Healthy Dietary Behaviors Research Articles

Female Endurance Runners Have a Healthier Diet than Males-Results from the NURMI Study (Step 2).

Sex has been recognized to be an important indicator of physiological, psychological, and nutritional characteristics among endurance athletes. However, there are limited data addressing sex-based differences in dietary behaviors of distance runners. The aim of the present study is to explore the sex-specific differences in dietary intake of female and male distance runners competing at >10-km distances. From the initial number of 317 participants, 211 endurance runners (121 females and 90 males) were selected as the final sample after a multi-level data clearance. Participants were classified to race distance (10-km, half-marathon, marathon/ultra-marathon) and type of diet (omnivorous, vegetarian, vegan) subgroups. An online survey was conducted to collect data on sociodemographic information and dietary intake (using a comprehensive food frequency questionnaire with 53 food groups categorized in 14 basic and three umbrella food clusters). Compared to male runners, female runners had a significantly greater intake in four food clusters, including “beans and seeds”, “fruit and vegetables”, “dairy alternatives”, and “water”. Males reported higher intakes of seven food clusters, including “meat”, “fish”, “eggs”, “oils”, “grains”, “alcohol”, and “processed foods”. Generally, it can be suggested that female runners have a tendency to consume healthier foods than males. The predominance of females with healthy dietary behavior can be potentially linked to the well-known differences between females and males in health attitudes and lifestyle patterns.

The Effect of Food Advertisements on Social Media on the Dietary Behaviors of the Community of King Faisal University in Saudi Arabia

ObjectivesThis study aimed to evaluate the effect of food advertisements on social media (Twitter, Snapchat, Facebook, and Instagram) on the dietary behaviors of 550 members (58% female) of a Saudi university (King Faisal University) through an electronic questionnaire.MethodsThe study design is cross-sectional, and an electronic questionnaire was used. The Pearson correlations were used to evaluate the relationship between food advertisements on social media watched daily and participants’ body mass index (BMI) and dietary behaviors. The one-way ANOVA analysis was used to analyze the differences between participants watched food advertisements on social media daily based on their body mass index and demographic data.ResultsOver 50% of the participants were students, single, healthy, normal weight, and with a household income of less than SR 1,600. The most used social media networks that viewed at least 3 food advertisements daily were Snapchat (46%) and Instagram (30%). The study findings revealed there was a low relationship (−0.14) between the participants’ body mass index and the number of food advertisements on social media watched daily. However, there was a high relationship (0.794) between food advertisements on social media watched daily and participants’ dietary behaviors, such as consuming high amounts of fast foods. Moreover, the one-way ANOVA analysis findings showed that single and divorced males with a low household income were the most affected group by food advertisements on social media watched daily.ConclusionsThe study suggested taking the necessary actions to raise awareness and educate the public about healthy dietary behaviors, especially when selecting and purchasing foods advertised on social media networks.Funding SourcesNone.

Culturally Tailored Nutrition Education for Promoting Healthy Dietary Behavior and Reducing Body Weight and Waist Circumference Among Bhutanese Adults in Massachusetts

ObjectivesRefugees bear a high burden of diet-related chronic diseases due to unhealthy eating habits. Culture strongly influences their dietary behavior; however, culturally tailored nutrition education intervention targeted at refugees is limited. We assessed the effect of culturally-tailored nutrition intervention to promote healthy dietary behavior and reduce body weight and waist circumference among Bhutanese adults in Massachusetts. MethodsA community-based nutrition education intervention (once a week of 60 mins for 3-week) was implemented among 44 Bhutanese adults resettled in Massachusetts with a pre-post test evaluation. The intervention focused on the health benefits of nutrients, healthier food choices, healthy cooking techniques, healthy eating plate, and hands-on activities to make a weekly diet plan. We measured body weight and waist circumference, and dietary behavior (green leafy vegetables, colored vegetables, fruits, salad, meat, egg, rice, curry, milk, and sugary drinks, etc.) using a food frequency questionnaire before and after the intervention. We used paired t-tests for continuous and McNemar tests for categorical variables to analyze the pre-and post-test differences. ResultsAll participants completed intervention sessions, along with pre-and post-intervention assessments. The mean (SD) age of the participants was 30.6 (11.5) years, and duration in the US was 5.6 (2.9) years. The proportion of participants eating a healthy food at least one time per day increased significantly from pre- to post-intervention: fruits (29.5% vs. 72.7%), green leafy vegetables (29.5% vs. 75%), colored vegetables (25% vs. 61.4%), salad (18.1% vs. 52.3%), milk (27.2% vs. 47.7%), and egg (18.2% vs. 40.9%) (p < 0.001). Intake decreased significantly for rice (72.7% vs. 20.4%), meat (25% vs. 2.3%) and sugary drinks (27.3% vs. 4.5%) (p < 0.01). The mean body weight decreased significantly by 1.4 kg (67.0 kg vs. 65.6 kg) and waist circumference by 3.3 cms (90.2 cms vs. 86.9 cms) (p < 0.01). ConclusionsCulturally tailored nutrition education intervention improved healthy food consumption and reduced body weight and waist circumference among Bhutanese adults. This program should be evaluated with larger populations at community levels. Funding SourcesUniversity of Massachusetts Amherst.

