consumption of breakfast meal. Have impact on a child’s learning capability and behavior. Healthy eating habits should be established in. early childhood and maintained. Throughout adolescence stage. To attain. Good academic performance and to. Prevent diet-related chronic diseases as obesity and. diabetes mellitus. Objective: To study healthy dietary habits among Sudanese primary and intermediate. school children. In Algadid Althawra at. Algazeira state, and indentify the mostly consumed types of food and factors affect dietary habits. Method and Analysis: Descriptive cross-sectional study of. 235 sample size was conducted in: Moaz-lbn Jabal and Al-shaheed Hamza schools for male Al-gadid Althowra in Al-Gazeira state in Sudan. The data was collected randomly from the students by using structured-interview questionnaire and analyzed by SPSS (Statistical package for the social science) system. Result: Family size and number of children were found to influence the dietary pattern in the school-aged children, most fathers were free workers. About (50.2%) eat meals 3 times per day, (28.1%) tow times, (19.6%) more than three times and (2.1%) once per day. Lunch is the main meal per day in about (58.3%), dinner (35.3%) and breakfast in (6.4%). Lunch consist mainly of carbohydrate in (44.3) of them. About (45.1%) were prefer all types of food, (30.6%) carbohydrate. (16.2%) lipids and (8.1%) proteins. Nearly (78.3%) eat snacks during the day, Indome is the most consumed one about (58.2%) followed by chocolates and sweats (21.2%). Recommendation: Considering the results of this study it is suggested for public health and government torise awareness of the parent's especially mothers. Prepare balance food. And healthy diet contents and promoting provision of healthy diet at school

Food consumption and weight status among students in the third cycle of basic education and their parents: a cross-sectional study

Introduction: Eating behaviors acquired in childhood tend to be perpetuated in adulthood, so adherence to a healthy diet from an early age becomes important to prevent the onset of the occurrence of diet-related chronic non-communicable diseases. The aim of this study is to evaluate the food consumption of students in the third cycle of basic education and their parents and its relationship with weight status. Methodology: This is a cross-sectional study. Data from 358 students and 318 parents living on Terceira Island (Azores, Portugal) were included in the study. A questionnaire was developed to collect sociodemographic, dietary habits and anthropometric data, this was applied between May and June 2015. A food frequency questionnaire was used, and weight and height were used to calculate the body mass index. A descriptive analysis of the variables under study was performed and the Mann–Whitney’s test was used to compare the means between groups. Results: A high prevalence of pre-obesity/obesity (students: 33.0%; parents: 62.4%) was found. Vegetables are consumed most often by parents while fruits, fast food and sweets are consumed more frequently by students. Normal weight students reported a higher frequency of soy, olive oil, sunflower oil, and sweets compared with overweight students, on the other hand overweight parents reported a higher frequency of consumption of milk, pork, fatty fish, potatoes, vegetables, citrus fruits, and sunflower oil, compared with normal weight parents. Conclusions: Given the high prevalence of pre-obesity/obesity found, as well as the high frequency of consumption of unhealthy foods, it is recommended that health promotion measures be taken in these schools.

Multisectoral Strategies Needed to Establish Healthy Portion Size Norms That Disincentivize Hyperpalatable, Energy-Dense Foods and Sugary Beverages in Food Environments Linked to Obesity and Diet-Related Chronic Diseases in the United States

Over 40 y, Americans have consumed larger portions of hyperpalatable, energy-dense foods, sugary beverages, and meals prepared at home and away from home, which have contributed to obesity and diet-related chronic diseases in the United States (US). This perspective article explores synergies between the portion size and food matrix effects, and their associated biological, physiological, environmental, and cultural susceptibilities for populations. Thereafter, we describe evidence of US public- and private-sector initiatives to reduce, standardize, and incentivize portion size norms to align with recommended servings to promote a healthy weight for children, adolescents, and adults. Practitioners could use the Individual plus Policy, System, and Environment (I + PSE) Framework to implement multisectoral strategies for the US government, businesses, and civil society organizations to establish healthy portion size norms aligned with servings recommended by the Dietary Guidelines for Americans 2020–2025, and to disincentivize overconsumption of hyperpalatable products to reduce obesity and chronic disease risks.

Advances in Nutrigenomics and Applications in Public Health: A Recent Update

Nutrition research is achieving new paradigms through recent advances in the field of Nutrigenomics. The application of genomic principles for the identification of relationships between certain specific nutrients with genetic factors is termed “Nutrigenomics”. This knowledge is essential to understanding the risk factors behind diet-related chronic degenerative diseases, which further helps resolve the underlying mechanism of genetic predisposition. Advances in Sciences associated with the study of genes have assisted in developing a deep insight into genetic variants, and gene expression patterns to work out therapeutic responses toward chronic degenerative diseases associated with Public Health. To appraise recent advances in Nutrigenomics with its application in Public health several databases including Pub Med, Google Scholar, Medline etc were investigated in detail. A total of 72 relevant peer-reviewed journal articles were included in this review paper. Nutrigenomics has an important role in comprehending how homeostatic control is maintained and the way metabolic pathways are influenced by nutrient intake. The knowledge of Nutrigenomics helps in working out personalized nutrition strategies for both prevention and management of the diseased situation. The present review article aims to investigate and present a piece of in-depth information about the latest Advances in Nutrigenomics and its application in public health.

Enhancing Capacity for Food and Nutrient Intake Assessment in Population Sciences Research.

Nutrition influences health throughout the life course. Good nutrition increases the probability of good pregnancy outcomes, proper childhood development, and healthy aging, and it lowers the probability of developing common diet-related chronic diseases, including obesity, cardiovascular disease, cancer, and type 2 diabetes. Despite the importance of diet and health, studying these exposures is among the most challenging in population sciences research. US and global food supplies are complex; eating patterns have shifted such that half of meals are eaten away from home, and there are thousands of food ingredients with myriad combinations. These complexities make dietary assessment and links to health challenging both for population sciences research and for public health policy and practice. Furthermore, most studies evaluating nutrition and health usually rely on self-report instruments prone to random and systematic measurement error. Scientific advances involve developing nutritional biomarkers and then applying these biomarkers as stand-alone nutritional exposures or for calibrating self-reports using specialized statistics.

Preventive Care: Improving Health of Medicare, Medicaid, and Children’s Health Insurance Program Patients Through Access to Fresh Fruit and Vegetables

Diet is the number one risk factor for deaths in the United States. Members of marginalized and impoverished communities particularly struggle to afford nutritious food. Poor diets result in health disparities along socio-economic, age, racial, ethnic, indigenous, rural, and urban lines. Despite the ever-growing social and financial burden of diet-related chronic diseases, the U.S. has failed to invest in health care-related dietary policy. This Article proposes produce prescriptions as a national dietary preventive medicine program through Medicare, Medicaid, and the Children's Health Insurance Program (CHIP).Recently, nonprofits, governments, and health care providers have designed innovative produce prescription programs to combat diet-related chronic diseases. In these programs, clinical providers can prescribe subsidized fruit and vegetables to patients. Produce prescriptions empower patients by making dietary change affordable and by motivating patients to improve their health. Numerous studies, pilot projects, and local programs demonstrate that produce prescriptions can improve health care outcomes for individuals from diverse communities. Most at-risk members of our society receive health coverage through Medicare, Medicaid, or CHIP. This Article analyzes how to scale up produce prescriptions within these programs using law and policy.

Associations of Biomarker-Calibrated Healthy Eating Index-2010 Scores with Chronic Disease Risk and Their Dependency on Energy Intake and Body Mass Index in Postmenopausal Women