Diet Quality, Dieting, Attitudes and Nutrition Knowledge: Their Relationship in Polish Young Adults-A Cross-Sectional Study.

The purpose of this study was to examine the relationships between diet quality, dieting, nutrition knowledge and attitudes in a group of Polish young adults. A cross-sectional survey was conducted in 2018 amongst 638 students of food and nutrition-related majors. Based on the frequency of consumption of 24 food groups, the “Pro-Healthy Diet Index” (pHDI) and “Non-Healthy Diet Index” (nHDI) were calculated. To assess the nutrition knowledge, the “GAROTA” test was used. The k-means clustering method was used to identify clusters-attitudes towards food and nutrition. The relationships between pHDI and nHDI indices, dieting, nutrition knowledge (NK), and attitudes towards food and nutrition were verified, using multiple linear regression analysis. The results confirmed some relationships between the variables. Higher nHDI characterized males (p < 0.0001) and people with more unfavorable attitudes towards food and nutrition (p < 0.0001), and those not using a diet (p < 0.0001). Higher nutrition knowledge (p < 0.0001) and higher BMI (p = 0.0370) were correlated with lower nHDI. Higher pHDI characterized people with more favorable attitudes (p < 0.0001) and those using a diet (p = 0.0002). Nutrition knowledge showed an adverse association with nHDI (r = −0.172, p < 0.05) and no association with pHDI. Thus, declarative nutrition knowledge does not seem to be a good indicator of healthy dietary behavior. Nutrition education programs that concentrate only on knowledge of facts, and neglect the development of favorable attitudes towards food and nutrition, may not be efficient enough to develop adequate dietary behavior of students.

Dietary intake and its associated factors among in-school adolescents in Ghana.

Early-life nutrition related experiences may fuel the emergence of obesity and type 2 diabetes in adolescence. The adoption of unhealthy dietary practices early in life is an indicator of adverse cardiometabolic health in adulthood. In-school adolescents' dietary practices in Ghana have not been explored extensively despite increasing levels of obesity in adolescents. This study sought to examine dietary practices, socio-demographic disparities and the factors influencing dietary choices among in-school adolescents in Ghana. A school-based, cross-sectional study was conducted in the Central region of Ghana in 2017. Using multistage sampling procedures, a total of 1,311 in-school adolescents were selected for the study. A modified version of the generic Global School Health Survey questionnaire on dietary practices was adapted and used for data collection. Percentage and frequency counts were used to report on the dietary practices, while Chi-square was used to determine socio-demographic variations in the dietary practices. Binary logistic regression was used to compute the influence of socio-demographic characteristics of respondents on the prevalence of healthy dietary behavior among in-school adolescents. The study revealed the prevalence of healthy dietary practices (49.9%, n = 654) among in-school adolescents in the region. The study also found increased frequency in consumption of soft drinks (93%, n = 1220) and toffees/sweets (90%, n = 1183) among in-school adolescents. However, low intake of breakfast (57%, n = 749) was observed among the adolescents. Significant disparities were observed in relation to gender, age, parental communication, academic performance and geographical location in the dietary practices of in-school adolescents. Furthermore, gender (OR = 1.36, P = 0.007), academic performance (OR = 2.19, P = 0.001) and geographical location (OR = 1.79, P = 0.001) were found to be significantly associated with dietary practices among in-school adolescents in the region. There was low consumption of fruits and vegetables among adolescents. Fruits and vegetables consumption was associated with gender, academic performance and geographical location, and these may be a reflection that knowledge on healthy food choices and availability are important factors influencing dietary choices among in-school adolescents. School health policy interventions aimed at improving nutritional status among adolescents and enhanced fruit and vegetable consumption in the country should take into account the potential benefit of increasing availability of fruits and vegetables in schools, while reducing access to sweets and soft drinks in the schools and communities.

Combined environmental and educational intervention in hospital food service to increase patients attitude and intention about a healthy diet

Abstract Funding Acknowledgements Type of funding sources: None. Background The elimination of unhealthy risk behaviors such as unhealthy diet, smoking or physical inactivity can prevent at least 80% of cardiovascular disease.(1) Diet has been the number two in modifiable factors attributing to cardiovascular disease burden in the last thirty years.(2) In spite of this, adherence to dietary guidelines in The Netherlands is as low as 20-30%.(3) Clearly, more effective strategies towards healthier dietary behavior are needed.(1) According to the dual process theory, behavior can be influenced via the deliberate system and the intuitive system.(4) The food services on the cardiology ward were revised aiming to influence both systems in admitted patients to gear them towards healthier choices. Purpose To assess the impact of a combined environmental and rational intervention on patients’ attitude and intention towards a healthier diet. Methods A pre-post interventional study was conducted from June 2020 till November 2021 in patients admitted to the Cardiology ward. Patients’ attitude, self-efficacy and intention towards a healthy diet were evaluated through the validated Dietary Intention Evaluation Tool for In-hospitalized patients (DIETI). The intervention was aimed at intuitive and rational behavioral processes. The intuitive part consisted of posters, healthy standard options and a traffic light system on the menu. The rational part consisted of information about a healthy diet on the menu, emphasis on the importance of a healthy diet, a renewed website on lifestyle and an educational course on diet and nudging for nurses and food service employees. Also, at discharge, patients received two salt free spice mixes with healthy, easy and cheap recipes to prepare at home. Results A total of 512/853 (60%) complete responses were received. The intervention group reported to have learned significantly more during their admission than patients in the control group (4.58 vs. 4.80, p=0.009). However, our intervention does not influence patients’ attitude or intention regarding a healthy diet (p=0,41 and p=0,49 respectively). Conclusions A hospital admission of approximately 3 days is enough to make a significant impact on patients’ perceived learning. However, a combined environmental and educational intervention did not have an effect on patients’ attitude or intention regarding a healthy diet.

The lived experiences of women exploring ahealthy lifestyle, gestational weight gain and physical activity throughout pregnancy.

BackgroundWeight gain is inevitable during pregnancy. However, high prepregnancy body mass index and excessive gestational weight gain are associated with poor pregnancy outcomes. Understanding the experiences, social influences and decisions women make to maintain a healthy lifestyle during pregnancy are essential to consider how to improve services and interventions to help women engage in a healthy diet and physical activity (PA) behaviours.ObjectiveThe study investigated women's opinions and lived experiences of engaging in a healthy diet, promoting optimal gestational weight gain and PA during and after pregnancy.Design and MethodsTwenty‐two pregnant women contributed to qualitative data collection for this Grounded Theory (GT) study. Nineteen women completed semi‐structured interviews and three patient and public involvement (PPI) representatives sought to validate the analysis and GT framework.ResultsTwo substantive categories were constructed: (1) Evolving from ‘I’ to ‘we’, as informed by two subcategories and (2) the power of information and guidance, as informed by three subcategories. These categories informed the core category, ‘A navigational journey and evolution of the pregnant self’. The navigational journey involves constantly searching for knowledge and information to support and balance the interests of personal beliefs, the health of their unborn baby, their social circle and the wider world. A woman's psychological capability (e.g., their knowledge of a healthy lifestyle and confidence to implement such knowledge) is continuously tested.ConclusionsPregnancy may create a ‘teachable moment’ but there is a need for appropriate guidance from professionals to assist with lifestyle choices during pregnancy. The findings showed a significant influence of online resources, and lack of guidance on behaviour during pregnancy and may highlight areas of focus for future research and intervention.Public ContributionThree pregnant women were recruited to act as PPI representatives to assist with the validation of the analytical findings and aid the final theoretical saturation of the GT framework. Commentary from these PPI representatives was used to validate the analysis and support the interpretation of the data. In addition, these PPI representatives were also invited to provide commentary on the draft manuscript and those involved in this later process have been included as coauthors.