Prior studies examined associations between the Healthy Eating Index (HEI) and chronic disease risk based on self-reported diet without measurement error correction. Our objective was to test associations between biomarker calibration of the food-frequency questionnaire (FFQ)-derived HEI-2010 with incident cardiovascular disease (CVD), cancer, and type 2 diabetes (T2D) among Women's Health Initiative (WHI) participants. Data were derived from WHI postmenopausal women (n = 100,374) aged 50-79 y at enrollment (1993-1998) at 40 US clinical centers, linked to nutritional biomarker substudies and outcomes over subsequent decades of follow-up. Baseline or year 1 FFQ-derived HEI-2010 scores were calibrated with nutritional biomarkers and participant characteristics (e.g., BMI) for systematic measurement error correction. Calibrated data were then used in HR models examining associations with incidence of CVD (total, subtypes, mortality), cancer (total, subtypes, mortality), and T2D in WHI participants with approximately 2 decades of follow-up. Models were multivariable-adjusted with further adjustment for BMI and doubly labeled water (DLW)-calibrated energy. Multivariable-adjusted HRs modeled a 20% increment in HEI-2010 score in relation to outcomes. HRs were modest using uncalibrated HEI-2010 scores (HRs = 0.91-1.09). Using biomarker-calibrated HEI-2010, 20% increments in scores yielded multivariable-adjusted HRs (95% CIs) of 0.75 (0.60, 0.93) for coronary heart disease; 0.75 (0.61, 0.91) for myocardial infarction; 0.96 (0.92, 1.01) for stroke; 0.88 (0.75, 1.02) for CVD mortality; 0.81 (0.70, 0.94) for colorectal cancer; 0.81 (0.74, 0.88) for breast cancer; 0.79 (0.73, 0.87) for cancer mortality; and 0.45 (0.36-0.55) for T2D. Except for cancer mortality and T2D incidence, results became null when adjusted for DLW-calibrated energy intake and BMI. Biomarker calibration of FFQ-derived HEI-2010 was associated with lower CVD and cancer incidence and mortality and lower T2D incidence in postmenopausal women. Attenuation after adjustment with BMI and DLW-calibrated energy suggests that energy intake and/or obesity are strong drivers of diet-related chronic disease risk in postmenopausal women. The Women's Health Initiative is registered at clinicaltrials.gov at NCT00000611.

A brief self-persuasion intervention to strengthen health-promoting dietary intentions through autonomous motivation

Given the prevalence in obesity and other diet-related chronic diseases among adults in America, methods targeting dietary behavior change are essential. Interventions that aim to increase individuals' autonomous (i.e., self-driven) motivation to engage in health-promoting behaviors are highly effective, however, such interventions are difficult to scale. Thus, the current study tested the efficacy of a brief self-persuasion intervention to change participants' dietary goal content and increase intentions to make healthy dietary decisions, through autonomous motivation. The study also investigated the assumption that appearance-based goals decrease health-promoting behavior. The intervention was administered online to female college students (N = 300). Results showed that inspiring health-based and appearance-based goal content led to higher intentions compared to gaining others’ approval-based goals, indirectly through higher autonomous motivation. Appearance-based goal content also led to higher intentions compared to a control condition. Results imply that there is promise in using a brief, easily administrable, self-persuasion intervention to increase health-promoting dietary behaviors. Additionally, results reflect that bolstering appearance-based goal content can promote health-promoting behaviors, however, more research is necessary to delineate the parameters of the finding.

How community capacity building in urban agriculture can improve food access in predominantly Black communities

ABSTRACT Black Americans face disparate health burdens of diet-related chronic diseases. Black Americans who live in communities with inadequate access to healthy foods are at an even greater risk for disparate health outcomes. Urban agriculture in communities with inadequate access to healthy food can complement the existing traditional food system and can make a difference in the accessibility of fresh fruits and vegetables and subsequently, increase fruit and vegetable consumption. However, integrating urban agriculture into a local food system can be challenging. Community capacity-building efforts have the potential to enhance organizational development and enable collaborations to enhance efforts to incorporate urban agriculture into communities with inadequate food access. This study used Chaskin’s relational framework to describe community capacity-building efforts to enhance urban agriculture in predominantly Black communities. We found that strategies for community capacity building in urban agriculture include building on existing resources, community engagement, expanding organizational capacity, identifying threats to community capacity building, and identifying ideal solutions to enhance community capacity-building efforts. Urban farmers, gardeners, and advocates identified these strategies to strengthen local control of the food environment through sustainable urban agriculture. Additional research is needed to further identify community engagement strategies that emphasize sustainability, such as workforce development efforts, building networks for new growers, and strengthening connections between farmers, gardeners, urban agriculture advocates, and community residents.