Impact of Rotating Shifts on Lifestyle Patterns and Perceived Stress among Nurses: A Cross-Sectional Study.

Although rotating shifts have a negative health impact, their association with hospital nurses’ health risks remains controversial due to incomplete adjustment in lifestyle patterns and heterogeneity of work schedules. However, whether work schedule characteristics are associated with lifestyle patterns and perceived stress remains undetermined. We assessed the correlations of work schedule characteristics, lifestyle patterns, and perceived stress among hospital nurses. This cross-sectional study included 340 nurses from two hospitals. Final data from 329 nurses regarding work schedule characteristics, lifestyle patterns (physical activity, dietary behavior, and sleep pattern), and perceived stress were analyzed via linear regression models. Fixed-day-shift nurses had reduced perceived stress (β = 0.15, p = 0.007) compared with rotating-shift nurses. Additionally, among rotating-shift nurses, fixed-evening- and fixed-night-shift nurses had longer sleep duration (β = 0.27, p < 0.001; β = 0.25, p < 0.001) compared to non-fixed-rotating-shift nurses. Longer rotating-shift work was associated with healthier dietary behaviors (β = 0.15, p = 0.008), better sleep quality (β = −0.17, p = 0.003), lower perceived stress (β = −0.24, p < 0.001), and shorter sleep duration (β = −0.17, p = 0.003). Hospital nurses’ work schedule characteristics were associated with lifestyle patterns, dietary behavior, sleep pattern, and perceived stress. Fixed-shifts were beneficial for lifestyle and lower perceived stress. Longer rotating shifts could help nurses adjust their lifestyles accordingly.

Status and influencing factors on the leftover school meals among students the Nutrition Improvement Program for Rural Compulsory Education Students in 2019

Objective: To analyze the situation and influencing factors of school meals leftover among primary and secondary school students in the area of the Nutrition Improvement Program for Rural Compulsory Education Students, improve the quality of school meals, develop healthy dietary behavior, and reduce food waste. Methods: In 2019, among the 50 monitoring counties that implemented the Compulsory Education Student Nutrition Improvement Program, two primary schools and two junior schools were randomly selected according to different food supply patterns.This study randomly selected one or two classes from grade 3 to grade 9. Basic information and school meals of 26 778 students were collected by using a student questionnaire. Multivariate logistic regression was used to analyze the influencing factors of leftovers rate. Results: 54.93% (14 709) of students wasted school meals, in which the highest rate was the staple food, with the main reason as "not in favor". 11.87% (1 743) of the students wasted school meals 6-7 days a week, with 54.20% (7 957) of students wasted but in less amount. The leftover rate of staple food was the highest (29.78%), followed by vegetables and meat. The main reason of leftovers was that they didn't like this kind of food (33.52%). The rate of school meal waste was higher for girls (OR=1.19,95%CI:1.13-1.25), junior high school students (OR=1.17, 95%CI: 1.11-1.25), resident students (OR=1.06, 95%CI: 1.00-1.12), lower economic level (OR=1.06, 95%CI: 1.00-1.12), parents working outside their houses (OR=1.22, 95%CI: 1.13-1.30), health education classes (OR=1.70, 95%CI: 1.40-2.06), company-based meals (OR=1.89, 95%CI: 1.71-2.07) and school meals were not as good as home food(OR=1.89, 95%CI: 1.78-2.00)(P<0.05). Conclusions: It is common for poor rural primary and middle school students in central and western China to waste school meals, and the reasons were affected by many factors. Reducing food waste requires the joint efforts of individuals, families, schools and society.

Factors Influencing Adolescents' Dietary Behaviors in the School and Home Environment in Addis Ababa, Ethiopia.

BackgroundMalnutrition affects many adolescents in Ethiopia. Over one-third of adolescent girls and two-thirds of boys are thin. Overweight and obesity in Ethiopia is mostly a concern in urban populations of higher wealth quintiles. Urbanization and globalization of diets is shifting food environments. The objective of this study was to assess whether food environments in and around schools in urban Ethiopia influence dietary diversity, quality, BMI status or perceptions of adolescents.MethodsTwelve high schools were selected in Addis Ababa (private/government). From each school, 20 pupils aged 15–19 years were randomly selected (n = 217) and interviewed about assets in their households, their diets (categorized into 10 food groups of the Minimum Dietary Diversity, the Global Dietary Recommendations scores and four categories of the NOVA classification based on level of processing) and their use of pocket money. In addition, food environment audits were conducted within the school compound and a 0.5 km radius around each school and types of food outlets.ResultsOn average there were 436 food outlets and 246 food or drink advertisements around each school. The majority of the advertisements (89.9%) were of ultra-processed foods, mostly sugar-sweetened beverages (SSBs). Most were positioned on food outlets (89.1%). SSBs or sweets were visibly on display in 26.3% of the outlets and fresh fruits and vegetables in 17.9% of outlets. Dietary diversity of adolescents was poor with an average of 3.6 food groups out of 10 consumed in the last 24 h. Ultra-processed foods and beverages were consumed by 23.5% of adolescents. The majority of adolescents spent their pocket money on SSBs, sweets or fried foods. Our analysis found that higher assets in adolescents' households were associated with higher dietary diversity and consumption of healthy food groups. We found no association between the food environment and dietary indicators or the BMI-z-score.ConclusionWhile the school food environments investigated were not conducive with promoting healthy dietary behaviors, we cannot conclude that these environmental factors directly influence adolescents' diets. The pervasive advertising and availability of unhealthy foods and beverages requires policy action for healthy school food environments.

Frequent Eating Out and 10-Year Cardiovascular Disease Risk: Evidence from a Community Observatory in Malaysia.

Despite increasing mortality rates from cardiovascular diseases (CVDs) in low- and middle-income countries, information on the estimation of 10-year CVD risk remains to be sparse. Therefore, this study was aimed at predicting the 10-year CVD risk among community dwellers in Malaysia and at identifying the association of distal (socioeconomic characteristics) and proximal (lifestyle practices) factors with 10-year CVD risk. We calculated the 10-year CVD risk score among 11,897 eligible respondents from the community health survey conducted by the South East Asia Community Observatory (SEACO) using the Framingham risk score (FRS). The findings indicate that 28% of respondents have a high chance of having CVD within the next ten years. After adjusting for the age of respondents, demographic and socioeconomic factors such as gender, ethnicity, marital status, education, income, and occupation had an association with the 10-year CVD risk. In addition, frequent eating out had an association with 10-year CVD risk, while physical activity was found to have no association with predicted CVD risk. CVD remained among the top five mortality causes in Malaysia. Health promotion strategies should emphasize the importance of having home-cooked meals as a healthy dietary behavior, to reduce the mortality rate among Malaysians due to CVDs.

Abstract P223: The Relationship Between Positive Psychological Well-being And Dietary Intakes During The Covid-19 Pandemic: A Cross-sectional Analysis

Introduction: The Covid-19 pandemic had a negative impact on mental health and lifestyle behaviors, including dietary habits. Negative psychological factors are known to adversely impact lifestyle behaviors, but the influence of positive psychological well-being on dietary intakes is relatively unknown. Hypothesis: We assessed the hypothesis that psychological factors related to both negative emotional states and positive psychological well-being would have an impact on dietary intakes among adults reporting poor sleep quality and at least moderate perceived stress during the Covid-19 pandemic. Methods: Thirty-one individuals (age 40.2±13.0 y, 81% women, 55% White, BMI 23.2±2.6 kg/m 2 ) were enrolled in a pilot study testing the efficacy of a well-being and sleep hygiene intervention to improve sleep, diet, and mental health. Questionnaires were administered at baseline to assess diet (single-day food recall), psychological well-being (Psychological Well-Being scales of autonomy, environmental mastery, personal growth, purpose in life, positive relations with others, and self-acceptance) and negative emotional states (Symptom Questionnaire scales of anxiety, depression, hostility, and somatization). Separate linear regression models were estimated for each psychological variable that was significantly correlated with diet at baseline, controlling for age, sex, and BMI. Results: Linear regression models showed that, at baseline, higher depression and hostility were associated with higher energy ( B = 77.6±20.3 ( SE ), p &lt; 0.001 and B = 65.2±25.7, p = 0.01, respectively) and fat ( B = 4.6±1.5, p = 0.004 and B = 4.9±1.7, p = 0.008, respectively) intakes. Higher depression was also associated with higher intakes of protein ( B = 3.0±1.0, p = 0.006), carbohydrate ( B = 6.5±2.5, p = 0.01), sugar ( B = 3.9±1.1, p = 0.001), and sodium ( B = 130.7±36.6, p = 0.001). Higher positive relations was associated with lower carbohydrate ( B = -5.1±2.4, p = 0.04) and sugar ( B = -3.6±1.0, p = 0.001) intakes, and higher purpose in life was associated with lower sugar ( B = -3.3±1.2, p = 0.008), cholesterol ( B = -14.7±5.9, p = 0.01), and saturated fat ( B = -1.2±0.4, p = 0.008) intakes. When controlling for baseline levels of depression, hostility and purpose in life were no longer associated with dietary intakes, while positive relations remained associated with sugar intakes ( B = -2.3±1.2, p = 0.04). Conclusions: Under stressful circumstances, both negative emotional states and positive psychological well-being are associated with dietary intakes. Despite depression having the strongest overall impact on dietary intakes, positive relations with others independently affected sugar intakes. Personalized approaches focused on positive psychological well-being, along with distress reduction, should be considered in interventions aimed at promoting healthy dietary behaviors.