Making Healthy, Sustainable Diets Accessible and Achievable: A New Framework for Assessing the Nutrition, Environmental, and Equity Impacts of Packaged Foods

ABSTRACTThere is a growing global consensus among food system experts that diets and how we source our foods must change. The sustainable nutrition community continues exploring the environmental impact and dietary value of foods. Packaged foods have been largely ignored within the dialogue, and if they are addressed, existing frameworks tend to label them all as “ultraprocessed” and uniformly discourage their consumption. This approach lacks the nuance needed to holistically evaluate packaged foods within recommended dietary patterns. Additionally, there is considerable diversity of opinion within the literature on these topics, especially on how best to improve nutrition security in populations most at risk of diet-related chronic disease. In support of addressing these challenges, 8 sustainability and nutrition experts were convened by Clif Bar & Company for a facilitated discussion on the urgent need to drive adoption of healthy, sustainable diets; the crucial role that certain packaged foods can play in helping make such diets achievable and accessible; and the need for actionable guidance around how to recommend and choose packaged foods that consider human, societal, and planetary health. This article summarizes the meeting discussion, which informed the development of a proposed framework based on guiding principles for defining sustainable, nutritious packaged foods across key nutrition, environmental, economic, and sociocultural well-being indicators. Although additional research is needed to substantiate specific metrics in order to operationalize the framework, it is intended to be a foundation from which to build and refine as science and measurement capabilities advance, and an important step toward broader adoption of healthy, sustainable diets.

Perceptions of sugar-sweetened beverages among adolescents in North Carolina.

IntroductionSugar-sweetened beverage (SSB) consumption among adolescents contributes to diet-related chronic disease including obesity, type 2 diabetes, and poor oral health.ObjectiveTo better understand adolescents' perceptions, attitudes, and consumption behaviors around SSBs by conducting virtual workshop discussions with adolescents in NC.Materials and methodsAdolescents ages 11–17 in communities with a high proportion of Supplemental Nutrition Assistance Program (SNAP) eligible households were selected to participate in a series of virtual group workshops during summer 2021. A semi-structured discussion guide was used by a workshop facilitator. Workshop discussions centered around general health perceptions, SSB perceptions, and consumption behaviors. A thematic analysis was used to summarize knowledge, beliefs, attitudes, and perceptions around SSBs.ResultsApproximately 36 adolescents participated across four group workshops. Parents and caregivers influenced adolescents most when it came to making beverage choices. Positive SSB perceptions included liking the taste and the association with special times and social events. Negative opinions focused on associated health risks (diet-related chronic disease and poor oral health). Some adolescents acknowledged SSBs were not healthy but suggested they could be consumed occasionally. Very few participants mentioned any benefits from SSBs; those that mentioned benefits stated they provided energy, replaced electrolytes, and tasted good.ConclusionFindings provide several key insights that can contribute to the development of messages aimed at curbing SSB consumption among adolescents. For example, messages that focus on catching adolescents' attention and sharing short- and long-term health consequences of high SSB consumption resonated with adolescents, but because occasional SSB intake was not seen as consequential, messages that suggest abstinence from SSBs may not be helpful in reducing consumption.

Updated Meal Patterns in the Child and Adult Care Food Program and Changes in Quality of Food and Beverages Served: A Natural Experimental Study.

With diet-related chronic diseases being the largest contributors to U.S. morbidity and mortality, identifying population-level strategies to promote healthier diets is essential. Intervention during early childhood may be particularly important. The Child and Adult Care Food Program (CACFP), a federal nutrition assistance program in the U.S. that supports serving meals and snacks in child care settings, reaches millions of U.S. children. Recent 2017 updates to CACFP’s meal patterns were meant to improve the nutritional quality of food served through CACFP by providing more whole grains, fruit, and vegetables. In this study, we used a natural experimental, longitudinal study of child care centers participating in CACFP compared to nonparticipating centers to assess whether the quality of food and beverages served (per menu analysis) improved following the CACFP meal pattern changes. While we found that CACFP centers were more likely to meet several key nutrition standards in comparison to non-CACFP centers overall, there were no differences in menu quality from before to after the 2017 standards change between CACFP and non-CACFP centers. Nutrition standards for CACFP may need to be further strengthened with adequate financial and technical support given to child care programs for effective implementation.

Integrating Produce Prescriptions into the Healthcare System: Perspectives from Key Stakeholders.