Trends in risk factors and management strategies used by people with type 2 diabetes in New South Wales, Australia

Adopting healthy lifestyle behaviours is an important component of Type 2 diabetes (T2D) self-management, which can lower risks of further health complications. Monitoring lifestyle risk factors including overweight or obesity, healthy diet and physical activity behaviours, alcohol consumption, smoking and psychological distress remain important. This study examined prevalence trends in these factors and adoption of three diabetes lifestyle self-management strategies in adults (aged 40+) with T2D in New South Wales (NSW), Australia. Analyses were conducted on NSW Adult Population Health Survey data, 2004–2019 (n = 142,168), using predicted probabilities from generalised linear models, weighted to population estimates. Throughout the study period overweight or obesity prevalence remained higher amongst those with T2D (83.1% to 81.7%) compared to those without diabetes (61.0 to 61.2%); only 8.9% of those with T2D were trying to lose weight. During the study period, there were declines in the proportions of those with T2D reporting sufficient fruit consumption [63.9% to 50.1%], moderate vegetable consumption (3 serves) [49.0% to 37.7%], and achieving sufficient physical activity [40.0% to 34.0%]. There were also declines in those reporting they manage their diabetes through following a special diet [73.6% to 55.9%] and exercising most days [33.5% to 22.2%]. This study highlights potential gaps in T2D secondary prevention and suggests more targeted diabetes education services are needed to address lifestyle risks. Increased understanding of why fewer people with T2D adopt these lifestyle management strategies is needed to inform policy and practice.

Development and Validation of Nutrition Literacy Questionnaire for the Chinese Elderly.

(1) Background: Improving nutrition literacy is crucial for maintaining a healthier state of the elderly to achieve healthy ageing. Therefore, it is necessary to develop a Nutrition Literacy Questionnaire for the Chinese Elderly (NLQ-E). (2) Methods: an NLQ-E was developed according to the core components of nutrition literacy for the elderly. Internal consistency, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to validate the reliability and validity of the NLQ-E. A cross-sectional study of 1490 elderly people was used to analyze the application of the NLQ-E. (3) Results: The NLQ-E was constructed with 3 domains (knowledge and understanding, healthy lifestyle and dietary behavior and skill), with a total of 25 questions. The overall NLQ-E had acceptable reliability and validity (Cronbach’s α = 0.678, χ2/DF = 4.750, RMSEA = 0.045, PCFI = 0.776 and PNFI = 0.759). The average nutrition literacy score of the subjects in this cross-sectional study was 65.95 (65.95 ± 10.93). The OR between the nutrition literacy score and multimorbidity was 0.965 (95% CI: 0.954, 0.976); (4) Conclusions: We developed and validated the NLQ-E and found that the nutrition literacy level of the Chinese elderly was generally low. This study is of great value to improve the nutrition literacy of the elderly and effectively prevent nutrition-related chronic diseases and multimorbidity.

Web-Based Lifestyle Interventions for Survivors of Cancer: Usability Study.

BackgroundInternet-based lifestyle programs are increasingly being used to deliver health behavior change interventions to survivors of cancer. However, little is known about website use in this population or its association with healthy lifestyle changes.ObjectiveThe aim of this study is to describe lifestyle intervention website use (log-ins, time on website, and page views) among survivors of cancer and patterns of use by participant characteristics. In addition, associations were explored between website use and changes in healthy lifestyle knowledge and practice.MethodsA total of 35 survivors of cancer were recruited between August 2017 and 2018 to participate in a 2-week, single-arm pilot test of the SurvivorSHINE lifestyle intervention website. Knowledge and practices related to healthy diet and physical activity behaviors were measured at baseline and follow-up. Website use (eg, time spent on the website, frequency of log-ins, and page views) were collected from the SurvivorSHINE administrative site during the intervention period. Patterns of use were examined by participants’ gender and race. Correlations between website use and changes in healthy lifestyle knowledge, physical activity, diet, and weight were explored. Mann–Whitney U tests were used to compare demographic factors on website use.ResultsParticipants logged into the SurvivorSHINE intervention website an average of 3.2 (SD 2) times over the 2-week period and spent a total average of 94 (SD 56) minutes viewing the website during the intervention. Examining website activity, 1905 page views were logged. The User Profile (344 page views) and Home sections (301 page views) were the most frequently visited components. No associations were observed between the frequency of log-ins or the total time on the website, improvements in knowledge related to healthy lifestyles, or changes in body weight or dietary intake. However, the total time on the website was positively correlated with improvements in accelerometer-measured physical activity (r=0.74; P=.02) and self-reported physical activity (r=0.35; P=.04).ConclusionsSurvivors of cancer demonstrated clear interest in a diet and exercise intervention website, as evidenced by their frequency of log-ins, page views on numerous features, and total viewing time. Moreover, increased website use was correlated with improvements in physical activity.

The impact of health literacy on psychosocial and behavioural outcomes among people at low risk of cardiovascular disease

This study aimed to explore the impact of health literacy on psychosocial and behavioural outcomes for people who were not at high risk of cardiovascular disease receiving a hypothetical blood pressure reading of 135/85 mmHg. We performed a secondary analysis of data from a national sample of Australians aged 40 to 50 years (n = 1318) recruited online. Health literacy was measured using the validated Newest Vital Sign (inadequate: 0–3; adequate: 4–6). Analysed outcomes included: willingness to increase exercise and accept medication; perceived severity; positive and negative affect; illness perceptions and impacts on life and motivation. Participants with inadequate levels of health literacy perceived a blood pressure reading of 135/85 mmHg to be less serious compared to individuals with adequate health literacy (Mean Difference [MD]:0.21; 95%CI 0.03–0.39; p = .024; d = 0.13), and reported less motivation to eat well (MD:0.44; 95%CI 0.31–0.58; p < .001; d = 0.38) and exercise (MD:0.43; 95%CI 0.31–0.58; p < .001; d = 0.36). However, they were more willing to accept medication (MD:0.20; 95%CI 0.07–0.34; p = .004; d = 0.17). Participants with inadequate health literacy also perceived the condition to have fewer negative impacts on aspects of life and work than individuals with adequate health literacy, but reported greater negative emotion and more negative illness perceptions (all p < .001). Tailored communication and behaviour change support may be needed when communicating blood pressure information to people with lower health literacy and not at high risk of cardiovascular disease given the differential impacts on medication (increased willingness) and healthy exercise and diet behaviours (decreased willingness) observed in this study.

“Because I don’t come from the culture:” Examining dietitian’s experience promoting healthy dietary behaviors among Hispanic Caribbean clients in New York City

Dietitians are key in addressing existing diet-related health inequities, yet, research is lacking concerning how dietitians’ experiences working within culturally diverse communities. Addressing this gap, we interviewed fifteen dietitians working with Hispanic Caribbean (HC) communities in New York City, an understudied community with high incidence of diet-related conditions, to assess the best practices and experienced barriers when working with these communities. The best practices identified included building rapport, incorporating cultural values, and addressing food access. However, the interviews revealed important barriers that prevented successful implementation of these best practices. These included personal factors (language, food culture knowledge, food preferences), lack of culturally-relevant resources, cultural challenges that prevented engaging clients in participatory decision making, and institution-related constraints (time scarcity and funding). The findings underscore the need for improved training for dietitians to be better equipped to work with communities with different cultural and economic backgrounds from their own, for more culturally-relevant resources and funding to address underlying causes of diet-related health disparities in minority populations, and for increased diversity in the profession. Furthermore, our focus on Hispanic Caribbean communities expands existing research promoting cultural competence in the profession, presenting experiences working in with this large segment of the Hispanic community in the United States.