People with low incomes suffer disproportionately from diet-related chronic diseases and may have fewer resources to manage their diseases. The “food as medicine” movement encourages healthcare systems to address these inequities while controlling escalating healthcare costs by integrating interventions such as produce prescriptions, in which healthcare providers distribute benefits for fruit and vegetable purchases. The purpose of this study was to identify perceived facilitators and barriers for designing and implementing produce prescriptions within the healthcare system. Nineteen semi-structured in-depth interviews were conducted with experts, and interviews were analyzed using thematic analysis. Overall, interviewees perceived that produce prescriptions could impact patients’ diets, food security, disease management, and engagement with the healthcare system, while reducing healthcare costs. Making produce prescriptions convenient to use for patients, while providing resources to program implementers and balancing the priorities of payers, will facilitate program implementation. Integrating produce prescriptions into the healthcare system is feasible but requires program administrators to address implementation barriers such as cost and align complex technology systems (i.e., electronic medical records and benefit/payment processing). Engaging patients, clinics, retailers, and payers in the design phase can improve patient experience with a produce-prescription program; enhance clinic and retail processes enrolling patients and redeeming benefits; and ensure payers can measure outcomes of interest.

A Systematic Review of Literature on the Representation of Racial and Ethnic Minority Groups in Clinical Nutrition Interventions

The racial and ethnic disparities in diet-related chronic diseases are major concerns. This systematic review examines the extent to which diet-induced changes in health outcomes, such as cardiometabolic, inflammation, cancer, bone health, and kidney function outcomes, etc., have been reported and discussed by race or ethnicity in randomized trials with 2 or more diet arms that recruited both minority and non-Hispanic White groups. Databases (i.e., PubMed, Cochrane Library, and Web of Science) were searched up to August 2021. Thirty-four studies that discussed effects of defined dietary interventions on health outcomes by racial or ethnic minority group compared with non-Hispanic Whites were included in the systematic review (PROSPERO registration number: CRD42021229256). Acute trials and those with 1 diet arm that accounted for race or ethnicity in their analyses and studies that focused on a single racial or ethnic group were discussed separately. Most studies were conducted in Black compared with White adults testing effects of energy restriction, macronutrient modification, sodium reduction, or variations of the Dietary Approaches to Stop Hypertension (DASH) diet on cardiometabolic outcomes. There was limited focus on other minority groups. Evidence suggests greater blood pressure reduction for Black adults compared with Whites particularly with DASH (or similar) diets. Overall, there was limited consideration for group-specific eating patterns and diet acceptability. Overall risk of bias was low. With emerging precision nutrition initiatives that aim to optimize metabolic responses in population subgroups through tailored approaches, it is imperative to ensure adequate representation of racial and ethnic subgroups for addressing health disparities. Factors that help explain variability in responses such as socioecological context should be included and adequately powered. Given the racial and ethnic disparities in chronic diseases, studying the adoption, maintenance, and effectiveness of dietary interventions on health outcomes among different groups is critical for developing approaches that can mitigate diet-related health disparities.

Metabolic Health Immersion for Medical Education: A Pilot Program with Continuous Glucose Monitors in Medical and Dental Students.

Diet-related chronic diseases are increasing in prevalence and poised to dominate the future careers of current medical students. While the value of nutritionally-informed care and nutrition-based health interventions is increasingly recognized, nutrition education is inconsistently and often inadequately included in medical school curricula. One obstacle to incorporating nutrition into medical and dental school curricula is the density of existing coursework, with incorporation of new material necessitating removal of other material. One solution is to engage students outside the classroom in immersive education in nutrition and metabolism using health-wearables. We report the Metabolic Health Immersion for Medical Education pilot program, spearheaded and designed by Harvard Medical students centering on use of continuous glucose monitors (CGM). Students reported enjoyment with the study, felt encouraged to improve health behaviors, and shared that the experience enhanced their understanding of nutrition and metabolism, was valuable to their medical education, and would influence their future patient care. This study demonstrates proof-of-principle that metabolic health immersion opportunities for health care trainees provide a means of helping to address the current deficit in medical school nutrition education.

Food as we knew it: Food processing as an evolutionary discourse

BackgroundThe Industrial Revolution presented technological advancements that improved shelflife, palatability, convenience, availability, and safety of foods. These advancements led to reduced micronutrient-related diseases, greater food diversity, and enhanced food security; however, their chronic consumption, starting in the 1960s, has been implicated in epidemics of diet-related chronic diseases. Scope and approachThis commentary implies that diet potentially alters the human genome, evidenced by isolated populations consuming high starch versus low starch over successive generations. The control of fire and subsequent application to cooking illustrate that food processing potentially acts as an evolutionary discourse, and selective pressure favors less tooth dentation. Each is important to establish that the lack of whole food structure, the introduction of xenobiotics, and refined components in ultra-processed foods is an evolutionary discourse. Key findings and conclusionsOver the past 100 years, the displacement of dietary patterns that include meals and dishes prepared from whole or minimally processed foods by those increasingly based on ultra-processed foods and drinks has occurred globally. Such rapid, neoteric changes to food choice/diet had not occurred since the onset of bipedally when Neanderthals ventured from the forest searching for new food sources in response to changing climates. Only time can tell if changes imparted by ultra-processed foods being Western Society's staple represent a significant enough environmental discourse to drive evolutionary adaptations. Epidemiological studies are already pointing to the parallel between the globalization of UPF consumption and the rapid emergence of chronic non-communicable diseases worldwide (244 words).

Food Security, Fruit and Vegetable Intake, and Chronic Conditions among Supplemental Nutrition Assistance Program Education Participants Attending Free Food and Produce Events

Non-traditional settings, such as schools, early childhood education programs, and healthcare clinics, can play a critical role in preventing obesity by providing free and nutritious food outside of food pantries to households that are experiencing low or very low food security, particularly during emergency situations. This evaluation study describes a low-income population that attended free food and produce distribution events during the COVID-19 pandemic. In 2021, a cross-sectional survey was administered to this group (n = 1498) to assess their food security status, fruit and vegetable (F+V) consumption, and prevalence of chronic disease condition(s). Program and event assessments were carried out using descriptive, bivariate, and multivariable logistic regression analyses. More than a quarter (26%) of the participants attended the free food events for the first time. Approximately 70% reported some level of low food security, 57% to 64% did not meet F+V intake recommendations, and 37% had a diet-related chronic disease condition. In the adjusted models, households with very low food security had lower odds of meeting F+V recommendations (aOR, 0.41, 95% CI, 0.28, 0.58 and aOR, 0.27, 95% CI, 0.19, 0.39, respectively) and higher odds of having a chronic condition (aOR, 3.49, 95% CI, 2.34, 5.20) than those with high or marginal food security. Given these experiences, future research should examine how safety net food assistance programs can incorporate alternative service/distribution models to improve the nutritional value of the foods they offer.

P134 Produce Prescription Projects: Challenges, Solutions, and Emerging Best Practices - Perspectives from Health Care Providers Across the United States

<h3>Background</h3> Produce prescription programs (PPR) have become increasingly common to address the poor health outcomes associated with food insecurity and diet-related chronic disease. These programs involve "prescriptions" for fruits and vegetables within a routine medical visit for eligible individuals. Benefits of PPRs include increased fruit and vegetable purchasing and consumption, reduced household food insecurity, and improved clinical health outcomes. However, only a few regionally bound studies focus on experience of those health care providers (HCP) who make the ‘prescription.' <h3>Objective</h3> The purpose of this study is to explore HCP perspectives and experiences with PPRs funded by the United States Department of Agriculture Gus Schumacher Nutrition Incentive Program (USDA GusNIP). <h3>Study Design, Setting, Participants</h3> Multiple methods including descriptive survey (n = 34) followed by individual key-informant interviews. Interviewees were HCPs (n = 16) from across the United States recruited through USDA GusNIP PPR networks. Interviews were conducted via videoconference, recorded, and transcribed verbatim. <h3>Measurable Outcomes/Analysis</h3> Transcripts were coded using thematic qualitative analysis methods by three independent coders using Atlas.ti (Mac Version 8.1.1). <h3>Results</h3> Three cross-cutting key themes emerged. First, HCPs shared challenges of PPRs including: lack of time/staff, difficulty with provider and patient engagement, steep "trial and error" learning curve, and formidable barriers related to data sharing and research-related requirements (e.g., Institutional Review Board approval). Second, HCPs elucidated best practices/lessons learned (e.g., establishing a ‘program champion') as a response to the experienced challenges. Third, HCPs expressed robust program satisfaction and desire to expand sustainable PPRs. HCPs also provided a shared understanding of the need for rigorous program evaluation to establish sustained funding and policies, but contextualized this need with the aforementioned challenges with collecting and sharing patient-related data outcomes. <h3>Conclusions</h3> Findings provide emergent best practices and indicate what additional resources are needed to sustainably implement and rigorously evaluate PPRs. <h3>Funding</h3> USDA