A Mixed-Methods Exploration of Implementation of a Healthy School Canteen Program after a Year Intervention

Background: Previous studies have shown that adolescents prefer less healthy food and their eating habits will affect their nutritional status in adulthood and old age. School canteen is a part of food retailing and provisioning that influence the diet quality of the adolescents. Healthy school canteen intervention is recommended as one of the public health strategies in supporting the development of healthy diet behavior. &#x0D; Objectives: To evaluate the effects of a healthy school canteen intervention program among middle school children. &#x0D; Methods: A mixed-methods research design including focus group interviews for teachers and principal, observation on school canteen, a survey for food handlers and food testing for hazardous chemicals. Thematic analysis of focus group data and descriptive analyses of survey data were conducted. Four schools were selected as intervention groups and four schools as positive control groups. Data collection phase took place between April 22 and May 2, 2019. &#x0D; Results: Only one school out of eight schools that had written commitment and a food safety team. In intervention school 50% of food handlers use personal protective equipment and 25% of food handlers received training. In the positive control group, none of the food handlers used personal protective equipment and they had not received any training. Food handlers in the positive control group have a higher rate of correct answers. Only 2 out of 4 schools in the intervention group had nutritious foods available in the canteen and 3 out of 4 schools in the positive control group. None of the school canteens were found positive for metanil yellow. Higher positive findings for Rhodamin B, Formaldehyde and Borax (33.3%, 60.0%, 33.3%, respectively) in the control group compared to the control group (28.6%, 27.3%, and 28.6%, respectively). &#x0D; Conclusions: Intervention groups have been slightly more successful in creating healthy school canteens, as they had a slightly better total score in the observation sheet compared to the schools from the positive control group. Collaboration with another stakeholder such as Primary Health Center (PHC) can be thought of as a solution to train food handlers about healthy practice while handling the food.

Evidence and consensus-based clinical practice guidelines for management of overweight and obesity in midlife women: An AIIMS-DST initiative.

Evidence and consensus-based clinical practice guidelines for management of overweight and obesity in midlife women: An AIIMS-DST initiative.

Abstract PO-161: A community-based liver cancer education initiative led to healthier dietary and alcohol use behaviors among racial/ethnic minority community members

Abstract Background: There is an increasing body of literature that suggests a relationship between modifiable dietary behaviors and alcohol use and liver cancer. We designed and implemented a culturally tailored community-based education program to promote liver cancer prevention. Methods: Through NCI funded U54 TUFCCC/HC Cancer Partnership Community Outreach Core program, using CBPR approach, we engaged community-based organizations and community stakeholders serving underserved African, Asian, and Hispanic American communities in the Philadelphia metropolitan area and New York City. The community-based education incorporated in-person and virtual hybrid education workshops to address COVID-19 pandemic barriers. We conducted pre-education surveys and follow-up assessments at 6 months post-education. Participants' dietary behaviors, alcohol use, and sociodemographic characteristics were examined at both time points. Results: 526 participants were recruited including 92 African Americans, 247 Asian Americans, and 187 Hispanic Americans, with an average age of 59. We found that at 6-month follow-up assessment, participants had average decreased intake of red meat (3.148/6 vs. 2.685/6, p &amp;lt; 0.001), and average increased intake of vegetables (4.484/6 vs. 5.044/6, p &amp;lt; 0.001) and fruits (4.327/6 vs. 4.877/6, p &amp;lt; 0.001), compared to their intake at pre-education assessment. Additionally, average change in beer (-0.252) and spirit (-0.905) consumption substantively decreased from pre-intervention to 6-month follow-up assessment. Conclusion: This community-based education showed significant effects in improving healthy dietary behaviors and reducing alcohol intake among community members through CBPR community engagement from the two metropolitan areas. Future efforts are needed to sustain the positive changes in modifiable lifestyle behaviors and liver cancer prevention in these medically underserved communities. Citation Format: Tiffany Li, Wenyue Lu, Lin Zhu, Ellen Kim, Kerry Traub, Steven Zhu, Nathaly Rubio-Torio, Evelyn Gonzalez, Marilyn A. Fraser, Ming-Chin Yeh, Grace X. Ma, Olorunseun O. Ogunwobi, Yin Tan. A community-based liver cancer education initiative led to healthier dietary and alcohol use behaviors among racial/ethnic minority community members [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-161.